Isoda Atsushi, Iriuchishima Hirono, Saito Akio
Department of Hematology, Iryohojin Hoshiiin, Maebashi, JPN.
Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, JPN.
Cureus. 2025 Aug 13;17(8):e90029. doi: 10.7759/cureus.90029. eCollection 2025 Aug.
This report describes the case of a middle-aged man who presented with bilateral inguinal lymphadenopathy and an elevated serum level of soluble interleukin-2 receptor (sIL-2R), initially raising concern for malignant lymphoma. In Japan, sIL-2R is widely reimbursed as a diagnostic adjunct for lymphoma, which heightened the suspicion of malignancy in this case. However, serologic testing for syphilis returned positive, leading to a diagnosis of active syphilis. Lymph node biopsy was deferred, and the patient was treated with oral ampicillin, resulting in the resolution of lymphadenopathy and normalization of sIL-2R levels. This case underscores the importance of considering syphilis in the differential diagnosis of unexplained lymphadenopathy, particularly in regions where incidence is increasing.
本报告描述了一名中年男性的病例，该患者出现双侧腹股沟淋巴结病，血清可溶性白细胞介素-2受体（sIL-2R）水平升高，最初引发了对恶性淋巴瘤的担忧。在日本，sIL-2R作为淋巴瘤的诊断辅助手段被广泛报销，这增加了该病例中对恶性肿瘤的怀疑。然而，梅毒血清学检测呈阳性，导致诊断为活动性梅毒。淋巴结活检被推迟，患者接受口服氨苄青霉素治疗，淋巴结病得到缓解，sIL-2R水平恢复正常。该病例强调了在不明原因淋巴结病的鉴别诊断中考虑梅毒的重要性，尤其是在发病率正在上升的地区。
