Aozasa K, Ohsawa M, Iuchi K, Tajima K, Komatsu H, Shimoyama M
Department of Pathology, Nara Medical University, Kashihara.
Jpn J Cancer Res. 1993 Jan;84(1):55-7. doi: 10.1111/j.1349-7006.1993.tb02784.x.
An etiologically important role of chronic tuberculous empyema for development of pleural lymphocytic lymphoma of B-cell type has been suggested. To examine risk factors for development of pleural lymphoma in patients with chronic tuberculous empyema, a case-control study was carried out. Onset age of lung tuberculosis and empyema, presence of chemotherapy, surgical treatment, extent of empyema, presence of fistula, history of smoking, and height and weight of patients at first admission were compared in patients with empyema alone (70 controls) and empyema complicated with lymphoma (42 cases): the date of birth and sex were matched by group. The patients receiving artificial pneumothorax showed a significant increase in risk for development of pleural lymphoma (relative risk = 4.92, P < 0.05). We could not find any report describing development of pleural neoplasias in patients with chronic empyema receiving surgical resection of pleural pyogenic membrane. From these findings, it is suggested that artificial pneumothorax left chronic non-healing inflammation in the pleural cavity, which resulted in development of pleural lymphoma.
慢性结核性脓胸对B细胞型胸膜淋巴细胞性淋巴瘤的发生具有病因学上的重要作用,这一点已得到提示。为了研究慢性结核性脓胸患者发生胸膜淋巴瘤的危险因素,开展了一项病例对照研究。比较了单纯脓胸患者(70例对照)和合并淋巴瘤的脓胸患者(42例病例)的肺结核和脓胸发病年龄、化疗情况、手术治疗情况、脓胸范围、瘘管情况、吸烟史以及首次入院时患者的身高和体重:按组匹配出生日期和性别。接受人工气胸治疗的患者发生胸膜淋巴瘤的风险显著增加(相对风险=4.92,P<0.05)。我们未发现任何报告描述接受胸膜化脓性膜手术切除的慢性脓胸患者发生胸膜肿瘤的情况。根据这些发现,提示人工气胸在胸膜腔留下了慢性不愈合炎症,导致了胸膜淋巴瘤的发生。