Giant Lymphoma In Adult

Abstract

Abnormal proliferation of large lymphoid cells is referred to as giant lymphoma. Lymphoma is a hematological malignancy originating from the lymphatic system and is classified into Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL)^[1]. Diffuse Large B-Cell Lymphoma (DLBCL) is an aggressive subtype of NHL, with a global prevalence of 30-40% and an incidence of approximately 5-7 cases per 100,000 population per year in the United States and Europe.A 28-year-old woman presented to the RSI Nashrul Ummah Lamongan Surgery Clinic with complaints of a lump in her right neck for 8 months. During anamnesis, she reported that the lump was painless and immobile. Initially, the lump was the size of a chicken egg, but it had grown larger over the past two months, accompanied by the emergence of a new lump. On physical examination, the patient was in good general condition. A lump measuring 27 x 25 x 6 cm was observed in the right cervical region, with firm boundaries, solid consistency, attachment to the base, and no tenderness, along with enlarged lymph nodes in the right axilla. An incisional biopsy revealed histopathological findings of fragmented tissue weighing 1.3 grams, containing diffuse tumor cells that were large, with scant cytoplasm, round to oval indented nuclei, irregular nuclear membranes, prominent nucleoli, and frequent mitoses. Immunohistochemical analysis showed positive results for CD20, CD45, and Ki-67 (with a proliferation index of 50%), while CD3 and CD30 were negative.Primary DLBCL of the neck (Diffuse Large B-Cell Lymphoma) typically presents as a unilateral, painless cervical mass, with the average patient age being 60 years. In this case, the patient was notably younger (28 years old) and exhibited no systemic symptoms. Histopathological and immunohistochemical analyses were essential to confirm the diagnosis and classification of DLBCL. The prognosis for localized DLBCL in the neck is generally favorable compared to cases with systemic disease, although this case demonstrated a short tumor doubling time.This report underscores the importance of early detection, accurate diagnosis, and appropriate therapeutic management to improve the prognosis of DLBCL patients presenting with extranodal involvement in the neck region.