The epitrochlear lymph node: an unusual physical finding in lymphoma with important clinical significance.An 82-year-old Caucasian female was evaluated for a right breast mass detected by mammography. Her past medical history of patient included HTN, Type 2 diabetes mellitus Type 2 diabetes mellitus
One of the two major types of diabetes mellitus, characterized by late age of onset (30 years or older), insulin resistance, high levels of blood sugar, and little or no need for supple-mental insulin. , and rheumatoid arthritis. The patient denied breast pain, trauma or discharge from the nipple. She admitted to fevers, sweats, 30 lb weight loss, generalized weakness, and fatigue for 6 months. There was no history of animal bites or scratches or syphilis or HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. exposure. On physical examination generalized bilateral lymphadenopathy lymphadenopathy /lym·phad·e·nop·a·thy/ (-op´ah-the) disease of the lymph nodes.
angioimmunoblastic lymphadenopathy , angioimmunoblastic lymphadenopathy with dysproteinemia involving cervical, supraclavicular, axillary ax·il·lar·y
Relating to the axilla.
Located in or near the armpit.
Mentioned in: Mastectomy
of or pertaining to the armpit. and inguinal lymph nodes were identified. The lymph nodes were mobile and non-tender. In addition a right mobile, nontender epitrochlear nodule nodule: see concretion.
In geology, a rounded mineral concretion that is distinct from, and may be separated from, the formation in which it occurs. measuring 4 X 4 cm was noted. Her cardiopulmonary examination was unremarkable. On abdominal examination splenomegaly splenomegaly /sple·no·meg·a·ly/ (-meg´ah-le) enlargement of the spleen.
congestive splenomegaly Banti's disease; splenomegaly secondary to portal hypertension. was noted. The patient underwent an excisional biopsy of right axillary lymph nodes The Axillary lymph nodes are of large size, vary from twenty to thirty in number, and may be arranged in the following groups:
NODAL - Interpreted language implemented on Norsk Data's NORD-10 computers. Used by CERN and DESY high energy physics labs to control their accelerator hardware, PADAC and SEDAC. Included trackball input, graphics. irradiation and subsequent four-drug combination chemotherapy under a protocol was begun. Lymphomas are malignant neoplasms of cells native to lymphoid tissues. Like other neoplasms they are of monoclonal origin as can be documented by clone gene rearrangement and surface markers by flow cytometry. Lymphomas are segregated as Hodgkins lymphoma, by the presence of distinctive unifying morphologic feature the Reed-Sternberg giant cells, and non-Hodgkins lymphoma. Lymphomas often produce marked nodal enlargement that is almost always non-tender. Epitrochlear nodes involvement is a rare occurrence in both Hodgkins or non-Hodgkins lymphomas, either as the sole site of involvement or as part of more widespread disease. Only very limited information is available on association of epitrochlear nodes and lymphomas. A literature search revealed only a few isolated case studies. Epitrochlear nodes are noted in about 0.088% of Hodgkins lymphoma and indicates diffuse disease. Epitrochlear lymph node involvement is more common in the non-Hodgkins lymphoma and is a peculiar a site of relapse in these patients. We report here a patient who presented with epitrochlear node involvement with diffuse large B-cell non-Hodgkins lymphoma and emphasize the clinical importance of this physical finding.
A.K. Goli, MD, S.A. Goli, MD, M. Koduri, MD, Ryland P. Byrd, Jr, MD, and Thomas M. Roy, MD. Department of Medicine, James H. Quillen College of Medicine, Mountain Home, Johnson City, TN.