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Abstract

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Article in Japanese

Case Report

A case of gastropleural fistula resulting from diffuse large B-cell lymphoma of the stomach

Tsuyoshi Nozuea  Koshi Yokomuraa  Daisuke Akahoria  Takefumi Abea  Norimichi Akiyamaa  Takafumi Sudab 

aDepartment of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara Hospital
bSecond Department of Internal Medicine, Hamamatsu University School of Medicine

ABSTRACT

We report a rare case of gastropleural fistula as a result of diffuse large B-cell lymphoma of the stomach. A 67-year-old male with rheumatoid arthritis was admitted to the hospital because of left chest pain and fever. Chest radiography and CT showed left pneumothorax and multiple air-fluid levels in the left pleural cavity. Although pyopneumothorax was suspected, the fluid in the pleural cavity was rapidly decreased before insertion of the chest drain. The left lung expanded easily after the chest tube insertion, and Candida species were cultured from the pleural effusion. Gastrointestinal endoscopy revealed that the cause of left pyopneumothorax was diffuse large B-cell lymphoma of the stomach that perforated to the left pleural cavity. We must be aware that gastropleural fistura is one of the causes of pyothorax, and isolation of Candida species from pleural fluid is an important clue for suspecting gastrointestinal tract perforation as a cause of empyema.

KEYWORDS

Gastropleural fistula  Pyothorax  Pneumothorax  Candida  Malignant lymphoma 

Received 8 Aug 2014 / Accepted 21 Jan 2015

AJRS, 4(3): 235-239, 2015

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