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Case Reports: Reminder of important clinical lesson
Chronic dysphagia as a presenting complaint for primary mediastinal diffuse large B-cell lymphoma
  1. Logan Eslinger1,
  2. Taimoor Ahmed2,
  3. Samra Haroon Lodhi2 and
  4. Taha Ahmed2
  1. 1University of Kentucky College of Medicine, Lexington, Kentucky, USA
  2. 2Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA
  1. Correspondence to Dr Taha Ahmed; tahaahmedfairview{at}gmail.com

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy in adults. It manifests a variable presentation, depending on the tissue in which it arises. Rarely, it can present as dysphagia to solid and liquid foods in primary oesophageal lymphoma with or without B symptoms. We present a case of a 66-year-old man who presented with 3 months of progressive dysphagia with only a mild associated weight loss. This was later found to be caused by DLBCL of the mediastinum causing external compression of the patient’s distal oesophagus and gastric cardia. He was treated with one cycle of standard-of-care chemotherapy and subsequently discharged with outpatient follow-up. We emphasise the importance of ruling out life-threatening conditions such as lymphoma in patients who present with dysphagia, as well as the high variability in presentation of DLBCL.

  • Cancer - see Oncology
  • Cancer intervention
  • Gastroenterology

http://dx.doi.org/10.1136/bcr-2022-253357

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    Footnotes

    • Twitter @TahaAhmedMD

    • Contributors LE performed the literature review and drafted and reviewed the manuscript. TaiA edited the manuscript. SHL reviewed the manuscript. TahA designed the study, performed the literature review, and drafted and reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.