Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
Hematology and Oncology, University of Colorado School of Medicine, Aurora, Colorado, USA.
BMJ Case Rep. 2024 Feb 17;17(2):e257513. doi: 10.1136/bcr-2023-257513.
A man in his 30s presented with several months of non-bloody diarrhoea and nausea along with conjunctivitis, diffuse ichthyosis and cellulitis in the setting of progressive neck swelling. He was ultimately diagnosed with nodular sclerosing Hodgkin's lymphoma after undergoing a broad infectious, rheumatological and neoplastic workup. This represents a rare presentation of classic Hodgkin's lymphoma and demonstrates the known alteration of cellular immunity in Hodgkin's lymphoma alongside manifestations of the profound inflammatory state associated with the disease. The patient was initiated on chemotherapy and many of his symptoms resolved. Hodgkin's lymphoma may present as a multisystemic cascade of symptoms and should be high on the differential diagnosis for a patient with lymphadenopathy and associated infectious, gastrointestinal and cutaneous symptoms.
一位 30 多岁的男性患者出现数月无血腹泻和恶心,伴有结膜炎、弥漫性鱼鳞癣和蜂窝织炎,同时伴有进行性颈部肿胀。在广泛的传染性、风湿性和肿瘤学检查后,他最终被诊断为结节硬化型霍奇金淋巴瘤。这代表了经典霍奇金淋巴瘤的罕见表现,并显示了霍奇金淋巴瘤中细胞免疫的已知改变,以及与疾病相关的严重炎症状态的表现。患者开始接受化疗,他的许多症状得到缓解。霍奇金淋巴瘤可能表现为一系列多系统症状,对于伴有淋巴结病和相关感染、胃肠道和皮肤症状的患者,应高度考虑该病的鉴别诊断。