Angioimmunoblastic T-cell lymphoma with secondary hemophagocytic lymphohistiocytosis initially misdiagnosed as classical Hodgkin lymphoma: A case report.
Rui Li, Yong Chen, Xuefen Liu et al.
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Case in brief
A 72-year-old man presented with fatigue, recurrent fever, severe pancytopenia, and splenomegaly, initially diagnosed with Hodgkin lymphoma. Reevaluation revealed angioimmunoblastic T-cell lymphoma (AITL) with secondary hemophagocytic lymphohistiocytosis (HLH). Treatment included HLH-directed therapy followed by chemotherapy, achieving partial remission. However, the patient later experienced disease progression and died.
What made this case unusual
The case highlights the misdiagnosis of AITL as Hodgkin lymphoma due to overlapping histopathological features, particularly the presence of Hodgkin/Reed-Sternberg-like cells.
Diagnostic / clinical pearl
Clinicians should be aware of the potential for misdiagnosis of angioimmunoblastic T-cell lymphoma as Hodgkin lymphoma, especially in the presence of HLH.
Why it matters
This case emphasizes the need for careful pathological reassessment in patients with atypical presentations and highlights the importance of managing hyperinflammation in lymphoma cases.