Overt Clinical Hypereosinophilia in T- cell Non Hodgkin Lymphoma: A Case Report

Abstract

The study describes a case of hyper-eosinophilia who was presented with overt manifestation of high eosinophil and detected to have underlying non Hodgkin lymphoma. The male patient was presented with profound weakness and multiple non itchy nodular skin lesion for 2 weeks. Biopsy from skin nodule showed deposits of abnormal lymphocytes. Lymph node biopsy showed effacement with mono nuclear abnormal cells which showed positivity for CD4 and 5, negative for cytokeratin and CD20. He was diagnosed to have T-NHL. [Fig. 3a, Fig. 3b] Bone marrow showed involvement by NHL cells. His diplopia and headache responded to intra-thecal methotrexate and possibly CNS involvement of disease was considered. Family opted out of allopathic treatment plan due to clinical progression. He later died of disease progression. This case illustrates the rare and interesting association of overt clinical hyper-eosinophilia and T NHL. The study suggests that cases with hyper eosinophilia should be evaluated thoroughly for T cell disease.