Fibrin-Associated Diffuse Large B Cell Lymphoma Found on Revision Arthroplasty of the Knee

Abstract

Fibrin-associated diffuse large B cell lymphoma (FA-DLBCL) is a rare Epstein-Barr viruspositive B cell lymphoma that is nonmassforming, does not directly produce symptoms, and is incidentally discovered on histological examination of tissues excised for other reasons. Despite overlap in morphologic and immunophenotypic features with aggressive B cell neoplasms, FA-DLBCL shows an excellent clinical outcome, even with surgical excision alone. We report an extremely rare occurrence of FA-DLBCL found in association with a metallic implant on revision arthroplasty of the knee. This report also illustrates the need for an integrated multidisciplinary approach for accurate diagnosis and avoidance of overtreatment.

Cytological Features of Fibrin-associated Diffuse Large B-cell Lymphoma Arising in Retroperitoneal Pseudocyst: The First Case Report

“…Ho et al (7) summarized 87 patients with FA-DLBCL. Their literature review revealed that patients with FA-DLBCL had many types of underlying medical conditions, such as cardiac myxoma, thrombus, hematoma, aneurysms, prosthetic valves, breast implants, and cystic lesions at various locations (8)(9)(10)(11)(12). The mechanism of FA-DLBCL development in these lesions remains unknown.…”

Metallic implant-associated lymphoma: ALK-negative anaplastic large cell lymphoma associated with total knee replacement arthroplasty

“…Only seven cases of malignant lymphomas complicating total knee replacement arthroplasty have been reported in the medical literature [1][2][3][4][5][6][7]. The mean time between implantation of the prostheses and lymphoma diagnosis was 7 years (range, 6 months to 16 years).…”

“…Follow-up was reported in six patients, all of them being free of disease for 8 months to 3 years. In particular, one patient was alive for 2 years without evidence of disease, even though no additional treatment was received other than revision arthroplasty [ 6 ].…”

“…Malignant lymphomas related to metallic implants from an orthopedic procedure, called metallic implant-associated lymphomas, are extremely rare [1]. Only seven cases of malignant lymphomas complicating total knee replacement arthroplasty have been reported and occur several years after operation; all cases were large B-cell lymphoma [1][2][3][4][5][6][7].…”

Fibrin-Associated Large B-Cell Lymphoma (FA-LBCL) Involving Solid Organs as Necrotic Cystic Lesions—A Rare Entity with Potential Diagnostic Pitfalls: A Two-Case Series and Review of the Literature

“…FA-LBCL is now recognized as a distinct EBV-driven neoplasm by the 5th edition of WHO classification of hematolymphoid tumors. 2 It is rare, and approximately 60 patients have been reported in English literature until 2022, 3,4,7,9,10,25-31 most frequently associated with cardiac myxomas, with 18 tumors identified. A total of 14 tumors has been identified in association with prosthetic devices and associated thrombi (like cardiac valves and vascular grafts), and knee metallic implants.…”