PAL

 Q: 52 years old Japanese male is admitted to ICU with fever, and community-acquired pneumonia. Follow-up workup led to the diagnosis of pyothorax-associated lymphoma (PAL). This is the long-standing complication of? (select one) 

A) Tuberculosis

B) Sarcoidosis

C) Smoking

D) Asbestosis

E) Cystic Fibrosis

Answer: A

PAL is a non-Hodgkin's lymphoma of B-cell phenotype. It evolves in the pleural cavity. So far all of these patients have a history of at least more than 20 years of pyothorax. It is mostly reported in patients who had treatment of artificial pneumothorax for pulmonary tuberculosis or tuberculous pleuritis. 

PAL has no association with immunosuppression. Although it is human herpesvirus type 8 (HHV-8) negative, more than two-thirds of these patients are Epstein-Barr virus (EBV)-positive. 5-year survival is around 20 percent. Most of these patients are Japanese males.

#pulmonary

#oncology

#ID

References:

1. Nakatsuka S, Yao M, Hoshida Y, Yamamoto S, Iuchi K, Aozasa K. Pyothorax-associated lymphoma: a review of 106 cases. J Clin Oncol. 2002 Oct 15;20(20):4255-60. doi: 10.1200/JCO.2002.09.021. PMID: 12377970. 

2. Aozasa K, Takakuwa T, Nakatsuka S. Pyothorax-associated lymphoma: a lymphoma developing in chronic inflammation. Adv Anat Pathol. 2005 Nov;12(6):324-31. doi: 10.1097/01.pap.0000194627.50878.02. PMID: 16330929.