Jornal de relatos de casos clínicos

Atypical Presentation of Transformed Follicular Lymphoma.

Abstract

Dingani Nkosi and Marie Amanze

Transformation of follicular lymphoma (FL) to Diffuse Large B-Cell Lymphoma (DLBCL) occurs commonly is and associated with a rapidly progressive clinical course that is refractory to treatment and a short survival. The clinical presentation of this transformed disease is variable. We here report a 65 years old man with an atypical presentation of transformed FL. He initially presented with symptoms and clinical signs consistent with Multiple myeloma. His bone marrow biopsy result revealed plasma cell infiltration (CD 138+, CD56-) throughout the marrow. He had a rapid progressive worsening of his condition; he developed liver and renal failure. His imaging studies revealed diffuse lymphadenopathy, an excisional lymph node biopsy done showed FL which had transformed into DLBCL with prominent plasma cell differentiation. He was treated with of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone) with overall good response but has currently relapsed.