Moriya Yasumitsu, Iyoda Akira, Hayashi Ryo, Fujino Michio, Kuwao Sadahito, Hiroshima Kenzo, Yoshino Ichiro, Yamakawa Hisami
Department of Thoracic Surgery, National Hospital Organization Chiba-East Hospital, Chuo-ku, Chiba, Japan.
Acta Cytol. 2010 Jan-Feb;54(1):66-70. doi: 10.1159/000324970.
Pyothorax-associated lymphoma (PAL) is a comparatively rare tumor, and it is difficult to definitively diagnose it preoperatively, especially in patients with only pleural thickening without mass formation. Pleural effusion aspiration cytology is a useful and easy diagnostic method for a large number of chest diseases. However, the cytologic findings of PAL have been rarely described. Here we report on the cytologic findings in a patient with PAL, manifested by pleural thickening without mass formation, and which was diagnosed preoperatively by pleural effusion aspiration cytology.
A 64-year-old man was admitted to our hospital because of pleural thickening involving an empyema sac located in the left thorax and rapidly increasing pleural effusion. He had a 30-year history of chronic empyema and a 10-year history of diabetes mellitus. Left pleural effusion aspiration cytology showed malignant lymphoma. The patient was admitted to our hospital for PAL treatment. Because of poor respiratory function, he only underwent decortication with complete resection of the thickening pleural peel. However, he was well, without recurrence, 5 years after the operation. The histologic examination revealed that lymphoma cells were located only in the thickening pleural peel.
This is a very rare case of PAL diagnosed by preoperative aspiration cytology for an increasing pleural effusion. This report demonstrates that pleural effusion aspiration cytology can be valuable for the diagnosis of PAL.
脓胸相关性淋巴瘤（PAL）是一种相对罕见的肿瘤，术前很难明确诊断，尤其是对于仅有胸膜增厚而无肿块形成的患者。胸腔积液穿刺细胞学检查是一种用于大量胸部疾病的有用且简便的诊断方法。然而，PAL的细胞学表现鲜有报道。在此，我们报告一例PAL患者的细胞学表现，该患者表现为胸膜增厚而无肿块形成，术前通过胸腔积液穿刺细胞学检查得以诊断。
一名64岁男性因左胸脓胸囊所致胸膜增厚及胸腔积液迅速增多入院。他有30年慢性脓胸病史和10年糖尿病史。左胸腔积液穿刺细胞学检查显示为恶性淋巴瘤。该患者因PAL入院治疗。由于呼吸功能差，他仅接受了胸膜纤维板剥脱术，完整切除增厚的胸膜纤维板。然而，术后5年他情况良好，无复发。组织学检查显示淋巴瘤细胞仅位于增厚的胸膜纤维板中。
这是一例非常罕见的通过术前穿刺细胞学检查诊断为PAL且伴有胸腔积液增多的病例。本报告表明胸腔积液穿刺细胞学检查对PAL的诊断可能具有重要价值。
