Simultaneous hepatosplenic T-cell lymphoma and myelofibrosis
This was a case of a 37-year-old male patient who was admitted to the hospital because of a right sided abdominal mass. On examination, he had left axillary lymphadenopathy (1 cm) and hepatosplenomegaly. The complete blood count showed mild anemia and severe thrombocytopenia []. The peripheral blood smear showed intermediate-sized atypical lymphocytes, immature granulocytes, nucleated red blood cells and tear-drop cells []. Liver function tests were mildly impaired and screening for auto-antibody as well as viral serology for hepatitis A, B and C were negative. Computed tomography (CT) scan of the abdomen showed massive hepatosplenomegaly and minimal lymphadenopathy. He underwent left axillary lymph node biopsy followed 1 week later by bone marrow biopsy.\nThe patient was given two cycles of high dose dexamethasone, cytarabine and cisplatine followed by hyper-fractionated cyclophosphamide, doxorubicin, vincristine and dexamethasone chemotherapy regimen. There was an initial dramatic reduction in the size of spleen and liver which were confirmed by abdominal CT scan. However, 2 months later the spleen increased in size and he developed severe thrombocytopenia. At 5 months after completing radiotherapy for his enlarging spleen, the patient died of complications of septicemia. No post-mortem study was done on the patient.