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1.
Rinsho Ketsueki ; 61(3): 257-261, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32224587

RESUMO

A 54-year-old man with acute myeloid leukemia (AML) underwent allogeneic bone marrow transplantation from a human leukocyte antigen-matched unrelated donor in nonremission status. Bone marrow aspiration performed on day 14 showed that the patient had achieved complete remission; however, he relapsed on day 28. The patient developed a wet cough, and chest computed tomography performed on day 27 revealed pneumonia. Because pneumonia developed along with the leukemic relapse, we suspected that it was due to pulmonary leukemic infiltration (PLI). Giemsa-stained sputum showed some blast cells and fluorescence in situ hybridization indicated that the patient had monosomy 7, which was also detected in bone marrow blasts. Though we prescribed hydroxycarbamide and decreased tacrolimus rapidly, AML progressed and led to the patient's death on day 45. Histopathological findings of the autopsy performed the next day showed diffuse alveolar damage in both lungs. The blast cells were packed in blood vessels of alveolar septa and were also seen in alveoli. PLI was diagnosed pathologically. In conclusion, our case demonstrates that Giemsa stain of sputum is useful in quick diagnosis of PLI without invasive examination.


Assuntos
Leucemia Mieloide Aguda , Infiltração Leucêmica , Corantes Azur , Humanos , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Escarro
5.
Cancer Metastasis Rev ; 38(4): 657-671, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31820149

RESUMO

The cure rate of acute lymphoblastic leukemia (ALL), the commonest childhood cancer, has been sharply improved and reached almost 90% ever since the central nervous system (CNS)-directed therapy proposed in the 1960s. However, relapse, particularly in the central nervous system (CNS), is still a common cause of treatment failure. Up to now, the classic CNS-directed treatment for CNS leukemia (CNSL) has been aslant from cranial radiation to high-dose system chemotherapy plus intrathecal (IT) chemotherapy for the serious side effects of cranial radiation. The neurotoxic effects of chemotherapy and IT chemotherapy have been reported in recent years as well. For better prevention and treatment of CNSL, plenty of studies have tried to improve the detection sensitivity for CNSL and prevent CNSL from happening by targeting cytokines and chemokines which could be key factors for the traveling of ALL cells into the CNS. Other studies also have aimed to completely kill ALL cells (including dormant cells) in the CNS by promoting the entering of chemotherapy drugs into the CNS or targeting the components of the CNS niche which could be in favor of the survival of ALL cells in CNS. The aim of this review is to discuss the imperfection of current diagnostic methods and treatments for CNSL, as well as new attempts which could be significant for better elimination of CNSL.


Assuntos
Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/efeitos da radiação , Infiltração Leucêmica/tratamento farmacológico , Infiltração Leucêmica/radioterapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Animais , Sistema Nervoso Central/patologia , Criança , Irradiação Craniana , Humanos , Injeções Espinhais , Infiltração Leucêmica/diagnóstico , Infiltração Leucêmica/patologia
6.
Tunis Med ; 97(7): 925-928, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31872405

RESUMO

Optic nerve infiltration is relatively rare in acute lymphoblastic leukemia. We present a case of a -53 year-old-man who was diagnosed with T- acute lymphoblastic leukemia (ALL). The patient was treated with ALL national protocol and the central nervous system (CNS) prophylactic management. On treatment, the patient presented with sudden severe vision deterioration of both eyes. Fundoscopic examination of the eye and magnetic resonance imaging of the orbits were in favor of an infiltration of the optical nerve. An isolated extramedullary relapse of the optical nerve was retained. The patient was treated with salvage chemotherapy systematic and intrathecal. Waiting forthe beginning of radiotherapy, the patient presented a bone marrow relapse. He died of a severe hemorrhagic syndrome. Conclusion: Optic nerve leukemic infiltration has a severe prognosis. Ophthalmic assessment is essential in patients with ALL in order to diagnose an early ocular involvement and the patient's vision can be preserved if treatment is initiated promptly.


Assuntos
Infiltração Leucêmica/diagnóstico , Nervo Óptico/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Antineoplásicos/administração & dosagem , Evolução Fatal , Humanos , Infiltração Leucêmica/patologia , Masculino , Pessoa de Meia-Idade , Recidiva , Terapia de Salvação/métodos
7.
Tunis Med ; 97(3): 504-507, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729727

RESUMO

INTRODUCTION: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We report a case of unilateral infiltration of the optic nerve revealing a relapse of acute lymphoblastic leukemia. CASE REPORT: forty eight years-old woman in a remission of acute B lymphoblastic leukemia presented with headaches and blurred vision in the left eye. Ophthalmic examination showed a visual acuity reduced to 20/200 in the left eye, and a voluminous disc edema with papillary mass surrounded by retinal hemorrhages, exudates and important serous retinal detachment. CT scan showed a thickened left optic nerve and excluded true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. CONCLUSION: The incidence of ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.


