Angioimmunoblastic T-cell Lymphoma: An Unusual Case in an Octogenarian
| Autor: | Isha Shrimanker, Vinod Nookala, Tejaswi Kanderi, Siddharth Goel, Pratiksha Singh |
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| Rok vydání: | 2020 |
| Předmět: |
angioimmunoblastic t-cell lymphoma
Angioimmunoblastic T-cell lymphoma medicine.medical_specialty Pathology Constitutional symptoms Hepatosplenomegaly Aggressive lymphoma 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine lymphadenopathy Internal medicine Biopsy Internal Medicine medicine Hematology medicine.diagnostic_test business.industry General Engineering lymph node medicine.disease Lymphoma Oncology hepatosplenomegaly medicine.symptom business 030217 neurology & neurosurgery Generalized lymphadenopathy |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Angioimmunoblastic T-cell lymphoma (AITL) is an unusual subtype of mature peripheral T-cell lymphoma originating from the follicular T-helper cells and is often associated with autoimmune disorders. AITL is an aggressive lymphoma, presenting with constitutional symptoms, generalized lymphadenopathy, and hepatosplenomegaly. Immunohistochemistry and biopsy are diagnostic methods. The treatment modalities range from steroids, immunomodulators, and cytotoxic chemotherapy. An 87-year-old female presented to the emergency department with cough, dyspnea, dizziness, night sweats, and unintentional weight loss with multiple discrete swellings over her body for a duration of three days. Her physical exam was significant for tachycardia with dry mucous membranes and generalized lymphadenopathy. However, no hepatosplenomegaly was noted. Laboratory investigations revealed neutrophilic leukocytosis (12.8 K/uL), with elevated inflammatory markers (C-reactive protein of 1.39 mg/dL, sedimentation rate of 86 mm/hour). The biopsy of the cervical lymph node revealed atypical lymphoid infiltrates. Flow cytometry showed CD10+ and CD4+/CD8+ T-cells with a minority of CD23+ B-cells, and fluorescence in situ hybridization (FISH) reported gains of the BCL2 gene region on chromosome 18, all of which were suggestive of AITL. She was transferred to an advanced hematology center for staging and targeted therapy. A careful review of the patient with the prompt clinical and histological examination is essential for the correct diagnosis as the differentials are vast due to its non-specific clinical presentation and accurate treatment is a must for complete remission. |
| Databáze: | OpenAIRE |
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