{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:56:36Z","timestamp":1780059396230,"version":"3.54.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diffuse Large B-Cell Lymphoma (DLBCL) represents the most prevalent subtype of Non-Hodgkin Lymphoma (NHL). Cryoglobulinemia results from reversible precipitation of serum immunoglobulin complexes at low temperatures, with Type II (mixed) cryoglobulinemia commonly associated with hepatitis C virus (HCV) infection, autoimmune diseases, and B-cell lymphoproliferative disorders. However, its occurrence secondary to DLBCL is exceedingly rare. This report presents a rare case of DLBCL complicated by Type II cryoglobulinemia, acute liver injury, acute kidney injury, and severe infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A female patient in her 40s presented to an external hospital with unexplained high fever, dry cough, and chest tightness. She was diagnosed with DLBCL based on bone marrow cytology and histopathological findings. The patient received chemotherapy with the zuberitamab plus CHOP regimen. However, anaphylactic shock occurred during zuberitamab infusion, leading to temporary discontinuation of chemotherapy. Upon transfer to our hospital, laboratory tests indicated renal insufficiency and severe hepatic injury. Combined with clinical manifestations such as extensive skin and mucosal ecchymoses, bilateral lower limb edema, arthralgia, reversible serum cryoprecipitation, positive mixed type II cryoglobulin, and decreased C4 complement levels, a diagnosis of type II cryoglobulinemia was confirmed. Following fluid resuscitation, diuresis, and continuous renal replacement therapy, her condition temporarily improved. Unfortunately, the patient succumbed due to disease progression of lymphoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates the diagnostic and therapeutic management of type II cryoglobulinemia secondary to DLBCL. It highlights the importance of closely monitoring clinical manifestations and implementing early intervention for related complications during the treatment of B-cell lymphoproliferative disorders, aiming to reduce the high mortality rate and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1796461","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:35:48Z","timestamp":1776832548000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: A case of type II cryoglobulinemia secondary to diffuse large B-cell lymphoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Cuiping","family":"Mao","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohe","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-23488-0_25","article-title":"Cryoglobulinemia - one name for two diseases","volume":"391","author":"Cacoub","year":"2024","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/bor.0000000000000624","article-title":"Cryoglobulinemia","volume":"4","author":"Roccatello","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210636","article-title":"HCV-associated cryoglobulinemia vasculitis: are its days numbered","volume":"76","author":"Moiseev","year":"2017","journal-title":"Ann Rheum Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.1002\/hep.32425","article-title":"Letter to the editor: high rate of clinical and immunological response in patients with HCV-associated cryoglobulinemia","volume":"76","author":"Gavrisheva","year":"2022","journal-title":"Hepatology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1053\/j.gastro.2017.03.006","article-title":"Efficacy and safety of sofosbuvir plus daclatasvir for treatment of HCV-associated cryoglobulinemia vasculitis","volume":"153","author":"Saadoun","year":"2017","journal-title":"Gastroenterology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1111\/joim.70042","article-title":"Cryoglobulinemia: an update on classification, pathophysiology, clinical presentation, and management","volume":"299","author":"Zignego","year":"2026","journal-title":"J Intern Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-719773","article-title":"How I treat cryoglobulinemia","volume":"129","author":"Muchtar","year":"2017","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60242-0","article-title":"The cryoglobulinemias","volume":"379","author":"Ramos-Casals","year":"2012","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-3-25","article-title":"B-cells and mixed cryoglobulinemia","volume":"7","author":"Ferri","year":"2007","journal-title":"Autoimmun Rev"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.18.2010","article-title":"Risk of non-Hodgkin lymphoma and lymphoproliferative precursor diseases in US veterans with hepatitis C virus","volume":"297","author":"Giordano","year":"2007","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.jaut.2015.08.008","article-title":"Non HCV-related infectious cryoglobulinemia vasculitis: results from the French nationwide CryoVas survey and systematic review of the literature","volume":"65","author":"Terrier","year":"2015","journal-title":"J Autoimmun"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1801445","article-title":"Genetics