RESUMO
Three patients had the rare occurrence of multiple myeloma coexisting with chronic lymphocytic leukemia or lymphosarcoma. It is not possible at present to resolve the question as to whether these two diseases represent part of the spectrum of a single B-cell disease or wether multiple myeloma and lymphoproliferative disorders are two separate entities, which may rarely occur by coincidence in the same patient.
Assuntos
Leucemia Linfoide/complicações , Linfoma não Hodgkin/complicações , Mieloma Múltiplo/complicações , Idoso , Humanos , Leucemia Linfoide/diagnóstico , Metástase Linfática , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Osteoporose/complicaçõesRESUMO
A case with typical features of chronic myelogenous leukemia (CML) with two complex aberrations in addition to the standard t(9;22) is reported. Cytogenetic evaluation of the patient's bone marrow cells (BMC) showed 46,XX,t(6;19)(q16;p13.3),t(9;22)(q34;q11) in 60% of the mitotic cells and 46,XX,idem, t(6;15)(p25;q22) in the remaining 40% dividing cells. The patient's peripheral blood smear exhibited the usual differential observed in chronic-phase CML and was clinically indistinguishable from patients with the t(9;22) as the only translocation. We performed Southern blotting on BglII-digested DNA with the Trans-Probe (OSI) and in addition to the 4.8-, 2.3-, and 1.1-kilobase (kb) germline fragments, we detected an additional fragment at 7 kb. This probe spans the entire 5.8-kb M-breakpoint cluster region (BCR), and a single breakpoint in this region will appear as either one or two additional fragments. Because only one additional fragment was observed, both cell lines apparently share the same breakpoint in the ABL/BCR gene. Apparently the second aberrant cell line with the additional t(6;15) represents clonal evolution of the original abnormal clone.
Assuntos
Cromossomos Humanos Par 15 , Cromossomos Humanos Par 19 , Cromossomos Humanos Par 6 , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Translocação Genética , Adulto , Southern Blotting , Cromossomos Humanos Par 22 , Cromossomos Humanos Par 9 , Feminino , Humanos , CariotipagemRESUMO
Percutaneous embolization of large portosystemic collaterals was performed in three patients following placement of a transjugular intrahepatic portosystemic shunt in order to improve hepatopetal portal flow. Improved hepatic portal perfusion was achieved in these cases, thereby theoretically reducing the risk of chronic hepatic encephalopathy.