A Case of Peripheral T-cell Lymphoma, Unspecified Presenting as Multiple Ulcerative Tumors / 대한피부과학회지

Peripheral T cell lymphoma, unspecified (PTCL-U) comprises a heterogenous group of mature T-cell lymphomas that do not match with any defined T-cell entities in the current classification system. A 68-year-old man presented with extensive erythematous to brownish ulcerative tumors with yellowish discharge on the neck, trunk, and both upper extremities that had persisted for the past 7 months. Histological findings showed medium- to large-sized pleomorphic lymphocytes with cellular atypia infiltrating the deep dermis and subcutis. Immunohistochemical analysis of specimens from this patient revealed positive staining for CD2, CD45, and granzyme B and mildly positive staining for CD3, CD4, CD30, and CD79a. Based on these clinico-pathological findings, the patient was finally diagnosed with PTCL-U. We report herein a rare case of PTCL-U presenting as multiple ulcerative tumors.

Perfil nutricional e consumo dietético de crianças alérgicas à proteína do leite de vaca acompanhadas em um hospital infantil de Brasília/DF, Brasil / Nutritional profile and dietary intake of children allergic to cow’s milk protein accompanied by a children’s hospital, in Brasilia, Brazil

OBJETIVO: Investigar o perfil do estado nutricional e do consumo dietético de crianças com alergia à proteína do leite de vaca de até três anos de idade acompanhadas em um hospital infantil de Brasília/DF, Brasil. MÉTODOS: Trata-se de um estudo transversal descritivo e prospectivo. Foram aferidos o peso e a estatura das crianças para classificação do estado nutricional por meio das curvas da OMS para escore z. A caracterização e consumo das fórmulas infantis específicas para APLV foram coletados através de questionário e recordatório 24h. Verificou-se a contribuição calórico-proteica, de cálcio, vitamina D e ácidos graxos essenciais em relação às DRIs. RESULTADOS: 76,5% eram recém-nascidos a termo, de parto cesária (73,5%) e com peso adequado ao nascimento (85,3%). Foram encontradas adequações em relação aos indicadores E/I (91,2%), P/I (88,3%), P/E (88,2%) e IMC/I (85,3%). 17,6% da amostra tiveram AME até 6 meses e 94,1% das crianças não estavam em aleitamento materno. A idade média de introdução alimentação complementar foi de 5,16 ± 1,47 meses e 54,5% receberam alimentação complementar antes de 6 meses. A porcentagem de crianças que transgrediram a dieta foi de 11,8%. A fórmula extensamente hidrolisada foi a mais utilizada (64,7%) e 5,9% não recebiam fórmula infantil. As porcentagens médias de contribuição das fórmulas infantis em relação às DRIs foram: 45,72% (EER), 80,21% (proteína), 76,9% (cálcio), 176,64% (vitamina D), 34,77% (w3) e 24,87% (w6)....

OBJECTIVE: Investigate the nutritional status and dietary intake of children with allergy to cow ‘s milk protein of up to three years of age accompanied by a children’s hospital, in Brasilia, Brazil. METHODS: This is a descriptive cross-sectional and prospective study. Weight and height of children were measured to determine nutritional status through z-score of WHO’s curves. The characterization and consumption of infant formulas specific to CMPA were collected through questionnaire and 24h recall. There contribution of proteincalorie, calcium, vitamin D and essential fatty acids in relation to the DRIs was verrified. RESULTS: 76.5% were term newborns, with cesarean section (73.5%) and with adequate birth weight (85.3%). E / I (91.2%), P / I (88.3%), P / E (88.2%) and BMI / I (85.3%) were found to be adequate. 17.6% of the sample had EMA up to 6 months and 94.1% of the children were not breastfed. The mean age of introduction of complementary feeding was 5.16 ± 1.47 months and 54.5% received complementary feeding before 6 months. The percentage of children who transgressed the diet was 11.8%. The widely hydrolyzed formula was the most used (64.7%) and 5.9% did not receive infant formula. The mean contribution percentages of infant formulas in relation to DRIs were: 45.72% (EER), 80.21% (protein), 76.9% (calcium), 176.64% (vitamin D), 34.77 % (w3) and 24.87% (w6)...

