Abstract:
A 65-year-old man, a smoker, presented to the emergency department with progressive digital ischaemia, fever and weight loss. The clinical examination revealed generalised lymphadenopathy and ischaemic changes of the right distal phalanges of the second, third and fourth fingers. He had an ultrasound-guided biopsy of the cervical lymph node, which showed histopathological findings of classic Hodgkin\'s lymphoma. Paraneoplastic acral vascular syndrome (PAVS) is a rare phenomenon and seen more in solid malignancies. There are very few reported cases of PAVS in haematological malignancies, including Hodgkin\'s lymphoma. This case highlights the idea that the presence of acral vascular syndrome-especially in older patients-should alert physicians to search for an underlying malignancy as part of the medical evaluation. Also, it shows that medical treatment may slow the progress of the digital ischaemia until the culprit tumour has been identified and treated.
摘要:
一个65岁的男人,一个吸烟者,患有进行性数字缺血的急诊科,发烧和减肥。临床检查显示第二远端右指骨的广泛性淋巴结肿大和缺血性改变,第三个和第四个手指。他做了颈部淋巴结的超声引导活检,显示了典型霍奇金淋巴瘤的组织病理学发现。副肿瘤性肢端血管综合征(PAVS)是一种罕见的现象,在实体恶性肿瘤中多见。在血液系统恶性肿瘤中很少有PAVS的报道。包括霍奇金淋巴瘤.该病例强调了这样一种观点,即肢血管综合征的存在-尤其是在老年患者中-应提醒医生寻找潜在的恶性肿瘤,作为医学评估的一部分。此外,它表明,药物治疗可能会减缓数字缺血的进展,直到罪魁祸首肿瘤被识别和治疗。