Unusual Causes of Adenopathy in a Tropical Environment: About 3 Observations.
Introduction: The discovery of peripheral lymphadenopathy is a frequent reason
for consultation and hospitalization in Internal Medicine. The aim of this article
is to review through three cases the etiologies of chronic lymphadenopathy
rarely reported in a tropical environment. Observations: The first patient
is a 62-year-old man who has been infected with HIV-1 for 14 years and who
had a multicenter form of Castleman disease. The diagnosis was confirmed after
3 histological lymph nodes. The progression was favorable under Etoposide-based
chemotherapy. The second observation is about a 38-year-old woman with a
2-month chronic febrile adenopathy without improvement after anti-tuberculosis
treatment. The diagnosis of Kikuchi Fujimoto disease, in its necrotizing form,
was confirmed in histology. The evolution was made favorable by the corticosteroid
therapy. The third observation is about a 63-year-old woman with an enlargement
of groups of lymph nodes, liver, and spleen. This tumoral syndrome
was associated to an exudative ascites and a Systemic Inflammatory Response
Syndrome (SIRS). The initial diagnosis was a multifocal tuberculosis based on
a set of evidence (exudative lymphocytic ascites, epidemiological context and a
positive Quantiferon TB test). The first ganglionic histology was not contributory.
It was the second ganglionic histology that indicated the diagnosis of lymph
node plasmocytoma revealing a myeloma. The patient died of septic shock. Conclusion:
In tropical environment, the etiologies of chronic lymphadenopathy are
not limited to tuberculosis and malignant haemopathies. Carrying out ganglionic
histology is an absolute necessity.
Auteur(s) : NDIAYE Nafy, LEYE A, DIACK ND, LEYE YM, NDOUR MA.
Pages : 115-122
Année de publication : 2017
Revue : open journal of internal medecine
N° de volume : 7
Type : Article
Statut Editorial : SCRIP.org
Mise en ligne par : NDIAYE Nafy