Rare Co-occurrence: A Case Report on Hemophagocytic Lymphohistiocytosis and Pulmonary Metastasis

Abstract

ABSTRACT Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome marked by excessive activation of macrophages and T-lymphocytes, leading to cytokine overproduction and subsequent histiocytic phagocytosis. Cancer cells spread from the primary tumor to the lungs through nearby tissues, the bloodstream, or the lymphatic system. Eventually, this may result in pulmonary metastasis. Diagnosing HLH and pulmonary metastases is challenging due to the aggressive nature of these diseases. Therefore, early diagnosis is crucial for optimal patient outcomes. Here, we present the case of a patient with no previous comorbidities who was admitted to the emergency department with chief complaints of shortness of breath and excessive sweating. Subsequent comprehensive routine clinical and physiological examinations confirmed the patient with HLH. Furthermore, we performed high-resolution computed tomography for the confirmation of pulmonary metastasis and a bone marrow biopsy, for HLH. The primary site for both HLH and pulmonary metastasis was the lung. Unfortunately, the patient succumbed to the illness before the initiation of the prescribed treatment, possibly attributable to a delayed diagnosis. In the present case presentation, we highlighted the role of comprehensive diagnostic evaluation in complex medical conditions related to HLH and pulmonary metastasis, which have rapid progression and high mortality. Further, investigations and multidisciplinary collaboration are essential in leading the development of an appropriate treatment plan for such a complicated condition, ensuring the best possible outcomes for the patient.