A peripheral cause of asthma: Peripheral T-cell lymphoma.
A peripheral cause of asthma: Peripheral T-cell lymphoma.
复制标题
哮喘的外周原因：外周 T 细胞淋巴瘤。
DOI：
10.1016/j.anai.2019.01.009
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Eun-HyungLee,F
中科院分区：
文献类型：
--
作者：
Ramonell,RichardP;Kuruvilla,Merin;Sica,Gabriel;Bag,Remzi;Eun-HyungLee,F
Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) is an aggressive subtype of T-cell non-Hodgkin’s lymphoma. Despite the poor prognosis associated with PTCL, NOS, prompt diagnosis and treatment are critical to prevent further morbidity and mortality. 1 We report a case of new-onset asthma with peripheral eosinophilia, subsequently diagnosed with PTCL, highlighting the need to consider a broad differential in the setting of uncontrolled atypical respiratory symptoms.A 49-year-old woman without significant medical history or known atopy was transferred from an outside hospital for new-onset asthma, peripheral eosinophilia, diffuse rash, recently diagnosed thymoma, and respiratory distress. Eight months before presentation, the patient developed a pruritic papulonodular rash to her upper chest and proximal upper extremities, which improved with steroid treatment. Two months later, the patient noted a new nonproductive cough and dyspnea after the completion of a marathon. She presented to an outside physician and received treatment for pneumonia, with improvement in symptoms. Four months later, her respiratory symptoms recurred, and the patient was referred to a pulmonologist, who performed pulmonary function testing notable for a forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio of 0.62, FEV1 36% of predicted, and a 24% improvement in FEV1 after the administration of a bronchodilator. A methacholine challenge was also performed and was reportedly positive. She was diagnosed with new adult-onset asthma and treated with a short course of oral corticosteroids and eventually continued on inhaled corticosteroids with little improvement. A computed tomography (CT) scan of her chest demonstrated an anterior mediastinal mass that was consistent with a thymoma, and a complete blood count revealed peripheral eosinophilia. Given this constellation of symptoms, the patient underwent a bone marrow biopsy, which was negative for malignancy but did demonstrate 10% eosinophils. Before her thymoma could be
