An Unusual Presentation of Diffuse Large B-Cell Lymphoma

Gkoufa, Aikaterini; Georgakopoulou, Vasiliki; Lakiotaki, Eleftheria

doi:10.7759/cureus.20927

Cited by 4 publications

(6 citation statements)

References 20 publications

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“…In prior reports of patients with DLBCL affecting the pancreas, the average age of presentation was typically in their 50s or 60s, rather than in their 20s as seen in our patient. [10][11][12] Our case affirms the recommendation to pursue further testing in acute pancreatitis patients without a clear etiology. In our patient, ultrasound suggested gallstones pancreatitis as a cause (gallstones and sludge in the gallbladder) with a hypoechoic lesion, and if subsequent MRI was not performed, this could potentially have led to delay in diagnosis.…”

Section: Discussionsupporting

confidence: 74%

Acute Pancreatitis Revealing a Diagnosis of Diffuse Large B-Cell Lymphoma

Herman,

Wilson,

Abdallah

et al. 2024

ACG Case Rep J

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Acute pancreatitis is a common gastroenterological condition that can occur due to several causes. While not required for diagnosis, imaging is often performed and may reveal unexpected findings such as pancreatic masses. Malignancies such as lymphoma are uncommon causes of acute pancreatitis, especially as the initial presentation of malignancy. We present a case of a young patient with acute pancreatitis caused by diffuse large B-cell lymphoma with extranodal disease secondarily involving the pancreas. Our case highlights the importance of keeping a broad differential for acute pancreatitis and considering rare etiologies such as pancreatic lymphoma in patients without another obvious culprit.

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Section: Discussionsupporting

confidence: 74%

Acute Pancreatitis Revealing a Diagnosis of Diffuse Large B-Cell Lymphoma

Herman,

Wilson,

Abdallah

et al. 2024

ACG Case Rep J

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“…Diagnosis of DLBCL of the liver involves a combination of imaging tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and ultrasound. Liver biopsy is considered the gold standard in the diagnosis of primary hepatic lymphoma [ 14 ], but we consider endoscopic ultrasound-guided biopsies as the preferred option for the diagnosis. Treatment for DLBCL of the liver usually involves a combination of chemotherapy, immunotherapy, and radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Diffuse Large B-cell Lymphoma: A Case Report and Review of Literature of Primary Liver Tumors

Pérez-Turrent,

Hernández-Solís,

Sánchez Antonio

et al. 2024

Cureus

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Liver tumors rank as the fourth most common cause of cancer. This case report highlights a 45-year-old female patient who presented persistent abdominal pain and no other symptoms. Initially, she was approached with a probable hepatitis of unknown origin, but her condition worsened rapidly. An endoscopic ultrasound was used to characterize the lesion, and a fine needle biopsy of the lesion was performed which revealed a diffuse large B-cell lymphoma that is CD20+ and Ki67+. Hepatic diffuse large B-cell lymphoma, as diagnosed in the patient, is a rare type of lymphoma that arises in the liver. The treatment usually involves chemotherapy, immunotherapy, and radiation therapy. However, the prognosis depends on the stage of the disease and the patient's overall health. This case reinforces the importance of considering hepatic diffuse large B-cell lymphoma in differential diagnosis for primary liver neoplasia.

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“…As with our patient, other authors reported significant lactic acidosis in their patients. In fact, it was one of the first features in the case written by Gkoufa et al [ 14 ] before a histological diagnosis of DLBCL was made based on liver and bone biopsy, and the only unique feature was that the liver and bone marrow were involved by lymphoma. Various mechanisms have been explained for the occurrence of lactic acidosis in patients with acute liver failure, including impaired metabolism and enhanced aerobic glycolytic activity in tumor cells because of the over-expression of certain glycolytic enzymes [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

An Elusive Diagnosis: Diffuse Large B-Cell Lymphoma Masquerading as Acute Liver Failure with Persistent Lactic Acidosis

Weeraddana,

Odujoko,

Bal

et al. 2023

Am J Case Rep

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Patient: Male, 74-year-old Final Diagnosis: ALF secondary to DLBCL involving liver Symptoms: Abdominal pain • bloating • constipation Clinical Procedure: — Specialty: Critical Care Medicine • General and Internal Medicine • Oncology • Pathology Objective: Rare disease Background: Acute liver failure (ALF) associated with malignant lymphoma is a rare condition with non-specific clinical and radiological features. Here, we describe an unusual case of ALF due to DLBCL with an image negative on presentation posing diagnostic difficulty. Case Report: A 74-year-old man was admitted to our hospital with abdominal pain. Radiological and laboratory investigations revealed lymphadenopathy with mildly elevated transaminitis and alkaline phosphates levels. A right upper-quadrant ultrasound showed heterogeneous hepatic parenchyma. Eight days later, he had worsening abdominal pain. He was found to have altered mental status and asterixis. His liver function was worsened with ALT 101, AST 328, lactic acid 4.2, total bilirubin 2.5, INR 6.35, and ammonia level 117 µmol/L. He continued to deteriorate with worsening lactic acidosis, coagulopathy, severe anemia, elevated liver enzymes, and thrombocytopenia. Unfortunately, the patient died of multi-organ failure on the 14 th day of hospitalization. The autopsy findings revealed DLBCL involving multiple organs, including the liver, lung, bone marrow, and multiple lymph nodes. Despite an extensive diagnostic workup, an underlying diagnosis was unable to be established antemortem. Conclusions: We describe a case of ALF linked to DLBCL discovered at autopsy. The non-specific clinical and radiological features of this condition make diagnosis challenging, and the prognosis is often poor. Further research and awareness are needed to improve the early detection and management of ALF associated with malignant lymphoma. By expanding the literature on this topic, we aim to improve outcomes and optimize patient care in similar clinical scenarios.

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An Unusual Presentation of Diffuse Large B-Cell Lymphoma

Cited by 4 publications

References 20 publications

Acute Pancreatitis Revealing a Diagnosis of Diffuse Large B-Cell Lymphoma

Acute Pancreatitis Revealing a Diagnosis of Diffuse Large B-Cell Lymphoma

Hepatic Diffuse Large B-cell Lymphoma: A Case Report and Review of Literature of Primary Liver Tumors

An Elusive Diagnosis: Diffuse Large B-Cell Lymphoma Masquerading as Acute Liver Failure with Persistent Lactic Acidosis

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