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Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report

Background: Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin’s lymphoma, often presents diagnostic challenges due to its diverse clinical presentation. We present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering ma...

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Autores principales: Lee, Jae Hyun, Yun, Jiyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608036/
https://www.ncbi.nlm.nih.gov/pubmed/37893492
http://dx.doi.org/10.3390/medicina59101775
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author Lee, Jae Hyun
Yun, Jiyoung
author_facet Lee, Jae Hyun
Yun, Jiyoung
author_sort Lee, Jae Hyun
collection PubMed
description Background: Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin’s lymphoma, often presents diagnostic challenges due to its diverse clinical presentation. We present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering malignancy when faced with unresponsive soft tissue swelling. Methods: A 76-year-old man presented to the emergency department with right periorbital swelling and ecchymosis following a traumatic injury. Despite ongoing anticoagulant therapy (warfarin) for atrial fibrillation, the symptoms persisted. A CT scan of the facial bones revealed a large, irregular, homogeneous mass. Initially, the clinical history and radiologic findings suggested an extraconal hematoma. As a result, an incision and drainage procedure was performed, and the old blood was evacuated. However, the patient’s symptoms continued to worsen. A follow-up CT scan showed enlargement of the lesion, prompting a surgical excisional biopsy. Results: Pathologic examination of the excised mass revealed a diffuse infiltrate of lymphocytes surrounding the tissue, confirming the diagnosis of diffuse large B-cell lymphoma (DLBCL). The patient was subsequently referred to hematology for further management. Conclusions: Although rare, DLBCL is associated with a challenging prognosis. This case highlights the diagnostic complexities that can arise, particularly when factors such as prior injury and anticoagulant therapy confound the clinical picture. The initial misclassification of the condition as a hematoma led to a delay in diagnosis and the subsequent initiation of treatment. Therefore, it is imperative to remain vigilant and consider malignancy as a potential underlying cause of unresponsive soft tissue swelling. Timely recognition and accurate diagnosis are paramount to improving patient outcomes in DLBCL, an aggressive lymphoma with a diverse clinical presentation.
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spelling pubmed-106080362023-10-28 Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report Lee, Jae Hyun Yun, Jiyoung Medicina (Kaunas) Case Report Background: Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin’s lymphoma, often presents diagnostic challenges due to its diverse clinical presentation. We present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering malignancy when faced with unresponsive soft tissue swelling. Methods: A 76-year-old man presented to the emergency department with right periorbital swelling and ecchymosis following a traumatic injury. Despite ongoing anticoagulant therapy (warfarin) for atrial fibrillation, the symptoms persisted. A CT scan of the facial bones revealed a large, irregular, homogeneous mass. Initially, the clinical history and radiologic findings suggested an extraconal hematoma. As a result, an incision and drainage procedure was performed, and the old blood was evacuated. However, the patient’s symptoms continued to worsen. A follow-up CT scan showed enlargement of the lesion, prompting a surgical excisional biopsy. Results: Pathologic examination of the excised mass revealed a diffuse infiltrate of lymphocytes surrounding the tissue, confirming the diagnosis of diffuse large B-cell lymphoma (DLBCL). The patient was subsequently referred to hematology for further management. Conclusions: Although rare, DLBCL is associated with a challenging prognosis. This case highlights the diagnostic complexities that can arise, particularly when factors such as prior injury and anticoagulant therapy confound the clinical picture. The initial misclassification of the condition as a hematoma led to a delay in diagnosis and the subsequent initiation of treatment. Therefore, it is imperative to remain vigilant and consider malignancy as a potential underlying cause of unresponsive soft tissue swelling. Timely recognition and accurate diagnosis are paramount to improving patient outcomes in DLBCL, an aggressive lymphoma with a diverse clinical presentation. MDPI 2023-10-05 /pmc/articles/PMC10608036/ /pubmed/37893492 http://dx.doi.org/10.3390/medicina59101775 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Lee, Jae Hyun
Yun, Jiyoung
Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title_full Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title_fullStr Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title_full_unstemmed Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title_short Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report
title_sort diffuse large b-cell lymphoma misdiagnosed as a hematoma: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608036/
https://www.ncbi.nlm.nih.gov/pubmed/37893492
http://dx.doi.org/10.3390/medicina59101775
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