JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (7): 80-87.doi: 10.6040/j.issn.1671-7554.0.2016.026

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Multiple serous effusion complicated with Warburg effect: a case report of diffuse large B-cell lymphoma and literature review

HAN Kangkang, CUI Liwei, PENG Cheng, XUE Yuwen, XIAO Wei   

  1. Department of Pneumology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2016-01-11 Online:2016-07-10 Published:2016-07-10

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Abstract: Objective To explore the clinical diagnosis and treatment of a case of diffuse large B-cell lymphoma(DLBCL), presenting as multiple serous effusion complicated with Warburg effect. Methods Clinical data of a DLBCL case were retrospectively analyzed. A 51-year-old male was admitted due to abdominal pain and distension for 1 month, and right chest pain for 7 days. CT scan, PET-CT scan and thoracoscopy were conducted. Databases including CKNI and Pubmed were searched for relevant studies published during 2010 and 2016 with key words such as “large B-cell lymphoma, hypoglycemia, lactic acidosis, tumor”. Results CT scan showed pleural effusion and ascites, and echocardiography suggested slight pericardial effusion. PET-CT scan indicated high uptake ratio of 18-fluoro-2-deoxyglucose(18-FDG)of both bilateral pleura and peritoneum. Blood glucose tests showed the patient had low sugar at a minimum of 1.17 mmol/L, while blood lactic acid was abnormally high. The LDH in pleural effusion was 5 158 U/L, and CA-125 was 3 251 U/L. Cytological examination of pleural effusion found lymphoblasts and prolymphocytes. Thoracoscopic biopsy of the pleura confirmed the diagnosis of DLBCL. Remission was observed after 3 cycles of chemotherapy. Totally 605 studies involving 3 981 DLBCL patients were included in the literature review. Of all cases, 山 东 大 学 学 报 (医 学 版)54卷7期 -韩康康,等.多浆膜腔积液、Warburg效应——弥漫性大B细胞淋巴瘤1例报告并文献复习 \=-108 presented serous effusion, and 30 involved multiple serous cavities. Of the 15 cases presenting both hypoglycemia and lactic acidosis, 13 were NHL cases(4 were confirmed DLBCL; 3 were Burkitt lymphoma; 2 were T cell lymphoma, and 4 were not mentioned). Conclusion DLBCL characterized by multiple serous effusion complicated with Warburg effect is rather rare in clinical practice. Thoracoscopy is effective for the diagnosis and differentiation of similar lymphomas presenting multiple serous effusion.

Key words: Diffuse large B-cell Lymphoma, Lactic acidosis, Hypoglycemia, Multiple serous effusion, Warburg effect

CLC Number: 

  • R551.2
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