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Extranodal diffuse large B-cell lymphoma presenting with extensive organ involvement
  1. Kailyn Kim1,
  2. Sharvina Ziyeh2 and
  3. Phyllis Kim2
  1. 1Department of Medicine, UCLA Medical Center Olive View, Sylmar, California, USA
  2. 2Department of Hematology/Oncology, UCLA Medical Center Olive View, Sylmar, California, USA
  1. Correspondence to Dr Sharvina Ziyeh; sharvinaeras{at}


Extranodal involvement in diffuse large B-cell lymphoma (DLBCL) is defined as disease outside of the lymph nodes and occurs in up to one-third of patients, though multiorgan extranodal involvement is rare. Here, we describe a case of a patient presenting with widely metastatic lesions, including involvement of the lung, parotid gland, breast, pancreas, femur and multiple soft tissue masses, with initial concern for primary breast malignancy. Breast pathology and imaging were consistent with triple-expressor, double-hit stage IV high-grade B-cell lymphoma with extensive extranodal involvement. Extranodal involvement is a poor prognostic factor associated with high rates of treatment failure, and novel therapies targeting CD19 are currently being studied for relapsed and refractory DLBCL. Extranodal disease is a complex entity that can involve virtually any organ system and should be considered for new presentations of malignancy.

  • Chemotherapy
  • Oncology
  • Haematology (incl blood transfusion)
  • Malignant and Benign haematology

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KK, SZ and PK. The following authors gave final approval of the manuscript: KK, SZ and PK.

  • 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.