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1.
Rev. Bras. Cancerol. (Online) ; 67(3): e-091228, 2021.
Article in Portuguese | LILACS | ID: biblio-1292092

ABSTRACT

Introdução: O potencial de transformação maligna de células-tronco hematopoiéticas portadoras de mutações no gene glicosilfostatidilinositolclasse A (PIG-A) para leucemias agudas, embora raro, já é bem descrito na literatura. Objetivo: Neste estudo, porém, buscou-se evidenciar pela primeira vez na literatura o surgimento ou a manutenção de clones de hemoglobinúria paroxística noturna (HPN) em pacientes diagnosticados com leucemia aguda ou ainda após o início do tratamento quimioterápico. Método: A pesquisa de clones de HPN foi realizada por citometria de fluxo em blastos, hemácias, granulócitos ou monócitos de 47 amostras de sangue periférico e medula óssea de pacientes submetidos à investigação diagnóstica ou acompanhamento terapêutico, provenientes de dois hospitais oncológicos e públicos de Belém, no período de dezembro de 2017 a dezembro de 2018. Resultados: A presença de clones de HPN foi observada em 19/47 (40,4%) amostras de pacientes, em investigação diagnóstica ou acompanhamento terapêutico, que realizaram pelo menos um estudo de acompanhamento terapêutico e ainda tiveram o surgimento ou a manutenção do clone de HPN mesmo após iniciado o tratamento quimioterápico. Conclusão: Foi possível evidenciar, de forma primária, a presença de clones de HPN em pacientes diagnosticados com leucemia aguda tanto no período de investigação diagnóstica como durante o acompanhamento terapêutico, independentemente da ontogenia celular. Sem, porém, que se possa ainda avaliar a importância da presença desses clones de HPN para a evolução da doença primária, prognóstico ou necessidade de tratamento específico.


Introduction: The potential for malignant transformation of hematopoietic stem cells carrying mutations in theglycosylphosphatidylinositol class A (PIG-A) gene for acute leukemias, although rare, is already well described in the literature. Objective: In this study, however, it was attempted to show for the first time in the literature the emergence or maintenance of paroxysmal nocturnal hemoglobinuria (PNH) clones in patients diagnosed with acute leukemia or even after the beginning of the chemotherapy treatment. Method: The search of PNH clones was performed by flow cytometry in blasts, erythrocytes, granulocytes or monocytes of 47 samples of peripheral blood and bone marrow from patients undergoing diagnostic investigation or therapeutic follow-up in two oncological and public hospitals in Belém, from December 2017 to December 2018. Results: The presence of PNH clones was observed in 19/47 (40.4%) patient samples, in diagnostic investigation or therapeutic follow-up, who participated of at least one therapeutic follow-up study and still experience the appearance or maintenance of the PNH clone even after the beginning of the chemotherapy treatment. Conclusion: Primarily, it was possible to demonstrate the presence of PNH clones in patients diagnosed with acute leukemia both during the diagnostic investigation period and therapeutic follow-up, regardless of cell ontogeny. However, the importance of the presence of these PNH clones for the evolution of the primary disease, prognosis or need for specific treatment was not evaluated yet.


Introducción: El potencial de transformación maligna de las células madre hematopoyéticas que portan mutaciones en el gen glicosofosfatidilinositol (GPI) clase A (PIGA) para las leucemias agudas, aunque raro, ya está bien descrito en la literatura. Objetivo: En este estudio, sin embargo, buscamos mostrar por primera vez en la literatura la aparición o mantenimiento de clones de HPN en pacientes diagnosticados de leucemia aguda o incluso después del inicio de la quimioterapia. Método: La investigación de clones de hemoglobinuria paroxística nocturna (HPN) se realizó mediante citometría de flujo en blastos, eritrocitos, granulocitos o monocitos de 47 muestras de sangre periférica y médula ósea de pacientes sometidos a investigación diagnóstica o seguimiento terapéutico de dos hospitales oncológicos y públicos de Belém, durante el período. de diciembre de 2017 a diciembre de 2018. Resultados: La presencia de clones HPN se observó en 19/47 (40,4%) muestras de pacientes, en investigación diagnóstica o seguimiento terapéutico, que realizaron al menos un estudio de seguimiento terapéutico y aún tenían la aparición o mantenimiento del clon HPN incluso después de iniciado el tratamiento de quimioterapia. Conclusión: Se pudo evidenciar, de forma primaria, la presencia de clones de HPN en pacientes diagnosticados de leucemia aguda tanto durante el período de investigación diagnóstica como durante el seguimiento terapéutico, independientemente de la ontogenia celular. Sin embargo, no podemos todavía evaluar la importancia de la presencia de estos clones de HPN para la evolución de la enfermedad primaria, el pronóstico o la necesidad de un tratamiento específico.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Leukemia/diagnosis , Hemoglobinuria, Paroxysmal/blood , Bone Marrow/pathology , Leukemia/drug therapy , Clone Cells , Flow Cytometry , Hemoglobinuria, Paroxysmal/diagnosis
2.
Rev. méd. Chile ; 147(3): 275-280, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1004347

