Goldner, Breanna S, DO

Kears, Alaynna C, DO

Kotkiewicz, Adam J, DO

Lim, Kristina M, DO

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineA Nonclassical Presentation of Classical HodgkinLymphomaBreanna S. Goldner DOLehigh Valley Health Network, Breanna.Goldner@lvhn.orgKristina M. Lim DOLehigh Valley Health Network, Kristina.Lim@lvhn.orgAlaynna C. Kears DOLehigh Valley Health Network, Alaynna.Kears2@lvhn.orgAdam J. Kotkiewicz DOLehigh Valley Health Network, Adam_J.Kotkiewicz@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/medicinePart of the Internal Medicine CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtGoldner, B. S., Lim, K. M., Kears, A. C., Kotkiewicz, A. J. (2019, April 24). A Nonclassical Presentation of Classical Hodgkin Lymphoma.Poster Presented at: Research Day, Lehigh Valley Cedar Crest, PA.© 2018 Lehigh Valley Health NetworkINTRODUCTION:• Hodgkin lymphoma is a malignant condition of lymphoreticular     cell origin • Affects approximately 7,500 Americans each year • Typically presents with “B symptoms” such as fever, night sweats, weight loss     and chills • In rare circumstances, this disease can masquerade as an immunodeficiency     or autoimmune process CASE DESCRIPTION: Initial presentation • 66 y/o male with a history of hypertension who initially presented    with thrombocytopenia and neutropenia on outpatient labs • Bone marrow biopsy negative for malignancy• Abdominal ultrasound negative for splenic abnormalities• Treated with Valtrex for suspected shingles on forehead Initial presentation • 66 y/o male with a history of hypertension who initially presented with    thrombocytopenia and neutropenia on outpatient labs • Bone marrow biopsy negative for malignancy• Abdominal ultrasound negative for splenic abnormalities• Treated with Valtrex for suspected shingles on forehead  A Nonclassical Presentation of Classical Hodgkin Lymphoma  B. S Goldner, DO1; K M Lim, DO1; A C Kears, DO1; A J Kotkiewicz, DO2  1. Department of Internal Medicine, Lehigh Valley Health Network, Allentown PA 2. Department of Hematology and Oncology, Lehigh Valley Health Network, Allentown PA• Four days later  • Labs revealed worsening thrombocytopenia• Diagnosed with ITP and treated with Decadron and IVIG • Skin biopsy consistent with herpes incognito• Three months later • ITP refractory to treatment • CT of abdomen showed numerous splenic lesions• Underwent splenectomy that revealed pathology consistent     with Hodgkin Lymphoma • Started on ABVD therapy with brentuximabDISCUSSION:• There are a multitude of presentations of Hodgkin lymphoma. • Approximately 1-2% of HD cases present as refractory ITP or    neutropenia with the absence of B symptoms.• Consideration of lymphoma should be made in cases with refractory    thrombocytopenia despite normal exam and lack of B symptomsREFERENCES:Kennedy-Nasser AA, Hanley P, Bollard CM. Hodgkin disease and the role of the immune system.  Pediatric hematology and oncology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168532/.  Published April 2011. Accessed April 17, 2019.

A Nonclassical Presentation of Classical Hodgkin Lymphoma

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=2686&context=medicine

A Nonclassical Presentation of Classical Hodgkin Lymphoma

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