Abstract
A 59-year-old woman who had a high fever of more than 39°C for two days and suffered from general fatigue and generalized nodular rash without itching for one month was admitted to our hospital at the end of April 1991. Laboratory findings on admission showed leukocytopenia (3, 900/μl) and liver dysfunction (GOT 324 KU, GPT 186 KU). Her laboratory data and body temperature became normal with medication. However, subsequently her body temperature rose again and rash was exacerbated. With lymph node swelling in the neck and axillae, myalgia, polyarthralgia and abdominal pain, numbness in hands and Raynaud's phenomenon occurred. Laboratory findings at the 15th day were as follows: the erythrocyte sedimentation rate was 7mm/hour, CRP 9.07mg/dl, white blood cell 27, 000/ml, blood urea nitrogen 74mg/dl, serum creatinine 3.86mg/ml, IgG 571mg/dl, IgA 63mg/ml, IgM 106mg/ml, antinuclear antibody positive (80×), and CD 4/CD 8 ratio 0.54. From these findings, polyarteritis nodosa was highly suspected. Histological findings from biopsied lymphnodes, however, revealed IBL-like T cell lymphoma with surface markers of MT-1 and leu 3 a. Lymphoma cell infiltration was also observed in the biopsied skin. This is a rare case of IBL-like T cell lymphoma accompanied by hypogammaglobulinemia.
