30 December 2024
: Case report 
B-Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma Mimicking Fibrosing Mediastinitis: A Case Report and Diagnostic Insight
Unknown etiology, Challenging differential diagnosis, Unusual or unexpected effect of treatment
Aya Kitamura ABCDEF 1, Shigehisa Yanagi ABCDEFG 1*, Kotaro Shide
ABCDEF 2, Yuichiro Sato ABCDE 3, Ayako Kamiunten BDE 2, Yasuhiro Yamanari BE 1, Akiko Kitamura E 1, Makoto Sumiyoshi E 1, Yasuharu Oda E 1, Hironobu Tsubouchi E 1, Kazuya Shimoda ADEF 2, Taiga Miyazaki ADEF 1
DOI: 10.12659/AJCR.945804
Am J Case Rep 2024; 25:e945804
Table 1. Laboratory findings on admission.
| Complete blood count | Biochemistry | Serology | ||||||
|---|---|---|---|---|---|---|---|---|
| White blood cells | 4.8×10 | /μL | TP | 7.0 | g/dL | β-D-glucan | 6.0 | pg/mL |
| Neutrophils | 69.4 | % | Albumin | 4.6 | g/dL | CYFRA | 0.3 | ng/mL |
| Lymphocytes | 22.6 | % | BUN | 11.8 | mg/dL | SCC | 0.5 | ng/mL |
| Monocytes | 6.0 | % | Creatinine | 0.75 | mg/dL | CEA | 0.7 | ng/mL |
| Eosinophils | 1.4 | % | Na | 138 | mmol/L | Pro-GRP | 28.2 | pg/mL |
| Red blood cells | 4.67×10 | /μL | K | 4.4 | mmol/L | β-hCG | 1.2 | mIU/mL |
| Hemoglobin | 14.5 | g/dL | Cl | 103 | mmol/L | AFP | 2.0 | ng/mL |
| Platelets | 26.3×10 | /μL | Ca | 9.8 | mg/dL | sIL-2R | 431 | U/mL |
| IP | 3.8 | mg/dL | IgG | 1141 | mg/dL | |||
| LDH | 167 | U/L | IgG4 | 89.4 | mg/dL | |||
| PT-INR | 1.03 | AST | 22 | U/L | Antinuclear antibody | 40 | ||
| APTT | 31.1 | s | ALT | 30 | U/L | Rheumatoid factor | 3.0 | IU/mL |
| D-dimer | 0.70 | μg/mL | CK | 89 | U/L | PR3-ANCA | 1.0 | EU |
| CRP | 0.15 | mg/dL | MPO-ANCA | 1.0 | EU | |||
| BNP | 5.8 | pg/mL | Tb-IFNγ | (–) | ||||
| pH | 7.41 | antigen | (–) | |||||
| PaO | 99 | Torr | antigen | (–) | ||||
| PaCO | 39 | Torr | Red blood cells sediment | 0 | /HPF | HTLV-1 antibody | (–) | |
| HCO | 25.1 | mmol/L | White blood cells sediment | 0 | /HPF | Anti-AChR antibody | 0.2 | nmol/L |
| AFP – alpha fetoprotein; ALT – alanine aminotransferase; Anti-AChR – anti-acetylcholine receptor; APTT – activated partial thromboplastin time; AST – aspartate aminotransferase; BNP – brain natriuretic peptide; BUN – blood urea nitrogen; Ca – calcium; IP – inorganic phosphorus; CEA – carcinoembryonic antigen; CK – creatine kinase; Cl – chloride; CRP – C-reactive protein; CYFRA – cytokeratin 19 fragment; HCO – bicarbonate; HPF – high-power field; HTLV-1 – human T-lymphotropic virus type 1; IgG – immunoglobulin G; IgG4 – immunoglobulin G4; K – potassium; LDH – lactate dehydrogenase; MPO-ANCA – myeloperoxidase-specific antineutrophil cytoplasmic antibody; Na – sodium; PaCO – partial pressure of carbon dioxide; PaO – partial pressure of oxygen; PR3-ANCA – proteinase-3-specific antineutrophil cytoplasmic antibody; Pro-GRP – pro-gastrin releasing peptide; PT-INR – prothrombin time-international normalized ratio; SCC – squamous cell carcinoma antigen; sIL-2R – soluble interleukin-2 receptor; Tb-IFNγ – interferon gamma release assay; TP – total protein; β-hCG – beta-subunit of human chorionic gonadotropin. | ||||||||