ABSTRACT
Chronic lymphocytic leukemia (CLL) was largely considered to be a disease of slow progression, standard treatment with Chlorambucil and having almost similar prognosis. With the introduction of molecular methods for understanding the disease pathophysiology in CLL there has been a remarkable change in the approach towards the disease. The variation in B-cell receptor response and immunoglobulin heavy chain variable region (IGHV) mutation, genetic aberration and defect in apoptosis and proliferation has had an impact on therapy initiation and prognosis. Early diagnosis of molecular variant is therefore necessary in CLL.
Subject(s)
Chromosome Aberrations , Humans , Immunoglobulin Heavy Chains/genetics , Immunoglobulin Variable Region/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , Lymphocytosis/diagnosis , Mutation , Prognosis , Receptors, Antigen, B-Cell/genetics , Tumor Suppressor Protein p53/genetics , ZAP-70 Protein-Tyrosine Kinase/geneticsABSTRACT
Monoclonal B-cell lymphocytosis (MBL) is a recently described medical condition that displays biological similarities to the most common subtype of adult leukemia in the Western world, i.e. chronic lymphocytic leukemia (CLL). Diagnostic criteria have been published with the aim of differentiating between these two entities. The overall prevalence of MBL is at least 100 times higher than that of CLL, which indirectly suggests that MBL is not necessarily a pre-leukemic condition, although in some circumstances, CLL cases can really be preceded by MBL. In view of this high prevalence rate, general clinicians and even non-hematological specialists have a high chance of being faced with individuals with MBL in their routine clinical practice. MBL is classified as "clinical MBL", "population-screening MBL" and "atypical MBL" and the clinical management of affected individuals depends greatly on this differentiation. The present review provides a guide to diagnosing and following up MBL patients.
A linfocitose monoclonal de células B (LMB) é uma condição médica recentemente descrita que exibe similaridades biológicas com o mais comum subtipo de leucemia em adultos de países ocidentais, qual seja, a leucemia linfocítica crônica (LLC). Critérios diagnósticos foram publicados com o intuito de separar as duas entidades. A prevalência global da LMB é pelo menos 100 vezes maior do que a da LLC, o que, indiretamente, sugere que a LMB não é necessariamente uma condição pré-leucêmica, embora, em algumas circunstâncias, casos de LLC possam realmente ser precedidos pela LMB. Em virtude dessa alta taxa de prevalência, clínicos gerais e mesmo outros especialistas não hematologistas têm grande chance de deparar-se com casos de LMB em suas rotinas clínicas. A LMB é classificada como "LMB clínica", "LMB de screening populacional" e "LMB atípica", sendo que o manuseio clínico dos indivíduos afetados depende substancialmente dessa diferenciação. A presente revisão fornece um guia para o diagnóstico e acompanhamento dos pacientes com LMB.
Subject(s)
Humans , B-Lymphocytes , Lymphocytosis , B-Lymphocytes/immunology , B-Lymphocytes/pathology , Diagnosis, Differential , Disease Progression , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology , Lymphocytosis/diagnosis , Lymphocytosis/epidemiology , Lymphocytosis/immunology , Lymphocytosis/pathology , Lymphocytosis/therapy , PhenotypeABSTRACT
Lymphoproliferative disorders of lung have a broad clinical and pathologic spectrum. The clinical and radiographic features are non-specific. Accurate diagnosis is required to initiate appropriate therapeutic intervention. We report a case of Hodgkin's disease mimicking lymphocytic interstitial pneumonitis in a 21-year-young male.
Subject(s)
Adult , Diagnosis, Differential , Hodgkin Disease/diagnosis , Humans , Lung Diseases, Interstitial/diagnosis , Lung Neoplasms/diagnosis , Lymphocytosis/diagnosis , MaleABSTRACT
La linfocitosis aguda infecciosa es una enfermedad presumiblemente viral, cuyos hallazgos característicos son la hiperleucocitosis a predominio linfocitario. Con el objetivo de alertar al pediatra sobre esta causa poco conocida de linfocitosis y actualizar la bibliografía al respecto, se describe el caso clínico de una niña de 2 años con una enfermedad aguda caracterizada por fiebre, diarrea y convulsion de breve duración. El hemograma mostró una hiperleucocitosis linfocitaria, descartandose otras etiologías. La evolución fue hacia la recuperación clínica y hematológica en un período de 20 días. Se discuten los aspectos más importantes de la enfermedad y se concluye la importancia de considerar este diagnóstico ante un niño con aspecto sano e hiperleucocitosis linfocitaria
Subject(s)
Humans , Female , Child, Preschool , Lymphocytosis , Acute Disease , Lymphocytosis/diagnosis , Lymphocytosis/therapyABSTRACT
É descrito o caso de um paciente de 23 anos, com diagnóstico prévio de mielorradiculopatia que desenvolveu diminuiçäo gradual do nível de consciência, rigidez de nuca e cefaléia. O exame do LCR mostrou linfocitose com presença de células blásticas, hiperproteinorraquia e anticorpos para HTLV-I/II