66 yo female, original presentation of diarrhea of several month duration.
EGD was done. The duodenal biopsy was c/w CD30+ T cell lymphoproliferative disorder.
Abnormal PET in the lungs.
Initially negative lung biopsy.
Normal LDH.
Beta-2 -microglobulin 3.3 mg/dl.
Progressive dyspnea and new cervical lymphadenopathy.
Negative lymph node biopsy as well as negative bone marrow biopsy.
A repeat lung biopsy was eventually read as T cell lymphoma NOS.
Evidence of progressive disease on PET and worsening of symptoms.
The patient received one cycle of CHP/Brentuximab.
Was admitted to the hospital with progressive dyspnea and hypotension.
No evidence of HLH or tumor lysis syndrome.
As an inpatient she has received one cycle of CHOP-mini.
Deterioration of the respiratory status.
The family requested supportive care only. The patient died several days later.