Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 24, 2020; 11(6): 405-411
Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.405
Angioimmunoblastic T-cell lymphoma accompanied by pure red cell aplasia: A case report
Teiko Kawahigashi, Izumi Kitagawa, Eri Tanaka
Teiko Kawahigashi, Izumi Kitagawa, Department of General Internal Medicine, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan
Eri Tanaka, Department of Hematology, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan
Author contributions: Kawahigashi T has made substantial contributions to the development of this case report and wrote the initial draft of the manuscript; Kitagawa I and Tanaka E were involved in the drafting of the manuscript and for revising it critically with regard to important intellectual content; all authors meet the criteria for authorship and have read and approved of the manuscript for submission.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts-of-interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Teiko Kawahigashi, MD, Doctor, Department of General Internal Medicine, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa 247-8533, Japan. teikokawahigashi@gmail.com
Received: January 20, 2020
Peer-review started: January 20, 2020
First decision: April 29, 2020
Revised: May 21, 2020
Accepted: May 28, 2020
Article in press: May 28, 2020
Published online: June 24, 2020
Processing time: 156 Days and 3.9 Hours
Abstract
BACKGROUND

Angioimmunoblastic T-cell lymphoma (AITL) is a peripheral T-cell lymphoma, which is a rare subtype of lymphoma. Patients with AITL often have skin lesions, which are observed in 50% of all cases; the chief complaint of this patient was palpable purpura. AITL often complicates autoimmune or hematological disorders; however, among these, pure red cell aplasia (PRCA) is a very rare complication of AITL. We herein report a case of AITL with PRCA.

CASE SUMMARY

A 77-year-old Japanese man presented to our hospital with complaints of loss of appetite for 2 mo and a 10-d history of palpable purpura. On physical examination, the patient was afebrile but had bilateral multiple palpable purpuric lesions over the lower extremities, lower abdomen, and part of the upper extremities. Moreover, lymphadenopathy of the bilateral inguinal, cervical, and supraclavicular nodes was noted. Laboratory and imaging studies and skin biopsy were conducted but were inconclusive. Based on inguinal lymph node excisional biopsy, we diagnosed the patient with AITL. Subsequently, the patient developed progressive normocytic normochromic anemia that necessitated almost daily blood transfusion. The clinical presentations and results of bone marrow assessment were consistent with those of PRCA, which is associated with AITL. Chemotherapy was initiated but was not effective. The patient refused further chemotherapy and opted to continue receiving best supportive care.

CONCLUSION

PRCA is an extremely rare complication of AITL. As the pathophysiology remains unclear, further research is warranted.

Keywords: Palpable purpura; Lymphoma; Pure red cell aplasia; Case report

Core tip: Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon subtype of peripheral T-cell lymphoma. Moreover, the patient was diagnosed with pure red cell aplasia (PRCA) associated with AITL. Although AITL is often accompanied by various immunological and hematological diseases, PRCA with AITL is extremely rare.