A rare case of suspicious fluid lesions in patient with diffuse large B-cell lymphoma

International Meeting on Clinical Case Reports

April 18-20, 2016 Dubai, UAE

Akhmedov Mobil

N.N. Blokhin Russian Cancer Research Center, Russia

Posters & Accepted Abstracts: J Clin Case Rep

Abstract :

63-year-old man complaining about abdominal pain, 11 kg weight loss was admitted to our hospital. Thorax CT revealed enlargement of all mediastinal lymph nodes, left supraclavicular lymph node, multiple lesions in the right lung, pleural effusion, left lung atelectasis. MRI demonstrated a huge mass in the abdomen, spreading to the liver hilum, involving spleen, abdominal and retroperitoneal lymph nodes; splenomegaly with fluid subcapsular patterns that were initially suspected to be cysts or subcapsular ruptures. Located in spleen these lesions could not be verified by reason of the biopsy procedure unsafely. Immunohistochemistry of obtained left supraclavicular lymph node revealed expression of CD20, BCL-6, BCL-2, MUM1 with no expression of panCK, CD10. Ki-67 level was 95%. The diagnosis was set to diffuse large B-cell lymphoma involving retroperitoneal, peripheral, abdominal lymph nodes, lymph nodes of liver hilum and spleen. Due to myocardial infarction in anamnesis anthracyclines were contraindicated to this patient. For this reason he has undergone chemotherapy in R-CEPP regimen. After four courses of therapy imaging studies revealed excellent response with mediastinal lymph nodes size regress, almost total regress of abdominal mass, spleen and especially spleen's fluid patterns size. Considering good response of these lesions to chemotherapy they should be appreciated not as subcapsular ruptures or cysts, but as true spleen involvement. Despite high prevalence of spleen involvement in patients with DLBCL such fluid patterns are extremely rare presentation. The diagnosis was set to DLBCL stage IV SB. Patient continued therapy in regimen of six courses of R-CEPP with subsequent PET-scanning.

Biography :

Akhmedov Mobil was graduated from I.M. Setchenov First Moscow Medical University in 2015. He has completed Surgery Internship programs in Munich, Germany and Istanbul, Turkey and participated in many conferences for young scientists. Currently he is a Resident at the Department of Surgery of the I.M. Setchenov First Moscow Medical University.

Email: mobilakhmedov@gmail.com