Fahimeh Rezazadeh, Zahra Mansouri, Asma Sookhakian, Vahid Mohammadkarimi
{"title":"Uncommon presentation of diffuse large B-cell lymphoma: oral and pulmonary involvements in a young patient: a case report.","authors":"Fahimeh Rezazadeh, Zahra Mansouri, Asma Sookhakian, Vahid Mohammadkarimi","doi":"10.1186/s13256-024-04825-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphomas that remains a major diagnostic challenge due to the variety of its clinical presentations. This case highlights the importance of early biopsy of oral lesions without tendency to heal to attain the diagnosis more quickly. To the best of our knowledge, this study is the first to focus on both oral and pulmonary involvements in a patient with diffuse large B-cell lymphoma.</p><p><strong>Case presentation: </strong>The presented case describes an Iranian 18-year-old girl with chronic cough and dyspnea referred for evaluation of the upper jaw due to bone exposure, bone loss, and soft tissue ulceration. Her medical history revealed mediastinal mass, cavitary lesion, and mediastinal lymphadenopathy. However, cytologic and immunohistochemical analysis did not show any evidence of malignancy. In this case a lymphoproliferative disease was suspected but ultimately the oral biopsy diagnosed diffuse large B-cell lymphoma and chemotherapy could be started.</p><p><strong>Conclusions: </strong>Systemic conditions should be considered as a possible cause of oral lesions and a biopsy should also be performed immediately if there is any doubt concerning the nature of the lesion. Moreover, some conditions necessitate multiple biopsies to attain an accurate diagnosis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481727/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13256-024-04825-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphomas that remains a major diagnostic challenge due to the variety of its clinical presentations. This case highlights the importance of early biopsy of oral lesions without tendency to heal to attain the diagnosis more quickly. To the best of our knowledge, this study is the first to focus on both oral and pulmonary involvements in a patient with diffuse large B-cell lymphoma.
Case presentation: The presented case describes an Iranian 18-year-old girl with chronic cough and dyspnea referred for evaluation of the upper jaw due to bone exposure, bone loss, and soft tissue ulceration. Her medical history revealed mediastinal mass, cavitary lesion, and mediastinal lymphadenopathy. However, cytologic and immunohistochemical analysis did not show any evidence of malignancy. In this case a lymphoproliferative disease was suspected but ultimately the oral biopsy diagnosed diffuse large B-cell lymphoma and chemotherapy could be started.
Conclusions: Systemic conditions should be considered as a possible cause of oral lesions and a biopsy should also be performed immediately if there is any doubt concerning the nature of the lesion. Moreover, some conditions necessitate multiple biopsies to attain an accurate diagnosis.
背景:弥漫大 B 细胞淋巴瘤是非霍奇金淋巴瘤中最常见的亚型,由于其临床表现多种多样,因此仍然是诊断上的一大难题。本病例强调了对无愈合倾向的口腔病变进行早期活检以更快确诊的重要性。据我们所知,本研究是第一例同时关注弥漫大 B 细胞淋巴瘤患者口腔和肺部受累的病例:本病例描述的是一名患有慢性咳嗽和呼吸困难的 18 岁伊朗女孩,由于骨质暴露、骨质流失和软组织溃疡,她被转诊到医院对上颌骨进行评估。病史显示她有纵隔肿块、空洞性病变和纵隔淋巴结病。然而,细胞学和免疫组化分析并未显示任何恶性肿瘤的证据。该病例被怀疑患有淋巴增生性疾病,但最终口腔活检诊断为弥漫大 B 细胞淋巴瘤,并开始接受化疗:结论:全身性疾病应被视为口腔病变的可能原因,如果对病变的性质有任何怀疑,也应立即进行活检。此外,有些病症需要多次活检才能获得准确诊断。
期刊介绍:
JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect