Author(s)

Nafy Ndiaye^1,2, Abdoulaye Leye^1,2, Ngone Diaba Diack^1,2, Yakham Mouhamed Leye^1,2, Michel Assane Ndour^1,2

¹Department of Internal Medicine/Endocrinology, National Pikine Hospital Center, Dakar, Senegal.
²Faculty of Medicine, Cheikh Anta Diop University of Dakar, Dakar, Senegal.

Introduction: The discovery of peripheral lymphadenopathy is a frequent reason for consultation and hospitalization in Internal Medicine. The aim of this article is to review through three cases the etiologies of chronic lymphadenopathy rarely reported in a tropical environment. Observations: The first patient is a 62-year-old man who has been infected with HIV-1 for 14 years and who had a multicenter form of Castleman disease. The diagnosis was confirmed after 3 histological lymph nodes. The progression was favorable under Etoposide-based chemotherapy. The second observation is about a 38-year-old woman with a 2-month chronic febrile adenopathy without improvement after anti-tuberculosis treatment. The diagnosis of Kikuchi Fujimoto disease, in its necrotizing form, was confirmed in histology. The evolution was made favorable by the corticosteroid therapy. The third observation is about a 63-year-old woman with an enlargement of groups of lymph nodes, liver, and spleen. This tumoral syndrome was associated to an exudative ascites and a Systemic Inflammatory Response Syndrome (SIRS). The initial diagnosis was a multifocal tuberculosis based on a set of evidence (exudative lymphocytic ascites, epidemiological context and a positive Quantiferon TB test). The first ganglionic histology was not contributory. It was the second ganglionic histology that indicated the diagnosis of lymph node plasmocytoma revealing a myeloma. The patient died of septic shock. Conclusion: In tropical environment, the etiologies of chronic lymphadenopathy are not limited to tuberculosis and malignant haemopathies. Carrying out ganglionic histology is an absolute necessity.

Adenopathy, Kikuchi Disease, Castleman Disease, Lymph Node Plasmocytoma

Ndiaye, N. , Leye, A. , Diack, N. , Leye, Y. and Ndour, M. (2017) Unusual Causes of Adenopathy in a Tropical Environment: About 3 Observations. Open Journal of Internal Medicine, 7, 115-122. doi: 10.4236/ojim.2017.74012.