What does this research mean for the field?

Successful management of malignancy-associated hemophagocytic lymphohistiocytosis (HLH) requires prompt identification and definitive treatment of the underlying hematological malignancy, which can initially present as occult disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Document the diagnostic and clinical challenges of secondary hemophagocytic lymphohistiocytosis presenting as an initial manifestation of occult diffuse large B-cell lymphoma.

September 5, 2026CureusOpen Access

Hemophagocytic Lymphohistiocytosis As the Initial Presentation of Occult Diffuse Large B-cell Lymphoma: A Diagnostic Challenge

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Authors

KKKavish Khatib SAShamnas Abdul-Aziz KKKashif Khatib

Discussion

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Overview

Case report uncovers occult diffuse large B-cell lymphoma presenting as hemophagocytic lymphohistiocytosis in an older adult, highlighting the need for prompt trigger identification.

Key Points

Document the diagnostic and clinical challenges of secondary hemophagocytic lymphohistiocytosis presenting as an initial manifestation of occult diffuse large B-cell lymphoma.
Assessed a 76-year-old male with multiorgan compromise using clinical criteria, laboratory markers, and HScore calculation.
Initiated first-line immunomodulatory therapy with high-dose intravenous methylprednisolone and anakinra alongside diagnostic bone marrow biopsy.
Administered R-mini-CHOP chemotherapy upon confirmation of underlying diffuse large B-cell lymphoma.
Diagnostic workup established secondary hemophagocytic lymphohistiocytosis with an HScore of 220, marked hyperferritinaemia (>10,000 µg/L), and bone marrow biopsy confirming high-grade diffuse large B-cell lymphoma.
Treatment with R-mini-CHOP chemotherapy led to rapid clinical improvement and a complete metabolic response on PET imaging after two cycles, restoring the patient from bedbound to independent ambulation.

Cite This Study

Khatib et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3a66b95aff0620ead61 https://doi.org/10.7759/cureus.115630

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September 5, 2026CureusOpen Access

Hemophagocytic Lymphohistiocytosis As the Initial Presentation of Occult Diffuse Large B-cell Lymphoma: A Diagnostic Challenge

View Full Paper

Ask AI

Bookmark

Authors

KKKavish Khatib SAShamnas Abdul-Aziz KKKashif Khatib

Discussion

Member takes

Overview

Case report uncovers occult diffuse large B-cell lymphoma presenting as hemophagocytic lymphohistiocytosis in an older adult, highlighting the need for prompt trigger identification.

Key Points

Document the diagnostic and clinical challenges of secondary hemophagocytic lymphohistiocytosis presenting as an initial manifestation of occult diffuse large B-cell lymphoma.
Assessed a 76-year-old male with multiorgan compromise using clinical criteria, laboratory markers, and HScore calculation.
Initiated first-line immunomodulatory therapy with high-dose intravenous methylprednisolone and anakinra alongside diagnostic bone marrow biopsy.
Administered R-mini-CHOP chemotherapy upon confirmation of underlying diffuse large B-cell lymphoma.
Diagnostic workup established secondary hemophagocytic lymphohistiocytosis with an HScore of 220, marked hyperferritinaemia (>10,000 µg/L), and bone marrow biopsy confirming high-grade diffuse large B-cell lymphoma.
Treatment with R-mini-CHOP chemotherapy led to rapid clinical improvement and a complete metabolic response on PET imaging after two cycles, restoring the patient from bedbound to independent ambulation.

Cite This Study

Khatib et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3a66b95aff0620ead61 https://doi.org/10.7759/cureus.115630

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