Project Title

When Imaging Predicts Aggressiveness of Large B Cell Lymphoma Biology

Authors' Affiliations

Ahmed Minhas, MS4, ETSU Quillen College of Medicine Megan Ververis, MS3, ETSU Quillen College of Medicine Rossa Khalaf, MD, ETSU Quillen College of Medicine, Internal Medicine, Division of Oncology Elnora Spradling, MD, ETSU Quillen College of Medicine, Internal Medicine, Division of Oncology

Location

Mt. Mitchell Room 220

Start Date

4-5-2018 8:00 AM

End Date

4-5-2018 12:00 PM

Poster Number

132

Name of Project's Faculty Sponsor

Elnora Spradling

Faculty Sponsor's Department

ETSU Quillen College of Medicine Oncology

Type

Poster: Competitive

Classification of First Author

Medical Student

Project's Category

Biomedical and Health Sciences

Abstract Text

Case Report: Diffuse Large B Cell Lymphoma (DLBCL) is an aggressive tumor of B cells that can arise almost anywhere in the body. It is the most common type of non-Hodgkin lymphoma in adults. We report a case of double hit lymphoma, a rare subtype that has an abnormal MYC and BCL2 gene translocation and occurs in about 5% of DLBCLs. A 58-year-old male with a 15-year smoking history presented with abdominal pain accompanied by weight loss of 20 lbs, night sweats, poor appetite, and fatigue. CT angiogram showed posterior mediastinal mass 3.5x5.6x12.8 cm, massive lymphadenopathy in the retroperitoneum surrounding aorta 10.5x5.2x11cm and a large left upper quadrant mesenteric mass measuring 7.2x10.2x13.6 cm. Left abdominal mass was biopsied and pathology showed DLBCL. FISH showed double hit lymphoma. Bone marrow biopsy and aspiration was negative for involvement. LV EF was 61% per ECHO. Patient underwent PET/CT, which showed extensive adenopathy in the inferior neck, chest, and abdomen, as well as a retroperitoneal mass extending into T10-11 extradural space. International Prognostic Index (IPI) for DLBCL categorized the patient as having a poor prognosis and in the high-intermediate risk group with a 4 year overall survival of 55% and 4 year progression-free survival of 53%. The PET scan results showing multiple extranodal sites was a factor in calculating his prognosis. MRI T spine with contrast showed direct invasion of T9, 10, 11, and 12. Urgent chemotherapy was started with DA-R-EPOCH.

Our case demonstrates how imaging predicts the aggressiveness of DLBCL biology. The PET scan is very important in determining the extent of disease and the stage to allow for risk stratification of patients with DLBCL.

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Apr 5th, 8:00 AM Apr 5th, 12:00 PM

When Imaging Predicts Aggressiveness of Large B Cell Lymphoma Biology

Mt. Mitchell Room 220

Case Report: Diffuse Large B Cell Lymphoma (DLBCL) is an aggressive tumor of B cells that can arise almost anywhere in the body. It is the most common type of non-Hodgkin lymphoma in adults. We report a case of double hit lymphoma, a rare subtype that has an abnormal MYC and BCL2 gene translocation and occurs in about 5% of DLBCLs. A 58-year-old male with a 15-year smoking history presented with abdominal pain accompanied by weight loss of 20 lbs, night sweats, poor appetite, and fatigue. CT angiogram showed posterior mediastinal mass 3.5x5.6x12.8 cm, massive lymphadenopathy in the retroperitoneum surrounding aorta 10.5x5.2x11cm and a large left upper quadrant mesenteric mass measuring 7.2x10.2x13.6 cm. Left abdominal mass was biopsied and pathology showed DLBCL. FISH showed double hit lymphoma. Bone marrow biopsy and aspiration was negative for involvement. LV EF was 61% per ECHO. Patient underwent PET/CT, which showed extensive adenopathy in the inferior neck, chest, and abdomen, as well as a retroperitoneal mass extending into T10-11 extradural space. International Prognostic Index (IPI) for DLBCL categorized the patient as having a poor prognosis and in the high-intermediate risk group with a 4 year overall survival of 55% and 4 year progression-free survival of 53%. The PET scan results showing multiple extranodal sites was a factor in calculating his prognosis. MRI T spine with contrast showed direct invasion of T9, 10, 11, and 12. Urgent chemotherapy was started with DA-R-EPOCH.

Our case demonstrates how imaging predicts the aggressiveness of DLBCL biology. The PET scan is very important in determining the extent of disease and the stage to allow for risk stratification of patients with DLBCL.