Citation, DOI & article data
There is a strong association with EBV infection.
Commonly reported locations include 3:
- lateral costal pleura ~50%
- costophrenic angle ~30%
Histologically, pyothorax-associated lymphoma usually shows a diffuse proliferation of large B-cells (diffuse large B-cell lymphoma (DLBCL)).
May be seen as a lenticular or crescent-shaped soft tissue mass straddling the thickened pleura at the margin of a coexistent empyema cavity 3. It has a tendency to invade adjacent structures. Air-fluid levels or gas within the empyema cavity may also be present.
Treatment and prognosis
It is responsive to chemotherapy, but the overall prognosis is considered poor 1.
In some situations, differential considerations include:
- 1. Nakatsuka S, Yao M, Hoshida Y, Yamamoto S, Iuchi K, Aozasa K. Pyothorax-associated lymphoma: a review of 106 cases. (2002) Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 20 (20): 4255-60. doi:10.1200/JCO.2002.09.021 - Pubmed
- 2. Aozasa K, Takakuwa T, Nakatsuka S. Pyothorax-associated lymphoma: a lymphoma developing in chronic inflammation. (2005) Advances in anatomic pathology. 12 (6): 324-31. doi:10.1097/01.pap.0000194627.50878.02 - Pubmed
- 3. Ueda T, Andreas C, Itami J, Miyakawa K, Fujimoto H, Ito H, Roos JE. Pyothorax-associated lymphoma: imaging findings. (2010) AJR. American journal of roentgenology. 194 (1): 76-84. doi:10.2214/AJR.09.2603 - Pubmed
- 4. Bligh MP, Borgaonkar JN, Burrell SC, MacDonald DA, Manos D. Spectrum of CT Findings in Thoracic Extranodal Non-Hodgkin Lymphoma. (2017) Radiographics : a review publication of the Radiological Society of North America, Inc. 37 (2): 439-461. doi:10.1148/rg.2017160077 - Pubmed
- 5. Hibino M, Irie T, Ohe M, Nakamura N, Kondo T. Usefulness of diffusion-weighted magnetic resonance imaging-guided biopsy: pyothorax-associated lymphoma. (2015) Internal medicine (Tokyo, Japan). 54 (20): 2661-5. doi:10.2169/internalmedicine.54.4632 - Pubmed