Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

Naffaa, Mohammad E.; Rozin, Alexander; Horowitz, Netanel A.; Ben-Itzhak, Ofer; Braun‐Moscovici, Yolanda; Balbir‐Gurman, Alexandra

doi:10.1155/2016/1041787

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…This sparks interest in strategies trying to minimize treatments [20]. Another aspect to consider regards the differential diagnosis of both entities; in fact, lymphoma has been reported to present in a way that mimics vasculitis [22, 23] and the opposite clinical picture has also been widely described in scientific literature [24]. Lastly, the incidence of vasculitis occurring in close temporal association with cancer cannot be overemphasized, with some studies suggesting that these cases may constitute from 0.4 to 4.2% of all vasculitis cases [25].…”

Section: Paraneoplastic Aav: When Lymphoproliferative Disorders Trmentioning

confidence: 99%

ANCA-Associated Vasculitides and Hematologic Malignancies: Lessons from the Past and Future Perspectives

Folci

Ramponi

Shiffer

et al. 2019

Journal of Immunology Research

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The purpose of this paper is to collect and summarize all evidences relating to an association between ANCA-associated vasculitides (AAVs) and hematologic malignancies, in the form of either a paraneoplastic vasculitis or leukemias and lymphomas developing on a preexisting vasculitis. Additionally, the role of cyclophosphamide in vasculitis treatment has been assessed and compared to rituximab. Paraneoplastic AAV seems to be an uncommon presentation of hemopathies. Hematologic malignancy risk in AAV is more likely to be increased by cyclophosphamide, although not yet definitely proven. Furthermore, the pathogenesis of ANCA-associated vasculitis has been reviewed with particular emphasis on the role of proteinase 3 (PR3) in fuelling granulomatosis with polyangiitis (GPA) inflammation. PR3 is a bactericidal protein expressed by neutrophilic granules and on their plasma membrane. Derangements in its expression and function have been linked to leukemias and GPA alike. PR3-derived PR1 peptide is being studied as an immunotherapy target in leukemia and multiple myeloma. This study is aimed at bringing together various evidences from the field of immunological and hematological research, at exposing contradictions, and at revealing novel insights on the association between ANCA-associated vasculitis and hematologic malignancies.

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Section: Paraneoplastic Aav: When Lymphoproliferative Disorders Trmentioning

confidence: 99%

ANCA-Associated Vasculitides and Hematologic Malignancies: Lessons from the Past and Future Perspectives

Folci

Ramponi

Shiffer

et al. 2019

Journal of Immunology Research

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“…However, in our case, the patient presented with a misleading clinical picture resembling granulomatosis with polyangiitis, which, to our knowledge, has not been previously reported in PPHL cases. This is particularly interesting because GPA has been reported primarily in diffuse large B-cell lymphoma and lymphoid granulomatosis patients [ 12 , 13 ]. In our case, both diagnoses were considered in the differential diagnosis but were ultimately excluded based on comprehensive histological and immunophenotypic studies.…”

Section: Discussionmentioning

confidence: 99%

Primary pulmonary Hodgkin’s lymphoma mimicking granulomatosis with polyangiitis – a case report of diagnostic and therapeutic dilemmas

Sławiński,

Sołek,

Miłkowska-Dymanowska

et al. 2023

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Primary pulmonary Hodgkin’s lymphoma (PPHL) is a rare subtype of lymphoma that comprises a small percentage of primary pulmonary lymphomas. Due to its rarity and nonspecific symptoms, PPHL often presents diagnostic challenges. This case report presents a unique case of PPHL mimicking granulomatosis with polyangiitis, emphasizing the difficulties encountered during the diagnostic process. A 53-year-old female presented with vague symptoms including weakness, oedema, dry cough, and nasal cavity ulceration. Laboratory investigations revealed elevated C-reactive protein levels, a white blood cell count with neutrophilia, and lymphopaenia. Initial treatment with oral corticosteroids for suspected polyangiitis yielded no response. The patient subsequently developed a low-grade fever and pruritic erythematous rash. Diagnostic procedures, including bronchial brush biopsy, bronchial washing, mediastinal lymph node biopsy, nasal cavity ulceration biopsy, and initial lung biopsy, were inconclusive and resulted in exclusion of granulomatosis with polyangiitis. A subsequent computed tomography scan indicated disease progression in the left lung. A lung biopsy revealed fibrotic tissue with nodules containing Hodgkin- Reed-Sternberg cells, leading to the final diagnosis of classic Hodgkin lymphoma, nodular sclerosis subtype. Positron emission tomography scan findings confirmed PPHL. The patient received multiple chemotherapeutic regimens, with brentuximab vedotin demonstrating efficacy as the sole effective treatment. This exceptional case of PPHL underscores the extensive diagnostic and therapeutic workup involving a multidisciplinary team of clinicians, radiologists, and pathologists. Increased awareness of PPHL and its distinctive features will aid in the diagnosis of similar cases in the future, benefitting both clinicians and pathologists.

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“…Anemia is the most common hematologic abnormality [7], although thrombocytopenia is seen with the hemophagocytic variant [8]. Even a finding such as a myeloperoxidase-antineutrophilic cytoplasmic autoantibody (MPO+ ANCA), which has a reported specificity of up to 98% in the diagnosis of vasculitis, cannot necessarily exclude the presence of an underlying IVBCL [13,25].…”

Section: A Formidable Diagnostic Challengementioning

confidence: 99%

Unmasking the Master of Disguise: Defining Advancements in Diagnosis of Intravascular Large B-cell Lymphoma

2020

Journal of Clinical Haematology

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Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

Cited by 3 publications

References 28 publications

ANCA-Associated Vasculitides and Hematologic Malignancies: Lessons from the Past and Future Perspectives

ANCA-Associated Vasculitides and Hematologic Malignancies: Lessons from the Past and Future Perspectives

Primary pulmonary Hodgkin’s lymphoma mimicking granulomatosis with polyangiitis – a case report of diagnostic and therapeutic dilemmas

Unmasking the Master of Disguise: Defining Advancements in Diagnosis of Intravascular Large B-cell Lymphoma

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