Primary Pulmonary Diffuse Large B-cell Research Articles

Prognostic factors and predictive models for primary pulmonary diffuse large B-cell lymphoma: a population-based analysis

ABSTRACT Background Primary pulmonary diffuse large B-cell lymphoma (PP-DLBCL) is a rare extranodal non-Hodgkin's lymphoma (EN-NHL). Its prognosis as an aggressive lymphoma is abysmal, and predictive models are still lacking. Methods We screened patients diagnosed with PP-DLBCL between 2010 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. Then, univariate and multivariate COX regression analyses were used to identify independent risk factors affecting patient prognosis. Finally, a novel nomogram was constructed and the model was evaluated by looking at three dimensions. Results A total of 831 patients were included in this study. Most of the patients were elderly (526 (63.8%)) and female (428 (51.9%)). The included patients were randomized in a 7:3 ratio into a training group (577 (70%)) and a validation group (248 (30%)). We concluded that the independent risk factors of prognosis were age, extrapulmonary metastasis, radiotherapy, chemotherapy, and surgical intervention. The results of receiver operating characteristic curves, calibration curves, and decision curve analysis in the training and validation groups confirmed that the risk prediction nomogram could accurately predict the survival of PP-DLBCL. Conclusion This study is the first large population-based clinical data study on PP-DLBCL. A novel predictive model about prognosis has been developed to help clinical decision-making.

INCIDENTAL PRIMARY PULMONARY DIFFUSE LARGE B-CELL LYMPHOMA

INCIDENTAL PRIMARY PULMONARY DIFFUSE LARGE B-CELL LYMPHOMA

Primary Pulmonary Diffuse Large B-Cell Non-Hodgkin's Lymphoma in a Child

Primary Pulmonary Diffuse Large B-Cell Non-Hodgkin's Lymphoma in a Child

Primary Pulmonary EBV-positive Diffuse Large B-cell Lymphoma in a Patient with Primary Myelofibrosis on a JAK Inhibitor

Primary Pulmonary EBV-positive Diffuse Large B-cell Lymphoma in a Patient with Primary Myelofibrosis on a JAK Inhibitor

Primary pulmonary diffuse large B-cell lymphoma in a young female patient.

Even if the patient is young or female, a primary pulmonary diffuse large B‐cell lymphoma could be considered as a differential diagnosis of multifocal consolidation in the lung.

Primary pulmonary diffuse large B-cell lymphoma with multiple ground-glass nodules as the primary manifestation

Introduction:Primary pulmonary lymphoma (PPL) is a rare extranodal lymphoma. Only 5% to 20% of patients suffering from PPL have diffuse large β-cell lymphoma (DLBCL), and their chest computed tomography (CT) findings show single- or double-lung patchy or flocculated shadows, isolated or multifocal nodules, or masses. In this research paper, we report an older woman having multiple ground-glass nodules, who was eventually diagnosed with primary pulmonary diffuse large β-cell lymphoma (PPDLBCL).Patient concerns:A 69-year-old woman suffering from cough was admitted to the Second Hospital of Jilin University.Diagnoses:A chest CT scan showed multiple ground-glass nodules. She had received 2 weeks of antibiotic treatment, but the multiple ground-glass nodules were still present. Lung biopsy was performed by tracheoscopy, which showed non-Hodgkin diffuse large β-cell lymphoma.Interventions:The patient received R-CHOP-21 chemotherapy.Outcomes:The multiple ground-glass nodules were absorbed.Conclusion:The current study shows that spotting multiple ground-glass nodules in the lungs is a clear indication of the presence of PPDLBCL. It is important to spread awareness of PPDLBCL, which needs timely diagnosis and management.

