Eosinophilic Fasciitis with Hypereosinophilia as the Initial Clinical Manifestation of Peripheral T-Cell Lymphoma, Not Otherwise Specified

A 58-year-old man presented with painful edema of the extremities, and a diagnosis of eosinophilic fasciitis (EF) was confirmed. He also met the criteria for hypereosinophilic syndrome (HES), but there were no findings suggestive of malignancies or hematologic neoplasms despite a close examination....

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Published inInternal Medicine Vol. 61; no. 22; pp. 3425 - 3429
Main Authors Okuyama, Shuhei, Satomi, Hidetoshi, Ishikawa, Ryuto, Shishido, Tsutomu, Sato, Keijiro, Ueki, Toshimitsu, Sumi, Masahiko, Kobayashi, Hikaru
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 15.11.2022
Japan Science and Technology Agency
Subjects
Biopsy
Bone marrow
Case Report
Diagnosis
Edema
Eosinophilia
Eosinophilia - complications
Eosinophilia - diagnosis
eosinophilic fasciitis
Fasciitis
Fasciitis - diagnosis
Fasciitis - drug therapy
Fasciitis - etiology
Hematologic Neoplasms
Histiocytosis
Humans
hypereosinophilic syndrome
Hypereosinophilic Syndrome - complications
Hypereosinophilic Syndrome - diagnosis
Internal medicine
Leukocytes (eosinophilic)
Liver diseases
Lymphocytes T
Lymphocytosis
Lymphoma, T-Cell, Peripheral - complications
Lymphoma, T-Cell, Peripheral - diagnosis
Male
Malignancy
Middle Aged
T-cell lymphoma
hematologic neoplasms
eosinophilia
eosinophilic fasciitis
hypereosinophilic syndrome
T-cell lymphoma
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Summary:A 58-year-old man presented with painful edema of the extremities, and a diagnosis of eosinophilic fasciitis (EF) was confirmed. He also met the criteria for hypereosinophilic syndrome (HES), but there were no findings suggestive of malignancies or hematologic neoplasms despite a close examination. He was started on steroid therapy but subsequently developed severe liver dysfunction, hemophagocytic lymphohistiocytosis, hepatosplenomegaly, and renal involvement. The diagnosis of peripheral T-cell lymphoma, not otherwise specified was finally established by a bone marrow reexamination and liver biopsy. In cases of eosinophilia, EF, and/or HES, it is important to suspect an intrinsic abnormality, including potential T-cell lymphoma.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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Correspondence to Dr.　Shuhei Okuyama, okuyama442@gmail.com
ISSN:0918-2918
1349-7235
1349-7235
DOI:10.2169/internalmedicine.9300-21