ID 112987
Title Alternative
De novo CD 20‐negative diffuse large B‐cell lymphoma developed with sustained fever and markedly high C‐reactive protein level
CD20陰性DLBCL
Author
Miyakami, Yuko Tokushima University
Okamoto, Yasunobu Tokushima University
Takahashi, Mamiko Tokushima University
Iwasa, Masami Tokushima University
Keywords
CD20
fever of unknown origin
diffuse large B-cell lymphoma
CRP
Content Type
Journal Article
Description
A 68-year-old woman presented with sustained fever for more than 1 month and admitted due to hematemesis and systemic edema. Computed tomography scan revealed swelling of the cervical, paraaortic lymph nodes. Blood test results showed severe anemia, elevation of white blood cell count, elevation of liver enzyme and coagulopathy with high C-reactive protein. Biopsy of the right cervical lymph node showed proliferation of abnormal lymphoid cells with necrosis and hemorrhage, which are positive for CD79α, CD30, MUM‐1, and bcl‐6 and negative for CD20, CD5, CD10, ALK, CD38, CD138, and EBER. Gene rearrangement of immunoglobulin heavy chain was detected in tumor cells. Bone marrow aspiration showed tumor involvement. The patient was diagnosed with de novo CD20‐negative diffuse large B-cell lymphoma(DLBCL)stage IV B. Reduced CHOP therapy was performed under artificial respiration due to pulmonary edema and takotsubo cardiomyopathy. Although her general condition and high CRP levels temporarily improved, she died 47 days after admission due to rapid relapse. De novo CD20‐negative DLBCL was rare and presented with high CRP levels and rapid progression, and was thought to be clinically different from the existing DLBCL. It is imperative to elucidate molecular pathophysiology and establish new treatment strategy for de novo CD20‐negative DLBCL.
Journal Title
Shikoku Acta Medica
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
74
Issue
5-6
Start Page
193
End Page
200
Sort Key
193
Published Date
2018-12-25
FullText File
language
jpn
TextVersion
Publisher
departments
Medical Sciences
University Hospital