ABSTRACT

Background: Waldenström macroglobulinemia (WM) is an uncommon indolent B-cell lymphoma, due to the proliferation of lymphoplasmacytic cells, and secretion of a monoclonal IgM protein. Aim: To evaluate the clinical characteristics, management and results of treatment of patients with WM at a public hospital in Chile. Patients and Methods: Review of medical records of 31 patients aged 43 to 85 years (16 males) with WM diagnosed between 2002 and 2017. Clinical features and survival were recorded. Results: All patients had bone marrow compromise, and 31%, extranodal involvement. According to the International Prognostic Score System for WM (IPSSWM) 16, 58 and 26% were at low, intermediate and high risk, respectively. Twenty-five patients (81%) were treated, 32% with plasmapheresis and 36% with rituximab. Four cases (16%) achieved complete remission. Median follow up was 35 months (range 6-159). Estimated overall survival (OS) at 5 and 10 years was 74% and 53%, respectively. According to IPSSWM, the estimated five-year OS was 80, 92 and 39%, for low, intermediate and high-risk patients, respectively. Conclusions: OS was similar to that reported abroad, except for low risk patients, probably due to the low number of cases and short follow up. An improved survival should be expected with the routine use of immunochemotherapy.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Waldenstrom Macroglobulinemia/diagnosis , Vincristine , Biopsy , Bone Marrow/pathology , Prednisone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chile/epidemiology , Survival Rate , Retrospective Studies , Treatment Outcome , Waldenstrom Macroglobulinemia/mortality , Waldenstrom Macroglobulinemia/drug therapy , Cyclophosphamide/therapeutic use , Rituximab/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use
3.
Autops. Case Rep ; 9(1): e2018059, Jan.-Mar. 2019. ilus
Article in English | LILACS | ID: biblio-987013

ABSTRACT

An 84-year-old Japanese woman with myelodysplastic syndrome was admitted with pyrexia and dyspnea, but died suddenly during diagnostic evaluation. The autopsy revealed miliary tuberculosis in addition to myelodysplastic syndrome in the bone marrow. The immediate cause of the patient's sudden death was pulmonary fat embolism derived from bone marrow necrosis. This case shows that the infiltration of the myelodysplastic bone marrow by tuberculosis and consequent bone marrow necrosis and fat embolism can be the cause of sudden death. In this article, we report the autopsy results of this unusual cause of sudden death, and discuss tuberculosis-related sudden death with a review of the literature.


Subject(s)
Humans , Female , Aged, 80 and over , Tuberculosis/pathology , Death, Sudden/etiology , Embolism, Fat/complications , Autopsy , Bone Marrow/pathology , Fatal Outcome , Necrosis
4.
Braz. j. med. biol. res ; 51(11): e6278, 2018. graf
Article in English | LILACS | ID: biblio-951723

ABSTRACT

Rhabdomyolysis refers to the destruction or disintegration of striated muscles. This syndrome is characterized by muscle breakdown and necrosis, resulting in the leakage of intracellular muscle constituents into the circulation and extracellular fluid. We report a rare case of rhabdomyolysis complicating multi-organ failure caused by T-cell lymphoma in a 32-year-old woman. The final diagnosis was rhabdomyolysis caused by peripheral T-cell lymphoma based on bone marrow aspirate and biopsy.


