Linfoma difuso de células B primario de hueso, reporte de caso clínico
Resumen
El linfoma primario de hueso es una entidad rara, representa menos del 2% del total de linfomas no Hodgkin, el linfoma difuso de células B grandes es el subtipo más frecuente. El linfoma óseo requiere alta sospecha clínica y de métodos invasivos de diagnóstico, para el tratamiento se debe tomar en cuenta varios factores tales como edad, comorbilidades, estadio, índice pronóstico, así como una valoración geriátrica integral en el paciente adulto mayor.
Se presenta un paciente masculino de 70 años, que debuta con una masa en cadera derecha de rápida evolución, que limita la deambulación y conlleva repercusión sistémica. Durante su instancia hospitalaria el paciente como complicación presenta falla renal aguda lo cual retraso el diagnóstico por imagen, lo que llevo a tener varias opciones como diagnóstico diferencial se incluyen sarcomas en sus distintos tipos o metástasis de neoplasias de otros órganos.
El linfoma primario óseo es una presentación poco común y su coexistencia con enfermedad extraósea confiere mayor dificultad en el diagnóstico y tratamiento, ante un paciente con comorbilidades o edad avanzada se requiere de modificación de esquemas estándar de quimioterapia, con la meta de rescatar al paciente de una enfermedad con alto índice de mortalidad y así pueda tolerar un tratamiento más intenso. La identificación oportuna requiere de personal entrenado y que la institución cuente con todos las ayudas pertinentes para el diagnóstico tales como inmunohistoquímica, citometría de flujo entre otras.
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Derechos de autor 2022 Miguel Fernández Freire;Vanesa Carrera Alcivar;Ricardo Tixi Ramírez
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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