Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. The patient was treated as actinomycosis with adrenal involvement and was given intravenous penicillin and intravenous hydrocortisone. However, his condition did not improve and new signs appeared, that of left facial swelling and lymphadenopathy. A repeat biopsy of the palatal and adrenal masses revealed B-cell lymphoma. This case highlights the possibility that actinomycosis and lymphoma may share similar clinical presentations and may coexist. Either may mask and/or mimic the other, thus causing a delay in diagnosis. We describe the clinical progress and review the related literature. Interestingly, 9 out of the 12 reported cases of concomitant actinomycosis and malignancy (including this case) involve haematological malignancy. A high index of suspicion and treatment response reassessment is important in the management of either rare clinical entity.
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PMID:Masking and misleading: concomitant actinomycosis and B-cell lymphoma - a case report and review of literature. 3016 94

Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy.
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PMID:Colonic Diffuse Large B-cell Lymphoma Hidden in Actinomycosis. 3134 72