ABSTRACT
Diffuse large B-cell lymphoma (DLBCL) is the most frequent subtype of aggressive lymphomas. Approximately 10% of DLBCL cases express CD5 as a surface antigen. CD5-positive DLBCL can occur as the de novo or secondary type. De novo CD5-positive DLBCL arises without previous lymphoproliferative disease, and secondary CD5-positive DLBCL may or may not manifest as Richter syndrome. The transformation of follicular lymphoma (FL) into DLBCL occurs in approximately one-third of all cases. The transformation of CD5-negative low-grade B-cell lymphoma to CD5-positive DLBCL is extremely rare. We report the clinical features of a rare case that presented with a transformation from CD5-negative FL to CD5-positive DLBL over 11 years. This is the second such case published in the English literature.
Subject(s)
Antigens, Surface , B-Lymphocytes , Cell Transformation, Neoplastic , Lymphoma , Lymphoma, B-Cell , Lymphoma, Follicular , Lymphoma, Large B-Cell, DiffuseABSTRACT
Salmonella typhi infections usually manifest with high fever and gastrointestinal symptoms, however, occurrence of severe complications in other organs, such as pneumonitis, bronchitis, hepatitis, nephritis, encephalitis, and osteomyelitis, is possible. Although common surgical complications include ileal perforation and gastrointestinal haemorrhage, few cases of intussusception have been reported. Splenic infarction is another uncommon complication. In this report, we present a case of typhoid fever complicated with simultaneous small bowel intussusception and splenic infarction. A 27-year-old male patient with no previous history of interest underwent examination for fever, acute abdominal pain, and watery diarrhea of seven days duration. Findings on the initial examination indicated fever of 39.1degrees C, a distended abdomen with direct and rebound tenderness of diffuse localization, and rigidity. Abdominal computed tomography showed hepatomegaly, multiple lymphadenopathies, multiple segmental splenic infarctions, and small bowel ileus with intussusception, however, findings from the small bowel enema study showed spontaneous resolution of the intussusception. Despite antibiotic therapy, abdominal symptoms continued, therefore, the patient underwent exploratory laparotomy with suspicion of intestinal perforation. Surgical findings included multiple enlarged lymphadenopathies and coarse appearance of the liver, but no perforation was found. Results of the Widal test showed positivity for flagellar (H), somatic (O) and A antigens (1:640 dilutions each). Blood cultures showed Salmonella typhi. lymph nodes and biopsy showed mesenteric lymphadenitis, with enlarged lymph nodes due to distension of the sinusoids by macrophages, which showed erythrophagocytosis and tingible bodies. In addition, liver biopsy showed a granulomatous aggregate comprised of macrophages with an epithelioid configuration. After intravenous administration of antibiotics, the patient showed progressive improvement and was discharged for outpatient department follow up.
Subject(s)
Adult , Humans , Male , Abdomen , Abdominal Pain , Administration, Intravenous , Anti-Bacterial Agents , Biopsy , Bronchitis , Diarrhea , Encephalitis , Enema , Fever , Follow-Up Studies , Hepatitis , Hepatomegaly , Ileus , Intestinal Perforation , Intussusception , Laparotomy , Liver , Lymph Nodes , Macrophages , Mesenteric Lymphadenitis , Nephritis , Osteomyelitis , Outpatients , Pneumonia , Salmonella typhi , Splenic Infarction , Typhoid FeverABSTRACT
Cases of anaerobic bacteremia are rare, and the clinical impact of clostridial bacteremia remains to be clarified. Previous clinical reports have suggested that C. bifermentans is less virulent than other Clostridia species. This microorganism has occasionally been reported to cause septic arthritis, necrotizing pneumonia with empyema, brain abscesses, endocarditis, and metastatic osteomyelitis. Herein, we report on a case of C. bifermentans bacteremia in a patient with myelodysplastic syndrome in South Korea.