The correlation between platelet-lymphocyte ratio and the prognosis of patients with peripheral T-cell lymphoma, unspecified / 肿瘤

Objective: To identify the correlation between pre-treatment per ipheral blood platelet-l ymphoc y te rat io (PLR) and the clinicopathological features of the patients with peripheral T cell lymphoma, unspecified (PTCL-U), and to explore the prognostic significance of PLR in these patients. Methods: The clinical characteristics and survival state of 163 patients diagnosed of PTCL-U in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. All patients were divided into low PLR group (PLR < 170, n = 80) and high PLR group (PLR ≥ 170, n = 83) based on the receiver operating characteristic (ROC) curve's cut-off value. The relationship between pre-treatment PLR and the prognosis of these patients was analyzed. Results: In all 163 patients with PTCL-U, the 5-year overall sarvival (OS) and progression-free survival (PFS) rates of patients in low PLR group (76.3% and 60.0%, respectively) were higher than those in high PLR group (10.8% and 8.4%, respectively, both P < 0.05). Age, Eastern Cooperative Oncology Group performance status (ECOG PS), B symptoms, serum lactate dehydrogenase (LDH) level, platelet and PLR were remarkably relevant to OS (all P < 0.01). Age, serum LDH level, platelet and PLR were independent prognostic features for patients with PTCL-U (all P < 0.05). Conclusion: The peripheral blood PLR at pre-treatment is distinctly relevant to the prognosis of patients with PTCL-U. An elevated PLR predicts poor prognosis of these patients.

Clinical features of unspecified functional bowel disorder in servicemen from a Chinese army unit / 解放军医学杂志

Objective To investigate clinical manifestation of unspecified functional bowel disorder (UFBD), the features of coexistence with functional gastrointestinal disorder (FGID) and its relationship with psychological factors and sleep disturbance in the Chinese Army servicemen.Methodsc FGIDs were diagnosed based on the RomeⅢ Modular Questionnaire. The subjects were 189 servicemen with UFBD (UFBD group) and 372 without FGID (control group). All subjects completed symptom checklist 90 (SCL-90) and Pittsburgh Sleep Quality Index (PSQI) questionnaire.Results'Have to rush to the toilet when having a desire to defecate' was the most frequent symptom of UFBD (93.7%). More than one half of UFBD patients had the symptom 'a feeling of incomplete emptying as bowel movements' or 'straining during bowel movements'. Twenty-eight percent of UFBD subjects had combined FGID (namely cFGID). Among them, the most frequent was proctalgia fugax (7.9%), followed by cyclic vomiting syndrome (6.3%), functional fecal incontinence (6.3%), functional dyspepsia (4.8%) and belching (4.8%). The UFBD group scored significantly higher than the control group in the global severity index (GSI) and in all SCL-90 subscales (P0.05).ConclusionPathogenesis of UFBD may be closely correlated with psychiatric and psychological factors and sleep disturbance. cFGID are associated with an increased severity of psychopathological features.

Diagnosis of myeloid neoplasms for three patients with erythroblast more than 50 ％ of bone marrow nucleated cells / 临床检验杂志

Objective To further understand the diagnosis,clinical features and prognosis of myeloid neoplasms with erythroblast more than 50％ of bone marrow(BM) nucleated cells in the WHO Classification(2016) by analyzing the clinical data,diagnosis and prognosis of 3 patients with myeloid leukemia.Methods The ages,medical histories,symptoms and signs,and laboratory examinations from 3 patients with myeloid neoplasms whose erythroblast cells were more than 50％ of BM nucleated cells when newly diagnosed were collected.Then,they were diagnosed with the WHO Classification criteria(2008) and the WHO Classification criteria(2016),respectively,and their prognosis was evaluated with the revised International Prognostic Scoring System(IPSS-R).Results According to the WHO Classification criteria(2008),all of 3 patients were diagnosed as acute erythroid leukemia(AEL).However,according to the WHO Classification criteria(2016),2 patients were diagnosed as myelodysplastic syndrome with excess blasts-2(MDS-EB-2),and 1 was diagnosed as acute myeloid leukemia(AML) with maturation.Moreover,their prognostic scores were also different.The former two patients were older men with significant dysplasia and complex genetic abnormalities,and had poor prognosis,while the latter was a middle-aged woman with no obvious dysplasia and genetic abnormalities,and had medium prognosis.Conclusion The WHO Classification(2016) is more reasonable than the WHO Classification(2008),which tends to focus more on the different biological characteristics of diseases,and may better distinguish two types of diseases with different clinical features and prognosis.

