Résumé
When a patient with malignant lymphoma develops new lymph node enlargement, a recurrence of lymphoma is usually suspected first. However, painless and rapid lymph node enlargement, a manifestation of non-Hodgkin’s lymphoma, could also be due to other causes. A 3-year-old boy who was previously diagnosed with Burkitt lymphoma was admitted for routine tumor evaluation one year following completion of treatment. Abdominal computed tomography showed several enlarged lymph nodes in the right lower quadrant, and 18 F-fluoro-2-deoxy-D-glucose positron emission tomography revealed hypermetabolic enlarged lymph nodes in the corresponding lesion. The patient underwent ileocecal lymph node biopsy for pathologic confirmation, which revealed reactive hyperplasia without lymphoma recurrence. Serologic test results for cytomegalovirus immunoglobulin G and immunoglobulin M were positive. Additionally, the polymerase chain reaction test performed using a urine sample was positive for cytomegalovirus. After several outpatient follow-ups, we concluded cytomegalovirus infection that mimicked a recurrence of lymphoma on imaging as the cause for lymph node enlargements. This case highlights the importance of using prompt and multiple approaches after detecting a possible tumor recurrence through imaging studies.
Résumé
When a patient with malignant lymphoma develops new lymph node enlargement, a recurrence of lymphoma is usually suspected first. However, painless and rapid lymph node enlargement, a manifestation of non-Hodgkin’s lymphoma, could also be due to other causes. A 3-year-old boy who was previously diagnosed with Burkitt lymphoma was admitted for routine tumor evaluation one year following completion of treatment. Abdominal computed tomography showed several enlarged lymph nodes in the right lower quadrant, and 18 F-fluoro-2-deoxy-D-glucose positron emission tomography revealed hypermetabolic enlarged lymph nodes in the corresponding lesion. The patient underwent ileocecal lymph node biopsy for pathologic confirmation, which revealed reactive hyperplasia without lymphoma recurrence. Serologic test results for cytomegalovirus immunoglobulin G and immunoglobulin M were positive. Additionally, the polymerase chain reaction test performed using a urine sample was positive for cytomegalovirus. After several outpatient follow-ups, we concluded cytomegalovirus infection that mimicked a recurrence of lymphoma on imaging as the cause for lymph node enlargements. This case highlights the importance of using prompt and multiple approaches after detecting a possible tumor recurrence through imaging studies.