Lymph Node Cytology Raising Suspicion for Evolving Secondary Hemophagocytic Lymphohistiocytosis in a Case of Mendelian Susceptibility to Mycobacterial Disease.
Deepti Soni, Sramana Mukhopadhyay, Hemlata Panwar et al.
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Case in brief
A 4-month-old male infant with genetically confirmed Mendelian susceptibility to mycobacterial disease presented at 22 months with generalized lymphadenopathy, massive splenomegaly, bicytopenia, and high-grade fever. Fine needle aspiration cytology of a cervical lymph node revealed ill-formed granulomas, acid-fast bacilli, and hemophagocytosis. This raised suspicion for evolving secondary hemophagocytic lymphohistiocytosis, prompting further investigations and clinical monitoring.
Diagnostic / clinical pearl
Lymph node fine needle aspiration cytology can be a valuable tool in identifying evolving secondary hemophagocytic lymphohistiocytosis in patients with Mendelian susceptibility to mycobacterial disease.
Why it matters
Recognizing the potential for secondary hemophagocytic lymphohistiocytosis in immunocompromised patients can facilitate early diagnosis and management, improving patient outcomes.