Case 122

 A twenty two-year-old female presented in our hospital suffering from throat pain, swallowing disturbance, nausea, malaise, general fatigue and high fever. She consulted with a local clinic and got antibiotics five days before that day. But her symptoms were persistent. Laboratory test three days before revealed liver dysfunction AST 168 U/L, ALT 229 U/L, CRP 0.39 mg/dL (< 0.3), white blood cells 8100/mm³, lymphocytes 56 %, monocytes 5%. She could not eat anything and just got drip infusion. She was admitted in our hospital. Laboratory test revealed AST 238 U/L, ALT 369 U/L, CRP 0.68 mg/dL, white blood cells 18560/mm³, lymphocytes 68 %, monocytes 12%. She agreed to receive non-enhanced CT.

What is your diagnosis ?

1. Streptococcal tonsillitis

2. Viral tonsillitis

3. Malignant lymphoma

4. Burkitt lymphoma

5. Wegener granulomatosis (granulomatosis with polyangiitis)

answer

2018.9.26