scholarly journals Subcutaneous mass concerning for sarcoma: a peculiar presentation of diffuse large B-cell lymphoma

2019 ◽  
Vol 12 (7) ◽  
pp. e229327
Author(s):  
John Mayo ◽  
Kenneth Bogenberger ◽  
Thomas Raj ◽  
Jeffrey Reha
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Cutaneous Lesion ◽  
B Cell Lymphoma ◽  
Radical Resection ◽  
Tissue Mass ◽  
Large B Cell Lymphoma ◽  
Diffuse B Cell Lymphoma ◽  
Subcutaneous Mass ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) can present in a number of different ways, including as a primary cutaneous lesion or at various other extranodal sites. However, it is rare for a DLBCL to present as a clinically subcutaneous mass without visible skin changes or nodal involvement. A 36-year-old man presented with a 4×4×1 cm subcutaneous mass to his shoulder with normal overlying skin which had been enlarging over 6 months. Physical exam and imaging together made a strong case for sarcoma, and the patient underwent a radical resection. The final pathological diagnosis returned as a diffuse B-cell lymphoma (germinal centre type). The patient subsequently healed and tolerated chemotherapy well. DLBCL can masquerade as a soft tissue mass at initial presentation. If the diagnosis is not clear, a biopsy should be pursued.

scholarly journals Diffuse large B-cell lymphoma presenting as a sacral tumor

2003 ◽  
Vol 15 (2) ◽  
pp. 1-5 ◽  
Author(s):  
James K. Liu ◽  
Peter Kan ◽  
Meic H. Schmidt
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Radicular Pain ◽  
Tissue Mass ◽  
Large B Cell Lymphoma ◽  
First Case ◽  
Sacral Tumor ◽  
Consolidation Radiotherapy ◽  
Large B Cell

Primary lymphomas of the sacrum are rare tumors, reported only in a few cases in the literature. The authors describe two patients with diffuse large B-cell lymphomas presenting as a sacral tumor. In the first case a 52-year-old man presented with progressive back pain, bilateral radicular pain, and saddle block anesthesia secondary to a lytic, expansile soft-tissue mass. The mass arose from the sacrum and eroded through the right S-1 to S-4 foramina and extended into the epidural space of the spinal canal. On magnetic resonance imaging, the sacral mass enhanced homogeneously with Gd. In the second case a 64-year-old man presented with left-sided radicular pain, paresthesias, and progressive weakness due to a lytic soft-tissue mass in the left sacral ala extending into the left L-5 and S-1 foramina. Metastatic workup in each patient demonstrated unremarkable findings. In both cases, an open biopsy procedure was performed after nondiagnostic examination of needle biopsy samples. Histopathological examination showed evidence consistent with diffuse large B-cell lymphoma in both patients. In the first case the disease was classified as Stage IAE, and the patient subsequently underwent four cycles of cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP)– and rituximab-based chemotherapy followed by consolidation radiotherapy. In the second case the disease was also classified as Stage IAE, and the patient underwent CHOP-based chemotherapy and consolidation radiotherapy. In both cases radiography demonstrated a decrease in size of the sacral lymphomas. The authors review the clinical, radiological, and histological features of sacral lymphomas. Lymphoma should be considered in the differential diagnosis of sacral tumors.

High grade non-germinal centre-like diffuse large B-cell lymphoma double expressor presenting as a hydrocoele

2021 ◽  
Vol 14 (12) ◽  
pp. e247381
Author(s):  
Donnacha Hogan ◽  
Brian Hayes ◽  
Clodagh Keohane ◽  
Derek Barrry Hennessey
Keyword(s):  
Soft Tissue ◽  
B Cell ◽  
Multidisciplinary Team ◽  
Cell Lymphoma ◽  
Soft Tissue Mass ◽  
B Cell Lymphoma ◽  
Preoperative Imaging ◽  
Tissue Mass ◽  
Large B Cell Lymphoma ◽  
Large B Cell

A 72-year-old man was referred to our urology outpatient department with a left hemi-scrotal swelling increasing in size over a matter of weeks, initially suspicious for a left hydrocoele. Initial investigation with ultrasound (US) identified a heterogenous enlargement of the left testis and epididymis with a soft tissue mass extending through the inguinal canal. Subsequent CT detected this soft tissue mass to extend along the left gonadal vein to the level of the left renal vein. A biopsy of the retroperitoneal mass confirmed a diagnosis of diffuse large B-cell lymphoma. Immunohistochemical staining further categorised this lymphoma as double expressor but not double hit.Through multidisciplinary team involvement the patient was treated with combination steroids and chemotherapy. Given the scrotal involvement this was considered a sanctuary site for chemotherapy therefore the patient also received radiotherapy to the scrotum. He recovered well following his treatment. This case highlights how early specialist referral can identify rare variants of disease. Essential preoperative imaging with US prior to treating a presumed hydrocoele prevented inappropriate surgical excision. A multidisciplinary team approach improved the patient’s outcome and is hoped to have improved his chances of recurrence-free survival.

scholarly journals Orbital apex syndrome secondary to sinonasal diffuse large B cell lymphoma: how rare is it?

2021 ◽  
Vol 3 (3) ◽  
pp. 183-188
Author(s):  
See-Teng Tan ◽  
Nor Binti Tak Akmar ◽  
A/P V.S Menon Sudha
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Histopathological Examination ◽  
B Cell Lymphoma ◽  
Cranial Neuropathy ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Tissue Mass ◽  
Large B Cell Lymphoma ◽  
Large B Cell

A sinonasal lymphoma is an uncommon form of non-Hodgkin lymphoma (NHL), comprising only 1.5% of all lymphomas. We report a rare case of primary sinonasal diffuse large B cell lymphoma (DLBCL) found accompanying orbital apex syndrome. A 75-year-old Chinese man presented with progressively reduced visualacuity in the left eye for over 2 months and frequent rhinorrhoea for the previous 4 months. Upon examination, his left eye was noted with poor vision with incomplete ptosis, periorbital fullness, and ophthalmoplegia. Computed tomography scan of the brain and orbit showed nasal soft tissue mass with local extension to the left extraconal space. Histopathological examination of the nasal biopsy tissue showed high-grade DLBCL. The distal cranial neuropathy caused by the lymphomatous infiltration of the left paranasal sinuses had preceded the systemic manifestation. The patient was initiated on chemotherapy and has been, at the time of writing, in remission for 8 months after presentation.

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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