結核性膿胸に対する胸郭形成術後長期を経て発症した胸壁悪性リンパ腫の1例

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  • A CASE OF MALIGNANT LYMPHOMA WITH LONG INTERVAL AFTER THORACOPLASTY FOR TUBERCULOUS PYOTHOLAX

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This paper presents a case of malignant lymphoma of the chest wall, which developed 30 years after thoracoplasy for tuberculous pyotholax. A 70-year-old man was admitted to the hospital because of fever and a large mass of the chest wall. There were previous histories of undergoing artificial pneumotholorax for pulmonary tuberculousis 45 years before and thoracoplasty for right pyotholax 30 years before. Computed tomography and Ga scintigraphy were useful for diagnosis. The patient received resection of the tumor and drainage for complicated pyotholax. Histologically and immunologically, the tumor was disclosed as malignant lymphoma, diffuse large cell type B cell type. Chemotherapy was started after the operation. The patient was alive 18 months after the onset of symptoms, but complete remission has not been attained as yet.<br> Recently patients with malignant lymphoma of the thoracic wall after a long silent period from pulmonary tuberculosis have been increasingly reported. All patients having a primary lesion in the pleula had previous history of artificial pnemotholax or tuberculous pyotholax. Diffuse large cell type and B cell type are most common and the prognosis is poor. This disease appears important in diagnosis of patients with previous history of pulmonary tuberculosis, and demands early diagnosis and multidisciplinary treatment.

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