ABSTRACT
CASE PRESENTATION: An 87-year-old woman with a medical history of stroke, paroxysmal atrial fibrillation, type 2 diabetes mellitus, diastolic heart failure, and chronic bilateral lymphedema presents with 1 week of shortness of breath. The patient had a 20-pack-year smoking history and at baseline was able to ambulate freely without assistance. Her symptoms of dyspnea were mostly exertional and progressively worsening for 1 week before admission, despite compliance with her home furosemide. On admission, her temperature was 36.3 °C, BP was 101/59 mm Hg, heart rate was 82 beats/min, respirations were 18 breaths/min, and oxygen saturation was 91% on room air. On physical examination, the patient was tachypneic at rest, and auscultation of the lungs revealed minimal breath sounds on the left side. Admission laboratory test results were notable for leukocyte count of 11.67 × 109/L (82.2% neutrophils, 8.3% monocytes, 6.4% lymphocytes, and 2.1% eosinophils). Results of HIV screening tests were negative.
Subject(s)
Diabetes Mellitus, Type 2 , Stroke , Aged, 80 and over , Dyspnea/diagnosis , Dyspnea/etiology , Female , Humans , LungABSTRACT
CASE PRESENTATION: A 33-year-old man was admitted with a 4-week history of intermittent, right-sided chest pain. Two weeks before the incident, he had completed a 10-day course of levofloxacin for a presumed right-sided pneumonia without much improvement. He denied any dyspnea, cough, sputum production, hemoptysis, night sweats, or weight loss. He was an active smoker with a 20-pack-year smoking history and 1-year history of vaping nicotine.
Subject(s)
Carcinoma/diagnosis , Liver Neoplasms/diagnosis , Lung Neoplasms/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bronchoscopy , Carboplatin/administration & dosage , Carcinoma/drug therapy , Carcinoma/genetics , Carcinoma/secondary , Etoposide/administration & dosage , Fatal Outcome , Gene Rearrangement/genetics , Humans , Liver Failure/etiology , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Lymphadenopathy , Male , Neoplasm Proteins/genetics , Nuclear Proteins/genetics , Positron-Emission Tomography , Tomography, X-Ray Computed , Transcription Factors/genetics , Tumor Lysis Syndrome/etiologyABSTRACT
Chronic myelogenous leukemia (CML) is characterized by the presence of the chromosomal abnormality t(9;22)(q34;q11), which is detected in more than 90% of cases. Despite great strides in our understanding of this disease, few predisposing etiologic factors have been identified. We report on the case of a 45-year-old man with Philadelphia chromosome-positive, BCR-ABL fusion-positive chronic-phase CML, whose brother had succumbed to the same disease 22 years earlier. While a coincidental familial occurrence cannot be excluded in this case, we believe that this report underscores the need for further investigation of possible unknown environmental or heritable etiologic factors in this disease.
