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Case Reports: Unusual presentation of more common disease/injury
Diffuse large B cell lymphoma presenting as multiple cavitary lung lesions
  1. Manisha Uppal1,
  2. Ahmad Hassan2 and
  3. Jalil Ahari2
  1. 1The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  2. 2Pulmonary and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  1. Correspondence to Dr Manisha Uppal; muppal{at}mfa.gwu.edu

Abstract

A female patient in her 50s presented to the hospital with a 2 months history of shortness of breath and productive cough. She also had ongoing fatigue and unintentional weight loss. Investigations demonstrated a normal white cell count and elevated lactate dehydrogenase). A CT scan of the chest revealed multiple bilateral cavitary lung masses and pulmonary nodules. Bronchoscopy with transbronchial biopsy and fine needle aspiration of mediastinal lymph node was performed. The histopathology was consistent with the non-germinal centre B cell subtype of diffuse large B cell lymphoma (DLBCL). A regimen of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone was started, which improved her symptoms. Although a rare presentation, this case highlights the need to consider DLBCL among the differential diagnoses for cavitary lung lesions when the workup fails to elicit an alternate cause. Given its aggressive nature, prompt diagnosis and treatment are critical.

  • Lung cancer (oncology)
  • Respiratory medicine
  • Hematology

https://doi.org/10.1136/bcr-2022-254367

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    Footnotes

    • Contributors JA identified the case, sourced the clinical images, and reviewed and edited the text. MU was responsible for the first draft preparation, literature search, sourcing of investigation results, and reviewing and editing of the text. AH was responsible for review and editing of the text, and editing of clinical images. The following authors were responsible for critical revision for important intellectual content: JA, AH, MU. The following authors gave final approval of the manuscript: JA.

    • 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.