Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 6)
Eosinophilia as a first sign of Hodgkin's lymphoma – A case report
Authors:
Rajko Milošević, Danijela Leković, Nebojša Antonijević, Andrija Bogdanović
Introduction. It is well known that eosinophilia appears in amalignant disease. Frequency of all Hodgkin`s lymphoma patients
is estimated to about 15%. Prognostic importance of this
phenomenon is not completely investigated. Therefore we decided
to present a female patient with eosinophilia, six months
before lymphoma appearance. Case report. We presented a 51-
years old female, from Serbia, who had eosinophilia (1,530–2,040
eosinophils per μL of blood), six months before Hodgkin's lymphoma
appearance. Eosinophilic granuloma was confirmed by
tumor’s biopsy and histopathologic examination, from the right
femoral region. As eosinophilia was increasing, lymph nodes became
enlarged (120 × 65 mm diameter), in the right parailiac region.
All infectious and allergic examinations did not reveal eosinophilia's
cause. Histopathologic revision was made with added
immunohistochemical stains 17 months after tumor's biopsy.
The diagnosis was changed from eosinophilic granuloma to
mixed cellularity Hodgkin's lymphoma. After conducted Ann
Arbor staging classification, II B clinical stage was established.
The treatment was done by chemotherapy according to adriamycin,
bleomycin, vinblastine, dacarbarine (ABVD) protocol, with 6
courses. Complete remission of the disease was achieved after 4
courses. Eosinophils number dropped to 640 per μl blood. Conclusion.
Eosinophilia without revealed cause can precede Hodgkin's
lymphoma. We suggest careful search for enlarged lymph
nodes, anywhere in the patients’ body who suffer from eosinophilia.
Timely and accurate histopathologic diagnostic is a right
way to resolve such conditions.
