Angio-Immunoblastic T Cell Lymphoma Presenting With Vasculitis and Hypercalcemia

Abstract

Angioimmunoblastic T Cell Lymphoma (ATCL) is a rare variety of Non-Hodgkin’s lymphoma. It often presents with atypical signs like skin rash or arthritis and thus, the diagnosis is often delayed. We here present a case of ATCL that presented with cerebral vasculitis like features, followed by digital gangrene and then hypercalcemia. At first the lymph node biopsies were negative and only much later, repeat biopsy proved the diagnosis. In microscopy, effacement of paracortical area with infiltration of blood vessels was found. The patient responded to chemotherapy with resolution of some of the symptoms. The case highlights the atypical presentation of haematological malignancies and the need for follow up for proper diagnosis. Such a presentation has never been reported from Indian subcontinent.