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- Title
Intravascular lymphoma -- a clinical conundrum.
- Authors
Chapman, N.; Boyd, H. K.; Convery, R.
- Abstract
Case Report: A 75-year-old lady presented with a 5-week history of severe progressive fatigue; loss of appetite and thrombocytopenia. Scanning revealed an adrenal mass and hepatic abnormality suspicious of malignancy. Over the next 6 weeks the patient developed symptoms suggestive of Transient ischemic attacks. She suffered a myocardial infarction and developed pyrexia. Severe pain occurred in the left hypochondrium. She developed deranged liver function and pancytopenia. Bone marrow biopsy revealed an intravascular large B Cell non-Hodgkin's lymphoma. There was a good response to initial palliative treatment and subsequently the patient tolerated 6 cycles of intensive chemotherapy (PMitCEBO) plus Rituximab and intrathecal Methotrexate. Ten months after presentation remission was shown by follow-up CT Scan and Bone marrow biopsy. Discussion: This patient demonstrates the varied symptoms of this rare form of lymphoma, a diagnosis typically made post mortem. So far the response to chemo and immunotherapy has been good indicating that early diagnosis and modern management may dramatically improve the outlook for patients with this aggressive lymphoma.
- Subjects
FATIGUE (Physiology); THROMBOCYTOPENIA; ISCHEMIA; MYOCARDIAL infarction; RITUXIMAB; LYMPHOMAS
- Publication
Ulster Medical Journal, 2008, Vol 77, Issue 2, p140
- ISSN
0041-6193
- Publication type
Article