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Elevated FGR protein expression identifies a high-risk subset of diffuse large B-cell lymphoma and a potential therapeutic target.

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, and despite effective first-line immunochemotherapy a substantial proportion of patients develop relapse/refractory (RR) disease, underscoring the need for practical biomarkers beyond clinical risk scores. METHODS: We retrospectively evaluated FGR protein expression by immunohistochemistry (IHC) in 91 patients with de novo DLBCL treated with first-line R-CHOP. FGR staining was scored using an immunoreactive score (IRS), and high expression was defined as IRS ≥ 2. Associations with RR events and survival

Primary hepatic diffuse large B-cell lymphoma in a patient with polycystic liver disease: a case report and literature review.

Primary hepatic lymphoma (PHL) is an extremely rare extranodal non-Hodgkin lymphoma confined to the liver, accounting for <0.016% of all non-Hodgkin lymphomas. Polycystic liver disease (PLD) is a benign genetic disorder characterized by multiple hepatic cysts. The coexistence of PHL in a patient with PLD has not been previously reported. A 68-year-old woman with a long-standing history of polycystic liver and kidney disease presented with progressive abdominal distension. Laboratory tests showed markedly elevated lactate dehydrogenase (947 IU/L) and soluble interleukin-2 receptor (599 U/mL), w

A case of bone marrow-liver-spleen type diffuse large B-cell lymphoma: importance of rapid diagnosis and therapeutic intervention.

Bone marrow-liver-spleen (BLS)-type diffuse large B-cell lymphoma (DLBCL) is a rare and aggressive variant characterized by primary involvement of the bone marrow, liver, and spleen without lymphadenopathy. We describe the case of a 73-year-old woman who presented with multiorgan failure complicated by disseminated intravascular coagulation and clinical features suggestive of secondary hemophagocytic lymphohistiocytosis. Prompt initiation of intensive chemotherapy (R-CHOP: Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone) guided by characteristic clinical findings includ

Marked variation in eligibility criteria across registrational trials for relapsed diffuse large B-cell lymphoma limits applicability to clinical practice.

Therapeutic options for relapsed or refractory diffuse large B-cell lymphoma (rDLBCL) have expanded following accelerated approvals based largely on surrogate end-points, yet confirmatory studies have not consistently reproduced these benefits across all agents, and outcomes for many patients remain poor. Restrictive and heterogeneous eligibility criteria further limit generalisability of trial findings to routine populations. We examined eligibility criteria across seven registrational rDLBCL trials and applied them hypothetically to a real-world cohort of 180 patients treated in Australia wi

Case report: Diffuse large B-cell lymphoma associated with chronic inflammation presenting as a rapidly enlarging perigraft hematoma after TEVAR.

Thoracic endovascular aortic repair (TEVAR) has become the primary treatment for Stanford type B aortic dissection. The differential diagnosis of postoperative periaortic masses typically focuses on hematoma, endoleak, or graft infection. We report the case of a patient who underwent repeat TEVAR for stent-graft fracture 8 years after the index procedure. A periaortic hypodense lesion identified on preoperative computed tomography (CT) was initially interpreted as a hematoma but rapidly progressed into a large soft-tissue mass shortly after the secondary intervention, accompanied by a marked e

A Dual Response to CD20xCD3 Bispecific Therapy: Remission of Relapsed Diffuse Large B-cell Lymphoma and Improvement in Immune Thrombocytopenia.

Immune thrombocytopenia (ITP) is an autoimmune cytopenia that may occur in association with lymphoproliferative disorders. In such cases, treatment of the underlying malignancy may influence platelet recovery. CD20xCD3 bispecific antibodies have become important options for relapsed or refractory diffuse large B-cell lymphoma (DLBCL), but their effect on coexisting autoimmune cytopenias is not well defined. We report the case of an 81-year-old woman with relapsed DLBCL arising from an underlying marginal zone lymphoma and longstanding ITP. She achieved complete metabolic remission with initial

Case Report: Diagnostic pitfall and biomarker-guided therapy in CD20-negative Epstein-Barr virus-positive diffuse large B-cell lymphoma.

