Epitheloid granuloma of bone marrow- not always tuberculosis, think beyond what you see

Authors

  • Latha M. Sneha Division of Pediatric Hematology Oncology, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India
  • Indhuumathy S. Thayammal Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India
  • Nagarajan Priyathersini Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India
  • Vairan Vilvanathan Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212486

Keywords:

Fever of unknown origin, Bone marrow biopsy, Epithelioid granuloma, Hodgkins lymphoma

Abstract

Extra pulmonary tuberculosis has varied presentations and hence fever of unknown origin, with malaise, weight loss and cytopenias is generally attributed to tuberculosis in endemic regions. Tuberculosis being the most frequent cause of bone marrow granulomas, there is a risk of labelling granulomatous lesions as of infectious etiology when underlying etiology has an atypical presentation. Progressive painless lymphadenopathy, most commonly involving the cervical or supraclavicular area is the commonest presentation of Hodgkin’s lymphomas (HL) in 80%. Primary extra nodal presentation of HL is rare. We describe a case of an adolescent girl who presented with fever of unknown origin, weight loss, malaise, hematological derangements and bone marrow showing granuloma, all features pointing towards an infectious etiology, but later proven to be a case of HL.

Author Biographies

Latha M. Sneha, Division of Pediatric Hematology Oncology, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India

Division of Pediatric hematology and oncology, Associate professor

Indhuumathy S. Thayammal, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India

First year Pediatric Post graduate, Department of Pediatrics

Nagarajan Priyathersini, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India

Assistant Professor, Department of Pathology

Vairan Vilvanathan, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, India

Sr. Consultant, Department of Pediatrics, 

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Published

2021-06-24

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Section

Case Reports