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Primary diffuse large B-cell lymphoma as a chest-wall mass: A case report.
Qianwen Zhang1,2, Yuanrong Ju1, Tao Qu2
1Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan.
Medicine
|November 22, 2018
Summary
Primary diffuse large B-cell lymphoma of the chest wall is rare, often linked to chronic inflammation from conditions like pyothorax. Early diagnosis via histological examination is crucial for these aggressive malignancies.
Area of Science:
- Oncology
- Pathology
Background:
- Primary diffuse large B-cell lymphoma (DLBCL) of the chest wall is exceptionally rare.
- A significant proportion of pleural lymphomas arise in patients with a history of chronic tuberculous pyothorax.
- Chronic inflammation is a potential underlying mechanism driving lymphoma development.
Observation:
- A 79-year-old male presented with persistent chest pain, fever, anorexia, and a history of tuberculosis and chronic pyothorax.
- The patient also had a history of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis.
- Imaging revealed a chest wall mass, confirmed as DLBCL via biopsy.
Findings:
- The patient received reduced-dose CHOP chemotherapy due to advanced age and poor health.
- Tragically, the patient died five days after the first chemotherapy cycle, experiencing severe dyspnea and high fever.
Implications:
- Chronic inflammation from conditions like pyothorax, vasculitis, or autoimmune diseases may predispose individuals to chest wall lymphomas.
- Nonspecific symptoms such as fever or chest pain in at-risk patients warrant thorough investigation for potential malignant lymphoma.
- Histological examination is paramount for the accurate and timely diagnosis of this rare and life-threatening condition.
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Assessment:
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History:
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