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KMID : 0882420160900020163
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Korean Journal of Medicine
2016 Volume.90 No. 2 p.163 ~ p.168
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Rare Presentation of Richter’s Transformation to Diffuse Large B Cell Lymphoma: a Case Report
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구은주:Goo Eun-Ju
김민경:Kim Min-Kyoung/공은정:Kong Eun-Jung/고성애:Koh Sung-Ae/구미진:Gu Mi-Jin/정지윤:Jung Ji-Yoon/현명수:Hyun Myung-Soo
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Abstract
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Richter’s syndrome refers to the development of aggressive lymphoma in a patient with chronic lymphocytic leukemia (CLL). It occurs in about 2% to 10% of patients with CLL. The most frequent manifestation of Richter’s syndrome is diffuse large B cell lymphoma (DLBCL). Extranodal involvement is rare but can occur. The prognosis of Richter’s syndrome is very poor. We herein report a case of a rare presentation of Richter’s syndrome. A 42-year-old man diagnosed with CLL 2 years previously developed nodules on the bilateral thighs and buttocks. A positron emission tomography (PET)-CT scan revealed high fluorodeoxyglucose uptake in multiple lymph nodes, skeletal muscles, and the myocardium. An ultrasonography-guided biopsy confirmed Richter’s syndrome from CLL to DLBCL. The patient was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. After six cycles of chemotherapy, we performed a PET-CT scan that revealed a complete response. However, 3 months later, the syndrome recurred. The patient was undergoing salvage chemotherapy at the time of this writing.
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KEYWORD
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Chronic lymphocytic leukemia, Diffuse large B cell lymphoma
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