April 2007

 

Fig1.

 

 

Fig2.

 


History: 65 y/o white female with a history of Diffuse large B-cell lymphoma was admitted 2 months after an autologous stem cell transplant with increasing fatigue, shortness of breath and several small skin nodules on both of her legs, and chest which had been appearing over the course of a week and a half.

Past Medical History: Diffuse large B-cell lymphoma s/p 6 cycles of R-CHOP, then 3 cycles of R-ESHAP chemotherapy
Autologous stem cell transplant
Essential thrombocytosis
Seizure disorder

Medications: Dilantin, Primidone

Family History: Noncontributory

Physical Exam: Afebrile, O2 sat 94%, pulse 120
8 cm subcutaneous nodule on the right chest, and 6-7 cm subcutaneous nodule on the right thigh. Small pink/purple infiltrative papules and nodules 4-10mm were present on her chest, abdomen, and legs.

Labs: WBC: 2.6, HgB 8.1, Platelets 39. CXR showed a moderate sized right pleural effusion.

 

Click here for the diagnosis

Click here for CME Credit