An Unusual Presentation of T-cell/Histiocyte-Rich B-cell Lymphoma: A Diagnostic Challenge

TL;DR

A rare case of T-cell/histiocyte-rich B-cell lymphoma presented as a necrotizing chest mass, leading to multiple misdiagnoses before correct identification.

Contribution

This case report adds to the limited literature on the unusual clinical presentation of T-cell/histiocyte-rich B-cell lymphoma.

Findings

The patient's necrotizing mass was initially misdiagnosed multiple times before a definitive diagnosis was made.

R-CHOP therapy was initiated following correct histopathological and immunohistochemical evaluation.

The case emphasizes the need for thorough diagnostic approaches in rare lymphoma presentations.

Abstract

Necrotizing masses pose a remarkable diagnostic challenge as they masquerade as infections, ischemic events, malignancies, autoimmune conditions, etc. Herewith, we are discussing a rare presentation of a man in his early 40s who presented with a necrotizing mass in the anterior chest wall and underwent multiple evaluations resulting in several initial misdiagnoses before the definitive diagnosis of T-cell/histiocyte-rich B-cell lymphoma was made. The patient was initiated on the R-CHOP (rituximab, cyclophosphamide, Doxorubicin, Vincristine, and prednisone) regimen and is currently under therapy. This case report highlights the significance of the diagnostic approach with thorough histopathological and immunohistochemical evaluation to diagnose unusual presentations, for appropriate management, and improving patient outcomes.

Figures