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Virchow's node, jaundice, and weight loss—lymphoma mimicking gastrointestinal malignancy

Nature Clinical Practice Gastroenterology & Hepatology volume 3, pages 645–648 (2006)Cite this article

Abstract

Background A 46-year-old white male with a history of well-controlled paranoid schizophrenia presented with painless jaundice, progressive anorexia, weight loss, and dyspnea of 3 months' duration. His only medication at presentation was the antipsychotic olanzapine, taken orally.

Investigations Physical examination and laboratory tests, including a complete blood cell count, electrolyte, lactate dehydrogenase and haptoglobin levels, liver function tests, and a Coombs' test; CT scan of the chest and abdomen; invasive investigations, including thoracentesis and pleural fluid analysis, bone-marrow biopsy, and left supraclavicular lymph-node biopsy.

Diagnosis Diffuse large B-cell lymphoma.

Management Large-volume thoracentesis. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy followed by dexamethasone, cytarabine, and cisplatin chemotherapy, and autologous stem-cell transplantation.

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Figure 1: CT scan of the chest of a 46-year-old white male who presented with painless jaundice, progressive anorexia, and weight loss.
Figure 2: CT scan of the abdomen of a 46-year-old white male who presented with painless jaundice, progressive anorexia, and weight loss.
Figure 3: Pleural fluid cytology of a 46-year-old man with Virchow's node, painless jaundice, and weight loss, which shows atypical lymphoid cells suspicious for malignancy.

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Authors and Affiliations

  1. Mayo School of Graduate Medical Education,

    Constantinos P Anastassiades & Thomas H Poterucha

  2. Mayo Clinic College of Medicine, Rochester, MN, USA

    Constantinos P Anastassiades & Thomas H Poterucha

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  1. Constantinos P Anastassiades
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  2. Thomas H Poterucha
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Correspondence to Constantinos P Anastassiades.

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The authors declare no competing financial interests.

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Anastassiades, C., Poterucha, T. Virchow's node, jaundice, and weight loss—lymphoma mimicking gastrointestinal malignancy. Nat Rev Gastroenterol Hepatol 3, 645–648 (2006). https://doi.org/10.1038/ncpgasthep0635

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