An Atypical Case of Hepatosplenic T Cell Lymphoma

doi:10.13188/2380-6842.1000023

Abstract

Highlights

Hepatosplenic T cell lymphoma is a rare, aggressive subtype of T-cell non-Hodgkin lymphoma with extra-nodal and systemic presentations [1]
We present an atypical case of Hepatosplenic T cell lymphoma (HSTL) both in demographic and clinical course
A 55 year old female with a past history of pulmonary embolism, deep venous thrombosis, and type II diabetes presented to the emergency department upon referral from an outside facility with lightheadedness and diffuse, worsening abdominal pain accompanied by nausea and vomiting with concern for traumatic splenic rupture

Summary

Introduction

Hepatosplenic T cell lymphoma is a rare, aggressive subtype of T-cell non-Hodgkin lymphoma with extra-nodal and systemic presentations [1]. A 55 year old female with past history of pulmonary embolism, deep venous thrombosis, and diffuse abdominal pain, presented from an outside hospital with a immediate history of traumatic splenic rupture and hemoperitoneum, necessitating splenectomy. A 55 year old female with a past history of pulmonary embolism, deep venous thrombosis, and type II diabetes presented to the emergency department upon referral from an outside facility with lightheadedness and diffuse, worsening abdominal pain accompanied by nausea and vomiting with concern for traumatic splenic rupture. There was no evidence of lymphadenopathy and review of the peripheral smear from an admission specimen did not show an abnormal leukocyte population Given these findings a diagnosis of hepatosplenic T-cell lymphoma was made and this case was sent for second opinion to University of Virginia Health System with agreement of that diagnosis. Cancer gene mutation panel did not reveal any CML or myeloproliferative neoplasm related DNA mutations or RNA translocations (Figure 3)

Findings

Discussion

Conclusion