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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Angioimmunoblastic T-cell lymphoma induced hemophagocytic lymphohistiocytosis and disseminated intravascular coagulopathy: A case report
Mei Jiang, Jing-Hua Wan, Yi Tu, Yan Shen, Fan-Cong Kong, Zhang-Lin Zhang
Mei Jiang, Jing-Hua Wan, Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Yi Tu, Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Yan Shen, Department of Anesthesia, Medical College of Nanchang University, Nanchang 330006, Jiangxi Province, China
Fan-Cong Kong, Department of Hematology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Zhang-Lin Zhang, Department of Transfusion, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Jiang M and Wan JH contributed equally to this work; Zhang ZL and Kong FC contributed equally and should share the corresponding authorship; Jiang M, Wan JH, Kong FC, and Zhang ZL wrote the manuscript; Jiang M, Tu Y, Shen Y, and Zhang ZL collected the data and revised the manuscript; all authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82160692 and No. 82160037.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict 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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhang-Lin Zhang, Doctor, Associate Chief Technician, Transfusion, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Street, Nanchang 330006, Jiangxi Province, China. ndyfy02270@ncu.edu.cn
Received: September 18, 2022
Peer-review started: September 18, 2022
First decision: November 11, 2022
Revised: November 15, 2022
Accepted: January 28, 2023
Article in press: January 28, 2023
Published online: February 16, 2023
BACKGROUND
Angioimmunoblastic T-cell lymphoma (AITL) is a subtype of peripheral T-cell lymphoma, with heterogenous clinical manifestations and poor prognosis. Here, we report a case of AITL induced hemophagocytic lymphohistiocytosis (HLH) and disseminated intravascular coagulopathy (DIC).
CASE SUMMARY
An 83-year-old man presented with fever and purpura of both lower limbs for one month. Groin lymph node puncture and flow cytometry indicated a diagnosis of AITL. Bone marrow examination and other laboratory related indexes indicated DIC and HLH. The patient rapidly succumbed to gastrointestinal bleeding and septic shock.
CONCLUSION
This is the first reported case of AITL induced HLH and DIC. AITL is more aggressive in older adults. In addition to male gender, mediastinal lymphadenopathy, anaemia, and sustained high level of neutrophil-to-lymphocyte ratio may indicate a greater risk of death. Early diagnosis, early detection of severe complications, and prompt and effective treatment are vital.
Core Tip: Angioimmunoblastic T-cell lymphoma (AITL) is a subtype of peripheral T-cell lymphoma, with heterogenous clinical manifestations and poor prognosis. Early diagnosis is particularly important. Herein, we report a patient with AITL induced hemophagocytic lymphohistiocytosis (HLH) and disseminated intravascular coagulopathy (DIC). The patient rapidly succumbed to gastrointestinal bleeding and septic shock. The time between onset and death was about one month. To the best of our knowledge, this is the first case of AITL induced HLH and DIC. AITL is more aggressive in older adults. In addition to male gender, mediastinal lymphadenopathy, anaemia, and sustained high level of neutrophil-to-lymphocyte ratio may indicate a greater risk of death. Early diagnosis, early detection of severe complications, and prompt and effective treatment are vital.
