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Case Report

Abdominal Lymphadenopathy: Hypothesize Cat-Scratch Disease and Avoid Abdominal Excisional Biopsy

by
Valeria Filipponi
1,
Stefania Trasarti
1,
Francesca Maccioni
2,*,
Maddalena Zippi
3,
Ludovica Busato
2,
Francesca Arienzo
2,
Mario Biglietto
1,
Paolina Saullo
4,
Carla Giordano
2 and
Roberto Caronna
4
1
Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
2
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00185 Rome, Italy
3
Department of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital of Rome, 00157 Rome, Italy
4
Department of Surgical Sciences, Sapienza University of Rome, 00185 Rome, Italy
*
Author to whom correspondence should be addressed.
Hemato 2022, 3(4), 771-778; https://doi.org/10.3390/hemato3040052
Submission received: 8 September 2022 / Revised: 24 November 2022 / Accepted: 25 November 2022 / Published: 7 December 2022
(This article belongs to the Section Non Neoplastic Blood Disorders)
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Abstract

The finding of lymphadenopathy is usually the consequence of a benign infection, although a neoplastic origin must always be excluded. Through a careful anamnesis, physical examination, and serological tests several differential diagnoses are frequently possible. Nevertheless, sometimes an excisional biopsy of superficial lymph nodes is required, which is the best means to reach a definitive diagnosis. More concerns arise when lymphadenopathy is only abdominal/retroperitoneal: percutaneous biopsy is often inconclusive and the excisional node biopsy becomes a surgical procedure, certainly indicated in case of malignancy but avoidable in case of inflammatory diseases. We present the case of a 30-year-old man with a deep iliac lymphadenopathy who was evaluated at the Hematological Unit of Sapienza University of Rome. The enlargement of an iliac lymph node is quite unusual for an infectious disease. Although symptoms such as pain, fever, and chills suggested it was the case, cat-scratch disease was not hypothesized. Radiological investigations did not exclude a malignant disease and a laparoscopic excisional biopsy was scheduled, but the slight improvement of his spontaneous symptoms suggested a careful follow-up. Given the lack of disappearance of lymphadenopathy, the lack of diagnosis, and an ipsilateral superficial (inguinal) lymph node with similar ultrasonographic and radiological features, the patient underwent biopsy, which disclosed a diagnosis of cat-scratch disease, avoiding more invasive surgical procedures.
Keywords: cat-scratch disease; abdominal lymphadenopathy; inflammatory disease; excisional biopsy cat-scratch disease; abdominal lymphadenopathy; inflammatory disease; excisional biopsy

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MDPI and ACS Style

Filipponi, V.; Trasarti, S.; Maccioni, F.; Zippi, M.; Busato, L.; Arienzo, F.; Biglietto, M.; Saullo, P.; Giordano, C.; Caronna, R. Abdominal Lymphadenopathy: Hypothesize Cat-Scratch Disease and Avoid Abdominal Excisional Biopsy. Hemato 2022, 3, 771-778. https://doi.org/10.3390/hemato3040052

AMA Style

Filipponi V, Trasarti S, Maccioni F, Zippi M, Busato L, Arienzo F, Biglietto M, Saullo P, Giordano C, Caronna R. Abdominal Lymphadenopathy: Hypothesize Cat-Scratch Disease and Avoid Abdominal Excisional Biopsy. Hemato. 2022; 3(4):771-778. https://doi.org/10.3390/hemato3040052

Chicago/Turabian Style

Filipponi, Valeria, Stefania Trasarti, Francesca Maccioni, Maddalena Zippi, Ludovica Busato, Francesca Arienzo, Mario Biglietto, Paolina Saullo, Carla Giordano, and Roberto Caronna. 2022. "Abdominal Lymphadenopathy: Hypothesize Cat-Scratch Disease and Avoid Abdominal Excisional Biopsy" Hemato 3, no. 4: 771-778. https://doi.org/10.3390/hemato3040052

APA Style

Filipponi, V., Trasarti, S., Maccioni, F., Zippi, M., Busato, L., Arienzo, F., Biglietto, M., Saullo, P., Giordano, C., & Caronna, R. (2022). Abdominal Lymphadenopathy: Hypothesize Cat-Scratch Disease and Avoid Abdominal Excisional Biopsy. Hemato, 3(4), 771-778. https://doi.org/10.3390/hemato3040052

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