Hyun Jong Hong; Sang Yeob Lee; Hye-In Kim; Jin Yeon Hwang; Yong Min Jo; Hwan Cheol Ryu; Sung Won Lee; Won Tae Chung; Dae Cheol Kim

doi:10.4078/jkra.2008.15.1.63

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Hong, Lee, Kim, Hwang, Jo, Ryu, Lee, Chung, and Kim: A Case of Maxillary Diffuse Large B Cell Lymphoma Induced to Headache in Behçet's Disease

Original Article

J Korean Rheum Assoc 2008;15(1):63-69.

Published online: 20 March 2008

DOI: https://doi.org/10.4078/jkra.2008.15.1.63

A Case of Maxillary Diffuse Large B Cell Lymphoma Induced to Headache in Behçet's Disease

Hyun Jong Hong, M.D., Sang Yeob Lee, M.D., Hye-In Kim, M.D., Jin Yeon Hwang, M.D., Yong Min Jo, M.D., Hwan Cheol Ryu, M.D., Sung Won Lee, M.D., Won Tae Chung, M.D., Dae Cheol Kim, M.D.^∗

Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea

^∗Department of Pathology, College of Medicine, Dong-A University, Busan, Korea

Received 2 November 2007 Accepted 3 December 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Behçet's disease is chronic and systemic inflammatory vasculitis, characterized by immunologically involving in variable size of arteries and veins. Clinically, principal manifestations are recurrent oral ulcer, genital ulcer, skin and eye lesions. Compared to other connective tissue disease, cancer is not accompanied commonly in Behçet's disease. But, immunological confusion such as T cell depletion or B cell hyperplasia, or long-term of immunosuppressive treatment lead to occurrence of malignancy. Recently, we experienced a case of maxillary mass, induced to abrupt headache in Behçet's disease, confirmed diffuse large B cell lymphoma by biopsy, and treated by rituximab-CHOP chemotherapy. Thus we report these with literature review.

Keywords: Behçet's disease, Lymphoma

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Fig. 1.

A brain MRI shows low signal mass in right maxillary sinus (arrow). (A) T2 weighted image. (B) Gd-DTPA enhanced T1 weighted image.

Fig. 2.

A nasopharynx CT shows mass in right maxillary sinus (A: arrow) and invasions of mass to both ethmoidal air cell (B: arrows).

Fig. 3.

A chest CT shows enlarged lymph nodes in para-aortic and left hilar area (A: arrows). and a abdomen CT shows metastatic lymph nodes in right renal hilar and right para-aortic area (B: arrow).

Fig. 4.

PET (positron emission tomography) scan shows hypermetabolic masses (green arrow) in right maxillary sinus, left ethdmoidal air cell (A), para-aortic lymph nodes (B), right hilar kidney (C) and right common iliac area (D).

Fig. 5.

H&E (×400) shows diffuse infiltrated tumor cells with a single uniform centrally located nucleous (A). And immunohistochemical staining (×400) confirms large tumor cells express surface marker with CD20 (B).

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