Szokatlan lokalizációjú diffúz nagy B-sejtes non-Hodgkin-lymphoma

Translated title of the contribution: Diffuse large B-cell non-Hodgkin lymphoma of unusual localisation

Ress Zsuzsa, Illés Árpád, Matolcsy András, Tanyi Miklós, Szóvórdi Éva, Gergely Lajos

Research output: Contribution to journalArticle

Abstract

INTRODUCTION - Diffuse large B-cell lymphoma frequently has bone involvement, but primary bone lymphoma is rare (around 4% of primary extranodal lymphomas). Long bones are most often affected, followed in frequency by the ribs, vertebrae, and pelvic bones. The main symptom is bone pain. CASE REPORT - The case of a young man is presented whose disease started with lumboischialgia. Since rheumatological treatment did not relieve the symptoms, MRI was performed, which showed a tumour with massive iliac bone destruction. Three months after the initial symptoms a surgical biopsy from the right ilium showed diffuse large B-cell lymphoma. Soon after acute renal insufficiency developed and the patient was put on haemodialysis. Based on the findings the disease was staged as Ann Arbor IV/B (bone and kidney), ECOG PS 3, International Prognostic Index 4. On the basis of the preliminary histological findings, reduced-dose CHOP chemotherapy was given, which resulted in a significant improvement of the renal function and haemodialysis could be abandoned. This was followed by 6 additional cycles of Rituximab-CHOP treatment and further 2 cycles of Rituximab-DHAP salvage chemotherapy with intrathecal prophylaxis, and, finally, since no response could be detected, R-IVAC treatment was given. After an initial response, the disease became progressive, and the patient died 9 months after the diagnosis was made from a disseminated chemoresistant disease. Autopsy confirmed extensive infiltration of the right iliac bone, kidneys, bone marrow, spleen, supraclavicular and abdominal lymph nodes, pancreas, scalp and brain. CONCLUSIONS - This case was chosen to be presented because of the unusual localisation of the diffuse large B-cell lymphoma, the initial diagnostic difficulty, and the very rapid progression despite the application of several aggressive chemotherapy schemes. A primary bone large B-cell lymphoma represents a diagnostic challenge with its rheumatological symptoms thus delaying diagnosis.

Translated title of the contributionDiffuse large B-cell non-Hodgkin lymphoma of unusual localisation
Original languageHungarian
Pages (from-to)144-148
Number of pages5
JournalLege Artis Medicinae
Volume17
Issue number2
Publication statusPublished - Feb 1 2007

ASJC Scopus subject areas

  • Medicine(all)

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