Mahashabde Madhulika L, Bhavsar Harin M, Bhimani Yash R
General Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Pune, IND.
Cureus. 2024 Aug 2;16(8):e65991. doi: 10.7759/cureus.65991. eCollection 2024 Aug.
Lymphoma arises from mature B, T, and natural killer (NK) cells. Lymphomas are classified into Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). Diffuse large B-cell lymphoma (DLBCL) is a type of NHL. It can present with symptoms such as fever, chills, or night sweats, as well as symptoms due to extranodal involvement. Extranodal sites can include the gastrointestinal tract or renal involvement. A higher risk of developing diffuse large B-cell lymphoma (DLBCL) is seen in patients with congenital or acquired immunodeficiency, those on immunosuppression, and those with autoimmune disorders. In this case report, we present a case of pericardial effusion that, upon further evaluation, was diagnosed as diffuse large B-cell lymphoma (DLBCL). A 64-year-old male presented with complaints of retrosternal chest pain that progressed from New York Heart Association (NYHA) Grade II to IV over a month. The chest pain was moderate intensity, dull aching, and non-radiating. It was associated with orthopnea, paroxysmal nocturnal dyspnea, and anasarca. A chest X-ray (posteroanterior {PA} view) showed cardiomegaly with an increased cardiothoracic ratio, mediastinal widening, and pulmonary congestion. Echocardiography revealed moderate non-tappable pericardial effusion. A high-resolution computed tomography (HRCT) chest scan showed moderate pericardial effusion and a homogeneous enhancing mass in the left anterior superior mediastinum. A computed tomography (CT)-guided biopsy was performed to check for lymphoma, thymoma, or tuberculosis. The patient was diagnosed with diffuse large B-cell lymphoma (DLBCL). Owing to the diverse manifestations of diffuse large B-cell lymphoma (DLBCL), prompt diagnosis is required for controlling disease progression.
淋巴瘤起源于成熟的B细胞、T细胞和自然杀伤（NK）细胞。淋巴瘤分为霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）。弥漫性大B细胞淋巴瘤（DLBCL）是NHL的一种类型。它可表现出发热、寒战或盗汗等症状，以及结外受累引起的症状。结外部位可包括胃肠道或肾脏受累。先天性或获得性免疫缺陷患者、接受免疫抑制治疗的患者以及患有自身免疫性疾病的患者发生弥漫性大B细胞淋巴瘤（DLBCL）的风险更高。在本病例报告中，我们介绍了一例心包积液病例，经进一步评估后被诊断为弥漫性大B细胞淋巴瘤（DLBCL）。一名64岁男性主诉胸骨后胸痛，在一个月内从纽约心脏协会（NYHA）II级进展至IV级。胸痛强度适中，为钝痛，无放射痛。它与端坐呼吸、阵发性夜间呼吸困难和全身性水肿有关。胸部X线（后前位{PA}片）显示心脏增大，心胸比增加，纵隔增宽，肺淤血。超声心动图显示中度不可压缩性心包积液。胸部高分辨率计算机断层扫描（HRCT）显示中度心包积液，左前上纵隔有一均匀强化肿块。进行了计算机断层扫描（CT）引导下活检以检查是否存在淋巴瘤、胸腺瘤或结核病。该患者被诊断为弥漫性大B细胞淋巴瘤（DLBCL）。由于弥漫性大B细胞淋巴瘤（DLBCL）表现多样，需要及时诊断以控制疾病进展。
