Adult-Onset T-Cell Acute Lymphoblastic Lymphoma-Leukemia Presenting With Petechial Rash: A Case Report.
| Autor: | Kimball K; Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA., Elad V; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Hamad EJ; College of Medicine, Northeast Ohio Medical University, Rootstown, USA., Wasco C; Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Aug 25; Vol. 16 (8), pp. e67744. Date of Electronic Publication: 2024 Aug 25 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.67744 |
| Abstrakt: | T-cell acute lymphoblastic lymphoma-leukemia (T-ALL) is a rare neoplastic disease with presenting symptoms that are often non-specific. As such, accurate diagnosis requires high clinical suspicion and assessment of bone marrow aspirate with flow cytometry and morphology. While remission is achievable in most patients, the five-year survival rate is only 48% despite treatment. The standard chemotherapy regimen is referred to as hyper-CVAD, where CVAD stands for cyclophosphamide, vincristine sulfate, Adriamycin (doxorubicin), methotrexate, and dexamethasone. In this study, we describe a 38-year-old female who presented with atraumatic abdominal bruising and a petechial rash on the upper and lower extremities. Imaging revealed a 16 cm anterior mediastinal mass and a bone marrow and mediastinal mass biopsy confirmed a diagnosis of T-ALL. The patient received hyper-CVAD cycle 1A with several complications but ultimately achieved remission after four cycles. Here, we stress the importance of broadening differentials for new-onset petechial rashes in adults to include systematic lymphomas, such as T-ALL, and the need for early recognition so patients can receive timely treatment. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Kimball et al.) |
| Databáze: | MEDLINE |
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