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 in | Internal Medicine Vol. 61; no. 22; pp. 3425 - 3429 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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Japan
The Japanese Society of Internal Medicine
15.11.2022
Japan Science and Technology Agency |
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| Abstract | 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. |
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| AbstractList | 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. 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.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. |
| ArticleNumber | 9300-21 |
| Author | Ueki, Toshimitsu Satomi, Hidetoshi Shishido, Tsutomu Kobayashi, Hikaru Ishikawa, Ryuto Sato, Keijiro Sumi, Masahiko Okuyama, Shuhei |
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| Cites_doi | 10.1080/03009740410005061 10.1056/NEJM199402243300804 10.1016/j.jaci.2012.02.019 10.1016/j.iac.2007.07.002 10.3346/jkms.2000.15.3.346 10.2214/ajr.184.3.01840975 10.3324/haematol.2014.118042 10.1200/JCO.1984.2.7.788 10.1097/DAD.0b013e3182892230 10.3109/10428199709059688 10.1182/blood-2016-01-643569 10.1016/j.jaci.2010.03.042 10.3389/fimmu.2020.01765 10.1016/j.berh.2012.08.001 10.1046/j.1365-2133.1998.02535.x 10.1097/MD.0000000000000088 |
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| Keywords | hematologic neoplasms eosinophilia eosinophilic fasciitis hypereosinophilic syndrome T-cell lymphoma |
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| Notes | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Report-1 ObjectType-Feature-4 content type line 23 ObjectType-Article-3 Correspondence to Dr. Shuhei Okuyama, okuyama442@gmail.com |
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| References | 14. Carpentier C, Verbanck S, Schandené L, et al. Eosinophilia associated with CD3-CD4+ T cells: characterization and outcome of a single-center cohort of 26 patients. Front Immunol 11: 1765, 2020. 5. Moulton SJ, Kransdorf MJ, Ginsburg WW, Abril A, Persellin S. Eosinophilic fasciitis: spectrum of MRI findings. AJR Am J Roentgenol 184: 975-978, 2005. 10. Valent P, Klion AD, Horny HP, et al. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 130: 607-612.e609, 2012. 11. Simon HU, Rothenberg ME, Bochner BS, et al. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol 126: 45-49, 2010. 4. Lebeaux D, Sène D. Eosinophilic fasciitis (Shulman disease). Best Pract Res Clin Rheumatol 26: 449-458, 2012. 15. Lefèvre G, Copin MC, Staumont-Sallé D, et al. The lymphoid variant of hypereosinophilic syndrome: study of 21 patients with CD3-CD4+ aberrant T-cell phenotype. Medicine (Baltimore) 93: 255-266, 2014. 3. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127: 2375-2390, 2016. 16. Lefèvre G, Copin MC, Roumier C, et al. CD3-CD4+ lymphoid variant of hypereosinophilic syndrome: nodal and extranodal histopathological and immunophenotypic features of a peripheral indolent clonal T-cell lymphoproliferative disorder. Haematologica 100: 1086-1095, 2015. 9. Masuoka H, Kikuchi K, Takahashi S, Kakinuma T, Hayashi N, Furue M. Eosinophilic fasciitis associated with low-grade T-cell lymphoma. Br J Dermatol 139: 928-930, 1998. 12. Cogan E, Schandené L, Crusiaux A, Cochaux P, Velu T, Goldman M. Brief report: clonal proliferation of type 2 helper T cells in a man with the hypereosinophilic syndrome. N Engl J Med 330: 535-538, 1994. 7. Eklund KK, Anttila P, Leirisalo-Repo M. Eosinophilic fasciitis, myositis and arthritis as early manifestations of peripheral T-cell lymphoma. Scand J Rheumatol 32: 376-377, 2003. 1. Greer JP, York JC, Cousar JB, et al. Peripheral T-cell lymphoma: a clinicopathologic study of 42 cases. J Clin Oncol 2: 788-798, 1984. 6. Castellanos-González M, Velasco Rodriguez D, Blanco Echevarría A, et al. Eosinophilic fasciitis as a manifestation of a cutaneous T-cell lymphoma not otherwise specified. Am J Dermatopathol 35: 666-670, 2013. 8. Kim H, Kim MO, Ahn MJ, et al. Eosinophilic fasciitis preceding relapse of peripheral T-cell lymphoma. J Korean Med Sci 15: 346-350, 2000. 