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Concomitant Splenic Tuberculosis and Epstein–Barr Virus-Related T-Cell Leukemia/Lymphoma in a 28-Year-Old Pregnant Woman in South Sudan
Hannah B. Wild
hbwild@uw.edu
Hannah B. Wild
Department of Surgery, University of Washington, Seattle, Washington;
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Joseph Aumuller
Joseph Aumuller
Épicentre, Médecins Sans Frontières, Juba, South Sudan;
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Joseph Kuei
Joseph Kuei
Médecins Sans Frontières, Aweil Project, Aweil, South Sudan;
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Mel Simon
Mel Simon
Médecins Sans Frontières, Aweil Project, Aweil, South Sudan;
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Anna Palm
Anna Palm
Department of Obstetrics and Gynecology, Sundsvall Hospital, Sundsvall, Sweden;
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Jacob Pendergrast
Jacob Pendergrast
Division of Hematology, Department of Medicine, University of Toronto, Toronto, Canada;
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Jean-Pierre Letoquart
Jean-Pierre Letoquart
Surgery Advisor Médecins Sans Frontières France, Paris, France;
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Jefferson Terry
Jefferson Terry
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada;
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Shahrzad Joharifard
Shahrzad Joharifard
Division of Pediatric Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
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This case report presents a rare instance of concomitant splenic tuberculosis (TB), Epstein–Barr virus (EBV)-related T-cell leukemia/lymphoma, and malaria in a 28-year-old pregnant woman at a Médecins Sans Frontières-supported hospital in South Sudan. The patient was admitted with splenomegaly, anorexia, weakness, and transfusion-refractory anemia. She tested positive for malaria and was treated appropriately. Because of ongoing consumptive anemia, cachexia, and weakness severely impacting her quality of life, the patient underwent splenectomy. A diagnosis of TB was ultimately confirmed post-splenectomy through histopathological analysis and molecular testing. Gross findings from the pathologic analysis of a splenic sample revealed miliary deposits, necrotizing granulomas, and atypical lymphocytic infiltrates consistent with TB and EBV-associated leukemia/lymphoma. Despite temporary improvement post-operatively and the initiation of TB therapy, the patient discontinued treatment and was lost to follow-up, likely resulting in mortality. This report presents an unusual combination of concomitant pathologies that underscore the diagnostic challenges and complexity of managing overlapping infectious and hematological disorders in resource-limited settings.
- Supplemental Materials (PDF 557.35 KB)
Author Notes
Current contact information: Hannah B. Wild, Department of Surgery, University of Washington, Seattle, WA, E-mail: hbwild@uw.edu. Joseph Aumuller, Épicentre, Médecins Sans Frontières, Juba, South Sudan, E-mail: joe.aumuller@epicentre.msf.org. Joseph Kuei and Mel Simon, Médecins Sans Frontières, Aweil Project, Aweil, South Sudan, E-mails: drjosephakech@gmail.com and msff-aweil-mam@paris.msf.org. Anna Palm, Department of Obstetrics and Gynecology, Sundsvall Hospital, Sundsvall, Sweden, E-mail: anna.palm@rvn.se. Jacob Pendergrast, Department of Medicine, University of Toronto, Toronto, Canada, E-mail: jacob.pendergrast@uhn.ca. Jean-Pierre Letoquart, Surgery Advisor, Médecins Sans Frontières, France, Paris, France, E-mail: jean-pierre.letoquart@paris.msf.org. Jefferson Terry, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada, E-mail: jefferson.terry@cw.bc.ca. Shahrzad Joharifard, Division of Pediatric Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada, E-mail: shahrzad.joharifard@cw.bc.ca.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 231 | 231 | 231 |
| Full Text Views | 20 | 20 | 20 |
| PDF Downloads | 15 | 15 | 15 |