%0 Journal Article
%T Successful Treatment in a Child with Anaplastic Large Cell Lymphoma and Coexistence of Pulmonary Tuberculosis
%A Margarita Baka
%A Dimitrios Doganis
%A Apostolos Pourtsidis
%A Maria Tsolia
%A Despina Bouhoutsou
%A Maria Varvoutsi
%A Katerina Strantzia
%A Helen Kosmidis
%J Case Reports in Pediatrics
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/928701
%X A 13-year-old girl was admitted to our department with a history of severe pain of her left axilla and fever. On physical examination, a block of lymph nodes in her left axilla, diffuse papular rash, and red-violet swelling of her supraclavicular and subclavian region were noted. Imaging investigations revealed left axillar and supraclavicular lymphadenopathy and a small nodular shade in the upper lobe of her left lung. A biopsy from an axillary lymph node established the diagnosis of anaplastic large cell lymphoma (ALCL), whereas DNA of Mycobacterium tuberculosis was detected by polymerase chain reaction (PCR) in the same tissue biopsy. Patient was started on chemotherapy for ALCL and achieved remission of all initially involved fields. Nevertheless, two new nodular lesions were detected in the left lower lobe. Biopsy revealed granulomas, and PCR was positive for M. tuberculosis. Our patient received treatment with the combination of isoniazid and rifampin (12 months), pyrazinamide (the first 2 months), and maintenance chemotherapy for her ALCL for one year simultaneously. Four years later, she is disease free for both mycobacterial infection and lymphoma. We are reporting this successful management of mycobacterial infection in a patient with ALCL despite intensive chemotherapy that the patient received at the same time. 1. Introduction Children with cancer have an increased risk for life-threatening infections due to their underlying illness and intensive anticancer treatment as well [1]. Certain types of cancer, particularly Hodgkin¡¯s disease and non-Hodgkin¡¯s lymphoma, are associated with impaired cellular immunity which may persist even after the end of treatment while the disease is in remission [1, 2]. Chemotherapy in these diseases is an additional factor of altered cellular immunity [1]. Although the majority of infections in children with cancer are caused by bacteria, infections due to mycobacteria are also reported and may be severe and life threatening [1, 3]. In this report we describe a case of pulmonary tuberculosis (TB) in a girl with Anaplastic Large Cell Lymphoma (ALCL). 2. Case Report A 13-year-old girl was admitted to our department with a history of severe pain of her left axilla and limitation of her left arm active movements during the last 3 weeks. The parents reported no history of any other associated symptoms apart from fever of 39¡ãC three days after the first appearance of pain. No history of decreased appetite was reported. No prior surgeries or medical problems were also mentioned. On physical examination, she was well
%U http://www.hindawi.com/journals/cripe/2013/928701/