Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Lymphoma | Case report

Primary central nervous system CD20-negative diffuse large B-cell lymphoma: a case report

Authors: Shuai Luo, Xiang Huang, Yao Li, Jinjing Wang

Published in: BMC Neurology | Issue 1/2022

Login to get access

Abstract

Background

CD20-negative diffuse large B-cell lymphoma is a very rare and heterogeneous invasive cancer characterized by chemical resistance and poor prognosis. Primary CD20-negative diffuse large B-cell lymphoma of the central nervous system is even rarer, presenting great challenges in pathological diagnosis and clinical treatment.

Case presentation

We report a case of primary CD20-negative diffuse large B-cell lymphoma of the CNS in a 54-year-old woman admitted to the hospital with a headache lasting more than 10 days. CT and MRI scans showed right temporal lobe lymphoma. Microscopically, large infiltrating lymphoid cells that induced brain tissue damage were observed. Immunohistochemistry showed that the tumor cells were CD79a+, PAX-5+, MUM1+, and CD20-. The patient was diagnosed with lymphoma and transferred to an oncology hospital for chemotherapy. However, because the disease progressed rapidly, the patient died only after two rounds of chemotherapy.

Conclusions

To the best of our knowledge, this is one of the first reported cases of unclassifiable CD20-negative diffuse large B-cell lymphoma located in the CNS. This case report aims to deepen the understanding of clinicopathological features of this type of lymphoma and expand the scope of this disease.
Literature
1.
Deckert M, Engert A, Brück W, et al. Modern concepts in the biology, diagnosis, differential diagnosis and treatment of primary central nervous system lymphoma[J]. Leukemia. 2011;25(12):1797–807.CrossRef
2.
Tang D, Chen Y, Shi Y, et al. Epidemiologic characteristics, prognostic factors, and treatment outcomes in primary Central Nervous System Lymphoma: a SEER-Based Study[J]. Front Oncol. 2022;12:817043.CrossRef
3.
Boyd SD, Natkunam Y, Allen JR, et al. Selective immunophenotyping for diagnosis of B-cell neoplasms: immunohistochemistry and flow cytometry strategies and results[J]. Applied immunohistochemistry & molecular morphology: AIMM/official publication of the Society for Applied Immunohistochemistry, 2013, 21(2): p. 116.
4.
Pfreundschuh M, Kuhnt E, Trümper L, et al. CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group[J]. Lancet Oncol. 2011;12(11):1013–22.CrossRef
5.
Li J, Zhao S, Wang J, et al. CD20-negative diffuse large B cell lymphoma: a comprehensive analysis of 695 cases[J]. Tumour Biol. 2016;37(3):3619–37.CrossRef
6.
Maeshima AM, Taniguchi H, Fujino T, et al. Immunohistochemical CD20-negative change in B-cell non-hodgkin lymphomas after rituximab-containing therapy[J]. Ann Hematol. 2020;99:2141–8.CrossRef
7.
Maeshima AM, Taniguchi H, Fukuhara S, et al. Follow-up data of 10 patients with B-cell non-hodgkin lymphoma with a CD20-negative phenotypic change after rituximab-containing therapy[J]. Am J Surg Pathol. 2013;37(4):563–70.CrossRef
8.
Hato T, Yamanouchi J, Tamura T, et al. Existence of leukemic clones resistant to both imatinib mesylate and rituximab before drug therapies in a patient with Philadelphia chromosome-positive acute lymphocytic leukemia[J]. Int J Hematol. 2004;80(1):62–6.CrossRef
9.
Maeshima AM, Taniguchi H, Fujino T, et al. Immunohistochemical CD20-negative change in B-cell non-hodgkin lymphomas after rituximab-containing therapy[J]. Ann Hematol. 2020;99(9):2141–8.CrossRef
10.
Pavlasova G, Mraz M. The regulation and function of CD20: an “enigma” of B-cell biology and targeted therapy[J]. Haematologica. 2020;105(6):1494–506.CrossRef
11.
Czuczman MS, Olejniczak S, Gowda A, et al. Acquirement of rituximab resistance in lymphoma cell lines is associated with both global CD20 gene and protein down-regulation regulated at the pretranscriptional and posttranscriptional levels[J]. Clin Cancer Res. 2008;14(5):1561–70.CrossRef
12.
Fukumura K, Kawazu M, Kojima S, et al. Genomic characterization of primary central nervous system lymphoma[J]. Acta Neuropathol. 2016;131(6):865–75.CrossRef
13.
Schmitz R, Wright GW, Huang DW, et al. Genetics and Pathogenesis of diffuse large B-Cell Lymphoma[J]. N Engl J Med. 2018;378(15):1396–407.CrossRef
14.
Lacy SE, Barrans SL, Beer PA, et al. Targeted sequencing in DLBCL, molecular subtypes, and outcomes: a Haematological Malignancy Research Network report[J]. Blood. 2020;135(20):1759–71.CrossRef
15.
Wright GW, Huang DW, Phelan JD, et al. A probabilistic classification Tool for genetic subtypes of diffuse large B cell lymphoma with therapeutic Implications[J]. Cancer Cell. 2020;37(4):551–68.e14.CrossRef
16.
Bogusz AM. EBV-Negative Monomorphic B-Cell Posttransplant Lymphoproliferative Disorder with Marked Morphologic Pleomorphism and Pathogenic Mutations in ASXL1, BCOR, CDKN2A, NF1, and TP53[J]. Case Rep Hematol, 2017, 2017: 5083463.
17.
Abdullgaffar B, Seliem RM. De Novo unclassifiable CD20-negative diffuse large B-cell lymphoma: a diagnostic and therapeutic challenge[J]. Int J Surg Pathol. 2018;26(3):266–70.CrossRef
18.
Gaur S, Padilla O, Nahleh Z. Clinical features and prognosis of CD20 negative aggressive B-cell non-Hodgkins lymphoma[J]. Lymphoma, 2013, 2013.
19.
Garg M, Lee BE, Mcgarry K, et al. CD 20-negative diffuse large B‐cell lymphoma presenting with lactic acidosis[J]. Am J Hematol. 2015;90(3):E49–50.CrossRef
20.
Lu Y, Gao X, Fang M. [CD20-negative primary intestinal diffuse large B-cell lymphoma:a case report and literature review][J]. Zhonghua Xue Ye Xue Za Zhi. 2015;36(5):430–2.
Metadata
Title
Primary central nervous system CD20-negative diffuse large B-cell lymphoma: a case report
Authors
Shuai Luo
Xiang Huang
Yao Li
Jinjing Wang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-03031-3

Other articles of this Issue 1/2022

BMC Neurology 1/2022 Go to the issue

Research

The clinical, myopathological, and molecular characteristics of 26 Chinese patients with dysferlinopathy: a high proportion of misdiagnosis and novel variants

Research

Safety and efficacy of low-dose rt-PA with tirofiban to treat acute non-cardiogenic stroke: a single-center randomized controlled study

Research

Assessment of the mental workload of trainee pilots of remotely operated aircraft using functional near-infrared spectroscopy

Research

Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine

Research

Morphometry of cerebral arterial bifurcations harbouring aneurysms: a case-control study

Research

Recognition of freezing of gait in Parkinson’s disease based on combined wearable sensors