scholarly journals Severe peripheral oedema as the only presenting symptom of intravascular large B-cell lymphoma: a diagnosis too frequently made on autopsy

2019 ◽  
Vol 12 (5) ◽  
pp. e228802
Author(s):  
Rachel Kyle ◽  
Gillian Mount ◽  
Shao Shi Li ◽  
Jenny Thain
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Multiorgan Failure ◽  
B Cell Lymphoma ◽  
Definitive Diagnosis ◽  
Peripheral Oedema ◽  
Presenting Symptoms ◽  
Predominant Symptom ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Intravascular large B-cell lymphoma is seen in less than one per million people and can be an extremely difficult antemortem diagnosis to make due to a vast diversity of presenting symptoms. We present a case of an otherwise healthy 74-year-old woman whose predominant symptom was pitting oedema, and who likely died from multiorgan failure after >14 months of extensive workup that was unable to secure a definitive diagnosis.

Recurrence of Nodal Diffuse Large B-Cell Lymphoma as Intravascular Large B-Cell Lymphoma: Is an Intravascular Component at Initial Diagnosis Predictive?

2005 ◽  
Vol 129 (3) ◽  
pp. 391-394
Author(s):  
Xian-Feng Zhao ◽  
Amy M. Sands ◽  
Peter T. Ostrow ◽  
Regina Halbiger ◽  
James T. Conway ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Single Case ◽  
Multiorgan Failure ◽  
Molecular Genetic ◽  
B Cell Lymphoma ◽  
Initial Diagnosis ◽  
Chain Gene ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract We report a case of a 59-year-old man who first presented with a nodal diffuse large B-cell lymphoma that later relapsed as an intravascular large B-cell lymphoma. In the initial biopsy specimen, a few intranodal small vessels that contained large lymphoma cells were noted. After 8 months of multiagent chemotherapy, clinical remission was attained. Two years after the initial diagnosis of nodal diffuse large B-cell lymphoma, the patient presented with a rapid onset of multiorgan failure, which at autopsy was shown to be due to intravascular large B-cell lymphoma. Molecular genetic studies showed that these 2 lymphomas had immunoglobulin heavy-chain gene rearrangements that were of identical size, suggesting that they were derived from the same clone. To our knowledge, this is the first report of a nodal large B-cell lymphoma that relapsed as an intravascular large B-cell lymphoma. Although this report is of only a single case, the presence of a relatively inconspicuous intravascular component in an otherwise typical nodal large B-cell lymphoma may be predictive and could affect clinical decisions regarding diagnosis, monitoring, and prognosis of such lymphomas.

scholarly journals A Case ofDe NovoCD5+ Disseminated Intravascular Large B-Cell Lymphoma Presenting as Multiorgan Failure

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Daulath Singh ◽  
Devika Kapuria ◽  
Suparna Nanua ◽  
Rakesh Gaur
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Bone Marrow Biopsy ◽  
De Novo ◽  
Cell Lymphoma ◽  
Multiorgan Failure ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Intravascular large B-cell lymphoma is an extremely rare extranodal lymphoma that proliferates in the lumen of the blood vessels while sparing the organ parenchyma. It usually presents with CNS and skin involvement. A 65-year-old Caucasian female presented with fevers and chills of 3-4 months’ duration. Bone marrow biopsy done 3 months prior showed no significant myelodysplasia or lymphoid aggregates. The patient later died due to multiorgan failure. A bone marrow biopsy showed 20–30% CD5+ B cells consistent with infiltrative large B-cell lymphoma. An autopsy performed revealed diffuse intravascular invasion by lymphoma cells. Multiorgan involvement by intravascular B-cell lymphoma is very rare. Based on our literature review and to the best of our knowledge, there are only 5 case reports describing the presentation of this lymphoma with multiorgan failure. The immunophenotypic studies performed revealed that our patient hadde novoCD5+ intravascular large B-cell lymphoma which is known to be aggressive with very poor prognosis. Although it is an extremely rare lymphoma, it should be considered as a potential cause of multiorgan failure when no other cause has been identified. A prompt tissue diagnosis and high-dose chemotherapy followed by ASCT can sometimes achieve remission.

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

2020 ◽  
Vol 13 (4) ◽  
pp. e228818 ◽  
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.

scholarly journals Intestinal obstruction due to primary ileocolic diffuse large B-cell lymphoma: A case report

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Marina Alarcón Iranzo ◽  
◽  
Matías Gómez Calomarde ◽  
Estefanía Zorraquino ◽  
Miguel Ángel Sanz ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
B Cell ◽  
Cell Lymphoma ◽  
Ileocecal Valve ◽  
B Cell Lymphoma ◽  
Presenting Symptoms ◽  
Large B Cell Lymphoma ◽  
Frequent Site ◽  
Surgery Management ◽  
Large B Cell

The Gastrointestinal (GI) tract is the most frequent site of extranodal lymphoma involvement. Most GI lymphomas are non-Hodgkin’s mature B-cell lymphomas, being diffuse large B-cell lymphoma one of the most common histologic subtypes. About 7% of GI lymphomas are located in the colon, usually at the ileocecal valve, and may grow into the terminal ileum. Abdominal pain and weight loss are common presenting symptoms, although complications such as intestinal obstruction may occur. Abdominal CT scan and barium enema are the most frequently used imaging tests for diagnosis, although colonoscopy with biopsies is required to confirm the diagnosis. Treatment includes surgery and chemotherapy with or without rituximab. Keywords: Primary colonic lymphoma; Diffuse large B-Cell Lymphoma; Obstruction; Surgery; Management.

Lymphome

Praxis ◽  
2016 ◽  
Vol 105 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Andreas Lohri
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Staging System ◽  
Maligne Lymphome ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Ann Arbor ◽  
Large B Cell

Zusammenfassung. Maligne Lymphome unterteilen sich zwar in über 60 Entitäten, das grosszellige B-Zell-Lymphom, das follikuläre Lymphom, der Hodgkin und das Mantelzell-Lymphom machen aber mehr als die Hälfte aller Lymphome aus. Im revidierten Ann Arbor staging system gelten die Suffixe «A» und «B» nur noch für den Hodgkin. «E» erscheint nur noch bei Stadien I und II. Eine Knochenmarksuntersuchung wird beim Hodgkin nicht mehr verlangt, beim DLBCL (Diffuse large B cell lymphoma) nur, falls das PET keinen Knochenmark-Befall zeigt. Der PET-Untersuchung, speziell dem Interim-PET, kommt eine entscheidende Bedeutung zu. PET-gesteuerte Therapien führen zu weniger Toxizität. Gezielt wirkende Medikamente mit eindrücklicher Wirksamkeit wurden neu zugelassen. Deren Kosten sind hoch. Eine strahlen- und chemotherapiefreie Behandlung maligner Lymphome wird in Zukunft möglich sein.

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