Hemophagocytic Lymphohistiocytosis Secondary to Diffuse B-Cell Lymphoma

Abstract

Hemophagocytic syndrome (HPS) or hemophagocytic lymphohistiocytosis (HLH) arises in the setting of a highly stimulated but ineffective immune response. There is significant overlap between the presentations of HPS and lymphoma and there is still little knowledge and attention among caregivers for this life-threatening syndrome. The current case is a valuable reminder about the possibility of secondary HLH (malignancy-associated in this particular case) as a cause of prolonged unexplained fever. While diagnostic criteria for lymphoma-specific HPS have been previously suggested, their applicability is limited since the HLH 2004 criteria are used to diagnose all cases of HPS. This case shows the importance of accurate interpretation of laboratory and pathological data for the diagnosis of lymphoma-related HPS. HPS in the setting of B-cell lymphoma carries a poor prognosis. Early recognition and prompt treatment offers the best chance of survival, especially in the setting of multi-organ failure. J Hematol. 2015;4(1):151-154 doi: http://dx.doi.org/10.14740/jh192w