Peripheral T-cell lymphoma with unusual clinical presentation of rhabdomyolysis

Hematol Oncol. 2017 Mar;35(1):125-129. doi: 10.1002/hon.2203. Epub 2015 Apr 28.

Abstract

Primary extranodal lymphoma is known to occur in nose, gastrointestinal tract, skin, bone, and central nervous system. However, it is extremely rare for primary lymphoma to arise in skeletal muscle. We report a case of a 32-year-old man who presented initially with fever and fatigue. He had a history of alcohol abuse. Laboratory studies and computerized tomography scan showed results consistent with rhabdomyolysis, but the cause of the rhabdomyolysis was undetermined. After biopsy of abdominal skeletal muscle with histologic examination and T-cell receptor gamma chain gene rearrangement analysis, the diagnosis of peripheral T-cell lymphoma was established. After two cycles of the cyclophosphamide, doxorubicin, vincristine, prednisone, and etoposide regimen, the patient's symptoms greatly improved. This is the third reported case of peripheral T-cell lymphoma arising in skeletal muscle reported in the literature and which presented clinically with rhabdomyolysis. The alcohol abuse during the clinical course likely worsens the pathologic process of the rhabdomyolysis. Copyright © 2015 John Wiley & Sons, Ltd.

Keywords: CHOPE; PTCL-NOS; rhabdomyolysis; skeletal muscle.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alcoholism / complications
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Cyclophosphamide / therapeutic use
  • Diagnosis, Differential
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Gene Rearrangement
  • Humans
  • Immunohistochemistry
  • Lymphoma, T-Cell, Peripheral / diagnosis*
  • Lymphoma, T-Cell, Peripheral / drug therapy
  • Male
  • Muscle, Skeletal / physiopathology
  • Prednisone / therapeutic use
  • Receptors, Antigen, T-Cell, gamma-delta / metabolism
  • Rhabdomyolysis / diagnosis*
  • Rhabdomyolysis / drug therapy
  • Tomography, X-Ray Computed
  • Vincristine / therapeutic use

Substances

  • Antineoplastic Agents
  • Receptors, Antigen, T-Cell, gamma-delta
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • EPOCH protocol