[Primary granulocytic sarcoma of the peritoneum: a case report and literature review]. / Sarcome granulocytaire à localisation péritonéale primitive : à propos d'un cas et revue de la littérature.

Granulocytic sarcoma is a rare tumor composed of immature granulocytic cells. Prognosis is poor. The periosteum is preferentially involved. A peritoneum localization is unusual. We report the case of a 20 years old man without particular previous pathologies, which brutally presented an ascitic syndrome in a context of health impairment state. The laparoscopy showes many white nodules on all the peritoneum. The histologic examination of one of these nodules showed granulocytic sarcoma. The blood and bone marrow cell count are without any anomaly. The treatment consisted of a standard acute myeloid leukaemia's chemotherapy with very good evolution. The rarity of peritoneal chloroma causes a diagnostic problem, especially in the absence of hematologic abnormalities. It must be mentioned in the presence of peritoneal nodules even if the blood count and bone marrow are normal.

Acquired pure red cell aplasia after severe acute respiratory syndrome corona virus 2 infection: a case report.

BACKGROUND: Coronavirus disease 2019, caused by severe acute respiratory coronavirus 2, has been responsible, since December 2019, for a severe pandemic resulting in millions of deaths worldwide, and the number is still increasing. Although coronavirus disease 2019 is mostly a respiratory syndrome, it is considered a multisystemic disease and shows clinical diversity with a wide range of manifestations including hematological features. CASE PRESENTATION: We present the case of an Arab male, 77 years old, who developed severe anemia 8 weeks after acute infection with severe acute respiratory coronavirus 2. The investigations revealed acquired pure red cell aplasia. Workup for an associated underlying disorder was negative, ruling out secondary causes. The patient received corticosteroids as the standard treatment of primary acquired pure red cell aplasia, and he had a good response to treatment. CONCLUSION: This case illustrates that acquired pure red cell aplasia might occur weeks after severe acute respiratory coronavirus 2 infection, suggesting that it might be considered a delayed complication of coronavirus disease 2019. The most relevant hypothesis of the pathogenesis of acquired pure red cell aplasia, in this case, is an immune mechanism triggered by infection with severe acute respiratory coronavirus 2 resulting in interruption of normal erythroid differentiation. We highlight the importance of follow-up care after the acute phase of coronavirus disease 2019 to spot late complications in order to successfully manage the secondary burden of the pandemic.

[Extramembranous glomerulonephritis and myelodysplastic syndrome: a rare association]. / Glomérulonéphrite extra-membraneuse et syndrome myélodysplasique: une association rare.

Myelodysplastic syndromes may be associated with autoimmune diseases. Renal involvement is rare but, if occurs, it manifests predominantly as glomerular diseases. Extramembranous glomerulonephritis associated with myelodysplastic syndrome has been reported very rarely. We here report the case of a patient presenting with glomerulonephritis associated with anemia, revealing low-risk myelodysplastic syndrome. In the light of this case, we conducted a review of the literature of previously published cases and discussed the pathogenic link between these two entities.

[Etiological profile of anemia in a department of internal medicine]. / Profil étiologique des anémies dans un service de médecine interne.

Anemia is a major public health problem worldwide despite remarkable improvement in living conditions. The World Health Organization (WHO) classifies it as one of the ten most serious problems in the world. This study aims to describe the epidemiologic and etiologic profiles of the cases of anemia treated during our training. We conducted a retrospective study involving 150 patients carried out over 5 years, from January 2011 to December 2015. The average age of our patients was 48.8 years and women were more likely to be affected than men, with a sex ratio of 1.78. The mean hemoglobin was 8 g/dl, ranging from 3.4 to 11.4 g/dl. Iron deficiency anemia was the leading etiologic diagnosis made in 60% of cases, followed by megaloblastic anemia in 21% of patients and haemolytic anemia in 7.33% of cases. The occurrence of anemia in adults may represent a real diagnostic challenge for the internist as it is sometimes associated with an emergency context. Specialized examinations may be necessary.

[Treatment of systemic AL amyloidosis: about 25 cases]. / Traitement des amyloses AL systémiques: à propos de 25 cas.

