Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult

A 28 -year-old man presented to our hospital with a rapidly growing nodule in the left cervical and bilateral axilla with a history of loss of weight. He has been experiencing a nodule in her right cervical since two years ago and had done FNAC and diagnosed extrapulmonary tuberculosis (EPTB), on Ex...

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Main Authors: Aisyah Wirdah, Yenny Dian Andayani, Mediarty Syahrir, Norman Djamaludin, Krisna Murti, Ali Zainal Abidin
Format: Article
Language:English
Published: Interna Publishing 2023-11-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2485
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author Aisyah Wirdah
Yenny Dian Andayani
Mediarty Syahrir
Norman Djamaludin
Krisna Murti
Ali Zainal Abidin
author_facet Aisyah Wirdah
Yenny Dian Andayani
Mediarty Syahrir
Norman Djamaludin
Krisna Murti
Ali Zainal Abidin
author_sort Aisyah Wirdah
collection DOAJ
description A 28 -year-old man presented to our hospital with a rapidly growing nodule in the left cervical and bilateral axilla with a history of loss of weight. He has been experiencing a nodule in her right cervical since two years ago and had done FNAC and diagnosed extrapulmonary tuberculosis (EPTB), on Examination at left cervical colli; mass size 9cm x 7 cm, mobile, Lymphadenopathy at pre auricular size 3cm x 3cm, lymphadenopathy supraclavicular size 1cm x 0,5 cm. bilateral lymphadenopathy Axila size 4cmx 4cmx 2xcm mobile. The other physical exam was normal. Laboratory test Hb 10,4 d/dL, WBC 14.250/ mm3, LED 78 mm/hours, D-dimer 1,81 ug/mL, Fibrinogen 452 mg/dL. HIV test non-reactive. HbsAg and HCV test negative. CT-Scan Thorax: Enlarged Anterior mediastinal Lymph node with a diameter 0f 2.9 cm, right paratracheal with a diameter of 1,2cm and 1,1 cm, and right perihilar with a diameter of 1,3 cm. and the left perihilar diameter 0,9. And hypodense lesion of the spleen measuring 2,3cm x 1,6 cm. The patient underwent a biopsy with pathology biopsy and immunohistochemistry (IHC), CD 20+. CD 3-, CD 30+ CD79a +, MUM1 +, Ki67 80-90% +, CD15-, BCL6+ and BCL 2+.  For this patient, we started an R-CHOP regimen (Rituximab 375 mg/m2 (d1), Cyclophopamid 750 mg/m2 (d1), Doxorubicin 50 mg/m2 (d1), Vincristine1,2 mg/m2 (d1) and 1 Prednisone 100 mg (d1-d5). We presented the patient with PMGZL has achieved a complete response, especially with chemotherapy R-CHOP regimens
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institution Kabale University
issn 0125-9326
2338-2732
language English
publishDate 2023-11-01
publisher Interna Publishing
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series Acta Medica Indonesiana
spelling doaj-art-3ef8b42810b04463823a8d0f086cb6bc2025-08-20T03:27:21ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322023-11-01553Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young AdultAisyah Wirdah0Yenny Dian Andayani1Mediarty Syahrir2Norman Djamaludin3Krisna Murti4Ali Zainal Abidin5Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaDivision of Medical Hematology Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaDivision of Medical Hematology Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaDivision of Medical Hematology Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaPathology Anatomy Division, Faculty of Medicine, Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Sriwijaya - Mohammad Hoesin General Hospital, Palembang, IndonesiaA 28 -year-old man presented to our hospital with a rapidly growing nodule in the left cervical and bilateral axilla with a history of loss of weight. He has been experiencing a nodule in her right cervical since two years ago and had done FNAC and diagnosed extrapulmonary tuberculosis (EPTB), on Examination at left cervical colli; mass size 9cm x 7 cm, mobile, Lymphadenopathy at pre auricular size 3cm x 3cm, lymphadenopathy supraclavicular size 1cm x 0,5 cm. bilateral lymphadenopathy Axila size 4cmx 4cmx 2xcm mobile. The other physical exam was normal. Laboratory test Hb 10,4 d/dL, WBC 14.250/ mm3, LED 78 mm/hours, D-dimer 1,81 ug/mL, Fibrinogen 452 mg/dL. HIV test non-reactive. HbsAg and HCV test negative. CT-Scan Thorax: Enlarged Anterior mediastinal Lymph node with a diameter 0f 2.9 cm, right paratracheal with a diameter of 1,2cm and 1,1 cm, and right perihilar with a diameter of 1,3 cm. and the left perihilar diameter 0,9. And hypodense lesion of the spleen measuring 2,3cm x 1,6 cm. The patient underwent a biopsy with pathology biopsy and immunohistochemistry (IHC), CD 20+. CD 3-, CD 30+ CD79a +, MUM1 +, Ki67 80-90% +, CD15-, BCL6+ and BCL 2+.  For this patient, we started an R-CHOP regimen (Rituximab 375 mg/m2 (d1), Cyclophopamid 750 mg/m2 (d1), Doxorubicin 50 mg/m2 (d1), Vincristine1,2 mg/m2 (d1) and 1 Prednisone 100 mg (d1-d5). We presented the patient with PMGZL has achieved a complete response, especially with chemotherapy R-CHOP regimens http://www.actamedindones.org/index.php/ijim/article/view/2485Primary Mediastinal Gray Zone LymphomaRare case
spellingShingle Aisyah Wirdah
Yenny Dian Andayani
Mediarty Syahrir
Norman Djamaludin
Krisna Murti
Ali Zainal Abidin
Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
Acta Medica Indonesiana
Primary Mediastinal Gray Zone Lymphoma
Rare case
title Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
title_full Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
title_fullStr Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
title_full_unstemmed Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
title_short Primary Mediastinal Gray Zone Lymphoma in an Immunocompetent Young Adult
title_sort primary mediastinal gray zone lymphoma in an immunocompetent young adult
topic Primary Mediastinal Gray Zone Lymphoma
Rare case
url http://www.actamedindones.org/index.php/ijim/article/view/2485
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