A Case of Lymphoma with Multiple Identities

Alia Suzana Asri; Rabeya Yousuf; Azyani Yahaya; Isa Izzaki Zainal; Nor Rafeah Tumian; Dian Nasriana Nasuruddin; Nurasyikin Yusof; Suria Abdul Aziz

Return

A Case of Lymphoma with Multiple Identities

Author: Alia Suzana Asri ^{1
,

2} ; Rabeya Yousuf ¹ ; Azyani Yahaya ^{1
,

2} ; Isa Izzaki Zainal ³ ; Nor Rafeah Tumian ⁴ ; Dian Nasriana Nasuruddin ^{1
,

2} ; Nurasyikin Yusof ^{1
,

2} ; Suria Abdul Aziz ^{1
,

2}
Author Information

1. Department of Diagnostic and Laboratory Services, Hospital Canselor Tuanku Muhriz UKM, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia&
2. Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
3. Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
4. Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
Publication Type:Case Reports
Keywords: Discordant lymphoma, Diffuse large B-Cell lymphoma, Follicular lymphoma, Bone Marrow
From:Malaysian Journal of Medicine and Health Sciences 2023;19(No.5):431-434
CountryMalaysia
Language:English
Abstract: Discordant lymphoma (DL) is the coexistence of two or more distinct subtypes in separate anatomic sites. There are limited reports on DL cases especially involving more than two subtypes in more than two sites. We report a 76-year-old man who presented with constitutional symptoms, flank mass and painless lymphadenopathies for six months. Laboratory tests revealed moderate anaemia, markedly elevated serum IgM (13400 mg/dL), IgM Lambda paraproteinemia and Lambda light chain paraproteinuria with unmeasurable serum lactate dehydrogenase due to hyperviscous sample. CT scan showed multiple subcutaneous masses over chest wall and retroperitoneum, with lytic bone lesions, and hepatosplenomegaly. Further biopsy findings with morphological, immunohistochemical and molecular analysis of the tissue sections revealed diffuse large B-Cell lymphoma in the chest wall mass, follicular lymphoma in the inguinal lymph node and lymphoplasmacytic lymphoma in the bone marrow. This case highlights the rare DL. The importance of histopathological evaluation of lymphoma despite the availability of PET-CT scans for disease staging is undeniable.
Full text:11.2023my1652.pdf