RESUMO
Hemophagocytic Lymphohistiocytosis (HLH) is a fatal hyperinflammatory syndrome characterized by histiocytic proliferation along with hemophagocytosis. HLH can be primary (inherited) or secondary, to any severe infection, malignancy or rheumatological disease. HLH, though rare, has also been noted in association with scrub typhus which is an acute febrile illness resulting from the bite of infected larval form of mite (also known as chigger). We hereby describe two cases of HLH associated with rickettsial infection (Oriental tsutsugamushi) in a 36-year-old male and in a 10-year-old male child. The former presented with high-grade fever and pruritic macular rash over abdomen. While the latter was presented with fever and decreased urinary output at the time of admission
RESUMO
Among all acute leukemias, acute lymphoblastic leukemia (ALL) is five times more common than acute myeloid leukemia (AML). Lineage switch from ALL to AML is very rare. Lineage switching is a phenomenon noted in cases of leukemias where the initially diagnosed cases of leukemias of a lineage (lymphoid/myeloid) present with the opposite lineage at relapse. Here, we report the case of a 10-year-old male child who was initially diagnosed with ALL and on relapse after 4 years, presented with AML. The blast cell morphology and immunophenotype were consistent with the diagnosis of typical AML.
RESUMO
The recent discovery of the JAK2 mutations has rekindled interest in the approach to classic BCR/ABL-negative myeloproliferative neoplasms (MPNs) in terms of both diagnostic evaluation and treatment. However, additional clinical, laboratory and histological parameters play a key role to allow diagnosis and subclassification, regardless of whether JAK2 V617F mutation is present or not. Here are two cases which incidentally presented with splenomegaly and moderate leukocytosis, and were diagnosed as MPN-primary myelofibrosis (PMF) in prefibrotic phase and polycythemia vera (PV), respectively, using revised World Health Organization (WHO) 2008 criteria.