Angioimmunoblastic T-cell Lymphoma: A Mimic for Lupus

Authors

• Hui Boon Tay Division of Medicine, Sengkang General Hospital, SingHealth, Singapore
• Stanley Angkodjojo Division of Medicine, Sengkang General Hospital, SingHealth, Singapore
• Zhi En Amos Tay Department of Anatomical Pathology, Singapore General Hospital, SingHealth, Singapore
• Puay Hoon Tan Division of Pathology, Singapore General Hospital, SingHealth, Singapore
• Yan Denise Tan Division of Medicine, Sengkang General Hospital, SingHealth, Singapore

tay.hui.boon@singhealth.com.sg

Keywords

Abstract

New-onset systemic lupus erythematosus (SLE) is uncommon in elderly patients. We report the case of a 71-year-old woman who was diagnosed with SLE based on clinical manifestations of fever, alopecia, bicytopenia, hepatomegaly, lymphadenopathy, glomerulonephritis, positive antinuclear antibody (ANA) and anti-double stranded DNA (anti-dsDNA) antibody. Renal biopsy was consistent with lupus nephritis and excision biopsy of a right inguinal lymph node was initially reported as having features of reactive hyperplasia. However, a more careful review of the lymph node biopsy subsequently confirmed a concurrent angioimmunoblastic T-cell lymphoma. This case illustrates the importance of investigating secondary causes and possible alternative diagnoses in patients who present with atypical features of connective tissue disease, and the challenges in diagnosing a rare form of lymphoma.