CD7-Positive Diffuse Large B-Cell Lymphoma Presenting as an Intranasal Tumor

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin lymphoma.
• CD7 positivity is an unusual immunophenotype in DLBCL, rarely reported in the literature.
• Extranodal involvement, particularly in the nasal cavity, presents unique clinical challenges.

Observation:

• A 74-year-old male presented with a CD7-positive DLBCL in the right nasal cavity.
• Flow cytometry confirmed CD7 and CD20 positivity in the tumor cells.
• Positron emission tomography-computed tomography identified an intranasal lesion after initial treatment.

Findings:

• The patient achieved complete remission (CR) following 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and local radiation therapy.
• Among 11 reported cases of CD7-positive DLBCL with follow-up, 8 achieved CR or partial response with rituximab-based chemotherapy.
• Extranodal lesions were present in 9 of 12 reported cases, with 3 cases manifesting as intranasal tumors.

Implications:

• CD7-positive DLBCL, though rare, appears responsive to rituximab-containing chemotherapy and radiation.
• Intranasal localization of DLBCL requires specific diagnostic and therapeutic considerations.
• Further accumulation of cases is crucial for a comprehensive understanding of the clinical features and optimal management of CD7-positive DLBCL.