Primary renal diffuse large B-Cell lymphoma causing haemodialysis-dependent nephromegaly in a child

A 4-year-old boy presented with fatigue and was found to have severe kidney injury requiring haemodialysis. A renal ultrasound demonstrated bilateral nephromegaly with mild loss of corticomedullary differentiation but preserved echogenicity. He had a persistent isolated monocytosis. Renal biopsy revealed extensive infiltration by primary renal diffuse large B-cell lymphoma. He required haemodialysis for 18 days and received chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab and intrathecal methotrexate. He achieved remission with an estimated glomerular filtration rate of 50 mL/min/1.73 m2, and his kidneys returned to normal size. Nephromegaly due to renal-limited haematolymphoid disease is extremely rare, especially in children.

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Acute kidney injury secondary to renal large B-cell lymphoma: role of early renal biopsy

International Urology and Nephrology ◽

10.1007/s11255-010-9728-5 ◽

2010 ◽

Vol 43 (1) ◽

pp. 237-240 ◽

Cited By ~ 11

Author(s):

Suhail Al-Salam ◽

Ahmad Shaaban ◽

Maha Alketbi ◽

Naveed U. Haq ◽

Samra Abouchacra

Keyword(s):

Acute Kidney Injury ◽

B Cell ◽

Renal Biopsy ◽

Cell Lymphoma ◽

Kidney Injury ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Large B Cell

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Lactic acidosis: a unique presentation of diffuse large B-cell lymphoma

BMJ Case Reports ◽

10.1136/bcr-2019-230277 ◽

2019 ◽

Vol 12 (10) ◽

pp. e230277 ◽

Cited By ~ 1

Author(s):

Turab Jawaid Mohammed ◽

Rohit Gosain ◽

Rajeev Sharma ◽

Pallawi Torka

Keyword(s):

Lactic Acidosis ◽

B Cell ◽

Cell Lymphoma ◽

Performance Status ◽

B Cell Lymphoma ◽

Intrathecal Methotrexate ◽

Dramatic Improvement ◽

Metabolic Encephalopathy ◽

Large B Cell Lymphoma ◽

Large B Cell

An elderly man in the seventh decade of life was brought to the hospital with worsening mental status. Blood tests revealed anaemia and thrombocytopenia with elevated lactate dehydrogenase and serum lactate levels. CT scan showed bulky thoracic and abdominal lymphadenopathy with splenomegaly. A positron emission tomography scan confirmed the above and in addition, revealed bilateral adrenal involvement. Bone marrow biopsy revealed non-germinal centre B-cell-like (non-GCB)-diffuse large B-cell lymphoma (DLBCL). Prompt treatment with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab with intrathecal methotrexate chemotherapy resulted in a dramatic improvement in the patient’s condition. This vignette serves as a reminder to include aggressive lymphomas like DLBCL in the differential diagnoses of patients presenting with metabolic encephalopathy and lactic acidosis. Our patient was moribund at presentation with poor sensorium and failure to thrive. The dilemma was whether to take an aggressive stand and start chemotherapy urgently or whether to stabilise the patient first and then consider the treatment of DLBCL. We make a case for initiating therapy promptly in such patients irrespective of their performance status.

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Intravascular Large B-Cell Lymphoma Presenting as Acute Axonal Polyneuropathy: A Case Report and Literature Review

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620959997 ◽

2020 ◽

Vol 8 ◽

pp. 232470962095999

Author(s):

Jordan M. Minish ◽

Amar H. Kelkar ◽

Amol R. Mehta ◽

Maira Gaffar ◽

Nam H. Dang

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Disease Process ◽

B Cell Lymphoma ◽

Intrathecal Methotrexate ◽

Common Disease ◽

Success Rates ◽

Large B Cell Lymphoma ◽

Axonal Polyneuropathy ◽

Large B Cell

Intravascular large B-cell lymphoma (ILBL) is a rare and difficult to diagnose subtype of large B-cell lymphoma. The most common locations of presentation are in the central nervous system and the skin, but there are reports of other organ involvement. Due to the indolence, nonspecific symptoms, and rarity of the disease, this form of lymphoma is most often diagnosed postmortem. In this article, we describe a case of ILBL that presented as a rapidly progressive acute axonal polyneuropathy. Acute axonal polyneuropathy is a common disease process with a wide differential diagnosis, but there is limited literature on its prevalence as the presenting symptom of ILBL. This patient was treated with R-EPOCH and intrathecal methotrexate with significant improvement in his polyneuropathy after 1 cycle, and complete remission after 6 cycles. Data on chemotherapy regimens and their success rates for this disease are lacking.

