Tsagarakis Nikolaos J, Kentrou Nektaria A, Kakiopoulos Georgios, Androutsos Georgios, Galanopoulos Athanasios, Michaelidis Christos, Rontogianni Dimitra, Tolis Apostolos, Chini Stavroula, Gortzolidis Georgios, Papadimitriou Konstantinos A, Skoumi Dimitra, Tzanetou Konstantina, Paterakis Georgios
Flow Cytometry Laboratory, Department of Immunology, Athens Regional General Hospital "G. Gennimatas", 11527 Athens, Greece.
Case Rep Med. 2011;2011:743817. doi: 10.1155/2011/743817. Epub 2011 Jun 5.
Aggressive lymphomas can present with symptoms mimicking life-threatening infection. Flow cytometry (FC) is usually recommended for the classification and staging of lymphomas in patients with organomegaly and atypical cells in effusions and blood, after the exclusion of other possible diagnoses. FC may also have a place in the initial diagnostic investigation of aggressive lymphoma. Three cases are presented here of highly aggressive lymphomas in young adults, which presented with the clinical picture of fever of unknown origin (FUO) in patients severely ill. All followed a life-threatening clinical course, and two developed the hemophagocytic syndrome (HPS), but microbiological, immunological, and morphological evaluation and immunohistochemistry (IHC) failed to substantiate an early diagnosis. FC was the technique that provided conclusive diagnostic evidence of lymphoma, subsequently verified by IHC. Our experience with these three cases highlights the potential role of FC as an adjunct methodology in the initial assessment of possible highly aggressive lymphoma presenting with the signs and symptoms of life-threatening infection, although the definitive diagnosis should be established by biopsy. In such cases, FC can contribute to the diagnosis of lymphoma, independently of the presence of HPS.
侵袭性淋巴瘤可能表现出类似危及生命的感染的症状。对于有器官肿大且积液和血液中存在非典型细胞的淋巴瘤患者，在排除其他可能的诊断后，通常推荐采用流式细胞术（FC）进行淋巴瘤的分类和分期。FC在侵袭性淋巴瘤的初始诊断检查中也可能有一定作用。本文介绍了三例年轻成人的高度侵袭性淋巴瘤病例，这些病例表现为重症患者不明原因发热（FUO）的临床症状。所有病例均经历了危及生命的临床过程，其中两例发展为噬血细胞综合征（HPS），但微生物学、免疫学、形态学评估及免疫组织化学（IHC）均未能证实早期诊断。FC是提供淋巴瘤确诊证据的技术，随后经IHC验证。我们对这三例病例的经验突出了FC作为辅助方法在初始评估可能表现出危及生命感染体征和症状的高度侵袭性淋巴瘤中的潜在作用，尽管最终诊断应通过活检确定。在这种情况下，无论是否存在HPS，FC都有助于淋巴瘤的诊断。
