Case Report
Version 1
Preserved in Portico This version is not peer-reviewed
Diffuse Large B-cell Lymphoma Misdiagnosed as a Hematoma: Case Report
Version 1
: Received: 21 September 2023 / Approved: 21 September 2023 / Online: 22 September 2023 (08:36:21 CEST)
A peer-reviewed article of this Preprint also exists.
Lee, J.H.; Yun, J. Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report. Medicina 2023, 59, 1775. Lee, J.H.; Yun, J. Diffuse Large B-Cell lymphoma Misdiagnosed as a Hematoma: Case Report. Medicina 2023, 59, 1775.
Abstract
Background: Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma. Due to the variety of clinical manifestations, accurate diagnosis can be challenging. Here, we present a case of DLBCL that was initially misdiagnosed as a hematoma, highlighting the importance of considering malignancy in the setting of non-responsive soft tissue swelling. Methods: A 76-year-old man presented to the emergency department with right periorbital swelling and ecchymosis. The symptoms first appeared after an injury and did not resolve spontaneously. The patient was taking warfarin for atrial fibrillation. A facial bone CT revealed a large irregular homogeneous mass. An extraconal hematoma was suspected based on clinical history and radiologic findings. Incision and drainage were performed, resulting in evacuation of old blood. Despite continued drainage, the patient's symptoms worsened. A comparison with the previous CT revealed an increase in the size of the lesion. As a result, a surgical excisional biopsy was performed. Results: Biopsy of the mass showed a diffuse infiltrate of lymphocytes around the tissue. The diagnosis of diffuse large B-cell lymphoma was confirmed pathologically. The patient was referred to hematology for further management. Conclusions: DLBCL is a rare disease associated with a poor prognosis. Due to the previous injury and the use of anticoagulants, the patient was initially misdiagnosed as having a hematoma. This delayed the prompt diagnosis and affected the timing of treatment initiation. We must be aware that a malignant mass is a potential cause of unresponsive soft tissue swelling.
Keywords
lymphoma; large B-cell; diffuse; hematoma
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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