Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

A rare case of fever of unknown origin: subcutaneous panniculitis-like T-cell lymphoma (SPTCL).

ABSTRACT: A 26-year-old man presented with high-grade fever, chills, productive cough and episodic abdominal pain of 6 months duration. Physical examination revealed that the patient was febrile and had multiple, ill-defined, tender, indurated, erythematous nodules and plaques over the trunk and thighs. Systemic examination and investigations revealed bilateral exudative pleural effusion with an increased adenosine deaminase (ADA) level. Pulmonary tuberculosis was suspected and the patient was started on a standard four-drug antitubercular regimen. Since his fever persisted, biopsy of the plaque over the trunk was performed, which showed lobular panniculitis with atypical lymphoid cells. Immunohistochemistry showed atypical lymphoid cells, which were CD3 and CD8 positive and CD4 negative. Based on the clinical features, skin biopsy and immunohistochemistry, the diagnosis of subcutaneous panniculitis-like T-cell lymphoma was made. The patient was treated with chemotherapy followed by bone marrow transplantation, and 4-year follow-up showed complete remission of lymphoma.

SUBMITTER: Ganesh Y

PROVIDER: S-EPMC4550944 | biostudies-other | 2015 Aug

REPOSITORIES: biostudies-other

ACCESS DATA

Json Xml

Similar Datasets

Fever of unknown origin, a rare presentation of metastatic prostate cancer: Case report.

Project description:Metastatic prostate cancer can have an initial presentation with fever and systemic inflammatory response syndrome. Accurate diagnosis allows to differentiate this type of cancer from infectious conditions and to start early treatment. We report one case, in which the patient presented to the emergency department with lower urinary tract symptoms, fever and consumptive syndrome. Acute prostatitis was initially suspected, but subsequently prostate adenocarcinoma was diagnosed. This case enables us to consider the possibility of prostate adenocarcinoma as the diagnose in patients with fever of unknown origin, and the role of procalcitonin to rule out the presence of infection.

| S-EPMC6997235 | biostudies-literature

A difficult case of fever of unknown origin.

Project description:A 57-year-old holidaymaker in Madeira was airlifted to England with a 4-week history of fever, limb weakness and hypophonia. Having undergone a range of investigations during his hospital admission abroad - including ultrasound, CT, echocardiogram and lumbar puncture - the patient arrived without any explanatory diagnosis. At presentation, the only investigatory positives were raised blood inflammatory markers and a, previously unidentified, 'old left frontal infarct' found on head CT. A broad infective and immunological screen proved negative, raising the possibility of vasculitis. Finally, the presence of subacute cerebral and renal infarcts identified on MRI and CT in combination with a negative antineutrophil cytoplasmic antibodies (ANCA) test and distinctive muscle biopsy features confirmed the clinical suspicion of polyarteritis nodosa. An immunosuppressive regime of glucocorticoid therapy and cyclophosphamide were initiated with immediate significant clinical improvement.

| S-EPMC3417029 | biostudies-other

FEVER OF UNKNOWN ORIGIN.

Project description:Forty six patients of fever of unknown origin in Service Hospitals who met the standard criteria were studied between 1989 and 1997. Infectious diseases contributed 21 patients (45.65%) of which 13 (28.26%) were diagnosed to have tuberculosis. Eight patients each (17.39%) of malignancies and collagen vascular diseases were seen, solid tumours were found in 5 patients. One (2.17%) patient had intrabdominal abscess. No diagnosis was made in 4 (8.69%) patients. The pattern and height of fever bore no correlation to aetiology. Serially repeated radiograph of chest was the most contributory investigation giving diagnostic information in 41.3%. Tissue/body fluid biopsy and cytology, serology, ultrasonography, computerised tomography and laparotomy were other useful investigations.

| S-EPMC5531691 | biostudies-other

Primary bone marrow lymphoma: A hematological emergency in adults with fever of unknown origin.

Project description:Primary bone marrow lymphoma (PBML) represents non-Hodgkin lymphoma (NHL) that primarily arises in the bone marrow (BM) without lymphadenopathy. This condition has various definitions and can be masked by prolonged fever, leading to delayed diagnosis. We aimed to identify clinical features and risk indicators of PBML. We enrolled 269 adults with fever of unknown origin (FUO) who underwent a BM study for potential PBML. Thirty patients were diagnosed with PBML (26 and 4 patients in the training and validation cohort, respectively), and 20 patients (67%) showed initial manifestation of hemophagocytic lymphohistiocytosis (HLH). Among PBML patients in the training cohort, their median overall survival is short (8 days), with pneumonia being the most common direct cause of early mortality, followed by life-threatening HLH. Despite extremely poor prognoses, some B-cell PBML patients who survived 30 days after BM studies achieved long-term survival with rituximab-based treatment. To assist general practitioners in early PBML diagnosis when approaching adults with naïve FUO, we identified several risk indicators, including elevated serum alkaline-phosphate levels, lowered serum immunoglobulin-G levels, cytopenia in ?2 lineages, and peripheral blood leukoerythroblastosis. Our recently published scoring system, which can predict hematological BM disease in FUO adults, showed excellent ability in recognizing PBML early, with high sensitivity and specificity. We conclude that PBML is a specific "clinical" phenotype of NHL; moreover, we have identified diagnostic clues for early identification of FUO adults with underlying PBML, which should be considered a hematological emergency once suspected in any adult with FUO.

| S-EPMC6089188 | biostudies-literature

Fever of unknown origin, with a twist.

Project description:The authors present a case of an 81-year-old man with fever of unknown origin. The case report is illustrated with the images which clarified the diagnosis in this challenging case. The cardiac MR images were of critical importance in arriving at a diagnosis of aortic root mycotic pseudoaneurysm with rupture into the right ventricle.

| S-EPMC3618480 | biostudies-other

Delayed diagnosis of biopsy-negative giant cell arteritis presenting as fever of unknown origin.

Project description:Fever of unknown origin (FUO) presents a diagnostic challenge. Giant cell arteritis (GCA) may present with FUO and this entity should be included in the differential of elderly patients who present with constitutional symptoms. While a temporal artery biopsy is considered the gold standard for the diagnosis of GCA, a subset of patients with large vessel involvement by GCA may have a negative temporal artery biopsy and no cranial symptoms. We present a 79 year-old woman with FUO and negative temporal artery biopsies in whom diagnosis of GCA was delayed. Further imaging with CT-angiogram and positron emission tomography/computed tomography (PET/CT) scan showed diffuse extensive active vasculitis. The above case underscores the value of imaging studies in the evaluation of patients with FUO from occult large vessel vasculitis.

| S-EPMC2659161 | biostudies-other