ABSTRACT
OBJETIVO: Apresentar os achados na tomografia computadorizada do tórax indicativos de hematopoese extramedular de seis pacientes. MÉTODOS: Foram estudadas, retrospectivamente, as tomografias de seis pacientes adultos-cinco homens e uma mulher-com idade média de 36,5 anos. Os exames foram analisados por dois radiologistas, de forma independente, e as decisões finais foram obtidas por consenso. RESULTADOS: O achado mais freqüente nas tomografias foi o de massas paravertebrais inferiores, de conteúdo heterogêneo (quatro pacientes). As tomografias de dois pacientes mostravam uma massa solitária parietal e pleural. CONCLUSÕES: A hematopoese extramedular apresenta aspectos na tomografia computadorizada fortemente sugestivos do diagnóstico que, quando correlacionados com a presença de doença hematológica de base, permitem, na maior parte dos casos, dispensar a comprovação histopatológica.
OBJECTIVE: To present findings on computed tomography scans of the chest indicative of extramedullary hematopoiesis in six patients. METHODS: We retrospectively analyzed computed tomography scans of six adult patients - five males and one female - with a mean age of 36.5 years. Two radiologists independently reviewed the scans, and a consensus was reached in discrepant cases. RESULTS: The most common finding in the scans was lower paravertebral masses with heterogeneous content (four patients). The scans of two patients showed a solitary parietal and pleural mass. CONCLUSIONS: There are findings in computed tomography scans that are highly suggestive of extramedullary hematopoiesis, especially when those findings correlate with underlying blood diseases. Such findings, in most of the cases, allow physicians to dispense with histopathological confirmation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Anemia, Sickle Cell , Hematopoiesis, Extramedullary/physiology , Mediastinum , Tomography, X-Ray Computed/methods , Diagnosis, Differential , Mediastinum/physiology , Retrospective Studies , Thalassemia , Young AdultABSTRACT
Intrathoracic extramedullary haematopoiesis is a rare entity encountered in patients with long standing anaemias such as thalassaemia and congenital spherocytosis. It is rare in patients with homozygous sickle cell disease; only 11 cases of intrathoracic and two cases of pelvic extramedullary haematopoiesis have been documented in the literature. We report the case of a 30-year old man with homozygous sickle cell disease with intrathoracic and pelvic extramedullary haematopoiesis, the first case to be documented from the Caribbean.
La hematopoyesis extramedular intratorácica es una entidad que raras veces se encuentra en pacientescon anemias de larga duración tales como la talasemia y la esferocitosis congénita. También es rara en pacientes que padecen la enfermedad de células falciformes homocigóticas. En la literatura se han documentado sólo 11 casos de hematopoyesis extramedular intratorácica y dos casos de hematopoyesis extramedular pélvica. Reportamos el caso de un hombre de 30 años de edad con la enfermedad decélulas falciformes homocigóticas con hematopoyesis extramedular intratorácica y pélvica el primercaso que se documenta en el Caribe.
Subject(s)
Humans , Male , Adult , Anemia, Sickle Cell/physiopathology , Hematopoiesis, Extramedullary/physiology , Bone Marrow/physiology , Fatal Outcome , Pelvic Bones , Thoracic VertebraeABSTRACT
PURPOSE: To research the hyperbaric oxygen therapy effects on rats' livers and spleens. METHODS: 30 adult male Hotzman rats were used, being randomly distributed, by raffle, into 2 groups of 15 animals each: group 1 - control; group 2 - hyperbaric oxygen therapy. Group-2 animals underwent hyperbaric oxygen therapy for 120 minutes daily, 90 minutes of which were under pressure of 2.5 atmospheres. The first and last 15 minutes were used for gradual compression and decompression, respectively, for 20 days in a row. The livers and spleens of the animals from the two groups were taken out for histologic examination, on the day after the end of hyperbaric oxygen therapy in group 2 animals. Liver and spleen histologic changes of the animals from the two groups were compared by using Fisher exact test. P < 0.05 was regarded as a significant difference. RESULTS: The only change in liver and spleen histology was the significant reduction in hepatic extramedullary erythropoiesis in the animals that underwent hyperbaric oxygen therapy (p < 0.05). CONCLUSION: Hyperbaric oxygen therapy reduces hepatic extramedullary erythropoiesis in rats and doesn't jeopardize the other liver and spleen structures.
