Scedosporium prolificans: infección diseminada en un paciente inmunodeprimido / Scedosporium prolificans: diseminated infection in immunocompromised patient

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Paciente con coloración cutaenomucosa anaranjada y dolor abdominal inespecífico / Patient with orange muco-cutaneous discoloration and nonspecific abdominal pain

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Síndrome HELLP: complicación potencialmente grave de la preeclampsia en el puerperio inmediato

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[Non-Hodgkin's lymphoma of the maxillary sinuses. Pathological clinical study and current status of the treatment]. / Linfoma no Hodgkin en senos maxilares. Estudio clinicopatológico y estado actual del tratamiento.

Primary non-Hodgkin lymphoma (NHL) of the maxillary sinus is an infrequent neoplasm that represents about 8% of all malignancies in this area. A review was made of 74 patients diagnosed as malignancy of the maxillary sinus in a 20-year period. Five cases of primary extraganglionar NHL of the maxillary sinus were found. We describe all the cases and their extension in detail. The clinical manifestations, treatment, and long-term survival of these patients are discussed.

[Chronic myeloid leukemia developing into a multifocal extramedullary blast crisis]. / Leucemia mieloide crónica con evolución a crisis blástica extramedular politópica.

A 47-old male with accelerated-phase chronic myelogenous leukaemia is presented. In spite of a good response to hydroxyurea and interferon treatment, the patient developed multiple foci of granulocytic sarcoma as a special form of blastic crisis. A review was carried out of the different aspects of this entity, stress being laid on the diagnostic characteristics and the current therapeutic approach in such cases.

[Non-Hodgkin's lymphomas. I. Clinico-biological features of 307 cases]. / Linfomas no hodgkinianos. I. Características clínico biológicas de 307 casos.

PURPOSE: To assess the clinico-biological features appearing in 307 patients with non-Hodgkin's lymphomas (NHL). PATIENTS AND METHODS: The clinical records of 338 patients diagnosed of NHL between January 1975 and December 1988 were revised in retrospect. All cases with histologic diagnosis of NHL aged over 14 years were included, and classified in accordance with the Working Formulation criteria. The following data were analysed: age, sex, first complaints, time elapsed since onset, histologic type, number of sites involved, bulky disease, anaemia, thrombocytopenia, LDH, stage, type of treatment and initial response, survival, and cause of death. The statistical evaluation was performed by actuarial analysis (Kaplan and Meier) and comparison (log-rank test) of survival. RESULTS: According to the three categories of the malignancies, the NHL were distributed into low-grade (37.8%), intermediate (36.1%) and high-grade (26.9%). The mean age of the series was 56.6 years and the M/F ratio was 1.3. Lymph node enlargement was the commonest finding; 36.4% of the patients had symptoms related with the disease, and 26.7% had bulky disease. Anaemia was present in 37.7% of the cases and thrombocytopenia in 14.3%, with similar distribution among the three grades. High LDH levels were found in 44% of the patients. At diagnosis, 85% of the patients were in advanced stages (III+IV) already. Complete response was attained in 51.1% of the cases, with median survival of 48 months. CONCLUSIONS: The clinico-evolutive data found here are similar to other reports in the literature. In one-half of the patients the cause of the first visit is lymph node enlargement. Complete remission is achieved by one out of two patients, this figure being similar for each of the histologic groups. The Working Formulation is useful in determining the different prognostic groups with respect to survival.

[Non-Hodgkin's lymphomas. II. Analysis of the prognostic factors in a series of 307 patients]. / Linfomas no hodgkinianos. II. Análisis de los factores pronósticos en una serie de 307 enfermos.

PURPOSE: To analyse different clinico-biologic data in order to assess their prognostic value in non-Hodgkin's lymphoma (NHL) patients. MATERIAL AND METHODS: The series comprises 307 patients with NHL diagnosed and treated between 1975 and 1988. The histopathologic diagnosis was revised in accordance with the working formulation system, three prognostic groups being thus considered: low-grade (LGL), intermediate-grade (IGL) and high-grade (HGL) lymphomas. Age, sex, clinical course prior to diagnosis, presence of B symptoms, histologic type, number of lymph-node areas involved, bulky disease, anaemia, thrombocytopenia, LDH, stage and response to therapy were all evaluated for the study. Survival curves were drawn with the Kaplan-Meier method, and the log-rank test was used for comparison of median survival. Whenever the univariate analysis achieved statistical significance, a multivariate analysis was performed by means of a multiple correlation and regression study in accordance with the Cox's model, in which the variables were expressed in a binary model. RESULTS: The following 8 values were found significant in the univariate study of low-grade lymphomas: age, number of involved areas, bulky disease anaemia, thrombocytopenia, LDH, stage, and initial response to treatment. In intermediate-grade lymphomas, the significant findings were age, number of affected areas, bulky disease, thrombocytopenia, LDH, stage, and initial response. For high-grade lymphomas, number of affected areas, thrombocytopenia, LDH, stage and initial response were found statistically significant. Although no significant differences were found for survival within each of the three grades, such differences were significant between them. In the multivariate analysis, age was significant only in the LGL (p < 0.0001) in IGL, age (p < 0.07) and initial response to therapy (p < 0.0001) achieved significant value, and in HGL, stage (p < 0.02) and initial response to treatment (p < 0.0001) attained significance. CONCLUSIONS: The univariate analysis provides various prognostic factors of statistically significance, as reported in the literature, but these after the multivariate analysis was applied, were reduced to age, stage and initial response to treatment.