Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma
Digital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud’s syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hema...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2018/1980749 |
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| author | Fiorella Villano Adriana Peixoto Eloísa Riva Carina Di Matteo Lilián Díaz |
| author_facet | Fiorella Villano Adriana Peixoto Eloísa Riva Carina Di Matteo Lilián Díaz |
| author_sort | Fiorella Villano |
| collection | DOAJ |
| description | Digital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud’s syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hematological malignancies. We report the case of a 45-year-old male, smoker, with a 10-day history of pain, cyanosis, and progressive digital necrosis in both hands. In the previous four months, he noticed painless mass in the right axillary gap, drenching night sweats, and weight loss. Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs), enlarged lymph nodes in right axillary, and right supraclavicular gaps. Arteriography of upper limbs demonstrated a distal stop in all bilateral digital arteries. Digital ischemia was interpreted as a paraneoplastic phenomenon after other common etiologies were ruled out. Amputation of three phalanges was required due to necrosis. Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin’s lymphoma (HL). The patient started conventional ABVD protocol (doxorubicin, bleomycin, vinblastine, and dacarbazine). After 6 cycles, he remained asymptomatic and symptoms of digital ischemia were completely resolved. It was concluded that the presence of acral vascular syndromes should alert the physician about the possibility of underlying malignant disease. Prompt investigation and treatment should be rapidly performed to avoid digital sequelae. |
| format | Article |
| id | doaj-art-eb0dbebdd6994893933406c0cacc6d2c |
| institution | OA Journals |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-eb0dbebdd6994893933406c0cacc6d2c2025-08-20T02:22:02ZengWileyCase Reports in Hematology2090-65602090-65792018-01-01201810.1155/2018/19807491980749Digital Ischemia as an Unusual Manifestation of Hodgkin’s LymphomaFiorella Villano0Adriana Peixoto1Eloísa Riva2Carina Di Matteo3Lilián Díaz4Department of Hematology, Médica Uruguaya (MUCAM), Montevideo, UruguayDepartment of Hematology, Médica Uruguaya (MUCAM), Montevideo, UruguayDepartment of Hematology, Médica Uruguaya (MUCAM), Montevideo, UruguayLaboratory of Pathology Carina Di Matteo, Montevideo, UruguayDepartment of Hematology, Médica Uruguaya (MUCAM), Montevideo, UruguayDigital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud’s syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hematological malignancies. We report the case of a 45-year-old male, smoker, with a 10-day history of pain, cyanosis, and progressive digital necrosis in both hands. In the previous four months, he noticed painless mass in the right axillary gap, drenching night sweats, and weight loss. Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs), enlarged lymph nodes in right axillary, and right supraclavicular gaps. Arteriography of upper limbs demonstrated a distal stop in all bilateral digital arteries. Digital ischemia was interpreted as a paraneoplastic phenomenon after other common etiologies were ruled out. Amputation of three phalanges was required due to necrosis. Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin’s lymphoma (HL). The patient started conventional ABVD protocol (doxorubicin, bleomycin, vinblastine, and dacarbazine). After 6 cycles, he remained asymptomatic and symptoms of digital ischemia were completely resolved. It was concluded that the presence of acral vascular syndromes should alert the physician about the possibility of underlying malignant disease. Prompt investigation and treatment should be rapidly performed to avoid digital sequelae.http://dx.doi.org/10.1155/2018/1980749 |
| spellingShingle | Fiorella Villano Adriana Peixoto Eloísa Riva Carina Di Matteo Lilián Díaz Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma Case Reports in Hematology |
| title | Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma |
| title_full | Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma |
| title_fullStr | Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma |
| title_full_unstemmed | Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma |
| title_short | Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma |
| title_sort | digital ischemia as an unusual manifestation of hodgkin s lymphoma |
| url | http://dx.doi.org/10.1155/2018/1980749 |
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