Rash and Fever: Clues to an Elusive Hematologic Malignancy

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Presentation transcript:

Rash and Fever: Clues to an Elusive Hematologic Malignancy Samantha C. Shapiro, MD, Ibironke Oduyebo, MD, Rima Koka, MD, PhD, Allan C. Gelber, MD The American Journal of Medicine Volume 129, Issue 4, Pages e5-e8 (April 2016) DOI: 10.1016/j.amjmed.2015.12.012 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Anterior view of bilateral legs showing an erythematous, morbilliform, pruritic rash that also encompassed the arms, trunk, and back. The American Journal of Medicine 2016 129, e5-e8DOI: (10.1016/j.amjmed.2015.12.012) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Whole-body positron emission tomography scan, coronal view. Diffuse fluorodeoxyglucose uptake in the spleen, inguinal, axillary, cervical, and hilar lymph nodes, and pulmonary lymphatics. The American Journal of Medicine 2016 129, e5-e8DOI: (10.1016/j.amjmed.2015.12.012) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 The lymph node demonstrates atretic germinal centers with penetrating vessels. The germinal centers are surrounded by mantle zone lymphocytes and resemble the histologic feature of “onion skinning” (hematoxylin–eosin), features characteristic of the hyaline vascular variant of Castleman's disease. The American Journal of Medicine 2016 129, e5-e8DOI: (10.1016/j.amjmed.2015.12.012) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 Immunohistochemistry of the lymph node tissue demonstrates CD3-positive T cells (A), aberrantly dim CD5 expression (B), and near-complete loss of CD7 expression (C). The American Journal of Medicine 2016 129, e5-e8DOI: (10.1016/j.amjmed.2015.12.012) Copyright © 2016 Elsevier Inc. Terms and Conditions