Peripheral T-cell lymphoma mimicking classic Hodgkin's lymphoma in a patient presenting with fevers of unknown origin

BMJ Case Rep. 2018 Feb 2;2018:bcr2017220858. doi: 10.1136/bcr-2017-220858.

Abstract

A 52-year-old man presented to our hospital for further workup of fever of unknown origin after an extensive workup at an outside hospital had failed to reveal a diagnosis. At the outside hospital, he underwent excisional biopsy of the left supraclavicular lymph node, which showed non-necrotising granulomatous changes, and a bone marrow biopsy which showed a normocellular marrow. He was discharged without a diagnosis with recommendations to present to a tertiary hospital. During his admission, his hospital course was complicated by new direct hyperbilirubinaemia and eosinophilia, prompting liver and skin biopsies which showed CD30+ and CD3+ cells. He subsequently underwent left axillary lymph node biopsy, which was reported as 'classic Hodgkin's lymphoma'. With worsening lab values and T cells noted on liver and skin biopsies, excisional lymph node biopsy was sent to the National Institute of Health, where it was confirmed patient had peripheral T cell lymphoma.

Keywords: cancer intervention; haematology (incl blood transfusion); oncology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Biopsy
  • Diagnosis, Differential
  • Eosinophilia / complications
  • Eosinophilia / drug therapy
  • Fever of Unknown Origin / etiology*
  • Hodgkin Disease / diagnosis*
  • Humans
  • Hyperbilirubinemia / complications
  • Hyperbilirubinemia / drug therapy
  • Ki-1 Antigen
  • Lymph Nodes / pathology
  • Lymphoma, T-Cell, Peripheral / complications
  • Lymphoma, T-Cell, Peripheral / diagnosis*
  • Lymphoma, T-Cell, Peripheral / drug therapy
  • Lymphoma, T-Cell, Peripheral / pathology
  • Male
  • Reed-Sternberg Cells / pathology

Substances

  • Biomarkers, Tumor
  • Ki-1 Antigen