A case of intra-vascular large B-cell lymphoma presenting with multiple organ system involvement

Abstract Background: Tumor lysis syndrome (TLS) ranges from mild asymptomatic electrolyte derangement to severe organ dysfunction, is rarely associated with diffuse large B-cell Lymphoma (DLBCL). Standard chemotherapy of DLBCL is usually for clinical stable patients, however, it is still unclear for those in critical care situation with organ dysfunction. Case presentation: Here, we presented a rare case of aggressive bcl-2 and -myc double-positive DLBCL patient, 59-year-old, male, who rapidly progressed to severe multiple organ failure because of spontaneous TLS, and especially hepatic failure is very uncommon. Although the comprehensive treatments inclusive of early glucocorticoid usage, a stent implantation in superior vena cava, pleural and pericardial puncture drainage, anti-shock, non-invasive ventilator support, continuous renal replacement treatment (CRRT), plasma exchange and antibiotics alleviated or inverted the multiple organ failure, the patient was worsened to septic shock and died on the 12th day after new salvage chemotherapy regime with rituximab and cyclophosphamide under CRRT protection. Conclusions: The current case demonstrated a useful treatment framework to this kind of patient. We should cautiously give glucocorticoid to the patient suspected of lymphoma with high tumor burden. The comprehensive treatments for organ function supporting, especially CRRT, play a crucial role in the recovery of multiple organ failure. In addition, the optimal time and regimen choosing of rescue chemotherapy in severe DLBCL patients still remains a long way to define.

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Primary Extranodal Diffuse Large B Cell Lymphoma Masquerading As Acute Pyogenic Myositis: A Case Report

The Open Urology & Nephrology Journal ◽

10.2174/1874303x01912010056 ◽

2019 ◽

Vol 12 (1) ◽

pp. 56-59

Author(s):

Manisha Dassi ◽

Garima Aggarwal ◽

Lakshmi K. Jha ◽

Neeru P. Aggarwal

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Multiple Organ ◽

Extranodal Involvement ◽

Cortical Vein ◽

Vein Thrombosis ◽

Large B Cell Lymphoma ◽

Cortical Vein Thrombosis ◽

Large B Cell

Diffuse Large B Cell Lymphoma is the commonest subtype of Non-Hodgkin’s Lymphoma. It may present with primary nodal or extranodal involvement. Up to 40% of patients present with primary extranodal involvement, the commonest involved sites being gastrointestinal tract, testes, central nervous system, thyroid, nose, sinuses, skin, breast, bone and respiratory tract. Skeletal Muscle is a rare site of primary lymphomatous involvement. We present a case of Diffuse Large B Cell lymphoma primarily involving the skeletal muscles and breast, initially managed as a case of acute pyogenic myositis with sepsis with Multiple Organ Dysfunction Syndrome. In addition, the patient had hypercalcemia, cortical vein thrombosis, proteinuria and renal dysfunction, which were all speculated to be paraneoplastic in etiology.

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