Kyaw Aye-Mya-Mya, Aye Than-Than, Htun Lin-Lin
Gastroenterology Department, Thingangyun General Hospital, Yangon, Myanmar.
Pathology Department, Thingangyun General Hospital, Yangon, Myanmar.
Case Rep Gastrointest Med. 2022 Feb 27;2022:2687291. doi: 10.1155/2022/2687291. eCollection 2022.
Diffuse large B cell lymphoma (DLBCL) is the histological subtype of non-Hodgkin's lymphoma, representing approximately 30%. The most common primary extranodal sites of DLBCL are the gastrointestinal (GI) tract, the head and neck, and the skin/soft tissue. We report a case of DLBCL with cutaneous involvement presenting with skin nodules and GI manifestations such as obstructive jaundice and upper GI bleeding. Malignant cystic pancreatic tumor occupying the head and body with invasion to lower end of common bile duct and periampullary region causing biliary obstruction and mesenteric lymphadenopathy were found in abdominal computed tomography and endoscopic ultrasonography. There was also a large gastric ulcer (Forrest IIa) at the greater curvature of body of the stomach. Histopathological results of the skin and stomach were consistent with diffuse large B cell lymphoma; gastric biopsy being negative for leucocyte common antigen. The patient was considered to have disseminated DLBCL. The aim of the present case report was to present the clinical, radiological, and histological characteristics of the patient, which may aid physicians in diagnosing involvement of multiple extranodal sites in DLBCL.
弥漫性大B细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤的组织学亚型，约占30%。DLBCL最常见的原发结外部位是胃肠道（GI）、头颈部以及皮肤/软组织。我们报告一例伴有皮肤受累的DLBCL病例，表现为皮肤结节以及GI表现，如梗阻性黄疸和上消化道出血。腹部计算机断层扫描和内镜超声检查发现，恶性囊性胰腺肿瘤占据胰头和胰体，侵犯胆总管下端和壶腹周围区域，导致胆道梗阻和肠系膜淋巴结病。胃体大弯处还有一个大的胃溃疡（福里斯特IIa级）。皮肤和胃的组织病理学结果与弥漫性大B细胞淋巴瘤一致；胃活检白细胞共同抗原为阴性。该患者被认为患有播散性DLBCL。本病例报告的目的是展示该患者的临床、放射学和组织学特征，这可能有助于医生诊断DLBCL累及多个结外部位。
