Dasatinib associated lymphadenopathy in a chronic myeloid leukemia patient: A case report.

RATIONALE: Dasatinib associated lymphadenopathy (DAL) is a rare adverse event in chronic myeloid leukemia patients (CML). A case of voluminous lymphadenopathy in the context of DAL is presented. PATIENT CONCERNS: A 40-year-old male patient was diagnosed with BCR-ABL1 positive chronic stage CML 2 years ago and achieved complete molecular response on nilotinib, which was switched to dasatinib due to nilotinib intolerance. After 5 months on dasatinib, the patient presented with a large mass in the axillary region. DIAGNOSIS: Common infectious and autoimmune etiologies of lymphadenopathy were ruled out. The positron emission tomography/computed tomography (PET/CT) demonstrated a hypermetabolic lymphadenopathy highly suspicious of lymphoma. The subsequent biopsy excluded lymphoma or extramedullary blastic transformation of CML and revealed reactive lymphadenopathy with mixed (cortical and paracortical) pattern. Clinical history and clinicopathological correlation suggested the diagnosis of DAL. INTERVENTION: Dasatinib was discontinued and the patient remained in close follow-up. TKI treatment with nilotinib was reinitiated. OUTCOMES: Lymphadenopathy resolved clinically at 4 weeks and normalization of PET/CT findings was documented at 9 weeks after cessation of the drug. TKI treatment with nilotinib was reinitiated with good tolerance. LESSONS: DAL may present with voluminous lymphadenopathy consistent with malignancy in clinical and imaging workup. We describe the spectrum of lesions associated with DAL and identify common features with drug-induced lymphadenopathy.

Hibernoma of the thigh: a lipoma-like variant rare tumour mimicking soft tissue sarcoma.

A 43-year-old Caucasian woman appeared with painless progressively enlarging tumour of the anterior part of the left thigh of approximately 6 months' duration. A differential imaging diagnosis of liposarcoma or large lipoma was made. An excisional biopsy was performed with complete removal of a large lobulated and encapsulated grossly ovoid mass. Frozen section diagnosis was unidentified lipomatous tumour with no evidence of malignancy. The final pathological diagnosis was lipoma-like hibernoma. The patient's postoperative course was uneventful and discharged on the seventh postoperative day with full function of the involved leg. Hibernoma is benign tumour and it is not known to recur after complete local excision which is the treatment of choice.