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Aggressive CD5-Positive Primary Bone Marrow Diffuse Large B-Cell Lymphoma with Leukemic Presentation

Case Reports in Hematology ◽

10.1155/2021/2628100 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Mark G. Evans ◽

Sherif A. Rezk ◽

Lauren C. Pinter-Brown ◽

Xiaohui Zhao

Keyword(s):

Bone Marrow ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Intrathecal Methotrexate ◽

Non Hodgkin Lymphoma ◽

Large B Cell Lymphoma ◽

Primary Bone ◽

Primary Bone Marrow ◽

Large B Cell

Primary bone marrow diffuse large B-cell lymphoma is an exceedingly rare form of non-Hodgkin lymphoma. It may demonstrate a leukemic presentation, and a proportion of cases have CD5 expression. The prognostic implications of this CD5-positivity remain unknown. Here, we present a 78-year-old man who presented with circulating peripheral blood lymphoma cells and a hypercellular marrow involved by diffuse large B-cell lymphoma, germinal center B-cell subtype. The patient responded favorably to six cycles of etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R) and intrathecal methotrexate. He unfortunately relapsed in several enlarged inguinal lymph nodes and succumbed to the lymphoma approximately one year after diagnosis, demonstrating the particularly aggressive clinical course of his disease.

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Nephrotic syndrome without kidney injury revealing intravascular large B cell lymphoma

BMJ Case Reports ◽

10.1136/bcr-2019-229359 ◽

2019 ◽

Vol 12 (6) ◽

pp. e229359

Author(s):

Lucie Pothen ◽

Selda Aydin ◽

Alessandra Camboni ◽

Philippe Hainaut

Keyword(s):

Nephrotic Syndrome ◽

B Cell ◽

Cell Lymphoma ◽

Biological Evolution ◽

Kidney Injury ◽

Unknown Origin ◽

B Cell Lymphoma ◽

Cell Transplant ◽

Large B Cell Lymphoma ◽

Large B Cell

We describe the case of a 64-year-old woman admitted for fever of unknown origin, who developed nephrotic syndrome during hospitalisation and pulmonary infiltrates. Renal biopsy disclosed intracapillary glomerular invasion by intravascular large B cell lymphoma. Clinical and biological evolution was favourable after rituximab, cyclophosphamide, doxorubicine, vincristine and prednisone (R-CHOP) treatment and autologous stem cell transplant. Two years after diagnosis the patient was considered in remission.

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Diffuse large B-cell lymphoma of the rectum in a patient with Crohn’s disease

BMJ Case Reports ◽

10.1136/bcr-2018-228818 ◽

2020 ◽

Vol 13 (4) ◽

pp. e228818 ◽

Cited By ~ 1

Author(s):

Adam Joseph Hardy ◽

Ionica Stoica ◽

David Edward Kearney ◽

Diarmuid S O'Riordain

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

B Cell ◽

Cell Lymphoma ◽

Multiorgan Failure ◽

Rectal Stump ◽

B Cell Lymphoma ◽

Renal Ultrasound ◽

Large B Cell Lymphoma ◽

Large B Cell

A 62-year-old man presented to our institute with diarrhoea and dysuria on a background of subtotal colectomy and end ileostomy and biological therapy for Crohn’s disease. He was diagnosed with urinary tract infection and acute kidney injury (AKI). Renal ultrasound suggested left hydronephrosis, with renal protocol computed tomography (CT) showing a large pelvic mass. Magnetic resonance imaging (MRI) of the pelvis demonstrated a rectal tumour invading the bladder and compressing both ureters. He underwent cystoscopy, flexible sigmoidoscopy and positron emission tomography–CT and was diagnosed with stage IV non-Hodgkin’s diffuse large B-cell lymphoma. He was treated primarily with rituximab, cyclophosphamide, hydroxydaunomycin, oncovin and prednisolone chemotherapy regimen. He had ongoing urosepsis before admission for pelvic exenteration. He underwent cystoprostatectomy, excision of rectal stump and formation of ileal conduit. Histology showed no signs of residual malignancy. One year later, the patient was admitted to the intensive care unit with aspiration pneumonia, urosepsis and AKI. Despite maximal therapy, he developed multiorgan failure and passed away.

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Case Report of Diffuse Large B Cell Lymphoma of Uterine Cervix Treated at a Semiurban Cancer Centre in North India

Case Reports in Hematology ◽

10.1155/2016/3042531 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Vibhor Sharma ◽

Tapas Dora ◽

Mehul Patel ◽

Sankalp Sancheti ◽

Epari Sridhar

Keyword(s):

B Cell ◽

Uterine Cervix ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

North India ◽

Intrathecal Methotrexate ◽

Cancer Centre ◽

Large B Cell Lymphoma ◽

Response To Chemotherapy ◽

Large B Cell

Lymphoma of the uterine cervix is very rare. We report a case of diffuse large B cell lymphoma (DLBCL) involving the uterine cervix treated at a newly commissioned semiurban cancer centre in north India in 2015. Data for this study was obtained from the hospital electronic medical records and the patient’s case file. We also reviewed published case reports of uterine and cervical lymphoma involving forty-one patients. We treated a case of stage IV DLBCL cervix with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) and intrathecal methotrexate followed by consolidation with radiotherapy. The patient showed complete response to chemotherapy. We conclude that, in advanced stage lymphoma involving uterus and cervix, combination of chemotherapy and radiotherapy is effective in short term.

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