ArticleCase reports in oncology
Rapid On-Site Cytologic Evaluation-Facilitated Diagnosis of Fibrin-Associated Large B-Cell Lymphoma in a Right Atrial Fibrin Thrombus: A Case Report.
Article in Case reports in oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background: Fibrin-associated large B-cell lymphoma (FA-LBCL) is a rare extranodal lymphoma confined to fibrin deposits within cardiovascular structures and other anatomically restricted spaces. Due to its non-mass-forming nature and nonspecific clinical presentation, preoperative diagnosis remains challenging. Case Presentation: A 47-year-old woman with a history of mitral valve repair and pacemaker implantation presented with a right atrial mass extending from the coronary sinus. A catheter-based biopsy with rapid on-site cytologic evaluation (ROSE) revealed scattered large atypical lymphoid cells. Histology confirmed FA-LBCL, composed of CD20-positive cells with a high Ki-67 index (∼90%) and negative Epstein-Barr virus (EBV)-encoded RNA. The disease was staged as IE, with no evidence of extracardiac involvement. Despite no myocardial invasion, the patient opted for six cycles of R-CHOP and remains disease-free 2 years post-diagnosis. Conclusion: This case highlights the diagnostic utility of ROSE in FA-LBCL, particularly in guiding sample adequacy and expediting ancillary studies. Given the focal and sparse distribution of neoplastic cells, early recognition through ROSE may prevent misdiagnosis and unnecessary procedures. As EBV-negative FA-LBCL represents a distinct entity with evolving molecular insights, further research is warranted to delineate its pathogenesis and optimal management strategies.
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