Sudden appearance and spontaneous regression of diffuse large B cell lymphoma in a man with a broken arm

Abstract

An elderly, demented man with stable κ bi-clonal gammopathy of unknown significance suffered a severe displaced right humeral fracture in a fall. One week later a rapidly enlarging head, neck and axillary adenopathy first appeared, including a 2 cm tonsillar node that partially obstructed the oropharynx. A left cervical node biopsy demonstrated diffuse large B cell lymphoma with CD20+, bcl-2+, κ+, CD3-, Epstein-Barr virus negative malignant cells. During the next month lymphadenopathy regressed more than 90% in the absence of treatment with chemotherapeutic agents, radiation or glucocorticoids. Following 2 months of clinical improvement, he died of pneumonia 95 days after the injury. An autopsy demonstrated residual right hilar and mediastinal malignant lymphadenopathy. These unusual events may be related to immunosuppressive and other systemic effects of acute injury on tumour behaviour.

Effusion‐based lymphoma with morphological regression but with clonal genetic features after aspiration

“…Some hypotheses have been proposed, including modulation of immune status after traumatic or infectious events. [12][13][14] In the present case, the pleural effusion subsided after pigtail catheter drainage, suggesting a remission.…”

Self-Limited Effusion Large B-Cell Lymphoma: Two Cases of Effusion Lymphoma Maintaining Remission after Drainage Alone

“…It suggests that the modulation of the host immune to traumatic effects might cause the tumor regression. One report described the rapid progression of DLBCL days after a severe bone fracture followed by spontaneous remission [12]. Alternatively, an association between spontaneous regression of a tumor and infection has been discussed.…”

Complete Remission and Long-term Survival of a Patient with a Diffuse Large B-cell Lymphoma Under Viscum album Extracts After Resistance to R-CHOP: A Case Report

“…Infiltration with T lymphocytes has been observed after remission (37,48,49). A role of the tumor microenvironment is discussed as remission has been observed after biopsy (36), surgery (50), and injury (51). Remissions of malignant lymphoma have been induced by immunotherapy like active vaccination (immune peptides, DNA sequences, in situ vaccination), T cell stimulation, and modulation of the microenvironment (52).…”