A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors
A 75-year-old female with a history of stomach cancer and depression was referred to our hospital for left cervical lymphadenopathy. The biopsy of her left cervical lymph node revealed noncaseating granulomas with multinucleated giant cells. The positron emission tomography/computed tomography (PET/...
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MDPI AG
2023-04-01
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| author | Kazuki Furuyama Makiko Tsukita Yoichi Shirato Yusaku Sasaki Yugo Ashino Toshio Hattori |
| author_facet | Kazuki Furuyama Makiko Tsukita Yoichi Shirato Yusaku Sasaki Yugo Ashino Toshio Hattori |
| author_sort | Kazuki Furuyama |
| collection | DOAJ |
| description | A 75-year-old female with a history of stomach cancer and depression was referred to our hospital for left cervical lymphadenopathy. The biopsy of her left cervical lymph node revealed noncaseating granulomas with multinucleated giant cells. The positron emission tomography/computed tomography (PET/CT) indicated general lymphadenopathy (left supraclavicular left axillary, hepatic lymph nodes), except for the hilar lymph node. Both histology by transbronchial lung biopsy (TBLB) and analysis of broncho alveolar lavage fluid (BALF) were indicative of sarcoidosis. C-reactive protein (CRP) and soluble interleukin-2 receptor (sIL-2R) were increased in the sera. An alternative cause of granulomatous disease was ruled out, and on follow-up, she was diagnosed with sarcoidosis. Two years later, she was hospitalized for fever, anorexia, lymph node tenderness, and erythema nodosum with significant increases in CRP and sIL-2R. After admission, the repetitive axillary lymph biopsy showed the same histological findings as before, but the G-band staining showed clonal abnormalities. Bone marrow biopsy revealed abnormal lymphocytes with petal-like nuclei. Finally, she was diagnosed with malignant lymphoma infiltrating the bone marrow. After CHOP-based chemotherapy, her laboratory data, lymphadenopathy, and clinical findings improved, and she was discharged from the hospital on the 90th day. Careful medical treatment, including genetic analysis of the lymph node, is necessary in patients with sarcoidosis if lymphadenopathy is predominant. |
| first_indexed | 2024-03-11T01:57:36Z |
| format | Article |
| id | doaj.art-071808acdca7453a82f2d137d6f39c65 |
| institution | Directory Open Access Journal |
| issn | 2571-841X |
| language | English |
| last_indexed | 2024-03-11T01:57:36Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Reports |
| spelling | doaj.art-071808acdca7453a82f2d137d6f39c652023-11-18T12:28:01ZengMDPI AGReports2571-841X2023-04-01621910.3390/reports6020019A Case of Sarcoid-Lymphoma Syndrome with Various Etiological FactorsKazuki Furuyama0Makiko Tsukita1Yoichi Shirato2Yusaku Sasaki3Yugo Ashino4Toshio Hattori5Department of Respiratory Medicine, Sendai City Hospital, Sendai 982-8502, JapanDepartment of Hematology, Sendai City Hospital, Sendai 982-8502, JapanDepartment of Respiratory Medicine, Sendai City Hospital, Sendai 982-8502, JapanDepartment of Respiratory Medicine, Sendai City Hospital, Sendai 982-8502, JapanDepartment of Respiratory Medicine, Sendai City Hospital, Sendai 982-8502, JapanResearch Institute of Health and Welfare, Kibi International University, Okayama 716-0018, JapanA 75-year-old female with a history of stomach cancer and depression was referred to our hospital for left cervical lymphadenopathy. The biopsy of her left cervical lymph node revealed noncaseating granulomas with multinucleated giant cells. The positron emission tomography/computed tomography (PET/CT) indicated general lymphadenopathy (left supraclavicular left axillary, hepatic lymph nodes), except for the hilar lymph node. Both histology by transbronchial lung biopsy (TBLB) and analysis of broncho alveolar lavage fluid (BALF) were indicative of sarcoidosis. C-reactive protein (CRP) and soluble interleukin-2 receptor (sIL-2R) were increased in the sera. An alternative cause of granulomatous disease was ruled out, and on follow-up, she was diagnosed with sarcoidosis. Two years later, she was hospitalized for fever, anorexia, lymph node tenderness, and erythema nodosum with significant increases in CRP and sIL-2R. After admission, the repetitive axillary lymph biopsy showed the same histological findings as before, but the G-band staining showed clonal abnormalities. Bone marrow biopsy revealed abnormal lymphocytes with petal-like nuclei. Finally, she was diagnosed with malignant lymphoma infiltrating the bone marrow. After CHOP-based chemotherapy, her laboratory data, lymphadenopathy, and clinical findings improved, and she was discharged from the hospital on the 90th day. Careful medical treatment, including genetic analysis of the lymph node, is necessary in patients with sarcoidosis if lymphadenopathy is predominant.https://www.mdpi.com/2571-841X/6/2/19sarcoid-lymphoma syndromesarcoidosislymphoma |
| spellingShingle | Kazuki Furuyama Makiko Tsukita Yoichi Shirato Yusaku Sasaki Yugo Ashino Toshio Hattori A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors Reports sarcoid-lymphoma syndrome sarcoidosis lymphoma |
| title | A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors |
| title_full | A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors |
| title_fullStr | A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors |
| title_full_unstemmed | A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors |
| title_short | A Case of Sarcoid-Lymphoma Syndrome with Various Etiological Factors |
| title_sort | case of sarcoid lymphoma syndrome with various etiological factors |
| topic | sarcoid-lymphoma syndrome sarcoidosis lymphoma |
| url | https://www.mdpi.com/2571-841X/6/2/19 |
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