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A Case of Diffuse Large B-Cell Lymphoma Mimicking Primary Effusion Lymphoma-Like Lymphoma

Daisuke Usuda1,2, Masahisa Arahata3, Kento Takeshima2

  • 1Department of Infectious Diseases, Kanazawa Medical University, Uchinada, Japan.

Case Reports in Oncology
|December 28, 2017
PubMed

Insights

A 93-year-old patient presented with altered consciousness and low blood pressure, revealing atypical lymphoid cells in pleural and pericardial effusions. Bone marrow analysis confirmed diffuse large B-cell lymphoma, highlighting the importance of considering hematological malignancy in effusions.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Effusions, such as pleural and pericardial, can be challenging diagnostic dilemmas.
  • Distinguishing between malignant and non-malignant causes of effusions is critical for patient management.

Observation:

  • A 93-year-old female presented with altered consciousness and hypotension.
  • Computed tomography revealed bilateral pleural and pericardial effusions.
  • Cytodiagnosis identified atypical lymphoid-like cells with pan-B markers in pleural effusion, initially raising suspicion for primary effusion lymphoma-like lymphoma.

Findings:

  • Monoclonality was not confirmed in pleural effusion cells.
  • Bone marrow cytodiagnosis revealed lymphoma cells with monoclonal B-cell markers.
  • The patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) with bone marrow invasion.

Implications:

  • Clinicians must consider hematological malignancies, including diffuse large B-cell lymphoma, in patients presenting with unexplained pleural or pericardial effusions.
  • Accurate classification of lymphoma subtypes is crucial for effective treatment strategies.
  • Prompt diagnosis and management of bone marrow involvement in lymphoma can significantly impact patient outcomes.

Keywords:
DiagnosisDiffuse large B-cell lymphomaPericardial effusionPleural effusionPrimary effusion lymphoma-like lymphoma

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