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

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.

2019 ◽  
Vol 13 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Koichi Sato ◽  
Tomoaki Suga ◽  
Atsuhiro Hirayama ◽  
Seiichi Daikuhara ◽  
Takeshi Uehara ◽  
...  

2020 ◽  
Vol 8 (12) ◽  
pp. 3062-3065
Author(s):  
Meriam Sabbah ◽  
Fatma Ben Farhat ◽  
Nawel Bellil ◽  
Fatma Khanchel ◽  
Asma Ouakaa ◽  
...  

2015 ◽  
Vol 65 (4) ◽  
pp. 241 ◽  
Author(s):  
Tae Hyoung Koo ◽  
Won Jong Choi ◽  
Seung Hee Han ◽  
Su Young Kim ◽  
Jong Hun Lee

2005 ◽  
Vol 129 (3) ◽  
pp. 391-394
Author(s):  
Xian-Feng Zhao ◽  
Amy M. Sands ◽  
Peter T. Ostrow ◽  
Regina Halbiger ◽  
James T. Conway ◽  
...  

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Daulath Singh ◽  
Devika Kapuria ◽  
Suparna Nanua ◽  
Rakesh Gaur

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.


2018 ◽  
pp. bcr-2018-226328 ◽  
Author(s):  
Andrew Michael South

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.


2019 ◽  
Vol 12 (5) ◽  
pp. e228802
Author(s):  
Rachel Kyle ◽  
Gillian Mount ◽  
Shao Shi Li ◽  
Jenny Thain

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.


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