Primary pleural diffuse large B-cell lymphoma accompanied with immune thrombocytopenia: report of one case and review of literature

Abstract

Objective To explore the clinical features, laboratory examinations and diagnosis progress of primary pleural diffuse large B-cell lymphoma (DLBCL) and analyze the relationship between immune thrombocytopenia (ITP) and lymphoma, and to improve the diagnostic level of the rare disease. Methods The clinical features, diagnosis and treatment of one primary pleural DLBCL patient with ITP in Ruijin Hospital of Shanghai Jiao Tong University School of Medicine were observed. The related literatures were also reviewed. Results The patient was admitted to the hospital due to repeated chest tightness and shortness of breath for 6 months. Ultrasonic examination, chest CT scan, PET-CT and pleural effusion puncture were performed. The main clinical feature was only pleural effusion without hepatosplenomegaly, enlargement of lymph nodes and any other lesions. Pathological study of pleural effusion confirmed the diagnosis of DLBCL. The patient was suffered from ITP for 30 years. After confirmed diagnosis, 6 courses of R-CHOP regimen had been performed. Mid-term assessment showed the complete absorption of pleural effusion and achieved complete remission. Conclusions Primary pleural DLBCL is a rare disease. It is easy to misdiagnose due to the lack of specificity in clinical and imaging manifestations. The final diagnosis ultimately depends on histopathology. ITP can occur prior to lymphoma or onset of lymphoma, and a few patients can present with ITP in the course of lymphoma. Key words: Lymphoma, large B-cell, diffuse; Pleural; Immune thrombocytopenia