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Angioimmunoblastic T-cell lymphoma: Case report of a diagnostic challenge presented as a lymphoproliferative syndrome

Antunes Leticia Alves

Brazilian woman patient, 51-year-old, born within the State of Bahia, rural worker, married, Catholic, turned into living in São Paulo for 2 months. She become admitted to the Emergency Department at Santa Casa of São Paulo in October/2014 complaining of stomach pain, nausea, vomiting, lymphadenomegaly, fever, night time sweats and weight loss (10kg) that had begun about three months ago. She smoked 1 p.c. of cigarettes according to day for 36 years; however, she denied any beyond medical records or agrotoxic exposure. The entire blood count (CBC) showed anemia, eosinophilia, and thrombocytopenia. All the serologies for infectious diseases have been negative, besides for IgM EBV, that changed into fine. Abdominal ultrasound showed homogeneous hepatosplenomegaly, periportal lymphadenomegaly, a easy cyst in the proper kidney and small quantity of ascites. CT experiment of the chest showed small nodules inside the lungs, a small quantity of pericardial effusion, increased range of lymph nodes in mediastinal, tracheal and intracranial regions, multiplied size of lymph nodes in hilar region bilaterally as nicely as within the chains of the diaphragm, clavicles, and inside the axillaries chains. Myelogram ruled out Leishmaniasis. The bone marrow biopsy become most effective hypercellular, showing hyperplasia of the three myeloid types. Lastly, the cervical lymph node biopsy changed into done with immunophenotyping: CD45 diffusely advantageous; CD3 fine inside the small and medium cells; CD20 nice in immunoblasts; CD4 wonderful in maximum of the lymphocytes; T-cellular lymphoma with angioimmunoblastic features.