Diffuse large B cell lymphoma with chronic granulomatous inflammation

Wint Wint Thu Nyunt, Wong Yin Ping, Wan Fariza Wan Jamaludin, S Fadilah S. Abdul Wahid

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Non-necrotic epithelioid granulomas have been reported in association with neoplasms including Hodgkin and non-Hodgkin lymphoma. We report a case of diffuse large B cell lymphoma with chronic granulomatous inflammation to highlight awareness of obscure tumour cells within the granuloma, to avoid delay in diagnosis and management of lymphoma. A 39-year-old Malay lady with no past medical history, presented with a 2-month history of progressive worsening of difficulty in breathing, cough, low-grade fever, loss of weight and loss of appetite. Chest X-ray showed an anterior mediastinal mass and computed tomography (CT)-guided biopsy was reported as chronic granulomatous inflammation suggestive of tuberculosis. After 2 months of anti-TB treatment, her symptoms were not relieved. The patient underwent another CT-guided biopsy of the anterior mediastinal mass in another hospital and the histopathology revealed diffuse large B cell lymphoma. The patient was referred for treatment. On histopathological review, the first sample showed noncaseating granulomas engulfing tumour cells and large abnormal lymphoid cells which were CD20 positive and with high Ki-67 proliferative index. The patient was diagnosed with diffuse large B cell lymphoma stage IV B IPSS score 3. She underwent chemotherapy (R-EPOCH) and responded well to treatment.

Original languageEnglish
Pages (from-to)55-59
Number of pages5
JournalMalaysian Journal of Pathology
Volume38
Issue number1
Publication statusPublished - 1 Apr 2016

Fingerprint

Lymphoma, Large B-Cell, Diffuse
Granuloma
Inflammation
Tomography
Biopsy
Neoplasms
Appetite
Hodgkin Disease
Cough
Non-Hodgkin's Lymphoma
Weight Loss
Lymphoma
Respiration
Tuberculosis
Fever
Thorax
Therapeutics
X-Rays
Lymphocytes
Drug Therapy

Keywords

  • Granuloma
  • Histopathology
  • Lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology
  • Histology
  • Medicine(all)

Cite this

Diffuse large B cell lymphoma with chronic granulomatous inflammation. / Nyunt, Wint Wint Thu; Yin Ping, Wong; Wan Jamaludin, Wan Fariza; S. Abdul Wahid, S Fadilah.

In: Malaysian Journal of Pathology, Vol. 38, No. 1, 01.04.2016, p. 55-59.

Research output: Contribution to journalArticle

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