title: [Malignant lymphoma manifested by fever of unexplained origin and pure red cell aplasia in an elderly patient].
abstract: A 76-year-old woman was admitted to the University of Tokyo Hospital in June 2002 because of fever of unexplained origin. She had suffered a high grade fever (above 39 degrees C) for 2 weeks. Initial evaluation revealed elevated CRP and pancytopenia. Bone marrow aspiration (BMA) was performed, and a diagnosis of pure red cell aplasia (PRCA) was made. One month later, she complained right hypochondrial pain, and aspiration from her enlarged gall bladder was performed. Her fever and PRCA ameliorated, and she was discharged in August, 2002. In April 2003, she was readmitted to our hospital because of the recurrence of high grade fever, elevation of CRP, and pancytopenia. BMA was performed and revealed diffuse large B cell lymphoma. In the case of extranodal lymphoma which only presents pyrexia, differentiation with other diseases is very difficult especially in the elderly. It is necessary to bear in mind the possibility that a hematological malignancy, especially malignant lymphoma, can be latent in elderly patient with fever of unknown origin.
authors.affiliation: Department of Geriatric Medicine, the University of Tokyo Hospital.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hanaoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Iijima
authors.forename: Eijiro
authors.initials: E
authors.lastname: Ohga
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Ouchi
mesh_terms: D000368:Aged; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications*; D012010:Red-Cell Aplasia, Pure / Q000209:etiology*