De novo CD20-negative Epstein-Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified (EBV+ DLBCL, NOS), is a rare subtype of DLBCL. CD20 loss complicates both diagnosis and treatment by limiting anti-CD20 antibody use and broadening differential diagnosis. We report a case where comprehensive immunophenotypic and molecular analyses enabled accurate diagnosis. A biomarker-driven strategy combining CD30-targeted therapy and PD-1 blockade achieved a complete metabolic response. This case underscores the importance of biology-based individualized treatment in EBV-associated lym

Obstructive Jaundice Revealing Primary Diffuse Large B-Cell Lymphoma of the Ampulla of Vater in a Child: A Case Report.

INTRODUCTION: Primary lymphoma of the ampulla of Vater is an exceptionally rare entity, with most reported cases being low-grade B-cell lymphomas in adults. Diffuse large B-cell lymphoma (DLBCL) at this site is markedly aggressive and exceedingly uncommon in the pediatric population. CASE PRESENTATION: An 11-year-old male presented with obstructive jaundice. Abdominal ultrasound revealed a dilated gallbladder. Endoscopic retrograde cholangiopancreatography (ERCP) identified a fungating mass at the ampulla of Vater, causing significant biliary dilation. Histopathological and immunohistochemica

Epstein-Barr Virus-positive Diffuse Large B-cell Lymphoma Presenting as Pyrexia of Unknown Origin Complicated by Paraneoplastic Neurological Syndrome.

Chikungunya virus (CHIKV) infection is an arboviral disease transmitted by Aedes mosquitoes, typically presenting with fever, rash, and polyarthralgia. Neurological complications such as meningitis are rare and more often seen in neonates and immunocompromised individuals. Hepatic involvement is also uncommon, with only a few reports describing significant hepatitis in the absence of other risk factors. We report the case of a 68-year-old male, previously healthy with no comorbidities, who presented with acute febrile illness followed by severe headache, neck stiffness, and altered sensorium.

CD20-Negative Primary Intestinal Diffuse Large B-cell Lymphoma With TP53 Mutation in Poorly Controlled Celiac Disease: A Diagnostic Challenge.

Celiac disease (CD) is associated with an increased risk of intestinal lymphoma, predominantly of T-cell origin. Primary intestinal large B-cell lymphoma arising in the setting of CD is exceptionally rare. We report the case of a 34-year-old woman with poorly controlled CD who presented with abdominal pain, weight loss, and diarrhea. CT revealed a large jejunal mass. The patient underwent segmental jejunal resection with lymph node dissection. Histological examination showed a diffuse proliferation of large atypical lymphoid cells with focal anaplastic features. Immunohistochemical analysis de

Coexistence of diffuse large B-cell lymphoma and lung adenocarcinoma in one lymph node: a case report and literature review.

Older men demonstrate heightened susceptibility to both diffuse large B-cell lymphoma (DLBCL) and lung adenocarcinoma. Nevertheless, synchronous presentation of DLBCL and adenocarcinoma within the same lymph node remains exceptionally rare. A 70-year-old Chinese man presented with a 1-year history of a productive cough with white sputum, progressive shortness of breath, and chest tightness. The patient received four cycles of R-CHOP immunochemotherapy directed at the DLBCL. Cervical lymphadenopathy decreased markedly after treatment, and no obvious lymphoma progression was documented during th

Extranodal diffuse large B-cell lymphoma presenting as a rapidly growing palatal mass in a patient with prior breast carcinoma.

A rapidly growing palatal swelling poses a diagnostic challenge due to its wide differential, including odontogenic, epithelial, salivary gland, mesenchymal and haematolymphoid pathologies. We report the case of an elderly female with a history of treated breast carcinoma who presented with a solitary palatal mass. Clinical and radiographic findings initially raised suspicion of a metastatic lesion because of the patient's previous malignancy, rapid lesion enlargement, firm fixation, bone erosion, sinus extension and cervical lymphadenopathy. However, histopathological examination and immunohi

Prolonged chimeric antigen receptor-T apheresis to infusion time is associated with inferior outcomes in diffuse large B-cell lymphoma.

Chimeric antigen receptor (CAR) T-cell therapy is effective for relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL). However, delays between apheresis and infusion frequently occur due to limited facility capacity and prolonged bridging therapy, and the clinical impact of such delays remains uncertain. We retrospectively analysed R/R DLBCL patients who underwent CAR-T-cell therapy at Kyoto University Hospital. Among 90 patients, the median apheresis to infusion interval was 66 days (range, 28-203). Patients were categorized into delayed (≥66 days) and non-delayed (<66 days) groups.

