title: [Treatment failure as a consequence of the diagnostic difficulties in a 52-year-old patient treated for the pancreatic abscess].
abstract: Hodgkin Lymphoma (HL) is a neoplastic disease of the lymphatic system, primary involving lymph nodes and extranodular organs. Despite successful combined chemotherapy, a proper and prompt diagnosis remains a difficult challenge. The case report documents the case of a 52-year-old patient, who had been diagnosed in various internal medicine wards for nonspecific diseases during last two years. Due to the worsening of patient's general condition and suspected inflammatory, probably purulent, abdominal process, he was operated twice. Unexplained symptoms of the uncertain origin resulted in the further lack of successful diagnosis and therapy. The patient died from multiple organ failure on the 2nd day after the second operation. The final histopathological and immunohistochemical examination of the liver biopsy revealed the primary cause of death, i.e. Hodgkin lymphoma. The thorough analysis of the patient's documentation revealed a full-featured image of the classic HL. A special emphasis was placed upon misleading symptoms and difficulties in correct interpretation of more sophisticated diagnostic methods. The significant features of these patients can provide sufficient guidance to proper diagnosis and treatment of this rare disease.
authors.affiliation: Department of Surgery, 4th Military Clinical Hospital, Wroclaw, Poland.
authors.forename: Wiktor
authors.initials: W
authors.lastname: Pawłowski
authors.affiliation: Department of Surgery, 4th Military Clinical Hospital, Wroclaw, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dorobisz
authors.affiliation: Department of Surgery, 4th Military Clinical Hospital, Wroclaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Ziomek
authors.affiliation: Department of Surgery, 4th Military Clinical Hospital, Wroclaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Leśniak
authors.affiliation: Department of Clinical Proceedings, Faculty of Health Science, Medical University of Wrocław, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Chabowski
authors.affiliation: Department of Clinical Proceedings, Faculty of Health Science, Medical University of Wrocław, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000601:surgery*; D001706:Biopsy; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000601:surgery*; D012086:Reoperation; D017211:Treatment Failure
keywords: Hodgkin’s lymphoma; fever; hepatic tumor; lymph nodes