Association between Family Developmental Stages and Clinical Manifestations of Patients with Psychosomatic Morbidity Presenting at a Primary Care Clinic in South-West Nigeria.

Aim: This study aimed to find out the relationship between the clinical manifestations of patients with psychosomatic morbidity (PSM) and their family developmental stages. Study Design: A cross sectional study. Place and Duration of Study: The study period span between February 1st and April 30th 2013, during which patients who presented at the General Outpatient (GOP) clinic of the University College Hospital, Ibadan for various complaints were encountered. Methods: A sample of 360 patients with varying forms of PSM identified by five or more from the symptoms in the primary evaluation of mental disorder- patient health questionnaire somatoform, anxiety and depression modules (PRIME-MD PHQ SADs) was recruited consecutively. The international classification for primary care second electronic version (ICPC-2E) was used to categorize the clinical manifestations of respondents while Stevenson’s family developmental model classified the family developmental stages into emerging, crystallizing, interacting and actualizing family. Data were analyzed using statistical package for social sciences soft ware version 17. Statistical significance level was set at p ≤ 0.05. Results: Among the 360 respondents studied, 275 were married with age range between 19 and 80 years, 62.5% lived with their spouses, 3.1% divorced∕ separated and 10.8% were widowed. Majority was females (74.9%) and the predominant family developmental stage was the crystallizing family (30.2%). General and unspecified physical (GUP) complaints were the commonest clinical manifestation seen in all the stages except the emerging family which has gynaecological complaints. Comparing the mean scores of married respondents with moderate-severe PSM and family stages shows that being married and living with spouses may be protective against severe forms of PSM (P = .04). On the other hand, comparing the mean scores of single and married respondents with moderate-severe PSM shows that respondents who are single may come with severe forms of somatoform disorder when compared with other single respondents with anxiety or depressive disorder (P < .05). There is however no relationship between the family developmental stage and severity of PSM. Conclusion: There was interplay between medically unexplained physical complaints and patient’s family characteristics. Being married and living with spouses may be protective against severe forms of PSM.

A Case of Rapidly Aggravated Peripheral T-cell Lymphoma, Unspecified / 대한피부과학회지

Peripheral T-cell lymphoma, unspecified (PTCL-U) is an infrequent type of non-Hodgkin's lymphoma (NHLs), which occurs mainly in adults. The common predilection sites is the peripheral lymph node; however, other sites, such as bone marrow, liver, spleen, and skin, may also be affected. PTCL-U and other types of PTCLs are the most aggressive types of the NHLs. Response to treatment is poor and the overall 5-year survival rates do not surpass 20%. A 57-year-old female presented with a 1-week-history of multiple and painful subcutaneous nodules. The shape and distribution of the nodules were similar to those of erythema nodosum. The histopathologic findings of the skin lesion fitted that described for PTCL-U. In spite of chemotherapy, she expired in 1 month after diagnosis.

Anorectal and gastric peripheral T-cell lymphoma, unspecified in a non-AIDS patient

Anorectum is a rare location for malignant lymphoma. Involvement of is rare even for the lymphoma associated with acquired immune deficiency syndrome (AIDS), and AIDS has a relatively increased frequency of anorectal lymphoma. Most lymphomas in AIDS patients are of a B-cell origin, and T-cell lymphoma of the gastrointestinal tract is extremely rare. We report here on a case of anorectal and gastric peripheral T-cell lymphoma, unspecified (PTCLu) in a non-AIDS patient. A previously healthy 29-year-old man presented with hematochezia and tenesmus that he had suffered with for the previous 2 months. Sigmoidoscopy showed anal and rectal submucosal tumor. Multiple round-shaped, flat and elevated lesions were noted on the gastric antrum and body as well. He underwent excisional biopsy for the anal mass and the diagnosis was PTCLu. Biopsies of the gastric lesions gave the same diagnosis. There was no lymphoma involved in the bone marrow. At admission, no antibodies against human immunodeficiency virus were detected. He underwent systemic chemotherapy and upfront autologous stem cell transplantation.