Assuntos
Infiltração Leucêmica/diagnóstico , Nervo Óptico/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Diagnóstico Diferencial , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/secundário , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva
10.
Dermatol Online J ; 25(6)2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31329394

RESUMO

Leukemia cutis represents infiltration of the skin by malignant leukocytes and typically presents as firm, red-brown papules and nodules. The bullous clinical subtype is considered a rare entity and can be a diagnostic challenge. This case describes a patient with bullous leukemia cutis mimicking vesiculobullous skin disease.


Assuntos
Vesícula/patologia , Leucemia Mieloide Aguda/patologia , Infiltração Leucêmica/patologia , Pele/patologia , Face , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço
11.
Am J Dermatopathol ; 41(12): 940-944, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31268930

RESUMO

B-cell chronic lymphocytic leukemia (CLL), a low-grade malignancy consisting of CD5(+), CD23(+), and CD43(+) small B lymphocytes, is the most frequent leukemia in the western world. Patients with CLL may exhibit skin changes characterized by histopathologic evidence of infiltration by atypical B lymphocytes, also known as "specific cutaneous infiltrates of CLL"; in addition, CLL is known to be associated with an increased risk of second cancers, including Kaposi sarcoma (KS). The combination of KS and CLL within the same cutaneous biopsy specimen has only rarely been described. We report a peculiar case of KS occurring in a patient with CLL, in which histopathological evaluation of KS lesions revealed prominent accumulation of CLL lymphocytes within neoplastic vascular spaces. We believe that our findings represent a novel example of intravascular colonization of vascular neoplasms by neoplastic lymphoid cells, further expanding the evergrowing spectrum of specific cutaneous infiltrates of CLL.


Assuntos
Leucemia Linfocítica Crônica de Células B/patologia , Infiltração Leucêmica/patologia , Segunda Neoplasia Primária/patologia , Sarcoma de Kaposi/patologia , Neoplasias Cutâneas/patologia , Idoso , Biomarcadores Tumorais/análise , Humanos , Leucemia Linfocítica Crônica de Células B/metabolismo , Infiltração Leucêmica/metabolismo , Infiltração Leucêmica/radioterapia , Masculino , Segunda Neoplasia Primária/química , Sarcoma de Kaposi/química , Sarcoma de Kaposi/radioterapia , Neoplasias Cutâneas/química , Neoplasias Cutâneas/radioterapia
12.
Folia Med (Plovdiv) ; 61(2): 277-288, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31301659

RESUMO

AIM: Secondary malignancies of the thyroid gland are rarely diagnosed but their incidence at autopsy is not uncommon. MATERIALS AND METHODS: To investigate the clinicopathological features of patients with metastatic tumours of the thyroid gland, we reviewed autopsy records and pathological features of 36 cases with thyroidal secondary tumours from 266 cases of malignant neoplasias (excluding cases of primary thyroid cancer), over a 16-year period. RESULTS: There were 19 men and 17 women in the study, ranging in age from 37 to 95 years (mean 70.4 years). The incidence of metastasis in thyroid gland was 0.9% in all autopsy cases, and 13.53% of the malignant tumours. The majority were carcinomas of epithelial origin. The lung was the most common primary tumour site (33.3%), followed by the breast (8.33%) and the kidney (8.33%). The most common non-epithelial malignancy was lymphoma, followed by leukaemia (total of both 25%). As for the microscopic morphological observations, diffuse infiltration pattern of tumour cells was noted in 63.89% of the cases, the formation of nodules in 33.33% of the cases and contiguous invasion in 2.79% of the cases. There were 35.71% cases of metastases associated with multinodular goitre and 28.57% cases associated with papillary microcarcinoma. CONCLUSION: Our study indicates that thyroid secondary malignancies are not infrequent and may constitute a diagnostic problem. Lung cancer is the most common neoplasm that metastasizes to the thyroid gland in north-western Greek population.


Assuntos
Carcinoma/secundário , Neoplasias da Glândula Tireoide/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Neoplasias dos Ductos Biliares/patologia , Neoplasias da Mama/patologia , Carcinoma/epidemiologia , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/secundário , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/secundário , Neoplasias Colorretais/patologia , Feminino , Grécia/epidemiologia , Humanos , Incidência , Neoplasias Renais/patologia , Infiltração Leucêmica/epidemiologia , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/patologia , Linfoma/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/epidemiologia , Nódulo da Glândula Tireoide/patologia
14.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936351

RESUMO

Acute monocytic leukaemia (French-British-American classification: AML-M5b) is characterised by a predominance of cells of the monocytic lineage on bone marrow examination. Furthermore, a discerning feature is its tendency for tissue infiltration. While gum hypertrophy and hepatosplenomegaly are common, ocular involvement is rare. Here, we present a case of a 75-year-old man referred with proptosis and monocytosis-subsequently diagnosed as AML-M5b, whose disease course was distinguished by extensive tissue invasion (ocular, pulmonary, liver, spleen). Cytogenetics and molecular tests were consistent with blastic transformation of previously undiagnosed chronic myelomonocytic leukaemia, supported by the presence of long-standing, low-grade monocytosis. Notably, a BRAF V600E mutation was also detected-an oncogenic driver previously reported in de novo and therapy-related, but not chronic myelomonocytic leukaemia-transformed, AML-M5b. While an initial response to cytoreductive treatment was observed, his tissue-invasive disease soon progressed with worsening pulmonary infiltrates, disseminated intravascular coagulation and renal failure, resulting in death.


