Adult T-cell lymphoma mimicking Henoch–Schönlein purpura

Abstract

We report a male patient with adult T-cell lymphoma, who was initially diagnosed clinically as having Henoch-Schönlein purpura (HSP) with abdominal pain and specific purpura. Adult T-cell lymphoma-like cells were minimal and abdominal lymph nodes were transiently swollen, and the symptoms were improved by supportive management. Although the clinical course was compatible with HSP, the histological examination revealed infiltration of lymphocytes rather than neutrophils. Later he developed lymphoma and was treated with chemotherapy. This rare case suggests the importance of skin biopsies to seek the underlying pathology in adult HSP.

Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia/lymphoma

“…[24][25][26][27][28][29][30][31] When these are divided into the punctate and macular subtypes, the prognosis of the punctate purpuric subtype might be better than the macular purpuric subtype. [24][25][26][27][28][29][30][31] In our 5 purpuric cases, 2 cases of the punctuate purpuric subtype survived, with a 73.4-month mean survival time (the MST was not estimable), whereas 3 cases of the macular purpuric subtype died with 2.1 months of the MST. This suggests that the punctuate subtype has a good clinical prognosis, and the poor prognosis of the total purpuric type is derived from the macular subtype.…”

Pediatric acute lymphoblastic leukemia mimicking Henoch–Schönlein purpura

“…Tabata et al . reported an adult patient with T‐cell lymphoma, who was initially diagnosed clinically as having HSP, and the histological finding of the skin with purpura revealed the infiltration of lymphocytes, which differed from the specific findings for HSP 8 . Unfortunately, skin biopsy could be not performed for our patient, but he also must have had different findings from the specific findings for HSP, as his clinical findings and laboratory data improved by multiagent‐chemotherapy for ALL.…”

Henoch-Schönlein purpura associated with a neuroblastoma: Report of one case and a review of the literature

“…This suggests that adults, and especially older men who present with unexplained HSP, should be evaluated for an occult neoplasm (5,6), while patients with a known history of malignancy who present with HSP should be evaluated for metastatic disease (11). A skin biopsy is an important way to determine the underlying pathology in adult HSP (17). Malignancies induce or are associated with HSP mostly in older males, but children can also be affected, albeit rarely.…”

“…Many malignancies, such as solid tumors and hematologic malignancies, are reported to induce or be associated with HSP. Such tumors include carcinoma of the lung, bronchus, esophagus, stomach, intestine, breast, kidney, prostate, and thyroid (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) while hematologic malignancies include non-Hodgkin lymphoma, Hodgkin disease, multiple myeloma, myeloproliferative disease, and myelodysplastic syndrome (10,11,(13)(14)(15)(16)(17).…”