Leukemic infiltration of the breast in acute lymphocytic leukemia (ALL).

Extramedullary leukemic infiltration of the breast in adult acute lymphocytic leukemia (ALL) is rare. We report two such cases here. One patient died of relapsed ALL and the other was cured with local radiation therapy and remains alive and in remission 30 years after relapsing in her breast. A literature review of reported cases of ALL with breast involvement is discussed.

Intravascular lymphoma associated with hemophagocytic syndrome: a rare but aggressive clinical entity.

We report a 55-year-old male with a diagnosis of intravascular lymphoma and hemophagocytosis. He initially presented with hemolytic anemia and splenomegaly and was successfully treated with oral steroids. His clinical course was later complicated by fever, cytopenias, hypoalbuminemia, disseminated intravascular coagulation, gastrointestinal bleeding and acute tubular necrosis. Results of an extensive investigation for fever of unknown origin were negative. Although the patient was treated aggressively with antimicrobials, transfusion support and dialysis, he expired 3 weeks after hospitalization. Post-mortem analysis revealed large CD30- and CD45-positive lymphoma cells in an intravascular distribution in most of the organs studied. Histopathology of the spleen and bone marrow was significant for fulminant hemophagocytosis.

Partially successful treatment of a patient with chronic lymphocytic leukemia and Hodgkin's disease: case report and literature review.

Chronic lymphocytic leukemia (CLL) is rarely associated with Hodgkin's disease (HD). We report a case of nodular sclerosis HD in a patient previously diagnosed with CLL. Reed-Sternberg cells were CD15(+) and CD30(+). He was treated with dose-escalated CHOP and at relapse, mitoxantrone, vinblastine, and CCNU (MVC) with partial response to the former and complete response to the latter, although the patient died 15 months later. Data from 88 other similar cases published in the English language were analyzed. Based on the histological and clinical features at the time of transformation, these patients were divided into distinct categories for analysis. Prognosis was found to be poorer in patients with continued active CLL when compared with those with CLL in remission at the time of transformation to HD. It is suggested that these two presentations may derive from different pathogenic mechanisms.

Microangiopathic hemolysis refractory to plasmapheresis responding to docetaxel and cisplatin: a case report.

We report the case of a 56-yr-old woman with adenocarcinoma of unknown origin metastatic to the bone marrow presenting with a thrombotic thrombocytopenic purpura-like syndrome refractory to protracted daily plasmapheresis and steroids but readily and completely responsive to docetaxel plus cisplatin. Sustained and complete response was pathologically confirmed.