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Unusual behavior of diffuse large B-cell lymphoma as cardiac invasion with rapid spontaneous regression after fine needle aspiration cytology
Adel El-Badrawy, Reham Abd El-Wahab, Maha Elzaafarany, Ziad Emarah, Mona M. Taalab, Noha Eisa, Mohammad K. El-Badrawy, Mohamed Farouk Akl, Nirmeen Megahed and Sherif Arafa

Spontaneous regression (SR) of lymphoma is a rare phenomenon. While the precise mechanism of SR remains unknown, apoptosis may be associated with its process. Here, we present a case of a 52-year-old woman was admitted to our hospital with cough and orthopnea for 2 weeks. Multi-detector computed tomography of whole body showed anterior and middle mediastinal soft tissue mass with multiple adjacent malignant lymphadenopathy. The mediastinal mass invaded right atrium and pericardium. Another left subphrenic retro-pancreatic mass was detected. This mass surrounded upper pole of left kidney. Fine needle aspiration cytology was done and revealed lymphocytic smear with advised tru-cut biopsy. CT guided tru-cut was taken after 8 days. During CT guided technique; marked regression of left subphrenic mass was detected. Post-contrast MDCT scan was done and revealed partial response of the masses after 8 days. The partial regressive course of this disease suggests the effectiveness of fine needle aspiration cytology in initiating spontaneous regression. Tru-cut biopsy revealed non-Hodgkin lymphoma (diffuse large B-cell type). We report a case of NHL with abnormal location and spontaneous regression.

Keywords: non-Hodgkin lymphoma, spontaneous regression, fine needle aspiration

Abbreviations: Diffuse large B-cell lymphoma, DLBCL; HD; multi-detector computed tomography, MDCT; Non- Hodgkin lymphoma, NHL; Spontaneous regression, SR

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