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Pancoast syndrome: A rare presentation of non-Hodgkin's lymphoma.

Sarkar A, Das A, Basuthakur S, Pandit S, Das SK, Choudhury S - Lung India (2013)

Bottom Line: Pancoast syndrome is a common presentation of bronchogenic carcinoma, but other malignancies are rarely cited as its cause.Pancoast syndrome due to non-Hodgkin's lymphoma is rarely described in the literature.Here, we report a case of Pancoast syndrome due to non-Hodgkin's lymphoma to increase the awareness of the clinicians regarding essentiality of tissue diagnosis of Pancoast tumor before starting the treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Midnapore Medical College, Paschim Midnapore, West Bengal, India.

ABSTRACT
Pancoast syndrome is a common presentation of bronchogenic carcinoma, but other malignancies are rarely cited as its cause. Pancoast syndrome due to non-Hodgkin's lymphoma is rarely described in the literature. Here, we report a case of Pancoast syndrome due to non-Hodgkin's lymphoma to increase the awareness of the clinicians regarding essentiality of tissue diagnosis of Pancoast tumor before starting the treatment.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph of computed tomography-guided tru-cut biopsy specimen taken from anterior mediastinal mass showing effacement of normal architecture of lymph node with sheets of atypical large lymphoid cells (H and E, ×40)
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Figure 2: Photomicrograph of computed tomography-guided tru-cut biopsy specimen taken from anterior mediastinal mass showing effacement of normal architecture of lymph node with sheets of atypical large lymphoid cells (H and E, ×40)

Mentions: Complete hemogram and blood biochemistry were normal, except elevated serum lactate dehydrogenase level (340 U/L). Chest X-ray (P.A. view) showed a huge anterior mediastinal mass, compressing left lung and extending to the thoracic inlet, but no rib erosion. Sputum smear for acid fast bacilli was negative. Incisional biopsy from the neck swelling was inconclusive. Contrast enhanced computed tomography (CT) thorax showed heterogeneous huge anterior mediastinal necrotizing mass extending through thoracic inlet to the neck, but no rib erosion [Figure 1]. CT guided fine needle aspiration cytology (FNAC) was inconclusive. Excision biopsy from the left supraclavicular swelling revealed malignant round cell tumor involving lymph nodes. Histopathological examination of CT guided tru-cut biopsy of mediastinal mass showed effacement of normal architecture of lymph gland, which was replaced by sheets of atypical large lymphoid cells admixed with the histiocytes and plasmacytoid cells. Scattered immunoblasts were present. No Reed Sternberg cell or its variant was found [Figure 2]. Hence, histopathology ultimately confirmed the tissue diagnosis of NHL. Immunohistochemistry further substantiated the diagnosis of diffuse large B-cell phenotype of NHL, as the tumor cells expressed CD20 and CD10, but were immunonegative for CD3, CD5, CD23, and CD30 [Figure 3]. Bone marrow biopsy was within normal limit. Ultrasound of whole abdomen was normal. Hence, he was finally diagnosed as a case of diffuse large B-cell phenotype of NHL. The size of the lesion regressed following six cycles of combination chemotherapy, comprising of cyclophosphamide, doxorubicin, vincristine, and prednisolone.


Pancoast syndrome: A rare presentation of non-Hodgkin's lymphoma.

Sarkar A, Das A, Basuthakur S, Pandit S, Das SK, Choudhury S - Lung India (2013)

Photomicrograph of computed tomography-guided tru-cut biopsy specimen taken from anterior mediastinal mass showing effacement of normal architecture of lymph node with sheets of atypical large lymphoid cells (H and E, ×40)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3775202&req=5

Figure 2: Photomicrograph of computed tomography-guided tru-cut biopsy specimen taken from anterior mediastinal mass showing effacement of normal architecture of lymph node with sheets of atypical large lymphoid cells (H and E, ×40)
Mentions: Complete hemogram and blood biochemistry were normal, except elevated serum lactate dehydrogenase level (340 U/L). Chest X-ray (P.A. view) showed a huge anterior mediastinal mass, compressing left lung and extending to the thoracic inlet, but no rib erosion. Sputum smear for acid fast bacilli was negative. Incisional biopsy from the neck swelling was inconclusive. Contrast enhanced computed tomography (CT) thorax showed heterogeneous huge anterior mediastinal necrotizing mass extending through thoracic inlet to the neck, but no rib erosion [Figure 1]. CT guided fine needle aspiration cytology (FNAC) was inconclusive. Excision biopsy from the left supraclavicular swelling revealed malignant round cell tumor involving lymph nodes. Histopathological examination of CT guided tru-cut biopsy of mediastinal mass showed effacement of normal architecture of lymph gland, which was replaced by sheets of atypical large lymphoid cells admixed with the histiocytes and plasmacytoid cells. Scattered immunoblasts were present. No Reed Sternberg cell or its variant was found [Figure 2]. Hence, histopathology ultimately confirmed the tissue diagnosis of NHL. Immunohistochemistry further substantiated the diagnosis of diffuse large B-cell phenotype of NHL, as the tumor cells expressed CD20 and CD10, but were immunonegative for CD3, CD5, CD23, and CD30 [Figure 3]. Bone marrow biopsy was within normal limit. Ultrasound of whole abdomen was normal. Hence, he was finally diagnosed as a case of diffuse large B-cell phenotype of NHL. The size of the lesion regressed following six cycles of combination chemotherapy, comprising of cyclophosphamide, doxorubicin, vincristine, and prednisolone.

Bottom Line: Pancoast syndrome is a common presentation of bronchogenic carcinoma, but other malignancies are rarely cited as its cause.Pancoast syndrome due to non-Hodgkin's lymphoma is rarely described in the literature.Here, we report a case of Pancoast syndrome due to non-Hodgkin's lymphoma to increase the awareness of the clinicians regarding essentiality of tissue diagnosis of Pancoast tumor before starting the treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Midnapore Medical College, Paschim Midnapore, West Bengal, India.

ABSTRACT
Pancoast syndrome is a common presentation of bronchogenic carcinoma, but other malignancies are rarely cited as its cause. Pancoast syndrome due to non-Hodgkin's lymphoma is rarely described in the literature. Here, we report a case of Pancoast syndrome due to non-Hodgkin's lymphoma to increase the awareness of the clinicians regarding essentiality of tissue diagnosis of Pancoast tumor before starting the treatment.

No MeSH data available.


Related in: MedlinePlus