Tachibana J, Fukutoku M, Takeuchi Y, Yoshioka R, Hirose Y, Shimizu S, Sugai S, Takiguchi T, Konda S, Yuasa K
Department of Hematology and Immunology, Kanazawa Medical University.
Rinsho Ketsueki. 1992 Aug;33(8):1041-5.
A 60-year-old man who had had chronic empyema following an artificial pneumothorax for pulmonary tuberculosis when he was 26 years old developed malignant lymphoma of the chest wall. The patient was admitted because of right pyothorax as a result of pseudomonas aeruginosa infection and underwent right thoracotomy. During lavage of the right thoracic cavity a tumor was found arising from the empyematic wall. Pathologic examination revealed that it was malignant lymphoma (diffuse large, immunoblastic, B cell type). Treatment with VEAP-Bleomycin elicited a good response. Seven months after chemotherapy, the patient underwent thoracoplasty in addition to packing the cavity with the latissimus dorsi and the greater omentum. Following this, the patient received chemotherapy once a month for one and a half years, after which he was kept under close observation without treatment. Complete remission has now lasted for 49 months since the initial treatment. This is the first reported lymphoma case with closure of the empyematic wall and is remarkable since this patient has remained in complete remission for the last two years without any treatment.
一名60岁男性，26岁时因肺结核行人工气胸术后发生慢性脓胸，现发展为胸壁恶性淋巴瘤。患者因铜绿假单胞菌感染导致右侧脓胸入院，接受了右侧开胸手术。在右侧胸腔灌洗过程中，发现脓胸壁上有一肿瘤。病理检查显示为恶性淋巴瘤（弥漫大B细胞型，免疫母细胞型）。采用VEAP-博来霉素治疗效果良好。化疗7个月后，患者除用背阔肌和大网膜填充胸腔外，还接受了胸廓成形术。此后，患者每月接受一次化疗，持续一年半，之后未接受治疗，密切观察。自初始治疗以来，完全缓解已持续49个月。这是首例报道的脓胸壁闭合的淋巴瘤病例，值得注意的是，该患者在过去两年未接受任何治疗的情况下一直处于完全缓解状态。
