Article Text

Download PDFPDF
CASE REPORT
Hodgkin's lymphoma preceded by haemophagocytic lymphohistiocytosis
  1. Yoshinori Morita1,
  2. Tsuneaki Kenzaka1,
  3. Hideyuki Yoshimoto2,
  4. Nobuhito Ohno3
  1. 1Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
  2. 2Department of Internal Medicine, Kirishima Medical Center, Kirishima, Japan
  3. 3Department of Hematology, Ikeda Hospital, Kagoshima, Japan
  1. Correspondence to Dr Tsuneaki Kenzaka, smile.kenzaka{at}jichi.ac.jp

Summary

A 71-year-old woman was admitted because of persistent fever for 2 weeks. A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemophagocytosis in the bone marrow. CT showed neither infection nor lymphadenopathy. After administration of prednisolone, haematological findings improved and the fever resolved; however, the patient developed persistent fever after 6 months. In addition, levels of lactate dehydrogenase and sIL-2R increased again. CT scans revealed diffuse lymphadenopathy, and Hodgkin's lymphoma was diagnosed by lymph node biopsy. Progression of pancytopenia was observed, and bone marrow examination showed a relapse of HLH. After six courses of chemotherapy were given for Hodgkin's lymphoma, complete remission was achieved with no evidence of pancytopenia. Hodgkin's lymphoma may be the underlying cause in HLH cases of unknown aetiology. Hence, the clinical course should be carefully monitored even in the absence of lymphadenopathy.

View Full Text

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.