Subject(s)
Humans , Female , Adult , Rhabdomyolysis/etiology , Lymphoma, T-Cell/complications , Bone Marrow Neoplasms/complications , Biopsy, Needle , Bone Marrow/pathology , Immunohistochemistry , Lymphoma, T-Cell/pathology , Fatal Outcome , Bone Marrow Neoplasms/pathology , Acute Kidney Injury/etiology
5.
Arq. bras. med. vet. zootec. (Online) ; 70(5): 1362-1368, set.-out. 2018. tab, graf
Article in Portuguese | LILACS, VETINDEX | ID: biblio-946808

ABSTRACT

O objetivo com este estudo foi comparar as técnicas de citologia aspirativa, biópsia e citobloco para identificação e quantificação parasitológica de Leishmania (Leishmania) infantum chagasi em medula óssea de cães. Amostras de tecido medular de 26 animais, em diferentes estágios clínico-laboratoriais da doença, foram estudadas obedecendo-se os mesmos critérios de investigação nas técnicas de citologia aspirativa, biópsia e citobloco. O menor número de campos para a confirmação parasitológica foi constatado no esfregaço direto obtido por citologia aspirativa. O estágio clínico-laboratorial não influenciou no número de campos necessários para a primeira visualização do agente em nenhuma das técnicas (p>0,05), e menor intensidade parasitária foi observada nas lâminas de citobloco. As técnicas de citologia aspirativa e biópsia concordaram na estimativa do coeficiente de infectividade no tecido estudado (p<0,05). Apesar de a técnica de citobloco permitir a concentração de células e o melhor reaproveitamento de amostras, não demonstrou ser um método adequado para rápida identificação e quantificação parasitológica na leishmaniose visceral canina. Considerando-se suas vantagens, a citologia aspirativa foi o melhor método para detecção microscópica do parasito e determinação do nível de intensidade parasitária no tecido estudado.(AU)


The aim of the present study was to compare the aspiration cytology, biopsy and cell block techniques for identification and parasitological quantification of Leishmania (Leishmania) infantum chagasi in dog bone marrow. Bone marrow tissue samples from 26 animals, in different clinical-laboratory stages of the disease, were studied according to the same criteria of investigation in the aspiration cytology, biopsy and cell block techniques. The lowest number of fields for the parasitological confirmation was found in the direct smear obtained by aspiration cytology. The clinical-laboratory stage did not influence the number of fields required for the first visualization of the agent in any of the techniques (p> 0.05) and less parasitic intensity was observed in the cell block slides. The aspiration cytology and biopsy techniques agreed on the estimation of infectivity coefficient in the tissue studied (p< 0.05). Although the cell block technique allows the concentration of cells and better reutilization of samples, it has not been shown to be an adequate method for rapid identification and parasitological quantification in canine visceral leishmaniasis. Considering its advantages, aspiration cytology was the best method for microscopic detection of the parasite and determination of the level of parasite intensity in the tissue studied.(AU)


Subject(s)
Animals , Dogs , Biopsy, Fine-Needle/methods , Bone Marrow/pathology , Leishmaniasis, Visceral/parasitology
6.
Autops. Case Rep ; 7(4): 42-50, Oct.-Dec. 2017. ilus
Article in English | LILACS | ID: biblio-905406

ABSTRACT

Sickle cell disease encompasses a wide range of genotypic presentation with particular clinical features. The entity affects millions of people, particularly those whose ancestors came from sub-Saharan Africa and other countries in the Western Hemisphere, Saudi Arabia, and India. Currently, the high frequency of S and C genes reflects natural selection through the protection of heterozygotes against severe malaria, the high frequency of consanguineous marriages, improvement of some public health policies and the nutritional standards in the poorer countries where newborns are now living long enough to present for diagnosis and management. Although there is a high burden of the disease, in many countries, the new-born sickle cell screening test is being performed and is rendering an early diagnosis; however, it is still difficult for sickle cell patients to find proper treatment and adequate follow-up. Moreover, in many countries, patients are neither aware of their diagnosis nor the care they should receive to prevent complications; also, they do not receive adequate genetic counseling. Hemoglobin SC (HbSC) disease is the most frequent double sickle cell heterozygosis found in Brazil. The clinical course tends to be more benign with fewer hospitalizations compared with double homozygotic SS patients. However, HbSC patients may present severe complications with a fatal outcome. We report the case of a 36-year-old man who presented to the emergency care facility with symptoms consistent with the diagnosis of sickling crisis. The outcome was unfavorable and death occurred just hours after admission. The autopsy revealed a generalized vaso-occlusive crisis by sickled red cells, bone marrow necrosis, and fat embolism syndrome.


