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Linfoma de células B grandes asociado a sobrecarga de fluidos que se presenta como una efusión pleural aislada
Kevin Leeper1, Lauren Borecky1, Mojtaba Akhtari2
1Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Hematology reports
|February 20, 2026
Resumen
El linfoma de células B grandes asociado a la sobrecarga de líquidos es una afección rara que puede imitar otros linfomas. Reconocer sus características distintivas es crucial para un diagnóstico y tratamiento precisos en pacientes con sobrecarga de líquidos.
Área de la Ciencia:
- Hematología Hematología.
- Oncología Oncología.
- Patología Patología Patología.
Sus antecedentes:
- Los linfomas primarios basados en el derrame son poco comunes y difíciles de diagnosticar.
- El linfoma de células B grandes asociado a la sobrecarga de líquidos (FO-LBCL) es una entidad recientemente reconocida.
- FO-LBCL debe considerarse en los linfomas basados en efusión, especialmente en pacientes de edad avanzada con condiciones de sobrecarga de líquidos.
Objetivo del estudio:
- Para informar de un caso de FO-LBCL para contribuir a la literatura limitada.
- Para resaltar las características distintivas de FO-LBCL de otros linfomas de efusión primaria.
- Para enfatizar la importancia de considerar FO-LBCL en el diagnóstico diferencial.
Principales métodos:
- Informe de caso de un hombre de 77 años con enfermedad renal terminal y insuficiencia cardíaca.
- Análisis de la citología del líquido pleural y el inmunofenotipado (CD20, Pax-5, CD79a, CD45, MUM1, BCL2, BCL6).
- Exclusión del virus del herpes humano-8 y el virus de Epstein-Barr; estadificación con PET-CT.
Principales resultados:
- El líquido pleural mostró hojas de grandes células linfoides atípicas.
- La inmunofenotipización fue positiva para los marcadores de células B y MUM1, BCL2, BCL6 (débil).
- Paciente diagnosticado con FO-LBCL, tratado con quimioinmunoterapia y fallecido tres meses después.
Conclusiones:
- FO-LBCL es una nueva consideración importante para los linfomas basados en el derrame.
- Puede ser diagnosticado erróneamente como linfoma de efusión primario u otros linfomas difusos de células B grandes.
- Los linfomas de efusión humanos herpesvirus-8 negativos en pacientes ancianos, inmunocompetentes sin involucramiento nodal justifican la consideración de FO-LBCL.
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