RESUMO
Occurrences of second malignancies in hairy cell leukaemia are well recognised. Most of these malignancies are either solid tumours or lymphoproliferative disorders. The association of myeloproliferative disorders with hairy cell leukaemia (HCL) is very rare. This report describes a case of a patient with HCL who after remaining in remission developed Philadelphia chromosome positive chronic myeloid leukaemia (CML), which rapidly transformed to acute lymphoblastic leukaemia with further cytogenetic abnormalities.
Assuntos
Leucemia de Células Pilosas/patologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Segunda Neoplasia Primária/patologia , Evolução Fatal , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras B/patologiaRESUMO
A 40 year old man presented with abdominal pain, jaundice, weight loss, and hepatosplenomegaly. Liver function tests revealed cholestatic jaundice and a computed tomography scan showed an enlarged liver, with a normal biliary tree. Liver biopsy showed diffuse infiltration by neutrophils, monocytoid cells, and blasts. Peripheral blood film and bone marrow were consistent with acute myeloid leukaemia. After treatment with chemotherapy using an acute myeloid leukaemia protocol (UK Medical Research Council AML-12), there was complete resolution of jaundice and the patient went into complete molecular remission.
Assuntos
Icterícia Obstrutiva/etiologia , Leucemia Mieloide/patologia , Infiltração Leucêmica/complicações , Fígado/patologia , Doença Aguda , Adulto , Humanos , Leucemia Mieloide/tratamento farmacológico , MasculinoRESUMO
We present the case of a patient who presented with small joint polyarthralgia and mild lymphocytosis. The patient was subsequently diagnosed to have plasma cell leukaemia. Skeletal survey showed bony lytic lesions in the hands and feet with no skeletal lesions elsewhere. The most common sites of bony involvement in plasma cell dyscrasia are skull, vertebrae, ribs and long bones. Although it is quite unusual for plasma cell leukaemia or myeloma to involve solely small joints of hands and feet, we suggest plasma cell dyscrasia should be kept in the differential diagnostic list for polyarthralgia in adults if usual causes are ruled out.