A case of diffuse large B-cell lymphoma originating from chest wall complicated by benign asbestos pleural effusion

Our plain-English summary of A case of diffuse large B-cell lymphoma originating from chest wall complicated by benign asbestos pleural effusion, by N. Kondo, Y. Inoue, H. Takeyama, et al (Respirology Case Reports, 2021).

The study

• Authors: N. Kondo, Y. Inoue, H. Takeyama, A. Kobayashi, O. Matsubara, Y. Jinn
• Journal: Respirology Case Reports
• Published: 2021;9(3):e00714
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A 78-year-old man with exposure to asbestos was admitted to our hospital for back pain. A chest computed tomography showed right pleural effusion and a significant increase in the size of masses in the right chest wall over an interval of six months. He did not undergo further examinations and expired one month later. Autopsy revealed the presence of diffuse large B-cell lymphoma (DLBCL) and complicated by benign asbestos pleural effusion. We considered that this tumour had originated from the soft tissue in the chest wall based on the radiological and autopsy findings. The present report highlights that primary DLBCL of chest wall might be associated with chronic inflammation due to asbestos-related pleural diseases.

© 2021 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.

In plain English

This case report describes one patient, a 78-year-old Japanese man who had worked as an arc welder for 26 years and had a 25 pack-year smoking history. The article reports that he was exposed to asbestos but does not give the source or the fiber type. Six years before admission he had been diagnosed with benign asbestos pleural effusion, after a pleural biopsy showed fibrous plaques without cancer. He was admitted with two months of right back pain. Scans showed masses in the right chest wall that had grown markedly over six months. Fluid tests and a biopsy gave no diagnosis, and because of other illnesses he received palliative care. He died one month after admission. Autopsy found pleural plaques, asbestos bodies in the lungs, and diffuse large B-cell lymphoma that tested negative for Epstein–Barr virus. The final diagnosis was primary lymphoma of the chest wall with benign asbestos pleural effusion. The authors suggested this lymphoma might be associated with chronic inflammation from asbestos-related pleural disease. They concluded that chest wall lymphoma should be considered when a chest wall tumour occurs in someone exposed to asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient, confirmed by autopsy)
• Who was studied: One 78-year-old Japanese man with a 25 pack-year smoking history, treated at Hiratsuka Kyosai Hospital, Hiratsuka, Japan; dates of care not stated
• Exposure: Asbestos exposure (source and fiber type not stated); the patient worked as an arc welder for 26 years; asbestos bodies were found in the lungs at autopsy
• Main results:
  • Six years before admission, the patient was diagnosed with benign asbestos pleural effusion after a pleural biopsy showed fibrous plaques without malignant findings
  • Laboratory tests showed anaemia (haemoglobin 8.5 g/dL) and raised serum lactate dehydrogenase (453 IU/L) and soluble interleukin-2 receptor (9740 U/mL)
  • Pleural fluid analysis and pleural biopsy did not establish a diagnosis while the patient was alive; he received palliative care and died one month after admission
  • Autopsy showed pleural plaques, and asbestos bodies were found in the lungs
  • The tumour was a lymphoma with high Ki67 expression (80%), and it was negative for Epstein–Barr virus
  • Final diagnosis: primary diffuse large B-cell lymphoma of the chest wall, complicated by benign asbestos pleural effusion
• The authors' conclusion: The authors concluded that chest wall lymphoma should be considered as a possibility in a chest wall tumour when there is a background of asbestos exposure, and suggested it might be associated with chronic inflammation from asbestos-related pleural diseases

Topics

Medical terms in this study, explained in our Lexicon: Benign Asbestos Pleural Effusion, Pleural Effusion, Autopsy, Chronic Inflammation, Asbestos-Related Pleural Disease.

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