Diffuse large B-cell lymphoma with pulmonary cryptococcosis: report of 1 case and review of literature
10.3760/cma.j.cn115356-20240907-00138
- VernacularTitle:弥漫大B细胞淋巴瘤合并肺隐球菌病1例并文献复习
- Author:
Caiqin LIN
1
;
Suli WANG
;
Shaoying PAN
;
Dongsheng XIE
;
Miaomiao TIAN
;
Leina SONG
;
Huijun LING
;
Huizhen SHI
;
Bin ZHU
;
Zhiyong DING
;
Wenli ZHAO
Author Information
1. 上海交通大学附属第六人民医院南院 上海市奉贤区中心医院血液科，上海 201400
- Keywords:
Lymphoma, large B-cell, diffuse;
Immunochemotherapy;
Pulmonary cryptococcosis
- From:
Journal of Leukemia & Lymphoma
2025;34(3):155-158
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve the understanding of patients with diffuse large B-cell lymphoma (DLBCL) with pulmonary cryptococcosis.Methods:The clinical data of 1 DLBCL patient with pulmonary cryptococcosis in the Central Hospital of Fengxian District of Shanghai in May 2023 were retrospectively analyzed, and the relevant literatures were reviewed.Results:This 75-year-old female patient was asymptomatic after 2 cycles of R-CHOP chemotherapy. The high-resolution CT of lung showed that lung nodules were progressively enlarged. Antibacterial treatment was ineffective. Pulmonary cryptococcosis was confirmed by bronchoalveolar lavage fluid (BALF) targeted high-throughput sequencing (tNGS) and cryptococcus capsular antigen (CrAg) detection. The central nervous system was not involved. And the long-term adequate-dose fluconazole was prescribed for 6 months, and the treatment against lymphoma was given synchronously. The lung nodule lesions reduced after antifungal therapy for 1 month. The lung nodules disappeared after the follow-up of 6 months after completion of final chemotherapy. The evaluation of lymphoma indicated complete remission.Conclusions:Pulmonary cryptococcosis occurs insidiously and shows no specific symptoms; its imaging manifestations are variable and routine anti-infection is ineffective. Immunochemotherapy for lymphoma patients is a high-risk factor for cryptococcal infection. tNGS and CrAg testing for BALF are effective methods of the confirmed diagnosis. The early and long-term adequate-dose antifungal treatment is the key to preventing the recurrence or progression.
