title: [Multiple organ relapse in primary de novo CD5+ diffuse large B cell lymphoma of the bone after a complete response].
abstract: A 57-year-old woman was admitted with swelling of the femur. MRI showed that an intramedullary lesion had expanded from the trunk to the distal portion where it had formed an extramedullary tumor mass. An open biopsy showed diffuse proliferation of abnormal lymphoid cells. Immunohistochemical staining and flow cytometry demonstrated LCA+, CD3-, CD23-, CD79a+, CD5+, IgM+, IgD- and kappa + and cyclin D1-. FISH analysis did not detect t(11;14)(q13;q32). The final diagnosis was de novo CD5+ diffuse large B-cell lymphoma (DLBL) of the bone at clinical stage IEA. The patient suffered a pathological fracture in the femur after two courses of CHOP. The therapy was changed to ESHAP and irradiation. The result was assessed as a complete remission (CR). One month later, the patient presented with epigastric pain. MRI showed the tumor at the spleen and kidney and hydronephrosis due to pelvic lymphadenopathy, but did not show a tumor in the femur. An open biopsy of the pelvic lymph node showed relapse. The tumor and hydronephrosis disappeared and necrosis in the kidney was observed on MRI after ESHAP. De novo CD5+ DLBL appears to constitute a unique subset of DLBL with an aggressive clinical course and requires established therapeutic strategies.
authors.affiliation: Department of First Intenal Medicine, Osaka Medical College.
authors.forename: Shoko
authors.initials: S
authors.lastname: Nakayama
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Akioka
authors.forename: Taiji
authors.initials: T
authors.lastname: Yokote
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hara
authors.forename: Satoko
authors.initials: S
authors.lastname: Oka
authors.forename: Kazushi
authors.initials: K
authors.lastname: Yamane
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamano
authors.forename: Motomu
authors.initials: M
authors.lastname: Tsuji
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology* / Q000628:therapy; D018956:CD5 Antigens / Q000032:analysis*; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology* / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D012008:Recurrence
chemical_list: D018956:CD5 Antigens