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Diffuse large b-cell lymphoma presenting as a chest wall mass: case report with review of literature

Author: 
Dr Abhijit Ahuja, Dr. Lavina Mirchandani, Dr. Sindhu Kamath and Dr. Jayalakshmi, T.K.
Subject Area: 
Health Sciences
Abstract: 

Non Hodgkins lymphoma presenting as a mediastinal mass with localized invasion into adjoining structures and the chest wall is an extremely rare entity. Recent advances in immunohistochemistry and genetic profiling has helped to sub classify the malignancy type, which improves accuracy in treatment and in predicting prognosis. Diffuse large B cell lymphoma (DLBCL) and its subtype the mediastinal large B-cell lymphoma (MLBCL) have been identified as the most common types of Non Hodgkins lymphoma having mediastinal involvement. However the commonest lymphoma with chest wall involvement is classical Hodgkins lymphoma (cHL). Apart from the histopathological characteristics which differentiate NHL from cHL, immunohistochemistry definitively sub classifies the lymphomas. Our patient was a middle aged man who presented with a chest wall swelling, which was actually an anterior mediastinal mass locally invading adjacent structures and chest wall. Histopathology and immunochemistry wherein the tumour expressed B cell markers such asCD20 and showed weak staining for CD30 confirmed Non Hodgkins Lymphoma, diffuse large B-cell type. The primary treatment of choice for lymphoma with or without chest wall involvement is chemotherapy. CD30 DLBCL may be associated with an overall better prognosis.

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