Gastropleural fistula derived from malignant lymphoma.

An 88-year-old man developed pneumothorax and pleural effusion. After the finding of ingesta in the pleural effusion, a gastropleural fistula was diagnosed. A biopsy specimen of the stomach revealed non-Hodgkin lymphoma, diffuse large-cell, B-cell type. Autopsy examination demonstrated that the malignant lymphoma had originated from high-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Gastropleural fistula is an uncommon condition, as the diaphragm forms a thick barrier between the stomach and the thoracic cavity. We review 25 reported cases of gastropleural fistula found in a MEDLINE search from 1966 to 2000. In only 3 of the 25 patients was malignant lymphoma reported to have caused the gastropleural fistula.