Haematologica 2002; 87:(07)EIM20
[Medline] [prev] [index] [next]An unresolved hematoma
SY Ma, WY Au
Corresponding author: S. Y. Ma, M.D., Division of Hematology and Oncology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam Road, Hong Kong
A 78-year old woman was admitted from an old people's home to our hospital because of a painful and enlarging forehead mass present for one month after a slip and fall. She had a history of diabetes , hypertension and diffuse large B cell lymphoma of the tonsils and cervical lymph nodes in 1999 which was treated with COPP and attained remission .The mass was initially 1cm in size and non-tender and the staff in the old people's home regarded it as a hematoma . The staff in the old aged home did not notice the mass was enlarging as the patient often wore a wool hat (Figure 1).On physical examination, there was a 6 cm non-tender mass over the forehead and the overlying skin had no color change as would be seen in a hematoma (Figure 2). Complete blood picture, liver and renal function tests and bone marrow aspirate were normal. Only the lactate dehydrogenase (LDH) was raised to 503 U/L (Normal = 200-360) X ray of the skull (Figure 3) showed skull erosion. Fine needle aspiration cytology (FNAC) of the mass confirmed a lymphoma relapse and she was then treated with radiotherapy and chemotherapy.