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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Diffuse large B cell lymphoma originating from the maxillary sinus with skin metastases: A case report and review of literature
Daisuke Usuda, Toshihide Izumida, Nao Terada, Ryusho Sangen, Toshihiro Higashikawa, Sayumi Sekiguchi, Risa Tanaka, Makoto Suzuki, Yuta Hotchi, Shintaro Shimozawa, Shungo Tokunaga, Ippei Osugi, Risa Katou, Sakurako Ito, Suguru Asako, Yoshie Takagi, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Jiro Oba, Tomohisa Nomura, Manabu Sugita, Yuji Kasamaki
Daisuke Usuda, Toshihide Izumida, Nao Terada, Ryusho Sangen, Yuji Kasamaki, Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi-shi 935-8531, Toyama-ken, Japan
Daisuke Usuda, Sayumi Sekiguchi, Risa Tanaka, Makoto Suzuki, Yuta Hotchi, Shintaro Shimozawa, Shungo Tokunaga, Ippei Osugi, Risa Katou, Sakurako Ito, Suguru Asako, Yoshie Takagi, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Jiro Oba, Tomohisa Nomura, Manabu Sugita, Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-0035, Tokyo-to, Japan
Toshihiro Higashikawa, Department of Geriatric Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi-shi 935-8531, Toyama-ken, Japan
Author contributions: Usuda D wrote the manuscript; Izumida T, Terada N, Sangen R, Higashikawa T, Sekiguchi S, Tanaka R, Suzuki M, Hotchi Y, Shimozawa S, Tokunaga S, Osugi I, Katou R, Ito S, Asako S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Oba J, Nomura T, Sugita M, and Kasamaki Y proofread and revised the manuscript; All authors approved the final version to be published.
Informed consent statement: Written informed consent was obtained from the patient and his family for publication of this case report and any accompanying images. Both written and verbal informed consent were obtained from the patient and his family for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/ Corresponding author: Daisuke Usuda, MD, MSc, PhD, Doctor, Lecturer, Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, 1130 Kurakawa, Himi-shi 935-8531, Toyama-ken, Japan.
d.usuda.qa@juntendo.ac.jp
Received: April 17, 2021
Peer-review started: April 17, 2021
First decision: May 10, 2021
Revised: May 12, 2021
Accepted: June 25, 2021
Article in press: June 25, 2021
Published online: August 16, 2021
Processing time: 109 Days and 23.4 Hours
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma (ML), accounting for 30%-40% of cases of non-Hodgkin’s lymphoma (NHL) in adults. Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17% of all lymphomas. ML from the maxillary sinus (MS) is a particularly rare presentation, and is thus often difficult to diagnose. We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastasis.
CASE SUMMARY
An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve area. His medical history included splenectomy due to a traffic injury, an old right cerebral infarction from when he was 74-years-old, hypertension, and type 2 diabetes mellitus. A plain head computed tomography (CT) scan revealed a 3 cm × 3.1 cm × 3 cm sized left MS. On day 25, left diplopia and ptosis occurred, and a follow-up CT on day 31 revealed the growth of the left MS mass. Based on an MS biopsy on day 50, we established a definitive diagnosis of DLBCL, non-germinal center B-cell-like originating from the left MS. The patient was admitted on day 62 due to rapid deterioration of his condition, and a plain CT scan revealed the further growth of the left MS mass, as well as multiple systemic metastasis, including of the skin. A skin biopsy on day 70 was found to be the same as that of the left MS mass. We notified the patient and his family of the disease, and they opted for palliative care, considering on his condition and age. The patient died on day 80.
CONCLUSION
This case suggests the need for careful, detailed examination, and for careful follow-up, when encountering patients presenting with a mass.
Core Tip: Diffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma (ML), accounting for 30%-40% of cases of non-Hodgkin’s lymphoma (NHL) in adults. Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17% of all lymphomas. ML from the maxillary sinus (MS) is rarely encountered as a presentation, and is thus often difficult to diagnose. We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastases; this case suggests that there is a need for careful, detailed examination, and careful follow-up, when encountering patients presenting with a mass.
