Disappearance Of Lymphadenopathy Research Articles

Cutaneous sarcoidosis presenting with diffuse panniculitis: Report of a case

Cutaneous lesions in sarcoidosis are polymorphic. They can simulate most dermatological conditions. We report a case of cutaneous sarcoidosis presented as diffuse Panniculitis. Case Report: A 62 years patient with no significant past medical history consulted for infiltrated lesion on abdominal skin infiltration lasting for 2 years. On examination, there were multiple indurated plaques, topped with keratotic papules giving an orange peel view, extending on abdominal genitalia and thighs skin associated with lymph nodes enlargement in different sizes and elastic consistence in axillary and inguinal regions. The histopathological examination of the skin lesion and the lymph nodes revealed typical sarcoidosis granulomas. Thoracic abdominal CT scan was normal. After six months of treatment with methotrexate and prednisone, evolution was remarkable by a rapidly skin lesions des infiltration and disappearance of lymphadenopathy. Conclusion: Cutaneous sarcoidosis as disseminated panniculitis is rarely reported in the literature. In our patient, methotrexate combined with prednisone was effective. Other studies have confirmed the efficacy of methotrexate, especially as a steroid sparing treatment. This efficiency would be the result of adenosine production and a decrease in TNF a secretion in granulomatous lesions.

Unusual Extramedullary Plasmacytoma: A Rare but Possible Cause of Lymphadenopathy in Chronic Lymphocytic Leukemia.

Cervical bilateral lymphadenopathy is a frequent event during chronic lymphocytic leukemia (CLL) natural history. However, lymph node biopsy is generally not required as long as transformation into an aggressive lymphoma (Richter syndrome) is not suspected. We present here a rare case of CLL patient who developed progressive bilateral cervical lymph node and bilateral tonsillar hypertrophy. CLL front-line therapy was ineffective leading to adenectomy and diagnosis of concomitant extramedullary plasmacytoma. Radiotherapy did not result in the disappearance of lymphadenopathy. Adenectomy should be performed in CLL cases to avoid misdiagnosis.

Spontaneous tumor lysis syndrome with resolution of pancytopenia and disappearance of lymphadenopathy in a patient with peripheral T cell lymphoma unspecified

Tumor lysis syndrome is a well-described, serious complication of chemotherapy administered to treat malignancies. However, a very rare event resulting in the spontaneous necrosis of a tumor prior to therapy can also occur, which is termed spontaneous tumor lysis syndrome (STLS). We present a case of a 27-year-old male who presented to the hospital with epistaxis, dyspnea, and cervical lymphadenopathy. Laboratory findings included progressive pancytopenia, hyperuricemia, and acute renal failure. Bone marrow biopsy showed a T cell lymphoid neoplasm that had entirely infiltrated the marrow stroma. The patient was diagnosed with STLS in the setting of a T cell lymphoma with bone marrow infiltration. The patient was immediately treated with a blood transfusion and hemodialysis. After this urgent treatment, the patient's pancytopenia resolved and the lymphadenopathy disappeared spontaneously. One month post-treatment, the patient's cervical lymphadenopathy recurred and peripheral T cell lymphoma, not otherwise specified, was confirmed. STLS has previously been reported, however, most known cases of STLS did not show a decreased tumor burden resulting from massive tumor cell death. We present a rare case of STLS with resolution of pancytopenia and disappearance of lymphadenopathy in a patient with peripheral T cell lymphoma not otherwise specified.

Rapid and prolonged palliation of symptoms with improved quality of life (QOL) with endocrine therapy (anastrazole) in metastatic breast cancer (MBC)

10767 Background: Efficacy of anastrazole in receptor positive post-menopausal MBC; rapid palliation of symptoms with improved QOL. Methods: Case Report: A 62 year old woman diagnosed with right breast cancer in 1995, stage IIB, underwent surgery, adjuvant chemotherapy, and tamoxifen for 5 years. In February 2004, a left supraclavicular lymph node (1 cm) was felt. Chest x-ray (CXR) showed blunting of right cardiophrenic angle. CT scan of the neck showed multiple left cervical lymph nodes. In April 2004, her condition deteriorated rapidly needing hospitalization. She developed 15 pound weight loss, anemia, anorexia, shortness of breath, dyspnea on exertion, dry cough, and chest pain. CXR showed large right pleural effusion needing multiple thoracentesis. Hemorrhagic exudative effusion was seen with negative cytology and cultures. She also developed multiple palpable left cervical and left axillary lymphadenopathy. Breast exam was normal. Mammogram was not diagnostic but ultrasound of breast showed a 2.5cm left breast mass, axillary lymphadenopathy and additional lesions in the breast. Left cervical lymph node biopsy showed metastatic adenocarcinoma favoring primary breast cancer. A diagnosis of 2nd primary breast cancer with metastasis was made. Within 1 week of palliative capecitabine, she was readmitted with significant mucositis, diarrhea, dehydration, dysphagia, electrolyte imbalance, and reaccumulation of right pleural effusion. She lost 35 lbs. in 4 months. She was aggressively resuscitated and also needed thoracocentesis. Markers from prior biopsy showed Estrogen receptor 20%, Progesterone receptor <5%, and HER 2 (Herceptest) 3+. Palliative hormonal therapy with anastrazole was started in July 2004. Results: Within 4 weeks, she improved significantly with disappearance of lymphadenopathy and resolution of effusion. Performance status improved to ECOG 0. She is continuing anastrazole, 17 months since the diagnosis of debilitating metastatic breast cancer. Conclusions: Anastrazole is approved for the treatment of hormone receptor positive post-menopausal MBC. We describe the efficacy of endocrine therapy (anastrazole) leading to rapid and meaningful palliation of symptoms with improved QOL. No significant financial relationships to disclose.

Lymphadenopathy in Renal Transplant Patients Treated with Immunosuppressive Antibodies (OKT3 and Anti-thymocyte Globulin)

A clinicopathological study of nine patients who developed systemic lymphadenopathy following renal transplantation and immunosuppressive therapy (OKT3 and anti-thymocyte globulin) showed a rapidity of onset and disappearance of lymphadenopathy (nine of nine cases), a frequent association of systemic signs (nine of nine cases), and a heterogeneity of histological patterns ranging from diffuse lymphoid hyperplasia to one incorrectly considered to be immunoblastic lymphoma. The coexpression of both light chains was useful in the exclusion of the diagnosis of B lymphoma. These posttransplant lymphoproliferative syndromes seem to represent an allergic reaction to the introduction of foreign protein resembling serum sickness rather than a viral infection favored by immunosuppression, although in one case (with pseudolymphomatous features) a virus was the likely mechanism.