Bumps of blood cells: Blastic Plasmacytoid Dendritic Cell Neoplasm in an elderly Filipino

Introduction@#Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy derived from the precursors of plasmacytoid dendritic cells. This malignancy presents with various noticeable cutaneous lesions and usually occurs in elderly males. Cutaneous manifestations usually precede leukemic dissemination to the lymph nodes, bone marrow, and peripheral blood which is associated with poor prognosis.@*Case presentation@#We present a case of a 60-year-old Filipino male with a four-month history of multiple hyperpigmented, reddish brown, firm, fixed, non-tender cutaneous nodules on the extremities, trunk, chest, and face. Two large masses was also noted on the left arm and left upper back..Tissue biopsy of the cutaneous mass showed Immunohistochemical stain findings positive for LCA, CD68, CD4, CD56, and CD123 which are compatible with BPDCN. Patient was initially asymptomatic with relatively normal blood count and was treated supportively but serial blood count monitoring showed worsening with progression to acute myelogenous leukemia. Patient was then started on the 7+3 protocol of cytarabine and idarubicine which provided flattening of the cutaneous nodules and improvement of blood counts. However, due to complications of the disease and the treatment, the patient succumbed to severe pulmonary infection and sepsis.@*Discussion@#Due to the varied, non-specific cutaneous manifestations and the similarity in the morphology of the skin lesions with other cutaneous conditions along with the rarity of this disease, there is difficulty in establishing the diagnosis of BPDCN as well as standardizing its treatment. Immunohistochemical stains play an important role in confirming the diagnosis as well as ruling out other differential diagnoses to tailor appropriate treatment.@*Conclusion@#Blastic plasmacytoid dendritic cell neoplasm (BPDCN) generally has a poor prognosis owing to the rapidity of its spread to the bone marrow and peripheral blood. Early diagnosis is essential to initiate early therapy and prevent progression.

Carcinoma de mama masculina / Male breast carcinoma

El cáncer mamario en hombres es una enfermedad poco frecuente. Sólo representa 1 por ciento de todos los cánceres de mama y es responsable del 0,1 por ciento de las muertes por cáncer en el hombre. Su incidencia se ha incrementado en los últimos 25 años. Generalmente la forma de presentación de la enfermedad es una masa indolora, retroareolar, con retracción del pezón o no. La enfermedad en estadios avanzados (etapa III-IV) ocurre en más del 40 por ciento de los pacientes. La variedad histopatológica más frecuente es el carcinoma ductal infiltrante y el tratamiento de elección es la mastectomía radical modificada con vaciamiento axilar. El objetivo de este trabajo es la presentación de dos casos diagnosticados y tratados en el Hospital Salvador Allende, además de actualizar el tema(AU)

Breast cancer in men is a rare disease. It accounts only for 1 percent of all breast cancers and is responsible for 0.1 percent of cancer deaths in men. Its incidence has increased in the last 25 years. Generally speaking, the form of presentation of the disease is a painless mass, which is retroareolar, with retraction of the nipple or without it. The disease in advanced stages (stages III-IV) occurs in more than 40 percent of patients. The most frequent histopathological variety is the infiltrating ductal carcinoma and the treatment of choice is modified radical mastectomy with axillary dissection. The objective of this work is the presentation of two cases diagnosed and treated at Salvador Allende Hospital, in addition to updating the topic(AU)

Leukemia Cutis with PML-RAR-a Translocation.

Leukemia cutis is the infiltration by neoplastic leukocytes or their precursors into the epidermis, dermis or the subcutis resulting in clinically identifiable cutaneous lesions. The diagnosis is of great value in cases where leukemia cutis aids in the diagnosis of leukemia. This has a poor prognosis and strongly correlates with additional signs of extramedullary involvement. A 27-year-old male patient, known case of AML-M3, presented with cutaneous nodules on both lower limb, which on biopsy proved to be leukemic deposits. Immunohistochemistry confirmed the diagnosis and the patient was discharged with advice to continue chemotherapy.

Nodulos parasitrrios cutáneos: estudio ultrasongrafico de tres casos poco freccuentes en la edad pedáátrica / Cutaneous parasitic nodules: ultrasonographic study of three infrequent cases in the pediatric age

The parasitic nodules are part of the cutaneous manifestations of the parasitic diseases, fundamentally affect children. We report the clinic history, study by images and parasitological results of three infrequent parasitic cases in the pediatric age, which were studied with images, specially ultrasound, and this contributed somehow to the diagnosis. The final parasitological diagnoses were dirofilaria, toxocara and myiasis. The epidemiology, clinical and dermatológica! manifestations are discussed of each one.

Los nodulos parasitarios forman parte de las manifestaciones cutáneas de las enfermedades parasitarias, las cuales afectan fundamentalmente a niños. Se da a conocer la historia clínica, el estudio por imágenes y los resultados histopatológicos y parasitarios de tres casos poco frecuentes en la edad pediátrica, los cuales fueron estudiados con ultrasonido que contribuyó de alguna manera al diagnóstico. Los parásitos encontrados fueron dirofilaria, toxocara y una larva de mosca. Se discute la epidemiología, manifestaciones clínicas y dermatológicas de cada una de estas parasitosis.