Rationale: Hemophagocytic lymphohistiocytosis (HLH) is a hereditary or acquired hyperinflammatory response syndrome. Diagnosis of HLH is challenging. Patient concerns: We report a case of a 41-year-old male who was admitted to the hospital due to recurrent fever for 1 month and hematochezia for 2 days. Diagnoses: Positron emission tomography/computed tomography (PET/CT) showed multiple intrahepatic high-uptake nodules, and B-mode ultrasound could not accurately localize them. Contrast-enhanced ultrasound (CEUS)-guided liver biopsy combined with flow cytometry confirmed the final diagnosis of natural killer (NK)/T-cell lymphoma-associated hemophagocytic syndrome. Pathological confirmation was made with a lymph node biopsy. Interventions: The patient received the gemcitabine-dexamethasone-cisplatin (GDP) regimen and symptomatic supportive treatments. Outcomes: Unfortunately, the patient experienced persistent disease progression and passed away. Lessons: HLH is a hyperinflammatory response syndrome caused by immune dysfunction. Lymphoma-associated hemophagocytic syndrome is the most common type of HLH. Diagnosis can be confirmed through CEUS-guided biopsy, flow cytometry analysis, and relevant clinical information.
Ma et al. (Fri,) studied this question.