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Pyothorax‐associated pleural lymphoma. A case evolving from T‐cell‐rich lymphoid infiltration to overt B‐cell lymphoma in association with Epstein‐Barr virus
Author(s) -
Ibuka Tazuko,
Fukayama Masashi,
Hayashi Yukiko,
Funata Nobuaki,
Koike Morio,
Ikeda Takaaki,
Mizutani Shuki
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940201)73:3<738::aid-cncr2820730339>3.0.co;2-6
Subject(s) - lymphoma , gene rearrangement , epstein–barr virus , virus , b cell , medicine , lymphoproliferative disorders , infiltration (hvac) , clone (java method) , t cell receptor , t cell , pathology , immunology , biology , cancer research , antibody , gene , immune system , genetics , physics , thermodynamics
Background. Pyothorax‐associated pleural lymphomas (PAPL) occur in patients with long‐standing pyothorax. Epstein‐Barr virus (EBV) plays an important role in its development. Methods. An atypical case of PAPL is reported and its clinical features are compared with those of five cases of ordinary PAPL. Results. The histology of the lymphoma changed from prominent T‐cell infiltration to an overt B‐cell lymphoma of diffuse, large cell‐type. DNA studies of the lymphoma at the first presentation demonstrated dual rear‐rangement in the T‐cell receptor β (TCRβ) and immuno‐globulin heavy chain J region (IgJH) genes. EBV genome analysis demonstrated monoclonal expansion of EBV‐infected cells. EBV gene products were present only in large lymphocytes with B‐cell phenotype. The same rearranged band of the IgJH gene, but not clonal rearrangement of the TCRβ gene, was observed in the overt B‐cell lymphoma at the relapse. The same EBV‐infected clone was observed throughout the course of the disease. The tumor was localized at the pyothorax wall, and cell‐mediated immunity, reflected by a positive tuberculin reaction, was preserved only in the current case. Conclusions. T‐cell‐rich lymphoid infiltration in the current case is a variant of EBV‐associated PAPL, which is infiltrated by reactive T‐cells with clonal accentuation. This is the first documented case of EBV‐associated PAPL evolving from T‐cell‐rich lymphoid infiltration.