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<p>Fibrin-associated large B cell lymphoma is a rare Epstein–Barr virus-positive lymphoma arising in restricted anatomical spaces, predominantly in immunocompetent individuals; its clinical behavior and pathophysiology remain unclear. We report two cases of fibrin-associated large B cell lymphoma that were incidentally detected in bulky uterine leiomyomas and ovarian fibromas. The first patient presented with limited-stage disease and showed an indolent clinical course, managed with surgery alone; the second presented with advanced-stage disease with malignant pleural effusion, requiring chemotherapy. Lymphoma cells in the pleural effusion shared an immunohistochemical staining profile with the primary site, and genomic analysis confirmed B cell clonality. Both patients shared an unusual Epstein–Barr virus latency pattern, possibly reflecting a locally immunosuppressed microenvironment. These cases broaden the recognized spectrum of fibrin-associated large B cell lymphoma and highlight that, although typically localized, the disease may present with concomitant involvement of multiple sites at diagnosis.</p>

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Fibrin-associated large B-cell lymphoma arising in benign gynecologic tumors: insights into disease spectrum expansion and pathophysiology

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Taro Sawabe,
  • Junichi Kiyasu,
  • Yoshihiro Ohishi,
  • Naoki Abe,
  • Koki Yagi,
  • Makoto Oyama,
  • Kosuke Hoashi,
  • Mariko Tsuda,
  • Akiko Takamatsu,
  • Eriko Fujioka,
  • Yuka Hiraki,
  • Hiroshi Tsujioka,
  • Koichi Ohshima,
  • Hiroaki Miyoshi,
  • Motoaki Shiratsuchi

摘要

Fibrin-associated large B cell lymphoma is a rare Epstein–Barr virus-positive lymphoma arising in restricted anatomical spaces, predominantly in immunocompetent individuals; its clinical behavior and pathophysiology remain unclear. We report two cases of fibrin-associated large B cell lymphoma that were incidentally detected in bulky uterine leiomyomas and ovarian fibromas. The first patient presented with limited-stage disease and showed an indolent clinical course, managed with surgery alone; the second presented with advanced-stage disease with malignant pleural effusion, requiring chemotherapy. Lymphoma cells in the pleural effusion shared an immunohistochemical staining profile with the primary site, and genomic analysis confirmed B cell clonality. Both patients shared an unusual Epstein–Barr virus latency pattern, possibly reflecting a locally immunosuppressed microenvironment. These cases broaden the recognized spectrum of fibrin-associated large B cell lymphoma and highlight that, although typically localized, the disease may present with concomitant involvement of multiple sites at diagnosis.