ArticleFrontiers in medicine2026
Case report: Diffuse large B-cell lymphoma associated with chronic inflammation presenting as a rapidly enlarging perigraft hematoma after TEVAR.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Thoracic endovascular aortic repair (TEVAR) has become the primary treatment for Stanford type B aortic dissection. The differential diagnosis of postoperative periaortic masses typically focuses on hematoma, endoleak, or graft infection. We report the case of a patient who underwent repeat TEVAR for stent-graft fracture 8 years after the index procedure. A periaortic hypodense lesion identified on preoperative computed tomography (CT) was initially interpreted as a hematoma but rapidly progressed into a large soft-tissue mass shortly after the secondary intervention, accompanied by a marked elevation in serum lactate dehydrogenase. Imaging evaluation revealed a discordant pattern: restricted diffusion on magnetic resonance imaging (MRI) with absent enhancement on contrast-enhanced ultrasound (CEUS). Positron emission tomography/computed tomography (PET/CT) demonstrated markedly increased metabolic activity within the lesion. Core needle biopsy confirmed the diagnosis of Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) with a TP53 mutation. Diffuse large B-cell lymphoma associated with chronic inflammation (DLBCL-CI) occurring around a vascular graft and forming a well-defined mass is extremely rare. No previously reported case has simultaneously met the three criteria of a vascular graft background, Epstein-Barr virus-encoded small RNA (EBER) positivity, and the formation of a well-defined mass. Through retrospective analysis of the imaging features in this case, we aim to enhance clinicians' awareness of this rare entity, thereby facilitating earlier diagnosis and reducing misdiagnosis.
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