Unexplained Systemic Symptoms and Gallium-67–Guided Decisions
作者:
Ami Schattner,
Amos Cohen,
Leah Wolfson,
Moshe Melloul,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 2001)
卷期:
Volume 321,
issue 3
页码: 198-200
ISSN:0002-9629
年代: 2001
出版商: OVID
关键词: Non-Hodgkin lymphoma;Interleukin-6;Gallium-67 scintigraphy;Extranodal lymphoma;Kleinfeter syndrome.
数据来源: OVID
摘要:
Over 3 months, a healthy man developed prominent systemic symptoms that defied investigation. Physical examination was noncontributory, and extensive studies revealed only a marked acute-phase response associated with increased serum IL-6 levels. A whole body Gallium-67 scan was crucial in diagnosis, directing attention to high uptake in the left paraspinal and psoas muscles. Open surgical excision biopsy was performed, guided by intraoperative use of a gamma-probe. Removed tissue was diagnosed as diffuse, large B-cell non-Hodgkin lymphoma of muscle (stage IE), a rare extranodal lymphoma. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy was given, and the patient became asymptomatic with normal blood tests and was thought to be in remission. However, a repeat Gallium-67 scan revealed recurrent multifocal disease and salvage chemotherapy was instituted. A 47,XXY karyotype (Klinefelter syndrome) was later identified, possibly associated with the lymphoma.
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