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Extranodal diffuse large B-cell lymphoma presenting with extensive organ involvement
Kailyn Kim1, Sharvina Ziyeh2, Phyllis Kim3
1Department of Medicine, UCLA Medical Center Olive View, Sylmar, California, USA.
BMJ Case Reports
|June 30, 2024
Summary
Extranodal involvement, disease outside lymph nodes, is rare in diffuse large B-cell lymphoma (DLBCL). This case highlights extensive multiorgan DLBCL, emphasizing its potential for widespread metastasis.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Extranodal involvement in diffuse large B-cell lymphoma (DLBCL) occurs in up to one-third of patients.
- Multiorgan extranodal involvement in DLBCL is considered rare.
Observation:
- A patient presented with widely metastatic lesions across multiple organs, initially suspected as primary breast malignancy.
- Pathology and imaging confirmed stage IV high-grade B-cell lymphoma with extensive extranodal involvement, including lung, parotid gland, breast, pancreas, femur, and soft tissues.
Findings:
- The patient's diagnosis was triple-expressor, double-hit stage IV high-grade B-cell lymphoma.
- Extensive extranodal disease was documented across numerous organs.
Implications:
- Extranodal involvement is a significant poor prognostic factor in DLBCL, correlating with high treatment failure rates.
- Novel CD19-targeted therapies are under investigation for relapsed/refractory DLBCL.
- This case underscores the importance of considering extranodal disease in new presentations of malignancy, given its potential to affect any organ system.
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