Qureshi Ahmad Z, AlSheef Mohammad, Qureshi Waqas T, Amjad Waseem
Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2016 Nov;37(11):1265-1267. doi: 10.15537/smj.2016.11.15367.
Adult onset Still's disease (AOSD) is a chronic inflammatory disorder involving multiple systems. The symptoms mimic those of lymphomas, therefore, the diagnosis of lymphoma needs to be excluded prior to establishing the diagnosis of AOSD. Another similar condition is dermatopathic lymphadenopathy (DL). In DL, the histopathological appearance of lymph node biopsy may also mimic AOSD. The DL is associated with several systemic pathologies, such as malignant lymphomas, and rarely AOSD. We present a case of a 43-year-old male presented with 3 months history of fatigue, fever, and lymphadenopathy. Initial work-up satisfactorily met the criteria for diagnosis of AOSD. But considering the well-known association of DL with hematological malignancies, detailed pathological studies were considered, including tumor markers to rule out the possibility of malignancy. The patient was started on steroids and showed remarkable recovery within 2 weeks. Evaluation of malignant lymphomas in a patient with DL is important, in order to diagnose AOSD and rule out hematological malignancy.
成人斯蒂尔病(AOSD)是一种累及多个系统的慢性炎症性疾病。其症状与淋巴瘤相似,因此,在确立AOSD诊断之前需要排除淋巴瘤的诊断。另一种类似的疾病是皮肤淋巴细胞瘤(DL)。在DL中,淋巴结活检的组织病理学表现也可能与AOSD相似。DL与多种系统性疾病相关,如恶性淋巴瘤,与AOSD相关的情况很少见。我们报告一例43岁男性患者,有3个月的疲劳、发热和淋巴结病病史。初步检查结果符合AOSD的诊断标准。但考虑到DL与血液系统恶性肿瘤的已知关联,进行了详细的病理研究,包括肿瘤标志物检查以排除恶性肿瘤的可能性。患者开始使用类固醇治疗,2周内病情显著好转。对DL患者进行恶性淋巴瘤评估很重要,以便诊断AOSD并排除血液系统恶性肿瘤。