Multifocal nodular episcleritis and scleritis with undiagnosed Hodgkin's lymphoma.

Détails

ID Serval
serval:BIB_33B1F25F7C4B
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Multifocal nodular episcleritis and scleritis with undiagnosed Hodgkin's lymphoma.
Périodique
Ophthalmology
Auteur(s)
Thakker M.M., Perez V.L., Moulin A., Cremers S.L., Foster C.S.
ISSN
0161-6420 (Print)
ISSN-L
0161-6420
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
110
Numéro
5
Pages
1057-1060
Langue
anglais
Notes
Publication types: Case Reports ; Journal ArticlePublication Status: ppublish
Résumé
PURPOSE: To report the case of a patient with undiagnosed Hodgkin's lymphoma who presented with coexistent unilateral nodular episcleritis and scleritis.
DESIGN: Interventional case report and literature review
METHODS: Review of clinical history, laboratory findings, histology of episcleral and cervical lymph node biopsies, and follow-up.
RESULTS: A 20-year-old female presented with a 5-month history of redness and pain in her left eye, with associated symptoms of dyspnea, malaise, and fever. The patient was found to have multifocal nodular episcleritis and scleritis that was not responsive to topical steroids or systemic nonsteroidal anti-inflammatory treatment. Laboratory tests subsequently revealed evidence of systemic inflammation, and radiologic studies showed extensive mediastinal and cervical adenopathy. A cervical lymph node biopsy showed Reed-Sternberg cells and a chronic lymphocytic infiltrate consistent with nodular sclerosing Hodgkin's lymphoma. Histopathologic analysis of an episcleral nodule revealed a necrotizing granuloma with vasculitis. Systemic chemotherapy was instituted for the Hodgkin's disease; this therapy abolished the nodular scleritis.
CONCLUSIONS: This case raises the possibility of concurrent undiagnosed systemic vasculitis with only an ocular manifestation with Hodgkin's lymphoma, either as a coincidence or as a paraneoplastic syndrome. Moreover, it emphasizes the important role of tissue biopsy in establishing diagnosis and directing treatment.
Mots-clé
Adult, Antineoplastic Agents/therapeutic use, Eye Neoplasms/diagnosis, Eye Neoplasms/drug therapy, Female, Hodgkin Disease/diagnosis, Hodgkin Disease/drug therapy, Humans, Lymph Nodes/pathology, Lymphatic Metastasis, Scleritis/drug therapy, Scleritis/pathology
Pubmed
Web of science
Création de la notice
20/08/2012 10:47
Dernière modification de la notice
20/08/2019 13:19
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