Abstract
Chronic rhinosinusitis (CRS) is one of the most common persistent disorders of the developed world, requiring input from various specialists including primary care physicians, otolaryngologists, respiratory physicians, and allergologists. B-cell lymphoproliferative disorders (BLPDs) are a heterogenous group of malignant conditions defined by an accumulation of mature B lymphocytes in the bone marrow, blood, and lymphoid tissues. We present a case report of an elderly man with rhinosinusitis-like symptoms and atypical features prompting further investigations that culminated in a diagnosis of BLPD.
Highlights
Our patient was referred to haematology where on physical examination thisno case report,evidence we present a patient referred from primary care for Chronic rhinosinusitis (CRS) without thereInwas clinical of palpable lymphadenopathy or hepatosplenomegaly
While the diagnosis of B-cell lymphoproliferative disorders (BLPDs) was clinical, the value of endobronchial ultrasoundIn this case report,needle we present a patient referred from care and for CRS
Clinicians should have a high index of clinical clinical feature that often requires no specific treatment, it is crucial for the suspicion and our usual practice should be to check serum protein electrophoresis and clinician to identify the small number of cases that are due to a potentially wide differential immunoglobulins in all patients presenting with CRS-like symptoms and signs of immudiagnosis including systemic inflammatory disorders such as vasculitis, malignancy, and nosuppression as it may lead to an earlier diagnosis and potentially better outcome for infection, amongst others [13]
Summary
In addition to multiple courses of antibiotics, he had previously tried fluticasone furoate, mometasone furoate, and beclomethasone dipropionate nasal sprays to no avail He retained his sense of smell and denied post-nasal drip, sneezing, breathlessness, or cough. He had no history of excess fatigue, weight loss, or night sweats. A = aspergillus fumigatus; ALP = alkaline phosphatase; ALT = alanine aminotransferase; B = silver birch; C = cat dander; CD = cluster of differentiation; CTD = connective tissue disease; D = dog dander; H = house dust mite; MPO = myeloperoxidase; NK = natural killer; NR = normal range; PR3 = proteinase-3; RAST = radioallergosorbent testing for specific IgE. Image depicting disease affecting the ethmoid bullae and ostio-meatal complex
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