弥漫性大B细胞淋巴瘤(DLBCL)的结外受累定义为淋巴结外疾病,最多可发生在三分之一的患者中。尽管多器官结外受累很少见。这里,我们描述了一个患者出现广泛转移性病变的病例,包括肺的受累,腮腺,乳房,胰腺,股骨和多个软组织肿块,最初担心原发性乳腺恶性肿瘤。乳腺病理和影像学与三重表达者一致,双重打击IV期高级别B细胞淋巴瘤,广泛的结外受累。结外受累是与高治疗失败率相关的不良预后因素,和靶向CD19的新疗法目前正在研究复发和难治性DLBCL。结外疾病是一种复杂的实体,几乎可以涉及任何器官系统,应考虑新的恶性肿瘤表现。
Extranodal involvement in diffuse large B-cell lymphoma (DLBCL) is defined as disease outside of the lymph nodes and occurs in up to one-third of patients, though multiorgan extranodal involvement is rare. Here, we describe a case of a patient presenting with widely metastatic lesions, including involvement of the lung, parotid gland, breast, pancreas, femur and multiple soft tissue masses, with initial concern for primary breast malignancy. Breast pathology and imaging were consistent with triple-expressor, double-hit stage IV high-grade B-cell lymphoma with extensive extranodal involvement. Extranodal involvement is a poor prognostic factor associated with high rates of treatment failure, and novel therapies targeting CD19 are currently being studied for relapsed and refractory DLBCL. Extranodal disease is a complex entity that can involve virtually any organ system and should be considered for new presentations of malignancy.