22 yrs old male with polyserositis, fever, hemolytic anemia and liver failure. Original diagnosis (LN biopsy): "Peripheral T lymphoma".
HISTORY (EVENTS): 1. Antibiotic treatment with suspition of odontogenic sepsis (tooth extraction after fever, myalgia and sore throat presentation). 2. Pleuritis, pericarditis, hepatomegaly. Prednisone therapy. 3. Acute hepatorenal insufficiency. Dialysis. 4. Candida+ in blood culture. Antibiotic treatment.
5. After improvement of symptoms the patient redirected to HEMATOLOGY dept. (biopsy results).
HISTO (CONSULTATION CASE): The diffuse CD3+ CD2/CD5/CD7+ CD8+>CD4+ GranzymB/Perforin+ medium-large sized pleomorphic T cell infiltration with prominent diffuse apoptosis, high proliferation rate and focal CD68+/MPO+ histio- reaction with crescentic histyocytes. Scattered CD30+, single CD56+ cells. TDT/CD34/ALK1(-). Rudimentary B zones CD20+. NECROSIS IS ABSENT.
WORKING DIAGNOSIS: REACTIVE T CD8+ PROLIFERATION (KIKUCHI LYMPHADENITIS (CELLULAR PHASE)) VS ...