2. Kitano K, Ichikawa N, Shimodaira S, Ito T, Ishida F, Kiyosawa K. Eosinophilia associated with clonal T-cell proliferation. Leuk Lymphoma 27: 335-342, 1997. 13. Roufosse F, Cogan E, Goldman M. Lymphocytic variant hypereosinophilic syndromes. Immunol Allergy Clin North Am 27: 389-413, 2007. 11 12 13 14 15 16 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 5. Moulton SJ, Kransdorf MJ, Ginsburg WW, Abril A, Persellin S. Eosinophilic fasciitis: spectrum of MRI findings. AJR Am J Roentgenol 184: 975-978, 2005. – reference: 10. Valent P, Klion AD, Horny HP, et al. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 130: 607-612.e609, 2012. – reference: 3. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127: 2375-2390, 2016. – reference: 15. Lefèvre G, Copin MC, Staumont-Sallé D, et al. The lymphoid variant of hypereosinophilic syndrome: study of 21 patients with CD3-CD4+ aberrant T-cell phenotype. Medicine (Baltimore) 93: 255-266, 2014. – reference: 7. Eklund KK, Anttila P, Leirisalo-Repo M. Eosinophilic fasciitis, myositis and arthritis as early manifestations of peripheral T-cell lymphoma. Scand J Rheumatol 32: 376-377, 2003. – reference: 4. Lebeaux D, Sène D. Eosinophilic fasciitis (Shulman disease). Best Pract Res Clin Rheumatol 26: 449-458, 2012. – reference: 8. Kim H, Kim MO, Ahn MJ, et al. Eosinophilic fasciitis preceding relapse of peripheral T-cell lymphoma. J Korean Med Sci 15: 346-350, 2000. – reference: 11. Simon HU, Rothenberg ME, Bochner BS, et al. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol 126: 45-49, 2010. – reference: 12. Cogan E, Schandené L, Crusiaux A, Cochaux P, Velu T, Goldman M. Brief report: clonal proliferation of type 2 helper T cells in a man with the hypereosinophilic syndrome. N Engl J Med 330: 535-538, 1994. – reference: 13. Roufosse F, Cogan E, Goldman M. Lymphocytic variant hypereosinophilic syndromes. Immunol Allergy Clin North Am 27: 389-413, 2007. – reference: 16. Lefèvre G, Copin MC, Roumier C, et al. CD3-CD4+ lymphoid variant of hypereosinophilic syndrome: nodal and extranodal histopathological and immunophenotypic features of a peripheral indolent clonal T-cell lymphoproliferative disorder. Haematologica 100: 1086-1095, 2015. – reference: 2. Kitano K, Ichikawa N, Shimodaira S, Ito T, Ishida F, Kiyosawa K. Eosinophilia associated with clonal T-cell proliferation. Leuk Lymphoma 27: 335-342, 1997. – reference: 14. Carpentier C, Verbanck S, Schandené L, et al. Eosinophilia associated with CD3-CD4+ T cells: characterization and outcome of a single-center cohort of 26 patients. Front Immunol 11: 1765, 2020. – reference: 1. Greer JP, York JC, Cousar JB, et al. Peripheral T-cell lymphoma: a clinicopathologic study of 42 cases. J Clin Oncol 2: 788-798, 1984. – reference: 9. Masuoka H, Kikuchi K, Takahashi S, Kakinuma T, Hayashi N, Furue M. Eosinophilic fasciitis associated with low-grade T-cell lymphoma. Br J Dermatol 139: 928-930, 1998. – reference: 6. Castellanos-González M, Velasco Rodriguez D, Blanco Echevarría A, et al. Eosinophilic fasciitis as a manifestation of a cutaneous T-cell lymphoma not otherwise specified. Am J Dermatopathol 35: 666-670, 2013. – ident: 7 doi: 10.1080/03009740410005061 – ident: 12 doi: 10.1056/NEJM199402243300804 – ident: 10 doi: 10.1016/j.jaci.2012.02.019 – ident: 13 doi: 10.1016/j.iac.2007.07.002 – ident: 8 doi: 10.3346/jkms.2000.15.3.346 – ident: 5 doi: 10.2214/ajr.184.3.01840975 – ident: 16 doi: 10.3324/haematol.2014.118042 – ident: 1 doi: 10.1200/JCO.1984.2.7.788 – ident: 6 doi: 10.1097/DAD.0b013e3182892230 – ident: 2 doi: 10.3109/10428199709059688 – ident: 3 doi: 10.1182/blood-2016-01-643569 – ident: 11 doi: 10.1016/j.jaci.2010.03.042 – ident: 14 doi: 10.3389/fimmu.2020.01765 – ident: 4 doi: 10.1016/j.berh.2012.08.001 – ident: 9 doi: 10.1046/j.1365-2133.1998.02535.x – ident: 15 doi: 10.1097/MD.0000000000000088 |
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| SubjectTerms | 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 |
| Title | Eosinophilic Fasciitis with Hypereosinophilia as the Initial Clinical Manifestation of Peripheral T-Cell Lymphoma, Not Otherwise Specified |
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