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Tumor necrosis factor- and interleukin-6-producing high-grade B-cell lymphoma, not otherwise specified in the pleura

Shoko Nakayama1, Mitsuhiro Matsuda1, Tatsuya Adachi1

  • 1Department of Hematology, PL General Hospital, 2204, Shindo, Tondabayashi City, Osaka 584-8585, Japan.

Leukemia Research Reports
|July 13, 2018
PubMed

Insights

This case report details an aggressive high-grade B-cell lymphoma (HGBL, NOS) in the pleura, producing tumor necrosis factor (TNF) and interleukin-6 (IL-6). Radiological findings initially mimicked pleural mesothelioma, highlighting a rare presentation of aggressive lymphoma.

Area of Science:

  • Oncology
  • Pathology
  • Thoracic Medicine

Background:

  • Pleural thickening can present diagnostic challenges, often mimicking malignant mesothelioma.
  • High-grade B-cell lymphoma (HGBL, NOS) is an aggressive hematologic malignancy with diverse extranodal presentations.
  • Tumor necrosis factor (TNF) and interleukin-6 (IL-6) are pro-inflammatory cytokines implicated in various cancers.

Observation:

  • A 65-year-old male presented with chest pain, back pain, and dyspnea.
  • Computed tomography revealed significant circumferential left pleural thickening.
  • Thoracoscopic pleural biopsy diagnosed HGBL, NOS.

Findings:

  • The HGBL, NOS cells were positive for TNF and IL-6 production.
  • This represents the first reported case of TNF- and IL-6-producing HGBL, NOS involving the pleura.
  • Radiological imaging initially suggested pleural mesothelioma due to the pleural thickening.

Implications:

  • Aggressive HGBL, NOS can present with pleural involvement, mimicking other thoracic malignancies.
  • Abnormal cytokine production (TNF, IL-6) by lymphoma cells may drive rapid tumor progression.
  • This case underscores the importance of considering hematologic malignancies in the differential diagnosis of unexplained pleural thickening.

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