Subject(s)
Humans , Male , Adult , Bone Marrow/pathology , Embolism, Fat/pathology , Hemoglobin SC Disease/complications , Autopsy , Fatal Outcome , Hemoglobin SC Disease/diagnosis , Hemoglobin SC Disease/pathology
7.
An. acad. bras. ciênc ; 89(4): 2657-2662, Oct.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-886836

ABSTRACT

ABSTRACT The purpose of this study was to determine the effects of the high consumption of sucrose on the levels of DNA damage in blood, hippocampus and bone marrow of rats. Male Wistar rats were treated for 4 months with sucrose (10% for 60 initial days and 34% for the following 60 days) in drinking water, and then, glycemia and glycated hemoglobin (A1C) were measured. Levels of DNA damage in blood and hippocampus were evaluated by the comet assay. The micronucleus test was used to evaluate chromosomal damages in the bone marrow. The sucrose treatment significantly increased (p<0.01) the serum glucose levels (~20%) and A1C (~60%). The level of primary DNA damage was significantly increased (p<0.05) in hippocampal cells (~60%) but not in peripheral blood leukocytes (p>0.05). Additionally, it was observed a significative increase (p<0.05) in the markers of chromosomal breaks/losses in bone marrow, as indicated by the micronucleus test. This is the first study that evaluated DNA damage induced by high sucrose concentration in the hippocampus and bone marrow of rats. Sucrose-induced DNA damage was observed in both tissues. However, the mechanism of sucrose toxicity on DNA remains unknown.


Subject(s)
Animals , Male , Rats , Bone Marrow/drug effects , DNA Damage , Hippocampus/drug effects , Bone Marrow/pathology , Micronucleus Tests , Rats, Wistar , Dietary Sucrose/adverse effects , Comet Assay , Diabetes Mellitus, Type 2/complications , Disease Models, Animal , Hippocampus/pathology
8.
Rev. Assoc. Med. Bras. (1992) ; 63(12): 1025-1027, Dec. 2017. graf
Article in English | LILACS | ID: biblio-896327

ABSTRACT

Summary Gaucher's disease is characterized by glucocerebroside accumulation in the cells of the reticuloendothelial system. There are three subtypes. The most common is type 1, known as the non-neuropathic form. Pancytopenia, hepatosplenomegaly and bone lesions occur as a result of glucocerebroside accumulation in the liver, lung, spleen and bone marrow in these patients. Findings associated with liver, spleen or bone involvement may be seen at radiological analysis. Improvement in extraskeletal system findings is seen with enzyme replacement therapy. Support therapy is added in patients developing infection, anemia or pain. We describe a case of hepatosplenomegaly, splenic infarction, splenic nodules and femur fracture determined at radiological imaging in a patient under monitoring due to Gaucher's disease.


Subject(s)
Humans , Female , Pain/diagnostic imaging , Femur Head/diagnostic imaging , Gaucher Disease/diagnostic imaging , Splenomegaly/diagnostic imaging , Bone Marrow/pathology , Bone Marrow/diagnostic imaging , Radiography , Abdominal Pain/etiology , Femur Head/injuries , Gaucher Disease/pathology , Hepatomegaly/diagnostic imaging , Middle Aged
9.
Rev. méd. Chile ; 145(9): 1208-1212, set. 2017. graf
Article in Spanish | LILACS | ID: biblio-902609

ABSTRACT

Blastic plasmacytoid dendritic cell neoplasm is a rare hematological malignancy derived from immature plasmacytoid dendritic cells. The tumor cells have an immature blastic appearance, and diagnosis is based on the expression of CD4, CD56 y CD123 in the absence of other lymphoid, natural killer, or myeloid antigens. The majority of affected individuals are older people with a mean age of 66 years. Male to female ratio is approximately 3:1. Common presentation includes cutaneous lesions followed by tumor dissemination. Treatment with conventional chemotherapy is ineffective and allogeneic hematopoietic stem cell transplantation is required to achieve remission. We report three male patients, aged 23, 27 and 51 years with the disease. All had multiple, infiltrated pink plaques and nodules on the skin of their face, neck and thorax, measuring 1 to 12 cm in diameter. All tumors were histologically characterized by a monotonous proliferation of medium size cells with blastic features. Tumor cells were positive for CD123, CD56, CD4 and CD7 in all cases. After a mean of follow-up of 14.6 months, one patient died of the disease, one patient is alive and the disease relapsed after 17 months of remission and one patient is alive with no evidence of the disease.


