Digital gangrene as an unusual paraneoplastic manifestation of hodgkins lymphoma—a rare case report

• Published in: The Egyptian journal of internal medicine Vol. 33; no. 1; pp. 44 - 4
• Main Authors: Deme, Swaroopa, Kakarla, Bhaskar, P., Venkateswar Rao, YSN, Raju, M., Nageswara Rao
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2021; Springer Nature B.V; SpringerOpen
• Subjects: Abdomen; Antibodies; Biopsy; Bone marrow; Case Report; Case reports; Chemotherapy; Cold; Consent; Digital ischemia; Disease; Gangrene; Hodgkin’s lymphoma; Internal Medicine; Ischemia; Lymphatic system; Lymphoma; Medicine; Medicine & Public Health; Nervous system; Neurodegeneration; Paraneoplastic manifestation; Patients; Proteins; Thrombocytopenia; Thrombosis; Tumors; Case report; Paraneoplastic manifestation; Hodgkin’s lymphoma; Digital ischemia
• ISSN: 1110-7782; 2090-9098
• DOI: 10.1186/s43162-021-00076-7

Background Hodgkin’s lymphoma presenting with digital ischemia and gangrene is a rare manifestation. Paraneoplastic manifestations are rare in Hodgkin’s lymphoma but can occur in the form of paraneoplastic cerebellar degeneration (PCD) and dermatomyositis/polymyositis. This case report adds an exceptional presentation of Hodgkin's lymphoma as digital ischemia and gangrene. Case presentation We report a case of a 60-year-old male patient who presented with fever, cough, shortness of breath, the pain in the right middle finger. On examination bluish-black discoloration of the right middle finger, left middle finger, ring finger, and generalized lymphadenopathy was noted. On further evaluation, he was found to have anemia, eosinophilia, and severe thrombocytopenia with a normal coagulation profile and negative rheumatological workup. Arterial Doppler of both upper limbs showed the normal study. He was diagnosed to have Hodgkin’s lymphoma on the lymph node and bone marrow biopsy. He was started on chemotherapy with partial improvement in symptoms and was lost to follow-up after 2 cycles. Conclusions Digital ischemia can be a rare paraneoplastic manifestation of Hodgkin’s lymphoma.