Abstract
症例は65歳男性.46年前に左結核性胸膜炎の既往がある.左側胸部痛・発熱・咳嗽を主訴に受診した.左側胸部に7×5cmの腫脹と圧痛を認め, 胸部CTにて左胸壁の陳旧性膿胸腔と, 第8肋骨を破壊し外側に突出する3×4cmの腫瘤が存在した.経皮生検にて悪性リンパ腫と診断された.胸壁腫瘍と膿胸嚢の完全摘除術を施行し, 肺は温存した.摘出標本は膿胸腔に接するB細胞型の悪性リンパ腫で, EBV-DNAサザンプロットでEBV感染細胞のoligoclonalな増殖を認めた.EBV-in situ hybridizationにてEBV-encoded small RNAs陽性であり, 膿胸関連リンパ腫 (pyothoraxassociatedlymphoma) と考えた.EBV-LMPとEBV-EBNA2は陰性であった.術後CHOP療法を追加し, 術後10ヶ月現在再発なく健在である.
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