Non-Hodgkin's lymphoma developing in a pacemaker pocket

• Published in: International journal of hematology Vol. 77; no. 4; pp. 387 - 390
• Main Authors: HOJO, Nobumasa, YAKUSHIJIN, Yoshihiro, NARUMI, Hiroshi, MINAMOTO, Yoko, SAKAI, Ikuya, TAKADA, Kiyonori, HATO, Takaaki, YASUKAWA, Masaki, FUJITA, Shigeru
• Format: Journal Article
• Language: English
• Published: Tokyo Springer 01.05.2003; Springer Nature B.V
• Subjects: Adult; Antineoplastic Agents - therapeutic use; Autopsy; Biological and medical sciences; Genotype; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; Immunophenotyping; Inflammation - complications; Inflammation - etiology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - etiology; Male; Medical sciences; Necrosis; Pacemaker, Artificial - adverse effects; Human; Instrumentation therapy; Implantation; Malignant hemopathy; Inflammation; Non Hodgkin lymphoma; Case study; Instrumental stimulation; Chronic; Pacemaker; Lymphoproliferative syndrome; Titanium; Complication; Localization
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/BF02982649

A 29-year-old man developed diffuse large B-cell lymphoma in a subpectoral pacemaker pocket that 6 years previously had been created in the chest for a titanium-covered pulse generator. The patient had an 8-cm-diameter dark red tumor with necrotic tissue on a keloidal surgical scar in the left side of the chest. Left axillary lymphadenopathy also was present. Laboratory studies showed an increased level of soluble interleukin 2 receptor and a normal level of lactose dehydrogenase. A biopsy specimen showed a diffuse large B-cell phenotype and monoclonal immunoglobulin H gene rearrangement. A gallium scintigraphy study showed abnormal accumulation in the left chest and left axilla. On the basis of these findings, we diagnosed diffuse large B-cell lymphoma, stage II. The patient received THP-COP chemotherapy (pirarubicin, cyclophosphamide, vincristine, and prednisolone) and radiotherapy, achieved complete remission, and was free of disease for 16 months after treatment. This case suggests that there was a relationship between the development of non-Hodgkin's lymphoma and the presence of chronic inflammation in the pulse generator pocket.