title: Severe Hypercholesterolemia: A Unique Presentation of Non-Hodgkin's Lymphoma in a Patient with Neurofibromatosis Type 1.
abstract: We report a case of non-Hodgkin's lymphoma (NHL) with an unusual initial manifestation as severe hypercholesterolemia and obstructive jaundice in a patient with neurofibromatosis type 1 (NF 1). NHL should be considered in the evaluation of obstructive jaundice alone or in combination with severe hypercholesterolemia. Relief of biliary obstruction led to the resolution of hypercholesterolemia in our 59-year-old male patient, followed by doxorubicin-based chemotherapy for the underlying lymphoma. NF 1 is a genetic condition that results from a defect in a tumor-suppressor gene and it is likely that this led to the development of NHL in our patient. It is important that clinicians are familiar with the gastrointestinal manifestations of NF 1, especially its association with intra-abdominal malignancies, when treating patients with a personal or family history. To the best of our knowledge, this is the first case of NHL presenting initially as severe hypercholesterolemia and it is also one of the few instances where NHL has been reported in association with NF 1.
authors.affiliation: Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: Kenechukwu
authors.identifier: 0000-0003-2607-2750
authors.initials: K
authors.lastname: Chudy-Onwugaje
authors.affiliation: Department of Gastroenterology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: Nnaemeka
authors.initials: N
authors.lastname: Anyadike
authors.affiliation: Department of Gastroenterology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: Yuriy
authors.identifier: 0000-0002-1087-548X
authors.initials: Y
authors.lastname: Tsirlin
authors.affiliation: Department of Gastroenterology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: Ira
authors.identifier: 0000-0002-1833-2279
authors.initials: I
authors.lastname: Mayer
authors.affiliation: Department of Gastroenterology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: Rabin
authors.initials: R
authors.lastname: Rahmani
references.citation: Gut. 1975 May;16(5):379-91
references.pmid: 166902
references.citation: J Exp Med. 1954 Jan 1;99(1):43-53
references.pmid: 13118062
references.citation: Curr Opin Neurol. 2007 Apr;20(2):135-41
references.pmid: 17351482
references.citation: J Clin Lipidol. 2011 Jul-Aug;5(4):324-8
references.pmid: 21784379
references.citation: Cancer. 1995 Apr 1;75(7):1669-77
references.pmid: 8826926
references.citation: Korean J Intern Med. 2003 Sep;18(3):202-5
references.pmid: 14619393
references.citation: Lancet Neurol. 2007 Apr;6(4):340-51
references.pmid: 17362838
references.citation: Case Rep Med. 2013;2013:259642
references.pmid: 23818904
references.citation: Gut. 2002 Aug;51(2):265-9
references.pmid: 12117892
references.citation: Int J Clin Exp Pathol. 2012;5(9):852-62
references.pmid: 23119102
references.citation: Tohoku J Exp Med. 2006 Feb;208(2):169-76
references.pmid: 16434841
references.citation: J Atheroscler Thromb. 2008 Oct;15(5):276-80
references.pmid: 18981653
references.citation: Semin Liver Dis. 1987 Aug;7(3):269-77
references.pmid: 3317863
references.citation: Am J Cardiol. 1984 Jul 1;54(1):20-30
references.pmid: 6331147
references.citation: J Gastrointest Surg. 2010 Jan;14(1):186-94
references.pmid: 19495890