Misdiagnosis of primary pleural DLBCL as tuberculosis: A case report and literature review

Yang,Xinmei; Xu,Xiaofang; Song,Binbin; Zhou,Qiang; Zheng,Ying

doi:10.3892/mco.2018.1601

June-2018 Volume 8 Issue 6

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June-2018 Volume 8 Issue 6

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Case Report Open Access

Misdiagnosis of primary pleural DLBCL as tuberculosis: A case report and literature review

Authors:
- Xinmei Yang
- Xiaofang Xu
- Binbin Song
- Qiang Zhou
- Ying Zheng
View Affiliations / Copyright

Affiliations: Department of Oncology, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314001, P.R. China, The Central Laboratory, The First Hospital of Jiaxing, Jiaxing, Zhejiang 314001, P.R. China

Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 729-732
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Published online on: April 2, 2018

https://doi.org/10.3892/mco.2018.1601
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Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non‑Hodgkin lymphoma (NHL). DLBCL presents with pleural involvement at an advanced stage; however, primary pleural lymphomas without any other site of involvement are rare, and the possibility of misdiagnosis is high, particularly in developing countries, where tuberculosis or other severe pulmonary infections remain a major health concern. Furthermore, lymphoma and tuberculosis share a number of common clinical characteristics, such as fever, night sweats, feeling of satiety after a small meal, fatigue and unexplained weight loss, among others. We herein describe a case of misdiagnosis of primary pleural lymphoma as tuberculosis in a 49‑year‑old male patient who presented with pleural effusion and high adenosine deaminase (ADA) level in the pleural fluid. Anti‑tuberculosis treatment was administered for 1 month, but the patient's condition deteriorated. A surgical biopsy was performed and was diagnostic of DLBCL. CHOP chemotherapy was administered with a significant delay due to the misdiagnosis, and it was not efficient, as rituximab was not added to the regimen. The therapeutic efficacy was monitored by computed tomography scans, which revealed that the lesion had shrunk slightly. The overall survival of the patient was ~1 year and he eventually succumbed to severe thoracic infection and pleural effusion. Suspicion should be raised when a patient presents with pleural effusion and extremely high ADA levels, as ADA activity of >250 U/L should raise the suspicion of empyema or lymphoma rather than tuberculosis.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Misdiagnosis of primary pleural DLBCL as tuberculosis: A case report and literature review

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Abstract

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