تقرير
The chicken and the egg dilemma: A case of disseminated MAC with Hodgkin's lymphoma.
| العنوان: | The chicken and the egg dilemma: A case of disseminated MAC with Hodgkin's lymphoma. |
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| المؤلفون: | Varkey MR; Louisiana State University Health Sciences Center - Section of Pulmonary/Critical Care & Allergy Immunology, USA., Ali J; Louisiana State University Health Sciences Center - Section of Pulmonary/Critical Care & Allergy Immunology, USA., Lapinel NC; Louisiana State University Health Sciences Center - Section of Pulmonary/Critical Care & Allergy Immunology, USA. |
| المصدر: | Respiratory medicine case reports [Respir Med Case Rep] 2020 Oct 16; Vol. 31, pp. 101253. Date of Electronic Publication: 2020 Oct 16 (Print Publication: 2020). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101604463 Publication Model: eCollection Cited Medium: Print ISSN: 2213-0071 (Print) Linking ISSN: 22130071 NLM ISO Abbreviation: Respir Med Case Rep Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Oxford] : Elsevier Ltd., c2012- |
| مستخلص: | Introduction: Mycobacterium avium complex (MAC) as a cause of disseminated disease has been well described in immunocompromised hosts. We report a case of disseminated MAC diagnosed in an otherwise healthy patient, one year before further testing and follow-up revealed a diagnosis of Hodgkin's lymphoma. Case Presentation: A 48-year-old woman with no significant medical history presented with new-onset fever, chills and night sweats. Chest imaging revealed large conglomerate mediastinal lymph nodes (LN). Endobronchial ultrasound-guided biopsy demonstrated caseating granulomatous inflammation and MAC on broth culture. She was started on guideline-based antibiotic therapy for disseminated MAC but showed no improvement after 6 months. An open mediastinal biopsy confirmed the findings of non-caseating granuloma. However, due to continued symptoms and widespread lymphadenopathy on additional full body imaging, an iliac lymph node core biopsy was performed which revealed abnormal CD30 + lymphoid infiltrate consistent with Hodgkin's lymphoma (HL). She was started on steroids and chemotherapy, whilst maintained on MAC treatment. Discussion: Disseminated MAC is largely limited to immunocompromised hosts, signs and symptoms of which may overlap with lymphoma. Our case demonstrated that multiple initial LN biopsies were unrevealing except for MAC. As no clinical improvement was observed with guideline based MAC treatment, further diagnostic measures were aggressively pursued ultimately leading to a diagnosis of HL. It is unclear whether disseminated MAC preceded lymphoma, an early undiagnosed lymphoma led to MAC infection or an undefined systemic immune disorder was causative for both these processes. Competing Interests: The authors have no significant conflict of interests to report. (© 2020 The Author(s).) |
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| فهرسة مساهمة: | Keywords: Disseminated; Lymph Node Biopsy; Lymphoma; Mycobacterium Avium Complex |
| تواريخ الأحداث: | Date Created: 20201029 Latest Revision: 20220417 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC7582096 |
| DOI: | 10.1016/j.rmcr.2020.101253 |
| PMID: | 33117648 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2213-0071 |
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| DOI: | 10.1016/j.rmcr.2020.101253 |