Subject(s)
Humans , Male , Adult , Middle Aged , Young Adult , Dendritic Cells/pathology , Hematologic Neoplasms/pathology , Skin/pathology , Biopsy , Bone Marrow/pathology , Immunohistochemistry , Fatal Outcome
11.
Autops. Case Rep ; 7(2): 55-60, Apr.-June 2017. ilus
Article in English | LILACS | ID: biblio-905248

ABSTRACT

Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss. The physical examination revealed pallor, and the laboratory work-up depicted severe anemia and thrombocytopenia; the peripheral blood smear was consistent with leukoerythroblastosis. The ongoing investigation through a bone marrow biopsy showed massive involvement of the bone marrow by a signet ring cell adenocarcinoma. During hospitalization, the patient presented melena, and an upper digestive endoscopy depicted an ulcerated and infiltrative lesion in the cardia, upon which the histological examination revealed a signet ring cell adenocarcinoma. This case highlights the bone marrow invasion represented by bicytopenia and leukoerythroblastosis as the initial manifestation of this histological type of gastric cancer. Although treatment attempts were made with chemotherapy and radiotherapy, the patient died early on, showing the aggressive behavior of this form of tumoral presentation.


Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma/diagnosis , Carcinoma, Signet Ring Cell/diagnosis , Stomach Neoplasms/diagnosis , Anemia, Myelophthisic/etiology , Bone Marrow/pathology , Fatal Outcome , Hematologic Diseases/etiology
12.
Braz. j. infect. dis ; 21(1): 116-118, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-839187

ABSTRACT

Abstract A 37-year-old man with AIDS presented with altered mental status four weeks after stopping his medications for Mycobacterium avium-intracellulare (MAI). He had low CD4 cell count and severe hypercalcemia. Bone marrow biopsy revealed bone marrow infiltration by granulomas positive for acid-fast bacilli and cultures grew MAI. His hypercalcemia continued to worsen with the initiation of MAI therapy but we were able to treat it successfully with pamidronate and calcitonin.


Subject(s)
Humans , Male , Adult , Mycobacterium avium-intracellulare Infection/complications , AIDS-Related Opportunistic Infections/complications , Hypercalcemia/microbiology , Hypercalcemia/diagnostic imaging , Bone Marrow/microbiology , Bone Marrow/pathology , Magnetic Resonance Imaging , Mycobacterium avium Complex/isolation & purification , AIDS-Related Opportunistic Infections/microbiology , CD4 Lymphocyte Count , Hypercalcemia/drug therapy
13.
Arq. bras. med. vet. zootec ; 69(1): 95-100, jan.-fev. 2017. ilus
Article in English | LILACS, VETINDEX | ID: biblio-834118

ABSTRACT

A 20-year-old unneutered male poodle presented prostration, apathy, staggering gait, lack of appetite and tick infestation. The dog was diagnosed with a Sertoli cell tumor in an undescended testicle by cytological, histopathological and immunohistochemical tests. Pancytopenia with moderate nonregenerative anemia, leukopenia and severe thrombocytopenia were detected in the complete blood count. Cytological and histopathological evaluation of the bone marrow revealed a cellularity of 30%, with erythroid (59%), lymphoid (40%) and mast cells (1%), and an absence of granulocytic, monocytic and megakaryocytic lineage cells. In post-mortem examinations, changes related to hemostatic disorders were found. The absence of microorganisms in molecular tests and an estrogen serum concentration over reference values confirmed hyperestrogenism as a possible cause of pancytopenia. The literature describes a Sertoli cell tumor hyperestrogenism that induced pancytopenia, along with bone marrow hypoplasia of all hematopoietic lineages. In contrast, in the present case, the erythroid precursor cells were preserved in the bone marrow, although there were no reticulocytes circulating in the blood. This case, therefore, should be considered in future investigations of pancytopenia induced by Sertoli cell tumor hyperestrogenism.(AU)


