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作 者:Daisuke Usuda Toshihide Izumida Nao Terada Ryusho Sangen Toshihiro Higashikawa Sayumi Sekiguchi Risa Tanaka Makoto Suzuki Yuta Hotchi Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Yoshie Takagi Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Yuji Kasamaki
机构地区:[1]Department of General Medicine,Kanazawa Medical University Himi Municipal Hospital,Himi-shi 935-8531,Toyama-ken,Japan [2]Department of Emergency and Critical Care Medicine,Juntendo University Nerima Hospital,Nerima-ku 177-0035,Tokyo-to,Japan [3]Kanazawa Medical University Himi Municipal Hospital,Himi-shi 935-8531,Toyama-ken,Japan
出 处:《World Journal of Clinical Cases》2021年第23期6886-6899,共14页世界临床病例杂志
摘 要:BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common type of malignant lymphoma(ML),accounting for 30%-40%of cases of non-Hodgkin’s lymphoma(NHL)in adults.Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17%of all lymphomas.ML from the maxillary sinus(MS)is a particularly rare presentation,and is thus often difficult to diagnose.We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastasis.CASE SUMMARY An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve area.His medical history included splenectomy due to a traffic injury,an old right cerebral infarction from when he was 74-years-old,hypertension,and type 2 diabetes mellitus.A plain head computed tomography(CT)scan revealed a 3 cm×3.1 cm×3 cm sized left MS.On day 25,left diplopia and ptosis occurred,and a follow-up CT on day 31 revealed the growth of the left MS mass.Based on an MS biopsy on day 50,we established a definitive diagnosis of DLBCL,non-germinal center B-cell-like originating from the left MS.The patient was admitted on day 62 due to rapid deterioration of his condition,and a plain CT scan revealed the further growth of the left MS mass,as well as multiple systemic metastasis,including of the skin.A skin biopsy on day 70 was found to be the same as that of the left MS mass.We notified the patient and his family of the disease,and they opted for palliative care,considering on his condition and age.The patient died on day 80.CONCLUSION This case suggests the need for careful,detailed examination,and for careful follow-up,when encountering patients presenting with a mass.
关 键 词:Diffuse large B cell lymphoma Non-germinal center B-cell-like lymphoma Malignant lymphoma Maxillary sinus Skin metastasis Case report
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