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CD7-Positive Diffuse Large B-Cell Lymphoma Presenting as an Intranasal Tumor
Kazuaki Teshima1,2, Masaaki Kume1, Yasushi Kawaharada3
1Department of Hematology, Hiraka General Hospital, Yokote, Japan.
Insights
This study details a rare case of CD7-positive diffuse large B-cell lymphoma (DLBCL) in the nasal cavity. Treatment with R-CHOP and radiation led to complete remission, highlighting effective therapeutic strategies for this uncommon lymphoma subtype.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Diffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin lymphoma.
- CD7 positivity is an unusual immunophenotype in DLBCL, rarely reported in the literature.
- Extranodal involvement, particularly in the nasal cavity, presents unique clinical challenges.
Observation:
- A 74-year-old male presented with a CD7-positive DLBCL in the right nasal cavity.
- Flow cytometry confirmed CD7 and CD20 positivity in the tumor cells.
- Positron emission tomography-computed tomography identified an intranasal lesion after initial treatment.
Findings:
- The patient achieved complete remission (CR) following 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and local radiation therapy.
- Among 11 reported cases of CD7-positive DLBCL with follow-up, 8 achieved CR or partial response with rituximab-based chemotherapy.
- Extranodal lesions were present in 9 of 12 reported cases, with 3 cases manifesting as intranasal tumors.
Implications:
- CD7-positive DLBCL, though rare, appears responsive to rituximab-containing chemotherapy and radiation.
- Intranasal localization of DLBCL requires specific diagnostic and therapeutic considerations.
- Further accumulation of cases is crucial for a comprehensive understanding of the clinical features and optimal management of CD7-positive DLBCL.
Abstract:
We report a case of a 74-year-old man with a cluster of differentiation (CD) 7-positive diffuse large B-cell lymphoma (DLBCL) in the right nasal cavity. Flow cytometry analyses showed CD7 and CD20 positivity in tumor cells. The patient received 6 cycles of R-CHOP plus local radiation therapy because positron emission tomography-computed tomography after R-CHOP revealed an intranasal lesion. The patient achieved complete remission (CR) after radiation therapy. The frequency of CD7-positive DLBCL is rare, and only 11 cases with follow-up of clinical course have been reported thus far. CR or partial response was noted in 8 of 11 cases after receiving rituximab combined with chemotherapy. In total, 9 of 12 cases involved the development of extranodal lesions, which occurred as an intranasal tumor in 3 cases. It is important to examine the clinical features by accumulation of further cases.
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