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Sriskandarajah P, Davies R. Thrombocytopenia and fever: not just another infection…. BMJ Case Rep 2016; 2016:bcr-2016-214669. [PMID: 27174453 DOI: 10.1136/bcr-2016-214669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a high-grade, aggressive disease that typically presents with widespread lymphadenopathy and active 'B' symptoms, making it easy to recognise and manage. However, a small proportion of patients can present with no evidence of lymphadenopathy or organomegaly, with the disease confined to the bone marrow; this presentation is also known as 'Primary Bone Marrow DLBCL'. Subsequently, diagnosis can be a challenge, resulting in delayed treatment and an overall poorer prognosis. Given the rarity of this disease, we wished to describe a patient who presented initially with fevers associated with isolated thrombocytopenia and was later diagnosed with this condition. Unfortunately, due to the aggressive nature of this disease, subsequent treatment was unsuccessful. Overall, we felt that in future cases of fevers with thrombocytopenia, clinicians should include this rare lymphoma subtype as part of the differential diagnosis, as early identification and treatment can be associated with a favourable outcome.
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Affiliation(s)
- Priya Sriskandarajah
- Institute of Cancer Research, Sutton, UK Royal Marsden Hospital Sutton, Sutton, UK
| | - Rhys Davies
- Department of Haematology, Epsom and St Helier Hospital, Carshalton, UK
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Takahashi T, Tsukuda H, Itoh H, Kimura H, Yoshimoto M, Tsujisaki M. Primary and isolated adult T-cell leukemia/lymphoma of the bone marrow. Intern Med 2011; 50:2393-6. [PMID: 22001473 DOI: 10.2169/internalmedicine.50.5857] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The distribution of adult T-cell leukemia/lymphoma (ATLL) is typically systemic. In addition to peripheral blood (PB) and lymph nodes, extranodal sites such as the skin, lung, liver, gastrointestinal tract, and central nervous system are frequently involved. We report a unique case of ATLL in which the patient presented with prolonged fever. A 65-year-old man had high-grade fever lasting for 2 weeks. He showed no lymphadenopathy, hepatosplenomegaly, skin lesions, or PB involvement. Bone marrow examination showed widespread infiltration of ATLL cells. (18)F-fluorodeoxy glucose positron emission tomography (FDG-PET) revealed that the disease was confined to the bone marrow.
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Affiliation(s)
- Tohru Takahashi
- Department of Hematology and Gastroenterology, Tenshi Hospital, Japan.
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A Case of Primary Bone Marrow B-Cell Non Hodgkin's Lymphoma with Severe Thrombocytopenia: Case Report and A Review of the Literature. Indian J Hematol Blood Transfus 2010; 26:106-8. [PMID: 21886395 DOI: 10.1007/s12288-010-0040-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Accepted: 04/26/2010] [Indexed: 01/27/2023] Open
Abstract
A 78-year-old man presented with persistent gingival bleeding. He had low platelet count of 1.0 × 10(9)/L without any lymphadenopathy. Bone marrow specimen showed diffusely distributed small-sized lymphocytes. Combined with immunophenotypic analysis, a diagnosis of primary bone marrow B-cell non-Hodgkin's lymphoma was made. Thrombocytopenia was considered to be caused by autoimmune destruction of platelets.
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Lee JY, Kim JH, Shin JH, Kim HR, Lee JN, Kim KH, Lee WS, Joo YD, Sohn CH, Kim CH. Primary Isolated Bone Marrow Diffuse Large B-cell Lymphoma with Hemolytic Anemia as the First Manifestation. THE KOREAN JOURNAL OF HEMATOLOGY 2008. [DOI: 10.5045/kjh.2008.43.1.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ja Young Lee
- Department of Laboratory Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Jae Hyun Kim
- Department of Laboratory Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Jeong Hwan Shin
- Department of Laboratory Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Hye Ran Kim
- Department of Laboratory Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Jeong Nyeo Lee
- Department of Laboratory Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Ki Hyang Kim
- Department of Hemato-oncology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Won Sik Lee
- Department of Hemato-oncology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Young Don Joo
- Department of Hemato-oncology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Chang Hak Sohn
- Department of Hemato-oncology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Chan-Hwan Kim
- Department of Pathology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
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