Lymphomatoid granulomatosis after childhood acute lymphoblastic leukemia: report of effective therapy

Pediatrics
C L MoertelS C Simonton

Abstract

Lymphomatoid granulomatosis, a rare condition in children, affects the lungs primarily but may have significant extrapulmonary manifestations, especially in the central nervous system. We report a case of lymphomatoid granulomatosis with onset after the completion of chemotherapy for childhood acute lymphoblastic leukemia. Two months after treatment ended, the 7-year-old girl developed splenomegaly, cervical adenopathy, and bilateral interstitial pulmonary infiltrates. She improved on cefotaxime but experienced a seizure 1 month later. A computed tomography scan of the head was normal, but her pulmonary infiltrates had become nodular. A computed tomography-guided biopsy of 1 of the nodules revealed cellular interstitial pneumonitis. One month later, she had persistent pulmonary infiltrates, marked splenomegaly, and new seizures. Magnetic resonance imaging of the head revealed cerebral nodules. Itraconazole was begun, and the pulmonary infiltrates resolved. Five months after her initial symptoms, she developed tonic pupil and a decreased level of consciousness. Dexamethasone was initiated. Needle biopsies of the brain were carried out, yielding the diagnosis of severe chronic inflammatory changes focally consistent with granulom...Continue Reading

Citations

Feb 7, 2003·Journal of Pediatric Hematology/oncology·Hale OrenArzu Kovanlikaya
Nov 26, 2010·The American Journal of Surgical Pathology·Anna-Luise A KatzensteinSonia Narendra
Sep 26, 2012·The Cancer Journal·Mark Roschewski, Wyndham H Wilson
Oct 6, 2012·La Revue de médecine interne·H de Boysson, L Geffray
Dec 23, 2015·Middle East African Journal of Ophthalmology·Shaheer Aboobaker, Christopher Tinley
Sep 28, 2010·Journal of Ophthalmology·Thanuja Gopal PradeepDinesh Selva
Feb 8, 2003·Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·Amy Hareema

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