Primarye systemic AL amyloidosis is a rare hematologic disorder. The majority of the therapeutic guidelines are based on phase II studies or on retrospective comparisons and case series. Our study aimed to describe all the cases of primary AL amyloidosis reported in 2 military hospitals and to make a comparison between standard melphalan-dexamethasone protocol and new agents in first-line treatment of patients with this disease. We conducted a retrospective, descriptive and multicentric study of all patients with AL amyloidosis whose data were collected during the period July 2009-June 2016. Twenty five patients were enrolled in the study (12 patients treated with melphalan-dexamethasone and 13 with bortezomib-based protocol or lenalidomide-based protocol). There was no significant difference in the epidemiological, clinical and prognostic features between the 2 groups. After a median follow up of 40 months, median overall survival was 54 months in the melphalan-dexamethasone-treated group and 60 months in the new therapies-treated group (P = 0.98). Progression-free survival was 18 months in the standard treatment group vs 11 months in the 2nd group (p = 0.08). In our small case series we haven't found a superiority of the new therapies compared to the standard protocol. This result should be confirmed by a true prospective study, mainly because of the cost of these new molecules that are not always accessible, especially in developing countries.

[Acquired amegacaryocytic thrombocytopenic purpura hiding acute myeloid leukemia]. / Un purpura thrombopénique amégacaryocytaire acquis qui cache une leucémie aigue myéloblastique.

Acquired amegakaryocytic thrombocytopenic purpura is a very rare condition characterized by severe thrombocytopenia linked to the reduction or disappearance of megakaryocytes in the bone marrow. It may be primary idiopathic or secondary to many pathological conditions including hematologic disorders. We report the case of a 24-year-old patient admitted for haemorrhagic syndrome caused by immunological thrombocytopenic purpura. The diagnosis was acquired amegakaryocytosis after the failure of corticotherapy and the performance of myelography. The patient was treated with ciclosporin with rapid progression to acute myeloblastic leukemia. The progression of acquired amegakaryocytosis to acute leukemia is reported but it is generally not so rapid and above all it is preceded by myelodysplastic syndrome or medullary aplasia. This study highlights the importance of a close follow-up of these pathologies with a benign-like appearance.

[Association between multiple myeloma and acute myeloid leukemia secondary to myelodysplastic syndrome]. / Association d'un myélome multiple et d'une leucémie aiguë myéloïde secondaire à un syndrome myélodysplasique.

We report a rare case of association of two distinct hematologic malignancies: refractory cytopenia with multilineage dysplasia associated with del(5q) and symptomatic multiple myeloma associated with del(17p) and del(13q). After 16 months, the patient presented an acute leukemic transformation of the myelodysplasic syndrome.

[Cutaneous pseudolymphoma as an alternative presentation of IgG4 related disease]. / Le pseudolymphome cutané, une autre présentation du syndrome d'hyper-IgG4.

Hyper-IgG4 syndrome is a rare entity characterized by fibro-inflammatory lesions of organs, an excess of IgG4 positive plasma cells in histology and high serum level IgG4. Many organs can be affected (pancreas, kidney, salivary glands) and the list continues to grow. The skin damage is rarely reported in the literature and is usually associated with other typical lesions of this syndrome. We report the case of a 53-year-old female followed since 2005 for lymphadenopathy, associated with axillary nodular skin lesions. The assessments made at that time had retained the diagnosis of pseudolymphoma with implementation of multi-line therapy. Six years later, and the persistence of the lesions, plasma cells marked by anti-IgG4 and the serum IgG4 has attached injuries to the syndrome hyper-IgG4. The patient is treated with low dose corticosteroids with a good and protacted response. Cutaneous pseudolymphoma could be a new presentation of the syndrome of hyper-IgG4 in the absence of any other injury usually associated with this entity. This case illustrates the interest for proposing a plasma cell labeling with anti-IgG4 in any case of cutaneous pseudolymphoma.

[Plasma cell leukemia: three case-reports and review of literature]. / La leucémie à plasmocytes : à propos de trois cas et revue de la littérature.

Plasma cell leukemia (LP) is a rare hematologic malignancy. Its prognosis is very derogatory. It is defined by the presence in circulating blood of more than 2 G/L plasmocytes or greater than 20% of the total leukocytes. It comes in two forms: secondary plasma cell leukemia complicating multiple myeloma (MM) and primary setting. Its incidence is estimated at 0.9% of patients with acute leukemia and 2-4% of patients with MM. We report, through three observations, the clinical presentation of the plasma cell leukemia, its cytological features, immunophenotypic, physiopathological and therapeutic care.