Nature clinical practice. Gastroenterology & hepatology · 2006
Virchow's node, jaundice, and weight loss--lymphoma mimicking gastrointestinal malignancy.
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Anastassiades Constantinos P, Poterucha Thomas H
Аннотация
BACKGROUND: A 46-year-old white male with a history of well-controlled paranoid schizophrenia presented with painless jaundice, progressive anorexia, weight loss, and dyspnea of 3 months' duration. His only medication at presentation was the antipsychotic olanzapine, taken orally.
INVESTIGATIONS: Physical examination and laboratory tests, including a complete blood cell count, electrolyte, lactate dehydrogenase and haptoglobin levels, liver function tests, and a Coombs' test; CT scan of the chest and abdomen; invasive investigations, including thoracentesis and pleural fluid analysis, bone-marrow biopsy, and left supraclavicular lymph-node biopsy.
DIAGNOSIS: Diffuse large B-cell lymphoma.
MANAGEMENT: Large-volume thoracentesis. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy followed by dexamethasone, cytarabine, and cisplatin chemotherapy, and autologous stem-cell transplantation.
INVESTIGATIONS: Physical examination and laboratory tests, including a complete blood cell count, electrolyte, lactate dehydrogenase and haptoglobin levels, liver function tests, and a Coombs' test; CT scan of the chest and abdomen; invasive investigations, including thoracentesis and pleural fluid analysis, bone-marrow biopsy, and left supraclavicular lymph-node biopsy.
DIAGNOSIS: Diffuse large B-cell lymphoma.
MANAGEMENT: Large-volume thoracentesis. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy followed by dexamethasone, cytarabine, and cisplatin chemotherapy, and autologous stem-cell transplantation.
Предметные рубрики MeSH
AnorexiaAntineoplastic Combined Chemotherapy ProtocolsClinical Laboratory TechniquesDiagnosis, DifferentialGastrointestinal NeoplasmsHumansJaundiceLymphatic DiseasesLymphoma, Large B-Cell, DiffuseMaleMiddle AgedParacentesisSchizophrenia, ParanoidStem Cell TransplantationTomography, X-Ray ComputedWeight Loss