OBJETIVO: Pesquisar os efeitos da oxigenoterapia hiperbárica sobre o fígado e baço de ratos. MÉTODOS: Foram utilizados 30 animais machos adultos da espécie Holtzman, distribuídos aleatoriamente e por sorteio em dois grupos de 15 animais cada, assim designados: grupo 1 - controle; grupo 2 - oxigenoterapia hiperbárica. Os animais do grupo 2 foram submetidos à oxigenoterapia hiperbárica por 120 minutos ao dia, sendo 90 minutos sob pressão de 2,5 atmosferas e 15 minutos iniciais e finais para a compressão e descompressão gradativa, respectivamente, em 20 dias consecutivos. Os fígados e baços dos animais dos dois grupos foram retirados para exame histológico, no dia seguinte após o término da oxigenoterapia hiperbárica nos animais do grupo 2. Compararam-se as alterações na histologia do fígado e baço entre os animais dos dois grupos empregando-se o teste exato de Fisher, considerando diferença significante o valor de p<0,05. RESULTADOS: A única alteração na histologia dos fígados e baços foi a redução significativa da eritropoiese extramedular hepática nos animais submetidos a oxigenoterapia hiperbárica. (p < 0,05) CONCLUSÃO: A oxigenoterapia hiperbárica reduz a eritropoiese extramedular hepática em ratos e não compromete as demais estruturas do fígado e do baço.
Subject(s)
Animals , Male , Rats , Erythropoiesis/physiology , Hyperbaric Oxygenation , Hematopoiesis, Extramedullary/physiology , Liver/cytology , Spleen/cytology , Random AllocationABSTRACT
Os autores relatam o caso de um paciente do sexo masculino, de 40 anos de idade, portador de anemia falciforme, que desenvolveu a forma intratorácica de hematopoiese extramedular, apresentando lesões expansivas com densidade de partes moles, localizadas posteriormente, nas goteiras paravertebrais, na radiologia convencional. A tomografia computadorizada do tórax demonstrou massas bem delimitadas, de contornos lobulados, com densidade heterogênea à custa de áreas de tecido gorduroso e de densidade de partes moles, localizadas no terço inferior das goteiras paravertebrais. Os pulmões tinham coeficientes de atenuação preservados. A tomografia computadorizada de abdome revelou importante aumento da densidade e do volume do fígado, atribuídos à hemossiderose, e baço atrófico e calcificado devido a infartos esplênicos de repetição
The authors report a case of a 40-year-old male patient with sickle cell disease who presented with intra-thoracic extramedullary hematopoiesis and paravertebral expansive lesions that appeared as soft tissue density masses on conventional x-ray films. A computed tomography of the chest demonstrated soft tissue density masses in the lower third of the paravertebral spaces. These masses presented well-defined limits, lobulated edges and were heterogeneous due to areas of interposed adipose and soft density tissues. The lung parenchyma had no abnormalities. Computed tomography of the abdomen revealed diffuse hiperdensity and enlargement of the liver that was attributed to hemosiderosis, and an atrophic and calcified spleen due to repeated episodes of infarction.
Subject(s)
Humans , Male , Adult , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/diagnosis , Hematopoiesis, Extramedullary/physiology , Mediastinum , Diagnosis, Differential , Tomography, X-Ray ComputedABSTRACT
The objective of the present study was to determine the effect of protein malnutrition on the glycoprotein content of bone marrow extracellular matrix (ECM). Two-month-old male Swiss mice were submitted to protein malnutrition with a low-protein diet containing 4 percent casein as compared to 20 percent casein in the control diet. When the experimental group had attained a 20 percent loss of their original body weight, we extracted the ECM proteins from bone marrow with PBS buffer, and analyzed ECM samples by SDS-PAGE (7.5 percent) and ECL Western blotting. Quantitative differences were observed between control and experimental groups. Bone marrow ECM from undernourished mice had greater amounts of extractable fibronectin (1.6-fold increase) and laminin (4.8-fold increase) when compared to the control group. These results suggest an association between fluctuations in the composition of the hematopoietic microenvironment and altered hematopoiesis observed in undernourished mice
Subject(s)
Animals , Male , Mice , Bone Marrow Cells/chemistry , Extracellular Matrix/chemistry , Fibronectins/metabolism , Laminin/metabolism , Protein-Energy Malnutrition/metabolism , Blotting, Western , Case-Control Studies , Electrophoresis, Polyacrylamide Gel , Fibronectins/analysis , Glycoproteins/analysis , Hematopoiesis, Extramedullary/physiology , Laminin/analysisABSTRACT
Two cases of spinal cord compression due to extramedullary haemopoiesis in haemoglobine E thalassaemia are described. Possible mechanisms and treatment modes are discussed.