Unusual presentation of extranodal diffuse large B-cell lymphoma in a solid-organ recipient during long-term immunosuppressive treatment

Introduction: Posttransplant lymphoproliferative disorders (PTLDs) refer to a group of diseases, including diffuse large B-cell lymphoma (DLBCL), that develop after solid organ transplantation or hematopoietic stem cell transplantation. Extranodal involvement in PTLDs is common. Reports about exclus...

Full description

Saved in:
Bibliographic Details
Published in:Tumori 2021-12, Vol.107 (6), p.NP127-NP130
Main Authors: Camerini, Chiara, Sant’Antonio, Emanuela, Ginori, Alessandro, Pellegri, Marco, De Gaudio, Cataldo, Banti, Elena, Ciliberti, Vincenzo, Parrini, Manuela, Bozzoli, Laura, Simonetti, Federico, Capochiani, Enrico
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bone Marrow - pathology
Cyclophosphamide - therapeutic use
Disease Management
Disease Susceptibility
Doxorubicin - therapeutic use
Female
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Immunohistochemistry - methods
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Kidney - pathology
Lymphoma, Large B-Cell, Diffuse - diagnosis
Lymphoma, Large B-Cell, Diffuse - etiology
Lymphoma, Large B-Cell, Diffuse - therapy
Organ Transplantation - adverse effects
Positron Emission Tomography Computed Tomography
Prednisone - therapeutic use
Spleen - pathology
Symptom Assessment
Treatment Outcome
Vincristine - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction: Posttransplant lymphoproliferative disorders (PTLDs) refer to a group of diseases, including diffuse large B-cell lymphoma (DLBCL), that develop after solid organ transplantation or hematopoietic stem cell transplantation. Extranodal involvement in PTLDs is common. Reports about exclusive bone marrow involvement are rare. Case description: A 70-year-old woman, who had undergone kidney transplantation in 2018, was diagnosed with exclusively extranodal, Epstein-Barr virus–negative DLBCL, with bone marrow and spleen involvement, during long-term immunosuppression. She achieved complete remission with combined immunochemotherapy and temporary hold of immunosuppression. Conclusions: This case shows an uncommon clinical presentation of DLBCL, which was challenging to diagnose, being entirely extranodal. The favorable clinical course relied on timely diagnosis and a multidisciplinary approach. Long-term consequences of posttransplant immunosuppression require a high level of suspicion for an appropriate management, aimed at preserving the graft while eradicating the lymphoproliferative disorder.
ISSN:0300-8916
2038-2529
DOI:10.1177/03008916211040862