case_images: PMC10876290_01
case_images: Coronal views of computed tomography (CT) of the chest, abdomen, and pelvis with contrast were completed during the first hospital encounter.. (A) New hepatomegaly in the right lobe measuring 21 cm (previously 16 cm). (B) New splenomegaly measuring 17.7 cm (previously 8.9 cm) and bilateral nephromegaly (measurements not shown; left kidney 12.9 cm and right kidney 12.6 cm, both previously 11.3 cm). (C) Para-aortic lymphadenopathy (indicated by the green arrow, measuring >2 cm).
case_images: cureus-0016-00000052635-i01.jpg
case_images: PMC10876290_01_cureus-0016-00000052635-i01.jpg
case_images: FIG1
case_images: CT of the chest, abdomen, and pelvis revealed new organomegaly with hepatomegaly (right lobe 21 cm, previously 16 cm), splenomegaly (17.7 cm, previously 8.9 cm), and bilateral nephromegaly (left kidney 12.9 cm and right kidney 12.6 cm, both previously 11.3 cm), as well as lymphadenopathy in the hepatic portal region, mesentery, retroperitoneum, pelvis, and inguinal areas (Figure 1). Colonoscopy revealed a nodular patchy area of the terminal ileum; biopsy of which showed small intestinal mucosa with prominent lymphoid aggregates (Figure 2).
case_images: A colonoscopy performed due to bright red blood per rectum during the first hospital admission revealed nodular ileal hyperplasia.
case_images: cureus-0016-00000052635-i02.jpg
case_images: PMC10876290_01_cureus-0016-00000052635-i02.jpg
case_images: FIG2
case_images: CT of the chest, abdomen, and pelvis revealed new organomegaly with hepatomegaly (right lobe 21 cm, previously 16 cm), splenomegaly (17.7 cm, previously 8.9 cm), and bilateral nephromegaly (left kidney 12.9 cm and right kidney 12.6 cm, both previously 11.3 cm), as well as lymphadenopathy in the hepatic portal region, mesentery, retroperitoneum, pelvis, and inguinal areas (Figure 1). Colonoscopy revealed a nodular patchy area of the terminal ileum; biopsy of which showed small intestinal mucosa with prominent lymphoid aggregates (Figure 2).
case_images: Photographs of the scaly, hyperpigmented, maculopapular rash over the (A) left shoulder and (B) right lower leg.
case_images: cureus-0016-00000052635-i03.jpg
case_images: PMC10876290_01_cureus-0016-00000052635-i03.jpg
case_images: FIG3
case_images: This was followed by the eruption of a pruritic rash over all extremities and torso (Figure 3).
case_images: Hematoxylin and eosin-stained section (200x) of right ventricle biopsy showing mild lymphocytic infiltrate.
case_images: cureus-0016-00000052635-i04.jpg
case_images: PMC10876290_01_cureus-0016-00000052635-i04.jpg
case_images: FIG4
case_images: Endomyocardial biopsy of the RV septum revealed prominently vacuolated cardiomyocytes with scattered interstitial CD3 positive T-cell infiltrate (Figure 4).