Angioimmunoblastic T-cell Lymphoma Mimicking DRESS Syndrome

Angioimmunoblastic T-cell lymphoma (AITL) is a rare and aggressive lymphoma arising from follicular T-helper cells. Cutaneous findings and nonspecific systemic symptoms often associated with this malignancy can closely resemble those of more common entities, such as a viral exanthem or drug eruption, depending on the history and context. These similarities in presentation to more common entities can cause a delay in the diagnosis of AITL and subsequent initiation of treatment, which has considerable implications for morbidity and mortality. We present the case of a patient whose clinical features resembled drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) and who was found to have AITL after extensive workup. This atypical case highlights the importance of maintaining a flexible differential diagnosis in patients with suspected DRESS syndrome whose condition does not improve with appropriate drug withdrawal and therapy.