Angioimmunoblastic T-cell Lymphoma Presenting Research Articles

Angioimmunoblastic T-cell Lymphoma Presenting With a Neutrophilic Leukemoid Reaction: A Diagnostic Challenge

Angioimmunoblastic T-cell lymphoma (AITL) accounts for 1-2% of all non-Hodgkins lymphoma. Patients present with lymphadenopathy, hepatosplenomegaly, polyclonal hypergammaglobulinemia and skin lesions. The presence of rash and neutrophilia in the absence of circulating abnormal lymphocytes in the peripheral blood film leads to a misdiagnosis. A 33-year-old presented with cervical lymphadenopathy with WCC of 104.9 g/dl, maculopapular rash, loss of weight and appetite associated with B symptoms. His peripheral blood film revealed hyperleukocytosis with a neutrophilic leukemoid reaction. Neutrophil alkaline phosphatase (NAP) score was high. Bone marrow aspirate and trephine were suggestive of neutrophilic leukemoid reaction with features of granulocytic hyperplasia with no lymphoid aggregates suggestive of neutrophilic leukemoid reaction secondary to underlying malignancy with a differential of myeloproliferative neoplasm if no reactive causes of granulocytic hyperplasia could be found. A lymph node biopsy was done later and was consistent with AITL. This case illustrates the rare presentation of AITL with a neutrophilic leukemoid reaction in the absence of anaemia, eosinophilia and abnormal lymphoid cells.

Angioimmunoblastic T-cell lymphoma presenting as extensive pseudovesicular papuloplaques

Angioimmunoblastic T-cell lymphoma presenting as extensive pseudovesicular papuloplaques

Vacuolated lymphocytes as initial presentation of angioimmunoblastic T-cell lymphoma.

Vacuolated lymphocytes as initial presentation of angioimmunoblastic T-cell lymphoma.

1505 Relapsed Angioimmunoblastic T-Cell Lymphoma Presenting as Severe Colitis With Bowel Perforation

INTRODUCTION: Angioimmunoblastic T-cell lymphoma (AITL) is a subtype of the uncommon peripheral T-cell lymphomas that usually presents as acute onset of systemic B symptoms and generalized lymphadenopathy. Here, we report a case of a woman with relapsed AITL involving the descending, sigmoid colon, and rectum, presenting as persistent diarrhea and bowel perforation. CASE DESCRIPTION/METHODS: A 78-year-old woman who was diagnosed with AITL in 2002 and had been stable on continuous therapy of romidepsin for the past 2.5 years for relapsed disease, presented with a 6-week history of diarrhea, fatigue, and decreased appetite. The diarrhea was watery, non-bloody, occurred 4-5 times a day, with fecal urgency and incontinence. The patient denied any abdominal pain, nausea, vomiting, or fever. There was no recent change in her medications, and no recent history of travel or contact with children or pets. During the 6-week period, she was hospitalized twice and was initially thought to have infectious colitis, for which she was given ciprofloxacin, metronidazole, and re-hydration therapy. Abdominal CT showed severe left-sided colitis with multiple enlarged perirectal and mesenteric lymph nodes. Upon her third admission, infectious etiologies were ruled-out and sigmoidoscopy showed markedly edematous and erythematous rectum. Biopsies from the rectum and sigmoid colon showed dense atypical T-cell infiltration consistent with involvement of her previous AITL. Her hospital course was further complicated by bowel perforation and polymicrobial positive blood cultures. She refused surgery and was referred to home hospice for palliative care. DISCUSSION: AITL is an aggressive peripheral T-cell lymphoma that is believed to arise from CD4 positive follicular helper T-cells. It accounts for 1-2% of non-Hodgkin lymphoma cases and has a higher incidence among Asian/Pacific Islanders and Hispanic Whites in the United States. Initial presentation commonly includes generalized lymphadenopathy, fever, unintentional weight loss, and night sweats. With progression, it can commonly involve the bone marrow, spleen, skin and soft tissues. However, gastrointestinal involvement is rare. In 1996, Goenka et al. reported AITL presenting as colonic polyps. We are reporting a case of AITL progressing to involve the descending, sigmoid colon, and rectum, whose presentation was initially mistaken for infectious colitis. However, due to high clinical suspicion, sigmoidoscopy was performed and biopsies confirmed the diagnosis of AITL of the colon.

