Medicine, Central Gippsland Health Service, Sale, Victoria, Australia.
Medicine Department, Central Gippsland Health Service, Sale, Victoria, Australia.
BMJ Case Rep. 2021 Mar 10;14(3):e237806. doi: 10.1136/bcr-2020-237806.
Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) is a relatively rare condition in Australia. Here, we report a case of PTCL, NOS in a patient who presented with persistent fever and progressive pancytopenia on a background of mediastinal lymphadenopathy, initially presumed reactive and hepatosplenomegaly with deranged liver function tests. The diagnosis was challenging, with multiple negative blood cultures and inconclusive bone marrow studies, and it required extensive investigations that ultimately revealed the characteristic clinical, histopathological and immunophenotypic features of PTCL, NOS. The patient underwent multiple rounds of multiagent chemotherapy after the diagnosis. This case highlights the difficulty in diagnosing PTCL, NOS and the importance of including it as a differential diagnosis in younger patients who present with constitutional symptoms and hepatosplenomegaly.
非特指外周 T 细胞淋巴瘤（PTCL，NOS）在澳大利亚较为罕见。在此，我们报告 1 例 PTCL，NOS 患者，该患者以纵隔淋巴结病为背景，表现为持续性发热和进行性全血细胞减少，最初被认为是反应性的，伴有肝脾肿大和肝功能检查异常。该诊断具有挑战性，多次阴性血培养和骨髓研究结果不明确，需要进行广泛的检查，最终揭示了 PTCL，NOS 的特征性临床、组织病理学和免疫表型特征。诊断后，患者接受了多轮多药物化疗。该病例强调了诊断 PTCL，NOS 的困难，以及在出现全身症状和肝脾肿大的年轻患者中，将其作为鉴别诊断的重要性。
