Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency

Cutaneous Hodgkin lymphoma is a rare condition. Specific neoplastic involvement can be primary (confined to the skin) or secondary to systemic involvement (metastatic). Cutaneous involvement by HL usually occurs late in the course and is associated with poor prognosis; however in some cases it can e...

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Main Authors: Mohamad Khawandanah, Teresa Kraus, Mohamad Cherry
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2014/642868
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author Mohamad Khawandanah
Teresa Kraus
Mohamad Cherry
author_facet Mohamad Khawandanah
Teresa Kraus
Mohamad Cherry
author_sort Mohamad Khawandanah
collection DOAJ
description Cutaneous Hodgkin lymphoma is a rare condition. Specific neoplastic involvement can be primary (confined to the skin) or secondary to systemic involvement (metastatic). Cutaneous involvement by HL usually occurs late in the course and is associated with poor prognosis; however in some cases it can exhibit indolent behavior. Skin involvement with nonspecific cutaneous findings may represent a paraneoplastic syndrome. We describe a case of 46-year-old white male patient presented with rash and lymphadenopathy which led to the diagnosis of stage IVE mixed cellularity classical Hodgkin lymphoma with skin involvement. His disease was refractory to multiple lines of chemotherapy including (1) AVD (doxorubicin/bleomycin/dacarbazine), (2) brentuximab, and (3) bendamustine, he later achieved complete remission with (4) GCD (gemcitabine/carboplatin/dexamethasone) salvage regimen. Bleomycin was not given secondary to poor pulmonary function tests. His treatment was complicated after AVD with multiple pneumothoraces which unmasked the diagnosis of ZZ phenotype alpha-1 antitrypsin (ATT) deficiency. Simultaneous existence of Hodgkin lymphoma and ATT is rarely reported.
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spelling doaj-art-c4435829de7c4cb9b60fdd4d5eb593722025-08-20T02:18:47ZengWileyCase Reports in Hematology2090-65602090-65792014-01-01201410.1155/2014/642868642868Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin DeficiencyMohamad Khawandanah0Teresa Kraus1Mohamad Cherry2Hematology-Oncology Section, Department of Medicine, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, 800 NE 10th Street, Oklahoma City, OK 73104, USADepartment of Pathology, The University of Oklahoma Health Sciences Center, 940 Stanton L. Young Boulevard, BMSB 451, Oklahoma City, OK 73104, USAHematology-Oncology Section, Department of Medicine, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, 800 NE 10th Street, Oklahoma City, OK 73104, USACutaneous Hodgkin lymphoma is a rare condition. Specific neoplastic involvement can be primary (confined to the skin) or secondary to systemic involvement (metastatic). Cutaneous involvement by HL usually occurs late in the course and is associated with poor prognosis; however in some cases it can exhibit indolent behavior. Skin involvement with nonspecific cutaneous findings may represent a paraneoplastic syndrome. We describe a case of 46-year-old white male patient presented with rash and lymphadenopathy which led to the diagnosis of stage IVE mixed cellularity classical Hodgkin lymphoma with skin involvement. His disease was refractory to multiple lines of chemotherapy including (1) AVD (doxorubicin/bleomycin/dacarbazine), (2) brentuximab, and (3) bendamustine, he later achieved complete remission with (4) GCD (gemcitabine/carboplatin/dexamethasone) salvage regimen. Bleomycin was not given secondary to poor pulmonary function tests. His treatment was complicated after AVD with multiple pneumothoraces which unmasked the diagnosis of ZZ phenotype alpha-1 antitrypsin (ATT) deficiency. Simultaneous existence of Hodgkin lymphoma and ATT is rarely reported.http://dx.doi.org/10.1155/2014/642868
spellingShingle Mohamad Khawandanah
Teresa Kraus
Mohamad Cherry
Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
Case Reports in Hematology
title Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
title_full Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
title_fullStr Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
title_full_unstemmed Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
title_short Refractory Classical Hodgkin Lymphoma Presenting with Atypical Cutaneous Involvement and Diagnosis of ZZ Phenotype Alpha-1 Antitrypsin Deficiency
title_sort refractory classical hodgkin lymphoma presenting with atypical cutaneous involvement and diagnosis of zz phenotype alpha 1 antitrypsin deficiency
url http://dx.doi.org/10.1155/2014/642868
work_keys_str_mv AT mohamadkhawandanah refractoryclassicalhodgkinlymphomapresentingwithatypicalcutaneousinvolvementanddiagnosisofzzphenotypealpha1antitrypsindeficiency
AT teresakraus refractoryclassicalhodgkinlymphomapresentingwithatypicalcutaneousinvolvementanddiagnosisofzzphenotypealpha1antitrypsindeficiency
AT mohamadcherry refractoryclassicalhodgkinlymphomapresentingwithatypicalcutaneousinvolvementanddiagnosisofzzphenotypealpha1antitrypsindeficiency