J Pediatr Hematol Oncol Volume 40, Number 1, January 2018 Letters to the Editor To the Editor: A 7-year-old boy presented with Vanishing Bile Duct intermittent fever and cervical nodes for Hepatic involvement is uncommon 2 years. Diagnosis was classic HL, stage Syndrome Following (5%) at diagnosis in Hodgkin lym- 1,2 IVB (Figs. 1A–C). During evaluation, he phoma (HL). Causes include hepatic Cytomegalovirus developed fever, vomiting, jaundice, and inﬁltration, biliary obstruction, or viral 2–5 infections. Vanishing bile duct syn- clay-colored stools. Bilirubin was 6 mg/ Infection in a Child dL (direct, 3.4 mg/dL; alanine trans- drome (VBDS) is a rare paraneoplastic 1,5–7 aminase, 212 U/L; aspartate trans- phenomenon associated with HL. With Hodgkin aminase, 219 U/L; alkaline phosphatase, We report a child with HL who devel- 576 U/L; g-glutamyl transferase, 243 oped VBDS following cytomegalovirus Lymphoma U/L). This increased to 12mg/dL over (CMV) infection. FIGURE 1. A, Lymph node biopsy showed complete effacement of the nodal architecture (hematoxylin and eosin, 40). Inset: scattered neoplastic and classic Reed-Sternberg cells (white arrow) in the background of reactive lymphocytes and macrophages (hematoxylin and eosin, 400). B, These atypical cells demonstrated strong membranous and golgi zone positivity for CD30 immunostain (400). Inset: dim
Journal of Pediatric Hematology / Oncology – Wolters Kluwer Health
Published: Jan 1, 2018
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