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A case of lymphoma with multiple identities
Suria Abdul Aziz1, Alia Suzana Asri2, Azyani Yahaya3, Nasriana Nasuruddin4, Nurasyikin Yusof5, Rabeya Yousuf6, Isa Izzaki Zainal7.
Discordant lymphoma (DL) is the coexistence of two or more distinct subtypes in separate anatomic sites. There are limited reports on DL cases especially involving more than two subtypes in more than two sites. We report a 76-year-old man who presented with constitutional symptoms, flank mass and painless lymphadenopathies for six months. Laboratory tests revealed moderate anaemia, markedly elevated serum IgM (13400 mg/dL), IgM Lambda paraproteinemia and Lambda light chain paraproteinuria with unmeasurable serum lactate dehydrogenase due to hyperviscous sample. CT scan showed multiple subcutaneous masses over chest wall and retroperitoneum, with lytic bone lesions, and hepatosplenomegaly. Further biopsy findings with morphological, immunohistochemical and molecular analysis of the tissue sections revealed diffuse large B-Cell lymphoma in the chest wall mass, follicular lymphoma in the inguinal lymph node and lymphoplasmacytic lymphoma in the bone marrow. This case highlights the rare DL. The importance of histopathological evaluation of lymphoma despite the availability of PET-CT scans for disease staging is undeniable.
Affiliation:
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Malaysia
- Universiti Kebangsaan Malaysia Medical Center, Malaysia
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Indexation |
Indexed by |
MyJurnal (2021) |
H-Index
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3 |
Immediacy Index
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0.000 |
Rank |
0 |
Indexed by |
Scopus 2020 |
Impact Factor
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CiteScore (0.2) |
Rank |
Q4 (Medicine (all)) |
Additional Information |
SJR (0.144) |
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