AN UNUSUAL CASE OF PULMONARY CAVITARY LESIONS IN AN IMMUNOSUPPRESSED PATIENT

SESSION TITLE: Medical Student/Resident Lung Pathology SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: The differential diagnosis of pulmonary cavitary lesions is broad. They can be categorized in to infectious and non-infectious diseases, including neoplasms. Among malignancies, squamous cell carcinoma is a common cause of lung cavitation (1). Herein, we report a rare case of primary pulmonary diffuse large B-cell lymphoma (DLBCL) in a patient with rheumatoid arthritis that presented with multiple cavitary lesions and hypercalcemia. CASE PRESENTATION: 83-year-old male presented with hemoptysis, dyspnea, confusion, and constipation for several weeks. His past medical history was significant for tobacco abuse and interstitial lung disease from rheumatoid arthritis (RA) treated with methotrexate. CT chest showed bilateral cavitary lung lesions, left-pneumothorax and pneumomediastinum, needing chest-tube placement. Pulmonary function test showed a mild restrictive defect with a severe reduction in diffusion capacity. Labs showed hypercalcemia of 13.7 mg/dl, suppressed parathyroid hormone (PTH), elevated PTH-related peptide (PTHrp), and 1-25(OH) 2 Vitamin-D level. Quantiferon gold, sputum acid-fast bacilli and cultures were negative. Blood cultures (1/4 bottles) grew Actinomyces viscosus that was treated with 6-weeks of piperacillin-tazobactam. Bronchoscopy with lavage was unrevealing; however, due to a suspicion for malignancy with elevated PTHrp level, a CT-guided biopsy of left lower lobe lung mass was performed that confirmed a diagnosis of DLBCL, non-germinal center B-cell type. DISCUSSION: Pulmonary lymphoma is very rare and presents with nonspecific pulmonary symptoms (2). The pathogenesis of primary pulmonary DLBCL remains elusive. Patients with autoimmune disorders and recurrent bacterial infections are at a higher risk for developing DLBCL. Chest imaging may show nodular lesions, consolidation or interstitial /mixed alveolar infiltrates (2). DLBCL presenting with multiple cavitary lesions, is rarely reported. In our patient hypercalcemia was mediated by elevation of both PTHrp and 1-25(OH)2 Vitamin-D, which is unusual. Most primary pulmonary lymphomas (PPL) are low-grade mucosa-associated lymphoid tissue (MALT)-type, compared to more aggressive pulmonary diffuse large B-cell lymphoma (DLBCL), which is very uncommon (3). Most likely, our patient's autoimmune disorder (RA) and chronic methotrexate use contributed in the development of his DLBCL. CONCLUSIONS: We report a rare case of primary pulmonary DLBCL that manifested with multiple cavitary lesions and hypercalcemia. DLBCL must be considered in the differential diagnosis of cavitary lung lesions particularly in immunosuppressed patients. Reference #1: Chaudhuri MR. Primary pulmonary cavitating carcinomas. Thorax. 1973;28:354-366 Reference #2: Fujita N, Ando M, Goto A, Sakata M, Ogata M, Usagawa Y, et al. Diffuse large B-Cell lymphoma arising from the lesion of chronic lobar atelectasis. Tohoku J Exp Med. 2020;250(2):129–35. Reference #3: Brown S, Horton J, Rosario D, Dorsey DA, Hetz S, King CS. High-grade primary pulmonary B cell lymphoma presenting as a Necrotic mass. Respir Care. 2011 Jun 1;56(6):871–3. DISCLOSURES: No relevant relationships by Haytham Adada, source=Web Response no disclosure on file for Mahmoud Amarna; No relevant relationships by Pavan Annamaraju, source=Web Response No relevant relationships by Camelia Chirculescu, source=Web Response No relevant relationships by Nino Nemsadze, source=Web Response No relevant relationships by Sana Yakoob, source=Web Response

A Case of Primary Pulmonary Diffuse Large B-Cell Lymphoma Diagnosed by Transbronchial Biopsy

A Case of Primary Pulmonary Diffuse Large B-Cell Lymphoma Diagnosed by Transbronchial Biopsy

Primary pulmonary diffuse large B-cell lymphoma diagnosed by transbronchial biopsy: report of one case

Primary pulmonary diffuse large B-cell lymphoma diagnosed by transbronchial biopsy: report of one case

Diagnosis and management of a patient with primary pulmonary diffuse large B-cell lymphoma: A case report and review of the literature.

Primary pulmonary lymphoma (PPL) is an uncommon type of non-Hodgkin’s lymphoma. The majority of PPLs are of low-grade, mucosa-associated lymphoid tissue type. Primary pulmonary diffuse large B-cell lymphoma (DLBCL) is extremely rare, and prompt diagnosis may be challenging since its clinical symptoms and signs are nonspecific. Although the clinical features, diagnostic procedures, optimal management and prognostic factors of this disease have not yet been well defined, open thoracotomy and chest computed tomography (CT)-guided percutaneous biopsy are the preferred methods used in previous studies. In the present case report, the diagnosis and management of a patient with primary pulmonary DLBCL is reported. A 68-year-old patient was admitted to hospital in May 2013, with complaints of shortness of breath and intermittent wheezing and a cough associated with the production of small amounts of phlegm. Following admission, chest CT scans revealed a mass in the right middle lobe with ground-glass opacities at the lesion margins, as well as air bronchograms in the areas of consolidation. Bronchoscopy was performed and revealed an endobronchial lesion and partial stenosis in the distal end of the middle segment bronchus. Transbronchial needle aspiration (TBNA) of the right hilar lymph node, as well as endobronchial biopsy, was performed. The patient was diagnosed with primary pulmonary DLBCL by subsequent histopathological and immunohistochemical analysis of biopsy specimens collected via TBNA. Following the final diagnosis, standard treatment with CHOP chemotherapy resulted in significant clinical and radiological response and the patient remained in remission 8 months later. These results indicate that TBNA may be an effective method for the diagnosis of primary pulmonary DLBCL.

A Case Of Primary Pulmonary Diffuse Large B-Cell Lymphoma Initially Suspected Of Lung Abscess

A Case Of Primary Pulmonary Diffuse Large B-Cell Lymphoma Initially Suspected Of Lung Abscess

Primary pulmonary diffuse large B‐cell lymphoma

Primary pulmonary diffuse large B‐cell lymphoma