Non-Hodgkin's lymphoma presenting as anasarca: probably mediated by tumor necrosis factor alpha (TNF-alpha).

Abstract:

:Two patients presented with anasarca, fevers and sweats. Subsequent evaluation revealed aggressive lymphoproliferative disease. Both patients were treated with CHOP chemotherapy. One patient responded with spontaneous, vigorous diuresis and complete resolution of the edema. She relapsed two months later with recurrent edema that responded a second time to salvage chemotherapy. The second patient died of gram positive sepsis a week after diagnosis. As anasarca is an unusual presenting symptom of non-Hodgkin's lymphoma, we postulated that the malignant cells were secreting a cytokine that resulted in "vascular leakage" of fluid and development of diffuse edema. Several serum cytokine levels were tested. Both patients had elevated TNF-alpha levels, which could have been the cause of the edema; or there might be yet another unidentified mediator that was responsible for the anasarca. We report these two cases to bring to attention the unusual nature of this presentation.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Jillella AP,Day DS,Severson K,Kallab AM,Burgess R

doi

10.3109/10428190009087034

keywords:

subject

Has Abstract

pub_date

2000-07-01 00:00:00

pages

419-22

issue

3-4

eissn

1042-8194

issn

1029-2403

journal_volume

38

pub_type

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