and pathogenesis of diffuse large B-cell lymphoma","volume":"378","author":"Schmitz","year":"2018","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-018-0016-8","article-title":"Molecular subtypes of diffuse large B cell lymphoma are associated with distinct pathogenic mechanisms and outcomes","volume":"24","author":"Chapuy","year":"2018","journal-title":"Nat Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.4081\/rt.2009.e42","article-title":"Synchronous Malignant B-cell lymphoma and gastric tubular adenocarcinoma associated with paraneoplastic cutaneous vasculitis: hypereosinophilic syndrome with mixed cryoglobulinemia is an important sign of paraneoplastic syndrome","volume":"1","author":"Nozawa","year":"2009","journal-title":"Rare Tumors"},{"key":"B15","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.cca.2009.03.055","article-title":"Laboratory assessment and perioperative management of patients on antiplatelet therapy: from the bench to the bedside","volume":"405","author":"Lippi","year":"2009","journal-title":"Clin Chim Acta"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cca.2007.08.010","article-title":"Inherited platelet disorders","volume":"387","author":"Franchini","year":"2008","journal-title":"Clin Chim Acta"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13196","article-title":"Clinico-biological characteristics and treatment of type I monoclonal cryoglobulinemia: a study of 64 cases","volume":"168","author":"Harel","year":"2015","journal-title":"Br J Haematol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/md.0b013e318288925c","article-title":"The spectrum of type I cryoglobulinemia vasculitis: new insights based on 64 cases","volume":"92","author":"Terrier","year":"2013","journal-title":"Med (Baltimore)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd011403.pub2","article-title":"Treatment for hepatitis C virus-associated mixed cryoglobulinemia","volume":"5","author":"Montero","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-04-711234","article-title":"Treatment recommendations from the eighth international workshop on waldenstr\u00f6m's macroglobulinemia","volume":"128","author":"Leblond","year":"2016","journal-title":"Blood"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1501548","article-title":"Ibrutinib in previously treated Waldenstr\u00f6m's macroglobulinemia","volume":"372","author":"Treon","year":"2015","journal-title":"N Engl J Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1126\/science.aar6711","article-title":"CAR T cell immunotherapy for human cancer","volume":"359","author":"June","year":"2018","journal-title":"Science"},{"key":"B23","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13045-025-01702-5","article-title":"Therapeutic landscape of primary refractory and relapsed diffuse large B-cell lymphoma: recent advances and emerging therapies","volume":"18","author":"Bock","year":"2025","journal-title":"J Hematol Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1182\/blood.2019001239","article-title":"How I treat acute myeloid leukemia in the era of new drugs","volume":"135","author":"DiNardo","year":"2020","journal-title":"Blood"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-11-253948","article-title":"Safety and efficacy of rituximab in patients with hepatitis C virus-related mixed cryoglobulinemia and severe liver disease","volume":"116","author":"Petrarca","year":"2010","journal-title":"Blood"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.12.018","article-title":"Role of ribavirin in hepatitis flare in HCV-infected patients with B cell non-Hodgkin's lymphoma treated with rituximab-containing regimens","volume":"43","author":"Pellicelli","year":"2011","journal-title":"Dig Liver Dis"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25253","article-title":"Reactivation of hepatitis B virus after rituximab-containing treatment in patients with CD20-positive B-cell lymphoma","volume":"116","author":"Matsue","year":"2010","journal-title":"Cancer"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-024-03911-z","article-title":"Successful treatment of type I cryoglobulinemia with a combination of carfilzomib, cyclophosphamide, and dexamethasone: a case report and literature review","volume":"121","author":"Yasuda","year":"2025","journal-title":"Int J Hematol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26178132","article-title":"Unraveling the epigenetic landscape of mature B cell neoplasia: mechanisms, biomarkers, and therapeutic opportunities","volume":"26","author":"Maher","year":"2025","journal-title":"Int J Mol Sci"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1796461\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:36:12Z","timestamp":1776832572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1796461\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":29,"alternative-id":["10.3389\/fonc.2026.1796461"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1796461","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1796461"}}