Um cão Poodle, macho, de 20 anos, não castrado, apresentou prostração, apatia, andar cambaleante, falta de apetite e infestação por carrapatos. Nesse animal, foi diagnosticado tumor de células de Sertoli em um testículo não descendente, utilizando-se citologia, histopatologia e imuno-histoquímica. Pancitopenia com anemia moderada não regenerativa, leucopenia e trombocitopenia intensas foram detectadas no hemograma. Na avaliação citológica e histopatológica da medula óssea, havia celularidade de 30%, constituída pelas linhagens eritroide (59%) e linfoide (40%) e por mastócitos (1%), com ausência de células das linhagens granulocítica, monocítica e megacariocítica. Em exames post mortem, mudanças relacionadas à hemostasia foram encontradas. A ausência de micro-organismos nos testes moleculares e a concentração sérica de estrogênio acima dos valores de referência confirmaram hiperestrogenismo como a possível causa da pancitopenia. A literatura descreve hiperestrogenismo em tumores de células de Sertoli induzindo pancitopenia associada com hipoplasia da medula óssea de todas as linhagens hematopoiéticas. Em contraste, no presente caso, as células precursoras eritróides estavam preservadas na medula óssea, embora não houvesse reticulócitos no sangue. Assim, o relato apresentado deve ser considerado em futuras investigações de pancitopenia induzida por hiperestrogenismo em tumor de células de Sertoli.(AU)


Subject(s)
Animals , Male , Dogs , Bone Marrow/pathology , Pancytopenia/veterinary , Sertoli Cell Tumor/diagnosis , Sertoli Cell Tumor/veterinary , Testicular Neoplasms/veterinary
14.
An. bras. dermatol ; 92(5,supl.1): 50-52, 2017. graf
Article in English | LILACS | ID: biblio-887072

ABSTRACT

Abstract: Myeloid sarcoma is an extramedullary tumor of malignant myeloid cells often associated with acute myeloid leukemia, chronic myeloproliferative disorders and myelodysplastic syndromes. The skin is one of the most commonly affected sites. We report a rare case of cutaneous myeloid sarcoma associated with chronic myeloid leukemia.


Subject(s)
Humans , Female , Adult , Skin Neoplasms/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Sarcoma, Myeloid/pathology , Neoplasms, Multiple Primary/pathology , Skin/pathology , Biopsy , Bone Marrow/pathology , Immunohistochemistry , Rare Diseases/complications , Rare Diseases/pathology
17.
Rev. cuba. med ; 55(4): 319-323, oct.-dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-845002

ABSTRACT

Introducción: el mieloma múltiple es una enfermedad hematológica maligna caracterizada por una proliferación de células plasmáticas en la médula ósea. La edad más común del inicio es entre 65 y 70 años, sin embargo se documentan casos en jóvenes en formas cada vez más graves. Presentación de caso: hombre de 31 años, que cursa con dolores óseos generalizados, pérdida de peso y adinamia, de 6 meses de evolución. Se constatan cifras de creatinina y calcio sérico elevadas durante su hospitalización, presenta proteína de Bence-Jones positiva para cadenas ligeras Kappa, y se realiza biopsia de médula que concluye en mieloma plasmoblástico. Conclusiones: se comienza tratamiento con citostático asociado a esteroides. La presentación antes de los 40 años es infrecuente y el pronóstico, sombrío, a pesar del tratamiento oncoespecífico(AU)


Introduction: Multiple myeloma is a malignant hematologic disease characterized by a proliferation of plasma cells in the bone marrow. The most common age of onset is between 65 and 70 years, however cases are documented in young people in increasingly severe forms. Case presentation: A case of a 31-year-old man, with generalized bone pain, weight loss and adynamia, of 6 months of evolution is presented here. Serum creatinine and serum calcium levels are high during hospitalization, Bence-Jones protein is positive for Kappa light chains, and marrow biopsy is performed, which concludes in plasmoblastic myeloma. Conclusions: Treatment with cytostatic associated with steroids is started. This onset before age 40 is not frequent, and prognosis is bleak, despite the specific oncology treatment(AU)


Subject(s)
Humans , Male , Adult , Multiple Myeloma/diagnostic imaging , Bone Marrow/pathology , Bone Marrow Examination/methods , Patient Acuity , Multiple Myeloma/diagnosis
18.
Int. j. odontostomatol. (Print) ; 10(1): 23-28, abr. 2016. ilus
Article in English | LILACS | ID: lil-782617

