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A Case of Diffuse Large B Cell Lymphoma with Unusual Extranodal Breast, Brain Involvement and Autoimmune Hemolytic Anemia: Clinical and Radiological Presentations
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Case report
VOLUME: 56 ISSUE: 3
P: 277-284
2023

A Case of Diffuse Large B Cell Lymphoma with Unusual Extranodal Breast, Brain Involvement and Autoimmune Hemolytic Anemia: Clinical and Radiological Presentations

Acta Haematol Oncol Turc 2023;56(3):277-284
DOI: 10.5505/aot.2023.14890
İstemi Serin 1
Yuksel Erdal 2
Tahir Alper Cinli 1
Oğuz Altunok 3
Emre Eğilmez 4
Gülben Erdem Huq 5
1. University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, TURKEY
2. University of Health Sciences, Istanbul Training and Research Hospital, Department of Neurology, Istanbul, TURKEY
3. University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Istanbul, TURKEY
4. University of Health Sciences, Istanbul Training and Research Hospital, Department of Neurosurgery, Istanbul, TURKEY
5. University of Health Sciences, Istanbul Training and Research Hospital, Department of Pathology, Istanbul, TURKEY
6.
No information available.
No information available
Received Date: 2023-02-19T17:03:40
Accepted Date: 2023-12-04T07:29:30
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Abstract

Diffuse large B cell lymphoma (DLBCL) is a heterogeneous tumor group consisting of large and transformed B cells that make up 30-40% of all non-Hodgkin lymphomas. Extranodal breast involvement of DLBCL is very rare. We present a case of breast derived DLBCL who presented with coombs positive hemolytic anemia and neurological symptoms. A 54-year-old female patient was admitted to the emergency department with complaints of weakness and palpitations. Hemolytic anemia was considered in the foreground in the patient who did not show atypical cells in the peripheral blood smear. There were an increased fluorodexiglucose uptake detected in the middle and upper quadrant of the left breast in positron emission to-mography–computed tomography. She had impaired consciousness, her speech was dysarth-ric, orientation restricted, muscular strength and sensory examination was natural, and there was no pathological reflex. Cranial magnetic resonance imaging revealed a T2 and FLAIR hyperintense lesion at the pons level, which did not correspond to apparent diffusion coeffi-cient, and had an expansile feature that restricted the diffusion. In the tru-cut biopsy of the breast associated mass, CD20 (+), PAX5 (+), CD3 (-), CD5 (-) large b-cell lymphoma infiltra-tion was observed. The patient's need for transfusion regressed after a course of R-CHOP and MTX treatment. The patient's neurological symptoms and radiological findings improved and regressed completely after one course of therapy. This patient makes a significant contribution to the literature in terms of referring with neurological symptoms, getting a diagnosis of DLBCL from the breast associated mass during the investigation of autoimmune hemolytic anemia etiology and treatment preference.