Laryngeal Diffuse Large B-Cell Lymphoma Presenting as Laryngeal Stenosis
Autor: | David Cua, Jinping Lai, Yaoyun Tang, Peng Li |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Larynx
Male Cancer Research Pathology medicine.medical_specialty CD30 Stridor Subglottic stenosis General Biochemistry Genetics and Molecular Biology Diagnosis Differential 03 medical and health sciences 0302 clinical medicine immune system diseases hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols medicine Biomarkers Tumor Humans Aged Pharmacology business.industry Laryngostenosis medicine.disease BCL6 Prognosis Lymphoma medicine.anatomical_structure 030220 oncology & carcinogenesis Lymphoma Large B-Cell Diffuse medicine.symptom Laryngeal Stenosis business Diffuse large B-cell lymphoma Research Article |
Popis: | Background Laryngeal stenosis is challenging for treatment due to uncertain etiology. Primary laryngeal lymphoma as the initial clinical manifestation of laryngeal stenosis has been rarely reported. Primary diffuse large B-cell lymphoma as an underlying etiology has not been reported. Case report A 79-year-old male presented with dyspnea, stridor and dysphonia of 6 months' duration. Computed tomography scans and flexible laryngoscopic examination revealed vocal cord mobility with bilaterally limited abduction and a subglottic stenosis up to 50%. The laryngeal mucosa was smooth. Laryngeal biopsy showed atypical lymphoid infiltrates, predominantly large sized B-cells, in the submucosa with crush/cauterized artifacts. The tumor cells were positive for B-lymphocyte antigen CD20, paired-box 5 (PAX5), B-cell lymphoma 2 (BCL2), BCL6 and multiple myeloma oncogene 1 (MUM1). They were negative for CD10, CD30, cyclin D1 (CCND1), SRY-box 11 (SOX11), activin-receptor like kinase 1 (ALK1), CD138 and c-MYC, and negative for kappa/lambda light chain and Epstein-Barr virus-encoded small RNA by in situ hybridization. The pathologic diagnosis was diffuse large B-cell lymphoma. Fluorescent in situ hybridization (FISH) for MYC was negative. Next-generation sequencing using a 175-gene panel was performed and no pathologic mutations were identified. No lymphadenopathy elsewhere was identified. The patient was treated with chemotherapy and was doing well at the 5-month follow-up. Conclusion To the best of our knowledge, this is the first documented case of primary laryngeal diffuse large B-cell lymphoma presenting as increasing laryngeal stenosis. The rarity, diagnosis and treatment of this entity are discussed. |
Databáze: | OpenAIRE |
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