Diffuse large B-cell lymphoma presenting in the leukemic phase

Authors

  • Patricia Puccetti Pires Universidade de São Paulo. Faculty of Medicine. Internal Medicine Department
  • Marcia Yoshie Kanegae Universidade de São Paulo. Hospital Universitário. Internal Medicine Division
  • Jairo Rays Universidade de São Paulo. Hospital Universitário. Internal Medicine Division
  • Marcos Catania Universidade de São Paulo. Faculty of Medicine. Anatomy Pathology Department
  • Fabiana Roberto Lima Universidade de São Paulo. Hospital Universitário. Anatomy Pathology Service
  • Thiago Rodrigo Noronha Universidade de São Paulo. Hospital Universitário. Hematology Division of the Clinical Laboratory
  • Andre Neder Ramires Abdo Instituto do Câncer de São Paulo. Hematologic Oncology Department
  • Juliana Pereira Universidade de São Paulo. Hospital Universitário. Hematology Division of the Clinical Laboratory - University of São Paulo. Faculty of Medicine. Department of Hematology

DOI:

https://doi.org/10.4322/acr.2016.027

Keywords:

Lymphoma, Large B-cell, Diffuse, Leukemia, Flow citometry, Diagnosis

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma comprising a heterogeneous group of disorders with variable histological and clinical behavior. Although other lymphomas may present in the leukemic phase more frequently, this appearance is unusually observed among DLBCL cases. Diagnosing lymphoma is not always easy, and the patient’s clinical status quite often may hamper invasive procedures for diagnosis pushing the clinician to look for alternatives to reach the nearest possible accurate diagnosis. The authors report the case of a middle-aged man who presented the history of malaise, weight loss, and low-grade fever. The peripheral blood count showed leukocytosis with the presence of blasts and thrombocytopenia. The cytological morphology and immunophenotyping of the peripheral blood and bone marrow aspirate, as well as the bone marrow biopsy accompanied by a thorough immunohistochemical analysis, rendered the diagnosis of DLBCL in the leukemic phase. The patient was prescribed R-CHOP with a favorable outcome. Intra-abdominal lymph node biopsy was avoided because of the patient’s critical medical condition. The authors highlight this rare form of presentation of DLBCL as well as the combination of peripheral blood, bone marrow aspirate, and bone marrow biopsy for reaching the diagnosis in cases were a lymph node sample is unavailable for the diagnostic work-up

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Published

2016-03-10

How to Cite

Pires, P. P., Kanegae, M. Y., Rays, J., Catania, M., Lima, F. R., Noronha, T. R., Abdo, A. N. R., & Pereira, J. (2016). Diffuse large B-cell lymphoma presenting in the leukemic phase. Autopsy and Case Reports, 6(1), 41-45. https://doi.org/10.4322/acr.2016.027

Issue

Section

Article / Clinical Case Report