Primary pulmonary diffuse large B-cell lymphoma with pleural effusion as the first diagnosis: a case report
10.3760/cma.j.cn114452-20230824-00082
- VernacularTitle:以胸腔积液首诊的原发性肺弥漫大B细胞淋巴瘤1例
- Author:
Jiahao ZHAO
1
;
Yunping ZHANG
;
Yan WU
;
Jiyuan GE
;
Xuhua MAO
;
Guohong QIAO
;
Yaoxiang SUN
Author Information
1. 江苏大学附属宜兴医院检验科，宜兴 214200
- Keywords:
Pleural effusion;
Pulmonary lymphoma;
Diffuse large B-cell lymphoma;
Cell morphology
- From:
Chinese Journal of Laboratory Medicine
2023;46(10):1099-1103
- CountryChina
- Language:Chinese
-
Abstract:
A case of a 69-year-old female patient, with cough, expectoration, chest tightness and shortness of breath for 10 days accompanied by left pleural effusion, was reported. Initially, a large number of suspected malignant lymphoma cells were found in the patient′s pleural effusion through routine cell morphological examination after admission, which was the direction of clinical diagnosis and treatment in the next step. Then the patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) through imaging, bone marrow and lung biopsy pathology. Finally, the patient was treated effectively with R-CHOP regimen, but she died of respiratory failure 9 weeks later, because she did not receive regular follow-up and treatment after the sixth chemotherapy cycle. Primary pulmonary DLBCL, an extremely rare extranodal lymphoma' lacks specificity clinical manifestations and is easy to be missed and misdiagnosed. DLBCL with a large number of malignant pleural effusion progresses rapidly and has a poor prognosis. The routine cell morphology examination of pleural effusion is simple and intuitive, which can capture key information in the shortest time, preliminarily provide clinical diagnosis and treatment ideas, and provide accurate basis for disease diagnosis.
