Recurrence of lymphoma with isolated pericardial mass: a case report
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(2020) 14:175
CASE REPORT
Open Access
Recurrence of lymphoma with isolated pericardial mass: a case report Istemi Serin1* , Avni Ulusoy2, Mediha Irem Onar2 and Mehmet Hilmi Dogu1
Abstract Background: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma and may occur with lymph node and/or extranodal involvement. Recurrence in patients with diffuse large B-cell lymphoma usually occurs within the first few years after treatment and may occur in a different area outside the initial localization. Case presentation: A female Turkish patient who was diagnosed with nodular sclerosing Hodgkin lymphoma through lymphadenopathy examination reached remission after chemotherapy and radiotherapy. In the 11th year of follow-up and at the age of 45, newly developed multiple lymphadenopathies were diagnosed with a pathological result of diffuse large B-cell lymphoma in her advanced examination. Due to massive splenomegaly and cystic necrotic splenic residues, splenectomy was performed after eight cycles of a first-line chemotherapy regimen and two cycles of high-dose methotrexate treatment for central nervous system prophylaxis. A pericardial mass (maximum standardized uptake value 34.8), which was not present at the time of diagnosis and interim evaluation of positron emission tomography/computed tomography, was detected through chest pain in the third month after the last screening, although a complete response had been obtained. Pathological examination of the pericardial area revealed the pathological result was a recurrence. Conclusions: Patients with diffuse large B-cell lymphoma have an aggressive clinical course, but cardiac involvement is very rare. In our patient’s case, pericardial involvement was observed after treatment and scanning revealed that recurrence took place in an area different from the pericardium. Cooperation of clinicians and pathologists and rapid evaluation are very important in cases of diffuse large B-cell lymphoma relapse. Although a tumoral invasion of the pericardium mostly suggests secondary malignancies, it should be kept in mind that recurrence of lymphoma is also possible. Keywords: Diffuse large B-cell lymphoma, Recurrence, Extranodal recurrence, Pericardium, Case report
Introduction Diffuse large B-cell lymphoma (DLBCL) is the most common subtype among non-Hodgkin lymphomas (NHLs). It accounts for about 30–40% of NHL cases and more than 80% of aggressive lymphomas [1]. Like many other NHLs, it is more common in men, with about 55% of cases [2]. Incidence increases with age; the median age is 64 [3]. * Correspondence: [email protected] 1 Department of Hematology Istanbul, University of Health Sciences, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey Full list of author information is available at the end of the article
DLBCL, a clinically aggressive lymphoma, may occur in lymph node and/or extranodal areas. The most common areas of extranodal involvement are gastrointestinal tract, skin, bone marrow, or paranasal sinuses [4, 5]. Patients
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