Hemophagocytic lymphohistiocytosis secondary to diffuse large B-cell lymphoma presenting with recurrent multi-territory infarcts: A case report

Radiology Case Reports

article

Pham Thi Ngoc Quyen¹  Le Thi Yen Vy¹  Phan Cong Chien¹  Phan Dang Anh Thu¹  Nguyen Ba Thang¹ 

[1]Deparment of Neurology, University Medical Center

关键词: Lymphoma-associated hemophagocytic syndrome;    Hemophagocytic lymphohistiocytosis;    Recurrent multi-territory infarcts;    Diffuse large B-cell lymphoma;   

DOI  :  10.1016/j.radcr.2022.10.061

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Lymphoma-associated hemophagocytic syndrome is a life-threatening disease with poor prognosis and may present as ischemic stroke. We report a case of a 56-year-old female with recurrent multi-territory infarcts caused by diffuse large B-cell lymphoma with secondary hemophagocytic lymphohistiocytosis. She had been diagnosed with ischemic stroke and hemophagocytic syndrome probably secondary to Epstein-Barr virus infection 3 months previously and treated with Dexamethasone and Aspirin. High resolution vessel wall magnetic resonance imaging showed vessel wall thickening at some intracranial vessels suggesting vasculitis. Abdominal computed tomography scan revealed splenomegaly, multiple bilateral small nodules of the lung, multiple liver lesions, multiple bilateral renal masses, gastric wall thickening and multiple nodules in the omentum. Cerebrospinal fluid cytology showed increased cerebrospinal-fluid protein level. Hemophagocytosis was showed on bone marrow aspirate cytology. Gastric tissue biopsy revealed large B cell lymphoma. Chemotherapy was not given because the patient had severe pneumonia and sepsis. The patient died 28 days after the definitive diagnosis was confirmed. Ischemic stroke in our patient with diffuse large B-cell lymphoma may be due to vasculitis or intravascular large B-cell lymphoma.

【 授权许可】

CC BY|CC BY-NC-ND