Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge
The use of immune-checkpoint inhibitor (ICI) therapy has significantly improved patient outcomes in a wide variety of cancers and has become a cornerstone in the treatment of renal cell carcinoma. However, ICI treatment has the potential to cause a variety of immune-related adverse events (irAEs) th...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.876797/full |
| _version_ | 1818215491436544000 |
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| author | Matthew Scarlotta Robin Avery Ezra Baraban Zahra Maleki Yasser Ged |
| author_facet | Matthew Scarlotta Robin Avery Ezra Baraban Zahra Maleki Yasser Ged |
| author_sort | Matthew Scarlotta |
| collection | DOAJ |
| description | The use of immune-checkpoint inhibitor (ICI) therapy has significantly improved patient outcomes in a wide variety of cancers and has become a cornerstone in the treatment of renal cell carcinoma. However, ICI treatment has the potential to cause a variety of immune-related adverse events (irAEs) that can affect any tissue or organ. This report describes the diagnostic dilemma of a patient with both RCC and diffuse large B-cell lymphoma who developed acute onset of fever and diffuse lymphadenopathy following treatment with combined ipilimumab and nivolumab. While diagnostic considerations included worsening lymphoma, hyperprogression of RCC, sarcoid-like reaction from immunotherapy, and fungal infection, his lymphadenopathy eventually resolved with treatment for histoplasmosis and discontinuation of immunotherapy. Despite only receiving two doses of immunotherapy, he has not required additional systemic therapy for RCC. This case demonstrates both the effectiveness of ICI therapy and the need for multidisciplinary approach to potential irAEs. |
| first_indexed | 2024-12-12T06:36:55Z |
| format | Article |
| id | doaj.art-5f72688f580c4ee5b2b5e243a58663ae |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-12T06:36:55Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-5f72688f580c4ee5b2b5e243a58663ae2022-12-22T00:34:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-05-011210.3389/fonc.2022.876797876797Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological ChallengeMatthew Scarlotta0Robin Avery1Ezra Baraban2Zahra Maleki3Yasser Ged4Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesThe use of immune-checkpoint inhibitor (ICI) therapy has significantly improved patient outcomes in a wide variety of cancers and has become a cornerstone in the treatment of renal cell carcinoma. However, ICI treatment has the potential to cause a variety of immune-related adverse events (irAEs) that can affect any tissue or organ. This report describes the diagnostic dilemma of a patient with both RCC and diffuse large B-cell lymphoma who developed acute onset of fever and diffuse lymphadenopathy following treatment with combined ipilimumab and nivolumab. While diagnostic considerations included worsening lymphoma, hyperprogression of RCC, sarcoid-like reaction from immunotherapy, and fungal infection, his lymphadenopathy eventually resolved with treatment for histoplasmosis and discontinuation of immunotherapy. Despite only receiving two doses of immunotherapy, he has not required additional systemic therapy for RCC. This case demonstrates both the effectiveness of ICI therapy and the need for multidisciplinary approach to potential irAEs.https://www.frontiersin.org/articles/10.3389/fonc.2022.876797/fullimmune checkpoint inhibitorslymphadenopathyrenal cell carcinomadiffuse large B-cell lymphomasarcoid-like reactionhistoplasmosis |
| spellingShingle | Matthew Scarlotta Robin Avery Ezra Baraban Zahra Maleki Yasser Ged Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge Frontiers in Oncology immune checkpoint inhibitors lymphadenopathy renal cell carcinoma diffuse large B-cell lymphoma sarcoid-like reaction histoplasmosis |
| title | Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge |
| title_full | Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge |
| title_fullStr | Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge |
| title_full_unstemmed | Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge |
| title_short | Case Report: New Onset Lymphadenopathy After Immune Checkpoint Inhibitor Therapy Presents a Clinicopathological and Radiological Challenge |
| title_sort | case report new onset lymphadenopathy after immune checkpoint inhibitor therapy presents a clinicopathological and radiological challenge |
| topic | immune checkpoint inhibitors lymphadenopathy renal cell carcinoma diffuse large B-cell lymphoma sarcoid-like reaction histoplasmosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.876797/full |
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