Anastassiades CP, Poterucha TH. Virchow's node, jaundice, and weight loss--lymphoma mimicking gastrointestinal malignancy.
NATURE CLINICAL PRACTICE. GASTROENTEROLOGY & HEPATOLOGY 2006;
3:645-8. [PMID:
17068502 DOI:
10.1038/ncpgasthep0635]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Accepted: 08/17/2006] [Indexed: 11/09/2022]
Abstract
BACKGROUND
A 46-year-old white male with a history of well-controlled paranoid schizophrenia presented with painless jaundice, progressive anorexia, weight loss, and dyspnea of 3 months' duration. His only medication at presentation was the antipsychotic olanzapine, taken orally.
INVESTIGATIONS
Physical examination and laboratory tests, including a complete blood cell count, electrolyte, lactate dehydrogenase and haptoglobin levels, liver function tests, and a Coombs' test; CT scan of the chest and abdomen; invasive investigations, including thoracentesis and pleural fluid analysis, bone-marrow biopsy, and left supraclavicular lymph-node biopsy.
DIAGNOSIS
Diffuse large B-cell lymphoma.
MANAGEMENT
Large-volume thoracentesis. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy followed by dexamethasone, cytarabine, and cisplatin chemotherapy, and autologous stem-cell transplantation.
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