RESUMO
Myeloid sarcomas (MS) are rare extramedullary (EM) hematological tumors that generally arise during the natural course of acute myeloid leukemia (AML), occurring concomitantly with the onset of systemic leukemia; it can also occur following onset but rarely before. Common sites of EM involvement include the lymph nodes, skin, soft tissue, bone and peritoneum. Herein, we report the case of a 63-year-old man who presented EM AML upon initial diagnosis involving the bone marrow, lymph nodes and skin (leukemia cutis). A diagnosis was made based on immunohistochemistry (IHC). This case presents a diagnostic dilemma due to its atypical presentation and the sites involved. It also highlights the importance of IHC in the diagnosis of EM AML. The potential role of hypomethylating agents and Venetoclax in cases not eligible for hematopoietic stem cell transplant are also discussed.
RESUMO
The application of maraging steels such as 18Ni300 alloy is noteworthy for mould industries, applying repair purposes through direct energy deposition process. This objective requires microstructural characterizations and the evaluation of mechanical behaviour such as hardness. The state of substrate material, including the heat-affected zone (HAZ) and the interface between the HAZ and deposited layer, is essential, the formation of hard phases and abrupt transitions. Thus, the influence of the number of deposited layers or the pre-heating condition appears noteworthy. In the current study, microscopy observations did not reveal the presence of any crack in the cross-sections of deposited 18Ni300 alloy powder on AISI 1045 sheet steel; however, pores were observed in deposited layers. Besides, microscopic analyses revealed the achievement of a smooth HAZ in the deposited layers composed of three-layered depositions or that received preheating, confirmed by hardness measurements as well. Dilution effect ensured a metallurgical bonding between depositions and substrate, strongly affected by preheating. The HAZ microstructure, mainly martensitic transformation, distribution of chemical composition, epitaxial growth at the interface, and the size of crystals and grains were affected by preheating or the number of layers. Moreover, the heat propagation and/or dissipation across the deposited layers influenced the dendrite morphology and the texture of grains. The preheating condition provoked the formation of cellular/equiaxed dendrites that was highlighted in the three-layered deposition, increase in dendrite interspace growth.
RESUMO
Teaching Point: Aggressive angiomyxoma is a rare and benign soft tissue lesion, characterized by a "whorled" or "layering" appearance on T2-weighted and post-gadolinium magnetic resonance.