A case of pyothorax-associated lymphoma treated with the radiotherapy after a failure of initial chemotherapy *
Pyothorax-associated lymphoma (PAL) has been reported to be developed in 2.2% of patients with chronic pyothorax. Approximately 100 cases ot' PAL have been reported in Japan, but there has been little detailed description of its treatment. We report a case of PAL which was treated with radiotherapy after initial chemotherapy had failed. A 72-year-old man, who had a history of tuberculous pleuritis when he was 25 years old and had undergone pleurolysis for pyothorax two years earlier, visited a hospital complaining of right chest pain, dyspnea on exertion and edema of the right arm. Computed tomography revealed a tumor invading the right chest wall. This was proved to be a malignant lymphoma (diffuse large B-cell type) by a needle biopsy. He had also developed a right supraclavicular lymph node metastasis, and thus was diagnosed as stage ⅡE. Two courscs of chemotherapy with a regimen of CHOP were performed but failed. Therefore, he was introduced to our hospital for radiotheranv. External beam radiotherapy of 50.5 Gy was delivered to the tumors of the chest wall and the supraclavicular region with an involved field. The treatment resulted in both a reduction of the tumors and an improvement of subjective symptoms, this permitted the patient to stay home with a better quality of life. However, six weeks after the completion of radiotherapy, nine months after the onset of PAL, he died of respiratory failure caused by rapidly-spreading thoracoabdominal lymph node involvement without apparent evidence of in-field progression. (Accepted on May 13, 1999) Kawasaki Igakkaishi 25(2) : 105-111, 1999
