Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2018; 6(6): 121-126
Published online Jun 16, 2018. doi: 10.12998/wjcc.v6.i6.121
T-cell/histiocyte-rich large B-cell lymphoma in a child: A case report and review of literature
Chapman Wei, Chaplin Wei, Omar Alhalabi, Lei Chen
Chapman Wei, George Washington University School of Medicine and Health Sciences at Washington, DC 20052, United States
Chaplin Wei, St. George’s University School of Medicine, West Indies, Grenada
Omar Alhalabi, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center at Houston, TX 77030, United States
Lei Chen, Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School at Houston, TX 77030, United States
Author contributions: Chen L designed the study; Alhalabi O and Chen L collected patient’s clinical data; Wei C performed literature search and constructed table; all authors contributed in manuscript preparation.
Informed consent statement: This study was exempted by the IRB Committee for Protection of Human Subjects.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lei Chen, MD, Associate Professor, Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School at Houston, 6431 Fannin, MSB2.250, Houston, TX 77030, United States. lei.chen.1@uth.tmc.edu
Telephone: +1-713-5005374 Fax: +1-713-5000733
Received: January 12, 2018
Peer-review started: January 14, 2018
First decision: February 9, 2018
Revised: April 8, 2018
Accepted: April 16, 2018
Article in press: April 17, 2018
Published online: June 16, 2018
Abstract

T-cell/histiocyte-rich large B-cell lymphoma is uncommon in children population. There were few cases reported in the literature with wide range clinical presentations including advanced stage, and more involvement of liver, spleen and bone marrow. Head and neck lymphadenopathy tends to present in younger children. We report a case of 10-year-old boy who initially presented intermittent fever, headaches and neck lymphadenopathy. Subsequently, he developed diffuse lymphadenopathy and hepatosplenomegaly. T-cell/histiocyte-rich large B-cell lymphoma was diagnosed on a cervical lymph node biopsy. Cervical lymphadenopathy in this age group is most commonly reactive or non-malignant processes. Lymphoma is much less frequent; mainly are non-Hodgkin lymphomas. However, a subset of large B-cell lymphoma called T-cell/histiocyte- rich B-cell lymphoma is rare in children.

Keywords: Pediatric, T-cell/histiocyte-rich large B-cell lymphoma, Head and neck lymphadenopathy

Core tip: We report a case of a 10-year-old boy presenting with intermittent fevers, fatigue, weight loss, and head and neck lymphadenopathy. A cervical lymph node biopsy revealed scattered large neoplastic cells surrounded by small reactive lymphocytes and histiocytes without residual germinal center meshwork. These pathologic features are consistent with T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) which tends to be rare in the pediatric population and can be easily missed leading to inappropriate treatment and poorer outcome. Therefore, THRLBCL should be consisted as a differential diagnosis for persistent lymphadenopathy in the pediatric population.