ABSTRACT

Dental implants are considered the most effective treatment for teeth absence. Nevertheless, there are some bone conditions that could affect the osseointegration process, thus affecting the clinical and radiographic success rates. One of these conditions could be the Focal Osteoporotic Bone Marrow Defects. The objective of this study was to describe the 5-year period prevalence of Focal Osteoporotic Bone Marrow Defects (FOBMD) on dental implant treated patients. descriptive retrospective study was conducted. We systematically reviewed the clinical and radiographic data of treated patients in a Dental Implant Unit since January 2010 through December 2014. Once a FOBMD case was found, a detailed questionnaire was applied to the chart looking for demographic, medical and dental characteristics (clinical and radiographic). Also in a sub-sample histological analysis was carried out. Period prevalence (PP) was estimated calculating proportions and 95 % confidence intervals. Statistical analysis was performed using Stata v. 13.2 for Windows (Stata Corp., TX., USA). FOBMD 5-yPP was 9.52 % (CI 95 %: 6.87­13.5 %). We found 42 defects in 34 patients. Within the FOBMD patients, average age was 55.4±11.9 years, 67.64 % being females. Ninety-seven percent of the defects were located in the lower jaw, 79.41 % unilateral, 69.04 % single missed teeth lesions, 71.42 % affecting molar area and 59.52 % located on the right side of the maxillae. Histological analysis revealed inflammatory cells, dystrophic calcifications, hemorrhagic material and fatty cells for all the cases. FOBMD prevalence is low, so it should be considered as a rare condition but showing an exponential growing trend over the time. With no previous epidemiological data, these findings should be considered as a caution during x-ray examinations and treatment planning, in order to avoid surgical or prosthetic complications. Local factors as previous root canal treatments should be considered when elucidating reasons for its appearance.


Los implantes dentales se consideran el tratamiento más eficaz para la ausencia dentaria. Sin embargo, hay algunas condiciones óseas que pueden afectar el proceso de osteointegración, lo que afecta a las tasas de éxito clínico y radiográfico. Una de estas condiciones podrían ser los defectos focales osteoporóticos de la médula ósea (DFOMO). El objetivo de este estudio fue describir la prevalencia en un periodo de 5 años de los DFOMO en pacientes tratados con implantes dentales. Se realizó un estudio descriptivo y retrospectivo, con una revisión sistemática de los datos clínicos y radiológicos de pacientes tratados en una unidad de implantes dentales desde enero de 2010 hasta diciembre de 2014. Cuando se encontró algún caso de DFOMO, se aplicó un cuestionario detallado sobre la ficha en busca de características demográficas, médicas y dentales (clínicas y radiográficas). También se realizó un análisis histológico de la submuestra. Se estimó la prevalencia del periodo (PP), el cálculo de proporciones e intervalos de confianza con un 95 %. El análisis estadístico se realizó con el programa Stata v. 13.2 para Windows (Stata Corp, TX., EE.UU.). La prevalencia del periodo para los 5 años de DFOMO fue 9,52 % (IC del 95 %: 6,87 % a 13,5 %). Encontrado 42 defectos en 34 pacientes. Dentro de los pacientes con DFOMO, la edad promedio fue de 55,4±11,9 años, y 67,64 % fueron mujeres. El 97 % de los defectos se encuentraran en la mandíbula. El 79,41 % fue unilateral y 69,04 % con lesiones individuales de pérdidas dentarias; el 71,42 % afectó la zona de los molares y 59,52 % se encontró en el lado derecho del maxilar. El análisis histológico reveló células inflamatorias, calcificaciones distróficas, material hemorrágico y células grasas, en todos los casos. La prevalencia de DFOMO fue baja, por lo que debe considerarse como una enfermedad poco frecuente pero que muestra una tendencia creciente y exponencial en el tiempo. Sin datos epidemiológicos previos, estos resultados deben ser considerados para tener precaución durante los exámenes imagenológicos y la planificación del tratamiento, con el fin de evitar complicaciones quirúrgicas o prótesicas. Los factores locales como tratamientos endodónticos previos deben ser considerados para dilucidar las razones de su aparición.


Subject(s)
Humans , Male , Female , Osteoporosis/diagnosis , Bone Marrow/pathology , Jaw Diseases/diagnosis , Tooth Diseases/complications , Microscopy, Electron , Tomography, X-Ray Computed , Dental Implants , Retrospective Studies , Osseointegration , Oral Surgical Procedures/methods
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