Un caso inusual de Linfoma B difuso de células grandes CD5 positivo primario cerebral con coexpresión de c-MYC y BCL2

Carlos Barrionuevo; Carlos Pachas; Carlos Calderón; Daniela Dueñas; Enrique Orrego; Sandro Casavilca-Zambrano

doi:10.37711/rpcs.2019.1.1.6

Authors

Carlos Barrionuevo Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.
Carlos Pachas Hospital Central Policía Nacional del Perú, Lima, Perú
Carlos Calderón Hospital Arzobispo Loayza, Lima, Perú
Daniela Dueñas Department of Translational Molecular Pathology. MD Anderson Cancer Center. Houston, Texas, USA.
Enrique Orrego Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.
Sandro Casavilca-Zambrano Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.

DOI:

https://doi.org/10.37711/rpcs.2019.1.1.6

Keywords:

female, Humans, Middle Aged, Immunohistochemistry, Headache Seizures, Magnetic Resonance Imaging, Confusion, Magnetic Resonance Spectroscopy, Lymphoma, Brain, Neoplasms, Nausea, Vomiting, Adrenal Cortex Hormones, lymphoma, B-Cell

Abstract

Diffuse large B-cell lymphoma is a rare neoplasm of the central nervous system with aggressive behavior and poor outcome. CD5 expression in nodal or extranodal in this neoplasm is infrequent. These cases tend to be more aggressive than the CD5 negative cases. Herein, we report a case of primary brain CD5-positive diffuse large B-cell lymphoma presenting in an immunocompetent 64-year-old woman. She presented with intensity frontoparietal headache, nausea, vomiting, generalized seizures and confusional symptoms. Nuclear magnetic resonance showed characteristics of malignant lymphoma. The patient received treatment with corticoids with good response. Two years after the initial condition, she presented symptoms again. Brain images studies showed bifrontal neoplasm. No tumors were found in other sites. On the basis of morphology and immunohistochemistry, the diagnosis was CD5-positive diffuse large B-cell lymphoma. The present case confirms in this neoplasm multiple pathways are altered. Its identification can be used as therapeutic targets.