Diagnostic Dilemma: An Unusual Case of Angioimmunoblastic T-Cell Lymphoma Manifesting as Bone Marrow Non-Caseating Granuloma

Vineel Bhatlapenumarthi, Northern Light Eastern Maine Medical Center, 489 State Street, Bangor, ME 04401, USA.
Anannya Patwari, Northern Light Eastern Maine Medical Center, 489 State Street, Bangor, ME 04401, USA.
Sheila Karina Pascual, Northern Light Cancer Care, 33 Whiting Hill Road, Brewer, ME 04412, USA.

Abstract

We present here a rare and unusual presentation of angioimmunoblastic T-cell lymphoma with non-necrotizing granuloma of bone marrow. We did not find any case reports of such case in our literature search. A 77-year-old man presented with shortness of breath, generalized weakness, fatigue and weight loss. Laboratory data revealed elevated white count, low platelets and anemia. Imaging studies revealed generalized lymphadenopathy. A bone marrow biopsy showed hypercellular marrow with non-caseating granuloma which was non-diagnostic and lymph node biopsy showed angioimmunoblastic T-cell lymphoma.