Disseminated mucocutaneous trichosporonosis in a patient with histiocytic sarcoma

Abstract Trichosporon asahii is the causal agent of trichosporonosis. Patients with immunosuppression or hematological malignancies are at higher risk of infection. Skin and mucosal involvement appear as fast-growing papulonodular lesions and necrotic ulcers. Internal organ dissemination is lethal. Therapeutic success depends on the underlying disease. Here, the authors present the first case of disseminated mucocutaneous trichosporonosis in a patient with a post-mortem diagnosis of histiocytic sarcoma, a rare and aggressive haematolymphoid neoplasm. Regretfully, death occurred despite treatment with liposomal amphotericin B and supportive measures, showcasing the fatality of both diseases.

Pleomorphic large cell hemato-lymphoma (the so-called "malignant histiocytosis"): clinicopathological and immunophenotypic studies in 35 cases.

Thirty-five patients diagnosed with "malignant histiocytosis" from 1984 to 1989 were studied for clinical, laboratory, histopathological features as well as survival and response to therapy, Immunocytochemistry and immunophenotypic studies were performed in 12 cases using the paraffin immunoperoxidase method. The staining included alpha-1 antichymotrypsin, muramidase, immunoglobulins and monoclonal antibodies specific for T, B lymphocytes and macrophage. From the clinical features, responsiveness to therapy and survival, the patients were divided into 2 groups: the non-responders (25 cases) and responders (10 cases) groups. Very short median survival of 1.25 months was found in the non-responders, whereas, longer median survival of 14.15 months was found in the responder group. Important different clinical and laboratory features were observed among these two groups. Unresponsiveness to treatment; rapidly progressive pancytopenia, increased hemophagocytosis, presentation of immature cells in blood with extensive infiltration of malignant cells in the bone marrow; severe jaundice and deterioration of hepatic function accompanied by early extranodal involvement were almost exclusively observed initially in the non-responder group. Satisfactory response to treatment was observed only in the responder group. Similarity of histopathology, cytology and immunophenotype was observed in these two groups. The immunophenotypic study in 12 cases showed 5 cases of B-cell lymphoma, 3 cases of T-cell (with 1 Ki-1 -positive) lymphoma; 1 case of Ki-1 positive non-T, non-B anaplastic large cell lymphoma; and 3 cases of undetermined cell lineage. From this study, so-called "malignant histiocytosis" appears to be a disorder of heterogeneity. The immunophenotypes of malignant cells indicated that their origin belonged mostly to lymphoid cell lineage. Based on their clinical feature of the early hematogenous spread along with the distinct histopathological and immunophenotypic findings, the term "pleomorphic large cell hematolymphoma" is proposed to be used instead of the old misnomer, "malignant histiocytosis" (MH).

Efectos de las radiaciones y de los quimioterápicos antimitóticos sobre la dentición (trad) / Implact of radiation and antimitotic chemotherapy on the teeth. Apropos of 3 cases

Los autores muestran la desorganización del desarrollo dentario en tres niños que han recibido radiaciones y una quimioterapia antimitótica. Ellos piensan que, en esos casos, la quimioterapia induce anomalías dentarias y, en un caso, un efecto acumulativo o de potenciación de radiaciones por la quimioterapia que no puede ser excluido. Los efectos secundarios de las irradiaciones sobre el sistema dentario son frecuentemente incorporados en los estudios de larga duración en niños que sobreviven a un cáncer. Las incidencias sobre el desarrollo de la dentición son varias: agenesia(s) dentarias(s), microdoncia, interrupción en el crecimiento de las raíces, raíces cortas y en V, cierre prematuro de los ápices, hipoplasia adamantina. Por el contrario, los efectos producidos por los quimioterápicos sobre el desarrollo de la dentición son mucho menos conocidos y son objeto de pocas publicaciones. La casi totalidad de los estudios han sido hechos sobre animales. Nos ha parecido por lo tanto interesante incluir tres observaciones de niños tratados muy tempranamente con quimoterápicos (un caso) y radioterapi + quimioterapia (dos casos). Estos pacientes, de 10 años y medio, 11 años y 16 años de edad, son actualmente seguidos en consulta ortodóncica y presentan daños en su sistema dentario que puden ser atribuidos principalmente a la quimioterapia

Histiocitosis maligna durante el embarazo. Primer caso informado / Malignant histiocytosis during pregnancy. First reported case

Se presenta el caso de una paciente con un embarazo de 15 semans, que se complicó con una histiocitois maligna, de curso rápido, por lo que se inició quimioterapia combinada desde el primer trimestre del embarazo. El curso del embarazo fue normal, así como el parto. El recién nacido, de sexo femenino con 3,200 g, fue normal sin evidencia de malformaciones congénitas, la citología hemática fué también normal. Doce meses después del parto, tanto la madre como la niña se encuentran bien, con un desarrollo psicomotor normal. El uso de citotóxicos durante el primer trimestre del embarazo es brevemente analizado.