Primary nasal diffuse large B-cell lymphoma with synchronous pulmonary involvement: A case report

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Diffuse Large B-cell Lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma, frequently occurring at extranodal sites.
• Primary nasal DLBCL with synchronous pulmonary involvement is exceptionally rare, often mimicking other malignancies.
• This report details a unique presentation of DLBCL in the nasal cavity with concurrent lung mass.

Observation:

• A 62-year-old female presented with persistent nasal congestion and rhinorrhea.
• CT imaging revealed a nasal vestibule and cavity mass, alongside a left lower lobe lung mass.
• Histopathology and immunohistochemistry confirmed DLBCL in the nasal lesion.

Findings:

• The patient received 6 cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone).
• Treatment was well-tolerated, resulting in complete remission.
• No relapse was observed during a 3-year follow-up period.

Implications:

• Clinicians must maintain high suspicion for extranodal DLBCL, even in unusual sites like the nasal cavity.
• Synchronous presentations of DLBCL require careful diagnostic consideration across specialties.
• Immunohistochemistry is crucial for accurate diagnosis when clinical features are ambiguous.