Tumor Lesion Uptake of [ 177 Lu]Lu-DOTA-Rituximab in Skeletal and Splenic Disease in Diffuse Large B-Cell Lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, and a sizable fraction of the DLBCL patients presents with advanced, relapsed, and refractory disease, demonstrating poor response to standard chemotherapy regimens. Radioimmunotherapy (RIT) has shown to be clinically effective in refractory DLBCL. We present the case of a patient with DLBCL with [ 18 F]FDG-avid widespread skeletal as well as splenic involvement as poor prognostic extranodal disease on FDG PET/CT. RIT based on [ 177 Lu]Lu-DOTA-rituximab was explored to study the biodistribution and dosimetry

Survival and Outcome of Patients with Diffuse Large B-cell Lymphoma According to the Central Nervous System-International Prognostic Index.

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Several prognostic scores exist in DLBCL, including the International Prognostic Index (IPI). More recently, a modification of the IPI that estimates the risk of progression to the central nervous system (CNS-IPI) was published. Whether the CNS-IPI index is sufficient to prognosticate DLBCL survival is yet untested. OBJECTIVES: We aim to describe the outcomes of DLBCL patients based on CNS-IPI risk groups. METHODS: We retrospectively reviewed all DLBCL cases diagnosed from January 2015 until Ap

Transient penile erection following lumbar puncture with intrathecal prophylaxis in primary testicular diffuse large B-cell lymphoma: a case report.

Primary testicular diffuse large B-cell lymphoma (PT-DLBCL) is a rare and aggressive extranodal non-Hodgkin lymphoma that predominantly affects older men and carries a relatively high risk of central nervous system (CNS) relapse. Although lumbar puncture with intrathecal prophylaxis is commonly employed to reduce CNS involvement, transient penile erection after this procedure is extraordinarily rare. This case report describes a 51-year-old man diagnosed with PT-DLBCL (stage IA) who underwent right radical orchiectomy, followed by six cycles of R2-CHOP chemotherapy with intrathecal prophylaxis

Prognostic Role of Beta-2 Microglobulin in Diffuse Large B-Cell Lymphoma: Systematic Review and Meta-Analysis of Observational Studies.

BACKGROUND: Evidence indicates that beta-2 microglobulin (β2M) plays a prognostic role in patients with diffuse large B-cell lymphoma (DLBCL). AIM: However, due to controversies among previous studies, this meta-analysis was conducted to evaluate the prognostic role of β2M in DLBCL patients. METHODS AND RESULTS: Relevant studies were identified through a systematic search using specific keywords in PubMed/Medline, Scopus, and Web of Science databases. Studies that provided complete information on the hazard ratio with a 95% confidence interval for β2M with respect to overall survival (OS) an

Artificial Intelligence for Risk Stratification in Diffuse Large B-Cell Lymphoma: A Systematic Review of Classification Models and Predictive Performances.

Background: Diffuse large B-cell lymphoma (DLBCL) is a biologically heterogeneous malignancy, with various outcomes despite significant advances in therapeutic options. Current conventional prognostic tools, e.g., the International Prognostic Index (IPI), lack sufficient precision at an individual patient level. However, artificial intelligence (AI), including machine learning (ML) and deep learning (DL), can enable specialists to navigate complex datasets, with the final aim of improving prognostic models for DLBCL. Objectives: This scoping review aims to systematically map the current litera

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… The subsequent search strings, designed for comprehensive discovery, were applied: PubMed/MEDLINE: ((“Lymphoma, Large B-Cell, Diffuse”[Mesh]) AND “Prognosis”[Mesh]) AND “Artificial Intelligence”[Mesh] Scopus: TITLE-ABS-KEY ((“diffuse large B-cell lymphoma” OR DLBCL) AND (prognosis OR prognostic) AND …

Improving access to chimeric antigen receptor T-cells for refractory or relapsing diffuse large B cell lymphoma therapy in Asia.

Chimeric antigen receptor T-cell (CAR-T)-mediated therapies have shown promising clinical benefit in patients with refractory or relapsing (R/R) diffuse large B-cell lymphoma (DLBCL). However, CAR-T treatment presents challenges such as lack of drug accessibility, financial barriers, variable physician preference or experience, and risk assessment based on patient-specific characteristics. This article thus aims to provide an overview of the CAR-T landscape for R/R DLBCL in Asia, with a focus on identifying barriers to access, from the perspective of Asian and international lymphoma experts. P