Abstract
BackgroundLymphoma-associated hemophagocytic syndrome (LAHS) occurs in mostly extra nodal non-Hodgkin's lymphoma. LAHS arising from gastrointestinal lymphoma has never been reported. Here we report a case of gastric T-cell lymphoma-associated hemophagocytic syndrome.Case presentationA 51-year-old woman presented with pain, redness of breasts, fever and hematemesis. Hematological examination revealed anemia. Gastroscopy revealed small bleeding ulcers in the stomach and the computed tomography scan showed liver tumor. She underwent total gastrectomy for gastrointestinal bleeding and the histopathology revealed gastric T-cell lymphoma. She continued to bleed from the anastomosis and died on the 8th postoperative day. Autopsy revealed it to be a LAHS.ConclusionsIf Hemophagocytic syndrome (HPS) occurs in lymphoma of the gastrointestinal tract, bleeding from the primary lesion might be uncontrollable. Early diagnosis and appropriate treatment are needed for long-term survival.
Highlights
Lymphoma-associated hemophagocytic syndrome (LAHS) occurs in mostly extra nodal non-Hodgkin's lymphoma
Hemophagocytic syndrome (HPS) is a clinicopathological entity characterized by systemic proliferation of benign hemophagocytic histiocytes, fever, cytopenia, liver dysfunction, hepatosplenomegaly, and coagulopathy [1]
This syndrome has been observed during the clinical course of a wide variety of disorders, including viral infections and malignant neoplasms
Summary
Hemophagocytic syndrome (HPS) in adults is characterized by reactive and systemic proliferation of benign histiocytes that phagocytose blood cells [1]. It is often associated with infections, malignant neoplasms, autoimmune diseases and various immunodeficiencies. PpgFehigsotuitdnorgmeceai1cllgrsaowsgtritaihcphplylmeshopomhwoimrnpgahmi(cHefedemiautmautro-elaxsrygilnientsahinzeedsdtEoaomtsyiapnci,ch×als1ul7yg0m-) Photomicrograph showing medium-large sized atypical lymphoid cells with pleomorphic features in the stomach suggesting a gastric lymphoma (Hematoxylin and Eosin, ×170). Histopathology of the resected specimen showed it to be a gastric lymphoma (pleomorphic medium-large cell type, nonHodgkin's T-cell lymphoma) with liver metastasis (Fig. 1). Malignant lymphoid cell infiltration and hemophagocytosis were observed in the liver, spleen, heart, small bowel, lung, both breasts, kidney, pancreas, uterus, and gastroduodenal lymph nodes (Fig. 2).
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