Angioimmunoblastic T-cell lymphoma presenting with diffuse cutaneous ulceration: A rare clinical presentation of a protean disease

Angioimmunoblastic T-cell lymphoma presenting with diffuse cutaneous ulceration: A rare clinical presentation of a protean disease

Cardiac Tamponade as Initial Presentation of Angioimmunoblastic T-Cell Lymphoma

A 21-year-old man presented initially with impending cardiac tamponade secondary to an angioimmunoblastic T-cell lymphoma (AITL). Following unsuccessful pericardiocentesis and subxiphoid pericardiostomy, the patient's deteriorating hemodynamics prompted an urgent sternotomy. Histopathological diagnosis confirmed AITL. While chemotherapy remains the most effective treatment of AITL, life-threatening complications of the tumor necessitates surgical intervention.

Non-ST Elevation MI as a Unique Presentation of Angioimmunoblastic T-cell Lymphoma

Case A 61-year-old Chinese female with a history of hypertension, hyperlipidemia, asthma, and gastroesophageal reflux disease presented with four days of chest pressure that radiated to her left arm and jaw. On exam, her vital signs were within normal limits and cardiac and pulmonary exams were unremarkable. Her initial electrocardiogram (ECG) demonstrated ischemic ST segment depressions in leads II, III, and aVF; her first troponin I was elevated at 2.3 ng/mL (normal <0.05 ng/mL) and peaked at 6.8 ng/mL. She was given sublingual nitroglycerin and metoprolol, which controlled her symptoms, and she was started on a heparin infusion to prevent further ischemia. The patient’s medications included: amlodipine was notable for the following daily medications: amlodipine 5 mg, olmesartan 20mg, atorvastatin 20mg, esomeprazole 20mg, montelukast 10mg, and mometasone 110mcg twice daily. Her family history was significant for a brother who had a coronary stent placed at age 57. She denied drug, tobacco, or alcohol use. She was non-English speaking, and immigrated to the United States from China five years ago.

皮疹を伴った Angioimmunoblastic T-cell Lymphoma の 2 例

皮疹を伴った Angioimmunoblastic T-cell Lymphoma の 2 例

Angioimmunoblastic T-cell lymphoma presenting with both IgA-related leukocytoclastic vasculitis and mucous membrane pemphigoid

ejd.2010.1227 Auteur(s) : Yuichiro ENDO1,2, Masaaki TSUJI3, Tomoyuki SHIRASE4, Shunpei FUKUDA5, Takashi HASHIMOTO5, Yoshiki MIYACHI2, Yoshiaki YOSHIKAWA1 yyoshi@otsu.jrc.or.jp 1 Department of Dermatology, Otsu Red Cross Hospital, 1-1-35, Nagara, Otsu-shi, Shiga 520-8511, Japan 2 Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan 3 Department of Hematology, Otsu Red Cross Hospital, Shiga, Japan 4 Department of Hematology, Otsu Red Cross Hospital, Shiga, Japan 5 [...]

Angioimmunoblastic T-cell lymphoma presenting as extensive psoriasis: a case report and discussion

Angioimmunoblastic T-cell lymphoma presenting as extensive psoriasis: a case report and discussion

A rare case of angioimmunoblastic T-cell lymphoma presenting with fever and late polyarthritis

A rare case of angioimmunoblastic T-cell lymphoma presenting with fever and late polyarthritis

Angioimmunoblastic T-cell lymphoma presenting as giant kidneys: a case report

IntroductionAngioimmunoblastic T-cell lymphoma is a rare form of tumor of the lymph nodes or lymphoid tissue. In this report we describe an unusual presentation of angioimmunoblastic T-cell lymphoma consisting of giant kidneys with no nephrotic syndrome.Case presentationA 46-year-old Arabic man from Gaza was hospitalized in our ward due to abdominal pain and a weight loss of 20 kg during the preceding two months. The results of the physical examination and laboratory tests raised the possibility of neoplastic disease. A computerized tomographic scan of the abdomen showed huge kidneys, and a kidney biopsy showed infiltration by lymphocytes and eosinophils. The genetic examination revealed T-cell lymphoma. Diagnosis was made by a lymph node biopsy, which shows typical findings of angioimmunoblastic T-cell lymphoma.ConclusionsAngioimmunoblastic T-cell lymphoma can present with huge kidneys without nephrotic syndrome.

Angioimmunoblastic T-cell lymphoma presenting with rapidly increasing biclonal gammopathy

Angioimmunoblastic T-cell lymphoma presenting with rapidly increasing biclonal gammopathy