Diving Deep into Diagnosis: Unveiling High Grade B-cell Lymphoma

Abstract

The term “lymphoma” comprises a heterogeneous group of biologically and clinically distinct neoplasms that arise from cells in the lymphoid organs. Based on the identification of Reed-Sternberg cells (RS cells), it is divided into Hodgkin and Non-Hodgkin’s Lymphoma (NHL). Lymphadenopathy is a common presenting feature of lymphoma. Extranodal involvement may show gastrointestinal, cutaneous, neurological, or other symptoms. Hereby, the authors present a case report of 76-year-old male with non-Hodgkin’s lymphoma whose symptoms were masked by the abdominal pain of emphysematous pyelonephritis. Although the infection was treated, the patient continued to complain of dull, aching, persistent abdominal pain. As a result, the patient underwent additional radiological examinations, including a contrast-enhanced Computed Tomography (CT) scan of the abdomen-pelvis, which disclosed multiple lymphadenopathies. Hence, an endoscopic ultrasound-guided biopsy was performed from the lymph node between the portal vein and inferior vena cava, revealed High-grade B-cell Lymphoma (HGBL). The prognosis for HGBL with double- and triple-hit lymphomas is extremely bad. The patient that came to us had an early diagnosis of HGBL, which led to a favourable prognosis, in contrast to most cases of the disease, which usually manifest late in the course and are linked with a very grave prognosis.

Keywords

• emphysematous pyelonephritis
• lymphadenopathy
• non-hodgkin’s lymphomas