Autopsy and Case Reports
Autopsy and Case Reports
Article / Autopsy Case Report

Acute kidney injury and cardiac arrhythmia as the presenting features of widespread diffuse large B-cell lymphoma

Anthony Jacob Emanuel; Susan Erin Presnell

Downloads: 3
Views: 602


Diffuse Large B-cell Lymphoma, the most common adult non-Hodgkin lymphoma, is a proliferative neoplasm of enlarged B cells. Patients may be asymptomatic on presentation, but if present, symptoms often correlate with direct organ dysfunction resulting from the site of involvement. While the gastrointestinal system is the most common site of extranodal involvement, virtually any part of the body can be infiltrated by malignant lymphocytes. Here, we present an unusual case of cardiac and bilateral renal involvement by Diffuse Large B-cell Lymphoma in a 78-year-old male with a relatively unremarkable medical history. This combination of organ involvement and the resulting clinical symptoms are uncommonly described in the literature. The patient was treated for his symptoms prior to death, but the underlying cause that explained his presentation was not identified until performance of an autopsy. As such, this case demonstrates the utility of the medical autopsy, a gold standard in diagnostic medicine that can provide a variety of benefits in today’s healthcare system.


Lymphoma, Acute Kidney Injury, Arrhythmias, Cardiac, Autopsy


Molina K, DiMaio V. Normal organ weights in men: part 1 – the heart. Am J Forensic Med Pathol. 2012;33(4):362-7. []. [PMID:22182983]

Molina K, DiMaio V. Normal organ weights in men: part 2 – the brain, lungs, liver, spleen, and kidneys. Am J Forensic Med Pathol. 2012;33(4):368-72. []. [PMID:22182984]

Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues (4th ed). Lyon: IARC; 2017.

Zhou Z, Sehn L, Rademaker A, et al. An enhanced international prognostic index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123(6):837-42. []. [PMID:24264230]

QxMD Medical Incorporated. Calculate by QxMD. Diffuse large B-cell lymphoma prognosis (NCCN-IPI). 2018 [cited 2019 Feb 9]. Available from:

Medeiros L, Vega F, Miranda R. Diffuse large B-cell lymphoma, not otherwise specified. USA: Elsevier; 2018 [cited 2019 Feb 9]. Available from:

Hafeez I, Alai MS, Iqbal K, et al. Lymphoma presenting as severe left ventricular systolic dysfunction: a case report. Oman Med J. 2014;29(3):223-5. []. [PMID:24936276]

Amirimoghaddam Z, Khoddami M, Nayeri ND, Molaee S. Hodgkin’s lymphoma presenting with heart failure: a case report. J Med Case Rep. 2010;4(1):14. []. [PMID:20205760]

Al-Mehisen R, Al-Mohaissen M, Yousef H. Cardiac involvement in disseminated diffuse large B-cell lymphoma, successful management with chemotherapy dose reduction guided by cardiac imaging: a case report and review of literature. World J Clin Cases. 2019;7(2):191-202. []. [PMID:30705895]

Ban-Hoefen M, Zeglin MA, Bisognano JD. Diffuse large B cell lymphoma presenting as a cardiac mass and odynophagia. Cardiol J. 2008;15(5):471-4. [PMID:18810725]

Jeudy J, Burke A, Frazier A. Cardiac lymphoma. Radiol Clin North Am. 2016;54(4):689-710. []. [PMID:27265603]

Hamza A. Declining rate of autopsies: implications for anatomic pathology residents. Autops Case Rep. 2017;7(4):1-2. []. [PMID:29259925]

Turnbull A, Osborn M, Nicholas N. Hospital autopsy: endangered or extinct? J Clin Pathol. 2015;68(8):601-4. []. [PMID:26076965]

Zarbo RJ, Baker PB, Howanitz PJ. The autopsy as a performance measurement tool: diagnostic discrepancies and unresolved clinical questions. Arch Pathol Lab Med. 1999;123(3):191-8. [PMID:10086506]








Submitted date:

Accepted date:

Publication date:

5d6d6cd90e8825af6bb32234 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections