Cecinati Valerio, Brugnoletti Fulvia, D'Angiò Mariella, De Nicolò Maria Chiara, De Vellis Annalisa, Coluzzi Serelina, Testi Anna Maria
Department of Cellular Biotechnologies and Hematology, Division of Hematology, Rome, Italy.
J Pediatr Hematol Oncol. 2012 May;34(4):280-2. doi: 10.1097/MPH.0b013e318236c4e4.
We discuss an unusual clinical presentation of childhood Hodgkin lymphoma; a 16-year-old girl was referred for Coombs-positive severe anemia, thrombocytopenia, and asymptomatic anterior mediastinal mass. Bone marrow examination showed no evidence of neoplastic disease. Biopsy of the mass was possible only after administration of both intravenous immunoglobulins and steroids resulting in a prompt rise of the platelet count and partial hemoglobin level stabilization. The identification of this clinical picture as a possible complication of an underlying Hodgkin lymphoma presents difficulties in diagnosis and management of the primary condition.
我们讨论了儿童霍奇金淋巴瘤一种不寻常的临床表现;一名16岁女孩因库姆斯试验阳性的严重贫血、血小板减少症以及无症状的前纵隔肿块前来就诊。骨髓检查未发现肿瘤性疾病的证据。仅在静脉注射免疫球蛋白和类固醇后血小板计数迅速上升且部分血红蛋白水平稳定,才得以对肿块进行活检。将这种临床症状识别为潜在霍奇金淋巴瘤的一种可能并发症,给原发性疾病的诊断和治疗带来了困难。