TRAINING and EDUCATION
You Make the Call
Each month in “You Make the Call,” we’ll pick a challenging clinical question
submitted through the Consult-a-Colleague program and post the expert’s
response. But, what would YOU do? We’ll also pose a submitted question
and ask you to send your responses. See how your answer matches up to the
experts’ in the next print issue.
This month, Eric D. Jacobsen, MD, weighs in on administering CHOP-based
therapy to a patient diagnosed with peripheral T-cell lymphoma, not otherwise
specified (PTCL-NOS).
Clinical Dilemma:
I recently saw a 65-year-old veteran with an exfoliating rash and hypopigmented areas that has persisted for almost two
years. It was more pronounced on his face, the soles of his feet, and his hands. He also had hypopigmented areas on
his lower extremities. He was initially treated for psoriasis and atopic dermatitis and was recently treated with myco-
phenolic acid for autoimmune dermatitis. On a recent examination I found him to have full-blown lymphadenopathy
in his neck, axilla, and groin (no abdominal or mediastinal enlarged nodes were detected) with radiographic SUV as
high as 40. His LDH was high and he had patchy BM involvement. Peripheral blood flow showed T cell expressing
CD2, CD3, a