Fever and anasarca

Neoplasia accounts for 20% of fevers of unknown origin, and a half of these are due to lymphoma.1 Intravascular lymphoma is a rare variant of non-Hodgkin lymphoma, in which large neoplastic lymphocytes occlude the small vasculature. Selective intravascular growth may be due to lack of expression of...

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Bibliographic Details
Published in:The Lancet (British edition) 2002-05, Vol.359 (9319), p.1746-1746
Main Authors: Arrieta, V Acha, de Tejerina, JM Casas Fernandez, Etxeberria, D, García-Bragado, F
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brucella
Case reports
Edema - etiology
Female
Fever
Fever of Unknown Origin - etiology
Hematologic and hematopoietic diseases
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymphocytes
Lymphoma
Lymphoma, Non-Hodgkin - complications
Lymphoma, Non-Hodgkin - pathology
Medical diagnosis
Medical research
Medical sciences
Middle Aged
Tomography
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Summary:Neoplasia accounts for 20% of fevers of unknown origin, and a half of these are due to lymphoma.1 Intravascular lymphoma is a rare variant of non-Hodgkin lymphoma, in which large neoplastic lymphocytes occlude the small vasculature. Selective intravascular growth may be due to lack of expression of CD29 and CD54 molecules in neoplastic lymphocytes.2 Neurological signs may cause multifocal cerebrovascular events, subacute encephalopathy, spinal cord and root symptoms, and peripheral or cranial neuropathies.3 Our patient's polyradiculopathy developed into a subacute conus medullaris and cauda equina syndrome. Anasarca reported in this case is an unusual symptom of non-- Hodgkin lymphoma5 and intravascular lymphoma, caused by vascular or lymphatic occlusion. The diagnosis is confirmed by biopsy of symptomatic or swollen tissues. Muscle biopsy seems a safe and useful alternative in intravascular lymphoma with neurological signs.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(02)08656-7