Fukino S, Fukata T, Inoue A, Hatazawa Y, Morio S
Department of Surgery, Tottori Prefecture Kosei Hospital, Kurayoshi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Jan;40(1):113-7.
A 63-year-old male patient underwent artificial pneumothorax for right pulmonary tuberculosis 39 years ago, and thereafter suffered from chronic empyema, though asymptomatic. In December, 1989, he was found to have a 5 cm tumor in his right chest wall. The tumor grew to 15 cm in 2 weeks and was associated with severe pain. A chest CT revealed that the tumor of the chest wall corresponded to the area of the wall affected by empyema. The patient underwent full thickness resection of the chest wall including the tumor and the empyematous wall (20 x 20 cm) on March 7, 1990. The tumor was 11 x 8 x 7 cm large and had developed from the empyematous wall to the lateral side of chest wall. There was no invasion of the thoracic cavity by the empyema. The lesion was pathologically diagnosed as diffuse, large to intermediate T-cell non-Hodgkin's lymphoma. Postoperatively the patient was treated with radiotherapy and VEPA therapy, but the tumor metastasized to both lungs, and the patient died 161 days after surgery. The majority of cases of malignant lymphoma reported to have originated in empyematous chest walls have been of the B-cell type. The T-cell type is rare, and the present case is only the second case reported. Chest CT was an effective method of diagnostic imaging in this disease.
一名63岁男性患者39年前因右肺结核接受人工气胸治疗，此后虽无症状但患上慢性脓胸。1989年12月，他被发现右胸壁有一个5厘米的肿瘤。该肿瘤在2周内长至15厘米，并伴有剧痛。胸部CT显示胸壁肿瘤与脓胸累及的胸壁区域相对应。1990年3月7日，患者接受了包括肿瘤和脓胸壁（20×20厘米）的胸壁全层切除术。肿瘤大小为11×8×7厘米，从脓胸壁发展至胸壁外侧。脓胸未侵犯胸腔。病变经病理诊断为弥漫性大至中等大小T细胞非霍奇金淋巴瘤。术后患者接受了放疗和VEPA治疗，但肿瘤转移至双肺，患者术后161天死亡。据报道，大多数起源于脓胸胸壁的恶性淋巴瘤病例为B细胞型。T细胞型罕见，本病例是第二例报道。胸部CT是该病诊断成像的有效方法。