Assuntos
Transformação Celular Neoplásica/patologia , Exoftalmia/etiologia , Leucemia Monocítica Aguda/diagnóstico , Leucemia Mielomonocítica Crônica/diagnóstico , Infiltração Leucêmica/patologia , Proteínas Proto-Oncogênicas B-raf/metabolismo , Retina/patologia , Doenças Retinianas/patologia , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Azacitidina/uso terapêutico , Exoftalmia/patologia , Evolução Fatal , Humanos , Leucemia Monocítica Aguda/tratamento farmacológico , Leucemia Monocítica Aguda/fisiopatologia , Leucemia Mielomonocítica Crônica/tratamento farmacológico , Leucemia Mielomonocítica Crônica/fisiopatologia , Masculino , Mutação , Doenças Retinianas/tratamento farmacológico , Doenças Retinianas/fisiopatologia
16.
Curr Opin Endocrinol Diabetes Obes ; 26(3): 166-174, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30998603

RESUMO

PURPOSE OF REVIEW: This systematic review evaluates the state of the art in terms of strategies used to detect and remove contaminated malignant cells from testicular biopsy prior to spermatogonia stem cells (SSCs) autotransplantation to restore fertility. RECENT FINDINGS: Several trials have been done in past two decades to determine the reliable methods of detecting and purging cancer cells prior to SSCs autotransplantation. SUMMARY: The success in treating childhood cancer has dramatically increased over the past few decades. This leads to increasing demand for a method of fertility preservation for patients with pediatric cancer, as many cancer therapies can be gonadotoxic. Storing the SSCs prior to chemo- or radiation therapies and transplanting them back has been tested as a method of restoring fertility in rodents and nonhuman primate models. This has promise for restoring fertility in childhood cancer survivors. One of the major concerns is the possibility of malignant cell presence in testicular tissue biopsies that could re-introduce cancer to the patient after SSCs autotransplantation. Non-solid cancers - especially hematologic malignancies - have the risk of being transplanted back into patients after SSCs cryopreservation even if they were only present in small number in the stored testicular tissue biopsy.


Assuntos
Separação Celular/métodos , Preservação da Fertilidade , Neoplasias/patologia , Espermatogônias/patologia , Espermatogônias/transplante , Transplante de Células-Tronco/métodos , Testículo/patologia , Separação Celular/tendências , Criança , Criopreservação/métodos , Criopreservação/tendências , Preservação da Fertilidade/métodos , Preservação da Fertilidade/tendências , Neoplasias Hematológicas/patologia , Humanos , Infiltração Leucêmica/patologia , Masculino , Preservação do Sêmen/métodos , Preservação do Sêmen/normas , Preservação do Sêmen/tendências , Transplante de Células-Tronco/tendências , Transplante Autólogo
18.
Can J Ophthalmol ; 54(1): 20-26, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30851770

RESUMO

Acute lymphoblastic leukemia (ALL) relapse implies a poor prognosis and demands emergency treatment. Leukemic infiltration of the anterior segment can masquerade as intraocular inflammation; a high index of suspicion for this complication is essential. We describe a case of ocular relapse in a 2-year-old male on maintenance therapy for ALL. A systematic review of all known cases of similar leukemic infiltration of the anterior segment of the eye in ALL was performed. A total of 106 patients in 43 reports described leukemic infiltration of the eye as an initial presentation of ALL or relapse. Ocular relapse may be the first visible manifestation of systemic disease, with concurrent disease in the CNS, bone marrow, or testes. Prognosis for ALL patients with ocular relapse is poor, with death after initial presentation reported as early as 16 days. Patients with a history of ALL presenting with any sign of ocular inflammation should be assessed for relapse and leukemic infiltration. As soon as a diagnosis of relapse has been confirmed, appropriate leukemia therapy should be initiated.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Infiltração Leucêmica/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Uveíte/diagnóstico , Pré-Escolar , Humanos , Infiltração Leucêmica/complicações , Masculino , Microscopia Acústica , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Prognóstico , Uveíte/etiologia
20.
Clin Exp Dermatol ; 44(5): e200-e204, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30628105

RESUMO

Leukaemia cutis is a relatively rare manifestation in chronic lymphocytic leukaemia, characterized by a diverse morphology of skin lesions. We report two patients who developed zosteriform skin symptoms; however, the histological analysis revealed leukaemia infiltration as the cause of their symptoms. Contrary to previous reports, varicella zoster virus DNA was detectable in the lesions. These findings suggest that varicella zoster virus plays an active role in the development of zosteriform leukaemia cutis.


Assuntos
DNA Viral/isolamento & purificação , Herpesvirus Humano 3 , Leucemia Linfocítica Crônica de Células B/patologia , Infiltração Leucêmica/patologia , Pele/patologia , Idoso , Feminino , Humanos , Infiltração Leucêmica/virologia , Masculino , Pessoa de Meia-Idade , Pele/virologia
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