Abstract
IntroductionPeripheral T-cell lymphoma of the unspecified variant is a highly aggressive subtype of T-cell non-Hodgkin's lymphoma. This is the first reported case of this type of lymphoma presenting as an ischemic stroke in a woman.Case presentationA previously healthy 23-year-old woman presented with fever and hemiplegia. She was subsequently intubated after scoring 7 out of 15 at the Glasgow Coma Scale. Brain computed tomography scans of the patient depicted a massive sylvian infarction while an abdominal computed tomography scan revealed multiple enlarged abdominal lymph nodes and a retroperitoneal mass adjacent to the left psoas muscle. A diagnostic work up for inherited thrombophilia yielded negative results. Blood and cerebrospinal fluid cultures for infectious agents also gave negative results. A biopsy of the retroperitoneal mass guided by computed tomography was inconclusive. A biopsy of an enlarged inguinal lymph node of the patient, combined with an immunophenotypic analysis, revealed an unspecified variant of peripheral T-cell lymphoma. The patient underwent chemotherapy but developed multiple organ failure. She died 26 days after she was admitted to our intensive care unit.ConclusionPeripheral T-cell lymphoma of the unspecified variant is a highly aggressive subtype of peripheral T-cell lymphomas. The latter exhibit no consistent immunophenotypic, genetic, or clinical features. Clinicians should be aware of atypical clinical presentations of the above lymphomas such as ischemic stroke.
Highlights
Peripheral T-cell lymphoma of the unspecified variant is a highly aggressive subtype of T-cell non-Hodgkin's lymphoma
We present the case of a woman who was admitted to our intensive care unit (ICU) due to cerebral
While a brain tumor is a main differential diagnosis in patients with ischemia, Peripheral T-cell lymphoma of the unspecified variant (PTCL-U) presenting as a cerebral infarction has not been previously described in the literature
Summary
This case illustrates that peripheral T-cell lymphomas of the unspecified variant exhibit an aggressive clinical course and are usually associated with a poor outcome. Their clinical and pathologic characteristics are not consistent, which make diagnosis difficult. 8. Kojima H, Hasegawa Y, Suzukawa K, Mukai HY, Kaneko S, Kobayashi T, Kamoshita M, Shinagawa A, Komeno T, Komatsu T, Mitsuhashi S, Kawachi Y, Yamashita Y, Mori N, Nagasawa T: Clinicopathological features and prognostic factors of Japanese patients with "peripheral T-cell lymphoma, unspecified" diagnosed according to the WHO classification.
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