CD5-positive diffuse large B-Cell lymphoma presenting with protein-losing enteropathy.

Area of Science:

• Gastroenterology
• Hematology
• Oncology

Background:

• Gastrointestinal lymphoma is rare, but the GI tract is a common extranodal site for non-Hodgkin lymphoma.
• Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue lymphoma frequently involve the stomach and small intestine.
• Protein-losing enteropathy (PLE) secondary to lymphoma is rare, especially when caused by CD5-positive DLBCL.

Purpose of the Study:

• To report a rare case of CD5-positive DLBCL presenting with PLE.
• To highlight the diagnostic and therapeutic approach for this unusual condition.
• To propose CD5-positive DLBCL with PLE as a distinct clinical entity.

Main Methods:

• Case report of a 60-year-old woman with refractory diarrhea and edema.
• Diagnostic workup including assessment of protein leakage and double-balloon endoscopy.
• Histopathological confirmation of de novo CD5-positive DLBCL.

Main Results:

• The patient was diagnosed with CD5-positive DLBCL of the small intestine.
• Hypoproteinemia with significant protein leakage in the colon and small intestine was identified.
• Treatment with DA-EPOCH-R chemotherapy resulted in prompt improvement and resolution of PLE.

Conclusions:

• CD5-positive DLBCL can present as PLE, a rare but distinct clinical entity.
• Prompt diagnosis and treatment with chemotherapy and stem cell transplantation are effective.
• Further research is warranted to confirm this as a separate clinical entity.