Primary Pulmonary Diffuse Large B Cell Non-Hodgkin’s Lymphoma: A Case Report and Literature Review

Abstract

Patient: Female, 48Final Diagnosis: Primary pulmonary DLBCLSymptoms: Cough • weigh lossMedication: R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)Clinical Procedure: Bone marrow biopsy • CT-guided lung biopsySpecialty: OncologyObjective:Rare diseaseBackground:Primary pulmonary diffuse large B cell lymphoma (DLBCL) is extremely rare neoplasm representing only 0.5–1% of primary pulmonary malignancies. These patients usually have non-specific clinical presentation and radiological findings. Therefore, it is important to increase awareness of this rare disease, as the correct characterization of the tumors will have therapeutic and prognostic implications.Case Report:We present the case of a middle-aged Hispanic woman with chronic cough and an abnormal chest X-ray revealing a lung mass, who was found to have primary pulmonary DLBCL. She underwent 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy and attained complete remission.Conclusions:With its non-specific presentation, the diagnosis of primary pulmonary DLBCL is very challenging and often leads to misdiagnosis or delayed diagnosis. The pathogenesis of primary pulmonary DLBCL is still poorly understood. The choice of treatment approach should be based on the biological characteristic of the tumor, stage, and performance status.

Diffuse Large B-Cell Lymphoma Arising from the Lesion of Chronic Lobar Atelectasis

“…In the present case, high accumulation of FDG-PET was detected at multiple sites of extrathoracic locations, which did not fulfill the diagnosis of PPL. However, due to its rapid spread into the mediastinum and extrathoracic locations, the quite incidence of primary pulmonary DLBCL may be underestimated (Dirweesh et al 2017;Zhu et al 2017).…”

Rare Primary Pulmonary Marginal Zone Lymphoma Presenting with Incidental Pulmonary Nodules

“…Unlike gastric MALT lymphoma which is associated with Helicobacter pylori , MALT lymphoma of the lung has not been linked to any infectious or specific autoimmune conditions, although there have been case reports associated with tuberculosis [10]. Like gastric MALT lymphoma, it is postulated that pulmonary MALT lymphoma can progress to high-grade diffuse large B-cell lymphoma (DLBCL); however, this has not been well studied [1].…”

“…Primary pulmonary lymphoma (PPL) is a rare neoplasm accounting for 0.5-1% of pulmonary malignancies [1]. It can present with nonspecific symptoms or, in some cases, it can be detected as an incidentaloma during surveillance of other thoracic pathologies.…”

A Man with a Decade of Persistent Pulmonary Opacities

“…Highgrade B cell lymphomas may occur in the lungs in isolation or be seen concurrently with or transforming from MALT lymphoma (4). In addition, lymphomatoid granulomatosis is a rare lymphoproliferative disorder sometimes characterized as a PPL (5)(6)(7).…”