Diffuse Large B-Cell Lymphoma Associated with Chronic Inflammation Manifested as a Soft Tissue Mass: Incidental Discovery on Histological Examination
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We report an extraordinary case of diffuse large B-cell lymphoma arising in a cystic necrotic mass in a 35-year-old man who presented with a soft tissue mass at the site of previous surgery. A benign mass was surgically removed 17 years ago, after which a cystic lesion gradually developed at the same site. The resected mass appeared as a thick-walled cyst filled with brown necrotic and hemorrhagic material. On microscopic examination, the cyst wall was primarily necrotic tissue with some aggregates of large atypical lymphoid cells. These atypical cells were diffusely positive for CD20 and showed a high proliferation index, Epstein-Barr virus positivity, and clonal rearrangement of the immunoglobulin gene. His present condition was diagnosed as Epstein-Barr virus-associated diffuse large B-cell lymphoma arising from chronic inflammation. It is important to be aware of the clinical manifestations and histological features of this rare disease in light of diagnosis and treatment.
Abstract
We report an extraordinary case of diffuse large B-cell lymphoma arising in a cystic necrotic mass in a 35-year-old man who presented with a soft tissue mass at the site of previous surgery. A benign mass was surgically removed 17 years ago, after which a cystic lesion gradually developed at the same site. The resected mass appeared as a thick-walled cyst filled with brown necrotic and hemorrhagic material. On microscopic examination, the cyst wall was primarily necrotic tissue with some aggregates of large atypical lymphoid cells. These atypical cells were diffusely positive for CD20 and showed a high proliferation index, Epstein-Barr virus positivity, and clonal rearrangement of the immunoglobulin gene. His present condition was diagnosed as Epstein-Barr virus-associated diffuse large B-cell lymphoma arising from chronic inflammation. It is important to be aware of the clinical manifestations and histological features of this rare disease in light of diagnosis and treatment.
참고문헌 (19)
- Chan JK, "Diffuse large B-cell lymphoma associated with chronic inflmmation, in WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed", pp.245~246 (2008), IARC Press
- Copie-Bergman C, "Epstein-Barr virus in B-cell lymphomas associated with chronic suppurative inflammation", J Pathol, 183, pp.287~292 (1997)
- Cheuk W, "Metallic implant-associated lymphoma: a distinct subgroup of large B-cell lymphoma related to pyothorax-associated lymphoma", Am J Surg Pathol, 29, pp.832~836 (2005)
- Fujimoto M, "EBV-associated diffuse large B-cell lymphoma arising in the chest wall with surgical mesh implant", Pathol Int, 58, pp.668~671 (2008)
- McDonald I, "Malignant lymphoma associated with internal fixation of a fractured tibia", Cancer, 48, pp.1009~1011 (1981)
- Dodion P, "Immunoblastic lymphoma at the site of an infected vitallium bone plate", Histopathology, 6, pp.807~813 (1982)
- Albat B, "Surgical treatment for primary lymphoma of the heart simulating prosthetic mitral valve thrombosis", J Thorac Cardiovasc Surg, 108, pp.188~189 (1994)
- Radhi JM, "Soft tissue malignant lymphoma at sites of previous surgery", J Clin Pathol, 51, pp.629~632 (1998)
- Ito H, "Malignant lymphoma at the site of a total hip replacement", Orthopedics, 22, pp.82~84 (1999)
- Ganapathi M, "Periprosthetic high-grade B-cell lymphoma complicating an infected revision total hip arthroplasty", J Arthroplasty, 16, pp.229~232 (2001)
- Syed AA, "Osseous malignant non-Hodgkin’s B-cell lymphoma associated with total hip replacement", Leuk Lymphoma, 43, pp.2213~2216 (2002)
- Dürrleman NM, "Cardiac lymphoma following mitral valve replacement", Ann Thorac Surg, 79, pp.1040~1042 (2005)
- O’Shea K, "Periprosthetic malignancy as a mode of failure in total hip arthroplasty", J Arthroplasty, 21, pp.926~930 (2006)
- Afrapoli AH, "Heart lymphoma 6 years after a prosthetic ascending aorta replacement: related or unrelated", Minerva Chir, 62, pp.43~45 (2007)
- Bagwan IN, "Unusual presentation of primary cardiac lymphoma", Interact Cardiovasc Thorac Surg, 9, pp.127~129 (2009)
- Miller DV, "Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses", Am J Surg Pathol, 34, pp.377~384 (2010)
- Tresnasari K, "Telomere dysfunction and inactivation of the p16(INK4a)", Rb pathway in pyothorax-associated lymphoma, 2007, pp.98, 978~984
- Loong F, "Diffuse large B-cell lymphoma associated with chronic inflammation as an incidental finding and new clinical scenarios", Mod Pathol, 23, pp.493~501 (2010)
- Yoshitomi A, "Pyothorax associated lymphoma treated by chemotherapy after thoracostomy", Nihon Kokyuki Gakkai Zasshi, 37, pp.619~622 (1999)