Rare Endobronchial Presentation of Diffuse Large B-Cell Lymphoma in a Rural Midwestern Patient

Area of Science:

• Oncology
• Hematology
• Rural Health Disparities

Background:

• Diffuse large B-cell lymphoma (DLBCL) typically presents in lymph nodes, with endobronchial involvement being exceptionally rare.
• Cancer disparities exist, with rural and underserved populations facing challenges in accessing timely and effective oncology care.
• This case involves a 68-year-old male with significant smoking history, cardiovascular comorbidities, and limited socioeconomic resources.

Purpose of the Study:

• To report an extremely rare case of endobronchial DLBCL in a rural, underserved patient.
• To underscore the importance of thorough diagnostic assessment for unusual presentations of lymphoma.
• To highlight successful intervention strategies that can mitigate cancer outcome disparities in rural settings.

Main Methods:

• Initial presentation with non-specific respiratory symptoms (cough, shortness of breath).
• Diagnostic imaging including chest X-ray and CT scan revealing a left upper lobe consolidation.
• Bronchoscopy with biopsy confirming an endobronchial lesion as DLBCL.

Main Results:

• Diagnosis of diffuse large B-cell lymphoma (DLBCL) presenting as an endobronchial lesion.
• Successful treatment with standard Rituxan-CVP chemotherapy resulted in remission.
• Patient is currently managing a secondary fungal lung infection due to immunosuppression.

Conclusions:

• Early and accurate diagnosis of rare lymphoma presentations is critical, especially in rural areas.
• Standardized treatment protocols can be effective even in complex cases with comorbidities.
• Addressing rural cancer disparities requires focused efforts on diagnosis and timely intervention for all patients.