ABSTRACT
We report the case of a female patient that fulfills major criteria of Behcet's disease. Multiple esophageal aphthous ulcers seen by endoscopy responded to therapy with steroids and colchicine.
Subject(s)
Behcet Syndrome/complications , Esophageal Diseases/etiology , Adult , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Colchicine/administration & dosage , Drug Therapy, Combination , Esophageal Diseases/diagnosis , Esophageal Diseases/drug therapy , Esophagoscopy , Female , Humans , Prednisone/administration & dosage , Ulcer/diagnosis , Ulcer/drug therapy , Ulcer/etiologyABSTRACT
We have reported a case of phenytoin-induced hemocytophagic histiocytosis indistinguishable on clinical and histopathologic grounds from malignant histiocytosis. We emphasize the need to investigate for microbiologic causes and drug ingestion, even if the diagnosis of malignant histiocytosis is plausible. We think that reactive and malignant histiocytosis are not really two distinct entities with different etiologies, but a continuum of host responses to several insults with different degrees of aggressiveness depending on the host immune status.
Subject(s)
Histiocytic Sarcoma/diagnosis , Histiocytosis/chemically induced , Phenytoin/adverse effects , Child , Diagnosis, Differential , Histiocytic Sarcoma/blood , Histiocytosis/blood , Histiocytosis/diagnosis , Histiocytosis/pathology , Humans , MaleSubject(s)
Hamartoma/pathology , Lipoma/pathology , Nervous System Neoplasms/pathology , Child, Preschool , Female , Hand/innervation , HumansABSTRACT
Two cases of peritoneal mesothelioma (PM), with ultrastructural study, of females who lived in a rural area without asbestos exposition history are described and the Spanish literature reviewed. We highlight the association with severe autoimmune hemolytic anemia, due to the presence of cold agglutinins, in one patient without relationship to drugs or concomitant diseases. We focus on the need for thorough and multiple biopsies through laparoscopy to avoid false negative. We believe that there are no totally specific morphological data on mesothelioma, which means that the initial study is based on optical microscopy performed with hematoxylin-eosin and PAS-diastase stain using the electronic microscopy to confirm the diagnosis.
Subject(s)
Mesothelioma/ultrastructure , Peritoneal Neoplasms/ultrastructure , Aged , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/etiology , Anemia, Hemolytic, Autoimmune/pathology , Biopsy , Female , Humans , Mesothelioma/complications , Mesothelioma/diagnosis , Middle Aged , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/diagnosis , Peritoneum/pathologyABSTRACT
We report a series of seven patients with reactive hemophagocytic syndrome, which was quite characteristic of its etiological spectrum. Infections were the leading cause, among them a case associated with HIV and another one with Salmonella enteritidis (a hitherto unreported association). The clinical findings consisted of fever, hepatomegaly, splenomegaly, lymphadenopathy, rash and pancytopenia. The diagnosis was carried out by bone marrow aspiration-biopsy except in two patients who were diagnosed at autopsy. The difficulty of the differentiation from malignant histiocytosis is discussed: one case of hemophagocytic syndrome due to diphenylhydantoin toxicity (the second reported one in the literature) was histologically undistinguishable from it. We think that, in any etiology, hemophagocytic syndrome is a reactive syndrome with variable intensity. The need for extensive microbiological investigation even in cases of histiocytosis of neoplastic appearance is emphasized.
