Hodgkin's disease in a patient with Von Hippel-Lindau disease. A case report

Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited disorder with a predisposition to develop a wide variety of lesions: retinal, cerebellar, spinal and medullar hemangioblastomas, renal cell carcinomas, phaeochromocytomas, and renal, pancreatic and epididymal cysts are the most frequent manifestations of the disease. The prevalence of VHL disease has been estimated to be 1 per 36,000 persons. We report the case of a 68-year-old woman with Von Hipple-Lindau disease who developed high fever with pulmonary and hepatic lesions proven to be Hodgkin's disease on biopsy. To our knowledge, this is the first report of Hodgkin's disease in a patient with Von Hippel-Lindau.     

Capnocytophaga bacteremia in a patient with Hodgkin's disease following bone marrow transplantation: case report and review.

Capnocytophaga is a gram-negative, capnophilic, facultatively anaerobic bacillus that normally inhabits the oral cavity. We report the case of a patient who developed capnocytophaga bacteremia following autologous bone marrow transplantation for Hodgkin's disease, and we review other reported cases of capnocytophaga bacteremia in immunocompromised patients. In our case infection followed pretransplantation conditioning and was associated with severe oral mucositis and neutropenia. Antibiotic therapy resulted in clinical resolution of infection. Capnocytophaga bacteremia should be included in the differential diagnosis of febrile neutropenia in immunocompromised patients (e.g., those undergoing bone marrow transplantation) especially in the presence of mucositis and gingival bleeding.     

Infectious mononucleosis in a patient with Hodgkin's disease.

The case is presented of a patient, treated for Hodgkin's disease, who contracted infectious mononucleosis more than 3 years later. While Epstein-Barr virus has been considered a possible etiologic factor in Hodgkin's disease, the sequence of events reported in this case has to be interpreted as evidence against a causal relationship between the virus and Hodgkin's disease in this patient.     

Hodgkin's disease as a cause of pyrexia in a patient with valvular heart disease and suspicion of infective endocarditis--a case report

A case of a 75-year-old male with a history of aortic valve disease hospitalised due to pyrexia of unknown origin is reported. Initially the patient was diagnosed with infective endocarditis due to persistent pyrexia, history of valve disease, single positive blood culture and echocardiographic scan suggesting infective endocarditis. Treatment with two strong antibiotics did not bring expected amelioration. Patient's hemodynamic status remained unchanged. After several weeks of hospitalization X-ray scan revealed involved hilar lymph nodes, which was confirmed by CT scan of the chest. The patient was diagnosed with Hodgkin's disease. He died three months after initiation of chemotherapy.     

Abdominal miliary tuberculosis in a patient with AIDS: a case report

We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also.     

Cerebral toxoplasmosis in a patient with Hodgkin's disease

A case is described of a patient presenting with enlarged lymph nodes and in whom a diagnosis of acute toxoplasmosis was made. The patient later developed Hodgkin's disease for which chemotherapy was started. Reactivation of the quiescent toxoplasma infection took place with devastating results. Prophylactic treatment in such cases is discussed.     

Rectal malacoplakia in a patient with Hodgkin's disease

A 37-year-old man was found to have classic malacoplakia of the rectum after three courses of chemotherapy for stage IV Hodgkin's disease. Sigmoidoscopy with excisional biopsy was performed because of rectal bleeding. The biopsy specimen of the rectal lesion showed focal extensive granulomatous changes with large macrophages containing round, dense Michaelis-Gutmann bodies. Electromicroscopy demonstrated calcifying spheres with laminated concertric structures (Michaelis-Gutmann bodies) and coliform bacillus in the cytoplasm of macrophages (Von Hansemann bodies). Review of the literature revealed that association of malacoplakia with Hodgkin's disease has never been documented, although it has been reported to be associated with conditions such as malignancy, organ transplantation, collagen disease, and leukemia. The possible role of immune disturbance as an underlying cause of malacoplakia is discussed.     

Cardiac disease late after chest radiotherapy for Hodgkin's disease: a case report.

This report presents a case of occult constrictive pericarditis and mitral valve insufficiency following chest radiotherapy. A 44-year-old man had received radiotherapy for the treatment of Hodgkin's disease 8 years ago. At age 40 years, effusive pericarditis occurred and he was treated with intrapericardial drainage. Biopsy revealed a fibrotic and thickened pericardium. He developed congestive heart failure 3 years later. The patient was found to have occult constrictive pericarditis and mitral valve insufficiency. He underwent mitral valve replacement, tricuspid annul plasty, and pericardiectomy. Although there is the benefit of cure for the Hodgkin's disease, the prognosis after treatment is affected by radiotherapy-induced heart disease. After radiotherapy of the chest and mediastinum, long-term cardiological follow-up is recommended in order to detecting patients with radiation-induced heart disease, such as the present case.     

Investigation of a patient with Hodgkin's disease and cholestasis.

A patient with the cholestasis of Hodgkin's disease was investigated. Our studies failed to relate the cholestasis to endocrine abnormalities. The patient had severely abnormal aminopyrine metabolism, suggesting more profound hepatocellular dysfunction than had previously been appreciated.     

Rectal Epstein-Barr virus-positive Hodgkin's lymphoma in a patient with Crohn's disease: case report and review of the literature

We present the case of a 35-year-old man with Crohn's disease diagnosed at the age of 27, several months after an operation for small-bowel adenocarcinoma. Seven years after the adenocarcinoma diagnosis, the patient presented with severe continuous anal pain and diarrhea. In parallel with antibiotic administration, the patient was given treatment with Infliximab, but without clinical symptom amelioration. Sigmoidoscopy and subsequent biopsies from an ulcerated rectal area supported the diagnosis of Epstein-Barr virus-positive (EBV+) primary Hodgkin's lymphoma. Infliximab administration was immediately discontinued and the patient underwent oncological follow-up and began a course of chemotherapy. Only a few cases with primary gastrointestinal Hodgkin's lymphoma in Crohn's disease patients have so far been reported, including a variety of scenarios on the causal relationship including disease duration, presence of EBV, long-term immunosuppressive treatment and, recently, anti-TNFalpha administration.