Eosinophilic Fasciitis with Hypereosinophilia as the Initial Clinical Manifestation of Peripheral T-Cell Lymphoma, Not Otherwise Specified

Intern Med. 2022 Nov 15;61(22):3425-3429. doi: 10.2169/internalmedicine.9300-21. Epub 2022 Apr 30.

Abstract

A 58-year-old man presented with painful edema of the extremities, and a diagnosis of eosinophilic fasciitis (EF) was confirmed. He also met the criteria for hypereosinophilic syndrome (HES), but there were no findings suggestive of malignancies or hematologic neoplasms despite a close examination. He was started on steroid therapy but subsequently developed severe liver dysfunction, hemophagocytic lymphohistiocytosis, hepatosplenomegaly, and renal involvement. The diagnosis of peripheral T-cell lymphoma, not otherwise specified was finally established by a bone marrow reexamination and liver biopsy. In cases of eosinophilia, EF, and/or HES, it is important to suspect an intrinsic abnormality, including potential T-cell lymphoma.

Keywords: T-cell lymphoma; eosinophilia; eosinophilic fasciitis; hematologic neoplasms; hypereosinophilic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Eosinophilia* / complications
  • Eosinophilia* / diagnosis
  • Fasciitis* / diagnosis
  • Fasciitis* / drug therapy
  • Fasciitis* / etiology
  • Hematologic Neoplasms*
  • Humans
  • Hypereosinophilic Syndrome* / complications
  • Hypereosinophilic Syndrome* / diagnosis
  • Lymphoma, T-Cell, Peripheral* / complications
  • Lymphoma, T-Cell, Peripheral* / diagnosis
  • Male
  • Middle Aged

Supplementary concepts

  • Eosinophilic Fasciitis