2026-10-10T12:42:55Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33948727 2026-09-21T04:23:26Z category_388 portal_316 item_type_3 month_year_09_2026

Table 4_A case report and diagnostic-therapeutic analysis of de novo bilateral papillary thyroid carcinoma complicated with stage I a diffuse large B-cell lymphoma (ABC subtype, double-expressor).docx Lijing Wang (290763) Yang Zhou (65942) Long Liu (390523) Jinfeng Tian (14351432) Zhengyao Zhang (20606720) Ziyi Shao (6954908) Jingfei Shi (8530470) Shumei Liu (1516660) Chao Cui (1657387) Oncology and Carcinogenesis not elsewhere classified case report diffuse large B-cell lymphoma double primary malignant tumors immunochemotherapy neutropenia papillary thyroid carcinoma polatuzumab vedotin <p>Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma in adults, and papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid malignant tumor. Chronic systemic immune dysregulation, constitutive overactivation of the PI3K/AKT/mTOR and NF-κB signaling axes, reshaped immunosuppressive tissue microenvironment and aberrant B-cell clonal expansion serve as core shared molecular and immunological mechanisms that synergistically predispose patients to synchronous tumorigenesis of papillary thyroid carcinoma and ABC-type double-expressing diffuse large B-cell lymphoma. Both are clinically high-incidence malignancies; however, cases with synchronous diagnosis of de novo double primary DLBCL and PTC are extremely rare in clinical practice. Due to potential symptom overlap or lesion location correlation between the two diseases, misdiagnosis and missed diagnosis are likely to occur. Treatment regimens need to take into account the pathophysiological characteristics, clinical staging of both tumors, and the patient’s individual tolerance, leading to high difficulty in clinical decision-making. This article reports a 49-year-old female patient with de novo double primary bilateral PTC (with right cervical lymph node metastasis, metastasis rate 4/6) and stage I A DLBCL (not otherwise specified, activated B-cell-like subtype, double-expressor). The diagnosis was confirmed by preoperative imaging evaluation, puncture biopsy pathology, as well as postoperative specimen pathology, immunohistochemistry, and fluorescence in situ hybridization (FISH) detection. The patient received radical thyroidectomy combined with polatuzumab vedotin (Pola)-anti-CD20 monoclonal antibody-CHP regimen for immunochemotherapy. Grade III neutropenia occurred during treatment, which returned to normal after symptomatic treatment and secondary prevention, with good tolerance in subsequent treatment. After 6 cycles of immunochemotherapy, DLBCL achieved complete remission (CR), and the patient recovered well after thyroidectomy, completing planned iodine-131 therapy postoperatively. As of October 2025, the total follow-up duration was 6 months, with no signs of tumor recurrence noted to date; nevertheless, longer-term continuous surveillance is still required to definitively exclude late relapse risk, given the aggressive nature of double-expressor DLBCL. Meanwhile, combined with the diagnosis and treatment process of this case and relevant literature, we discuss the clinical characteristics, diagnostic key points, and individualized treatment strategies of double primary DLBCL and PTC, aiming to provide a reference for the standardized diagnosis and treatment of similar rare clinical cases.</p> 2026-09-21T04:23:26Z Dataset Dataset 10.3389/fonc.2026.1921091.s004 https://figshare.com/articles/dataset/Table_4_A_case_report_and_diagnostic-therapeutic_analysis_of_de_novo_bilateral_papillary_thyroid_carcinoma_complicated_with_stage_I_a_diffuse_large_B-cell_lymphoma_ABC_subtype_double-expressor_docx/33948727 CC BY 4.0