Two cases of thyroid small cell carcinoma / 대한내과학회지

Historically, small cell carcinoma in the thyroid has been regarded as a kind of lymphoma and small cell carcinoma in the thyroid as a distinct disease entity is still controversial. Here, we present two cases of thyroid small cell carcinoma that were differentiated from lymphoma, based on immunohistochemical staining. One case was misdiagnosed as anaplastic carcinoma that occurred during the treatment of follicular carcinoma. Both cases responded well to chemotherapy. These cases support the hypothesis that thyroid small cell carcinoma is a distinct disease entity. One should consider small cell carcinoma when there is a rapidly growing mass in the thyroid.

Central Pontine Myelinolysis in a Patient with Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation: A Case Report

We describe a 37-yr-old man who developed central pontine myelinolysis (CPM) after allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. After HSCT, desquamation developed on the whole body accompanied by hyperbilirubinemia. The liver biopsy of the patient indicated graft-versus-host disease- related liver disease, and the dose of methylprednisolone was increased. Then, the patient developed altered mentality with eye ball deviation to the left, for which electroencephalogram and magnetic resonance imaging (MRI) scans were done. Brain MRI scan demonstrated the imaging findings consistent with central pontine myelinolysis and extrapontine myelinolysis. He did not have any hyponatremia episode during hospitalization prior to the MRI scan. To the best of our knowledge, presentation of CPM after allogeneic HSCT is extremely rare in cases where patients have not exhibited any episodes of significant hyponatremia. We report a rare case in which hepatic dysfunction due to graft-versus-host disease has a strong association with CPM after HSCT.