Primary cardiac large B cell lymphoma.
Sumukh A KumarRahul MishraSarat Chandra MalempatiPoorva BindalPublished in: BMJ case reports (2023)
A female patient in her mid-60s presented with progressive shortness of breath, pleuritic chest pain and bilateral leg swelling for 1 week. Initial diagnostic workup revealed pericardial effusion, and a localised pericardial tubular mass on CT chest. Pericardial fluid analysis showed elevated white cells, with predominance of medium-large sized atypical lymphoid cells. Atypical lymphocytes stained positive for CD79a, CD10, PAX-5, BCL-2 and BCL6. Fluorescence in situ hybridisation testing demonstrated MYC and BCL6 rearrangements without BCL2 gene rearrangement. The overall morphological, immunohistochemical and cytogenetic findings supported a diagnosis of high-grade B cell lymphoma with MYC and BCL6 rearrangements. After extensive staging workup, localised disease involving the pericardium with a diagnosis of primary cardiac large B cell lymphoma was established. She was treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab chemotherapy. Rituximab was discontinued owing to largely absent CD20 expression. Interim positron emission tomography-CT after three cycles revealed a complete response, and the patient completed six cycles of therapy.
Keyphrases
- positron emission tomography
- diffuse large b cell lymphoma
- computed tomography
- induced apoptosis
- high grade
- cell cycle arrest
- case report
- pet ct
- image quality
- left ventricular
- transcription factor
- single cell
- contrast enhanced
- poor prognosis
- low dose
- heart failure
- dual energy
- nk cells
- pet imaging
- randomized controlled trial
- magnetic resonance imaging
- lymph node
- drug delivery
- endoplasmic reticulum stress
- cell death
- stem cells
- low grade
- copy number
- locally advanced
- endothelial cells
- long non coding rna
- mesenchymal stem cells
- cell proliferation
- magnetic resonance
- chronic lymphocytic leukemia
- pi k akt
- genome wide
- atrial fibrillation
- hodgkin lymphoma
- smoking cessation
- double blind
- placebo controlled