ABSTRACT
A 64-year-old woman had been given a diagnosis of Ph-positive chronic myelogenous leukemia (Ph+ CML) in October 1992 and accordingly treated with interferon-alpha busulfan, and hydroxyurea. She was admitted to our hospital with a one-day history of consciousness disturbance on May 30, 1993. Two weeks before admission, she had received chemotherapy consisting of vincristine and predonisolone because of progressive thrombocytopenia, basophilia, and leukocytosis accompanied by a heightened degree of cell immaturity in peripheral blood and bone marrow. Cranial computerized tomography on admission disclosed tumoral masses in the left frontal lobe and the right temporal lobe. Moreover, lumbar puncture ezinkns disclosed blastoid cells in cerebrospinal fluid. Based on these laboratory findings, the diagnosis was blastic crisis CML, 46XX t(9; 22; 17) (q34; q11; q23), cytogenetic aberration and extramedulary brain disease Although the patient underwent the same combined chemotherapy again, her unconsciousness did not resolve. She died of cerebellar herniation on the 7th hospital day. Post mortem examination revealed three extramedullary tumors localized in cranial dura. This was a rare case of CML presenting multiple extramedullary tumors localized in cranial dura.
Subject(s)
Blast Crisis/pathology , Cerebral Cortex/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Cerebellar Diseases/etiology , Chromosome Aberrations , Dura Mater/pathology , Encephalocele/etiology , Fatal Outcome , Female , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Male , Middle AgedSubject(s)
Arteriovenous Fistula/therapy , Biopsy, Needle/adverse effects , Embolization, Therapeutic/methods , Kidney Transplantation/pathology , Renal Artery/abnormalities , Renal Veins/abnormalities , Adolescent , Adult , Aged , Angiography , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/etiology , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Retrospective StudiesABSTRACT
We present an unusual case of 30-year-old man who was admitted to our hospital with dysesthesia of the limbs and skin eruptions. Polyarteritis nodosa was diagnosed based on the histopathological examination of sural nerve and renal biopsies. A month after initiation of corticosteroid therapy, a small infiltrative shadow was detected in the right mid-lung field by chest X-ray. Aspergillus infection was suspected based on a culture of bronchial lavage fluid. Despite intravenous administration of the antifungal agents, miconazole and fluconazole, a thin-walled cavity with a fungus ball gradually formed in the infiltrative lesion. The patient's clinicopathological findings were consistent with a diagnosis of chronic necrotizing pulmonary aspergillosis, a rare aspergillus infection in the lung. Treatment with intracavitary instillation of amphotericin B proved effective.
Subject(s)
Amphotericin B/administration & dosage , Aspergillosis/drug therapy , Lung Diseases, Fungal/drug therapy , Adult , Aspergillosis/etiology , Chronic Disease , Humans , Immunocompromised Host , Instillation, Drug , Lung/pathology , Lung Diseases, Fungal/etiology , Male , Necrosis , Polyarteritis Nodosa/complications , Prednisolone/adverse effectsABSTRACT
A 73-year-old man was admitted to our hospital with nasal hemorrhage and high grade fever on Aug, 1992. Physical examination revealed a tumor in the nasopharyngeal cavity, generalized skin eruptions and three tumors on different subcutaneous lesions, splenomegaly 2 cm below the costal margin, and the enlargement of the right cervical and axillary lymph nodes. Biopsy of the nasopharyngeal and cutaneous tumor disclosed non-Hodgkin's lymphoma (WF: Diffuse small cleaved). Peripheral blood examination showed a WBC of 4,800/microliters with 10% blastoid cells. Bone marrow examination showed 60% blastoid cells which frequently appeared a hand mirror configuration had no azurophilic granules in the cytoplasm. Flow cytometic analysis of these cells in the bone marrow showed that they expressed CD56 (NKH-1) and Ia but not expressed T-cell antigens as well as B-cell antigens and myeloid cell antigens. Phenotype of subcutaneous tumor biopsy cells was similar to that of blastoid cells in the bone marrow. T-cell receptor gene (TCR beta and gamma) rearrangements in blastoid cells were not found. The patient was treated with local radiotherapy to nasopharyngeal and skin tumors, followed by chemotherapy. The patient died of complication with pulmonary bleeding due to DIC. These results suggested that this nasopharyngeal lymphoma derived from NK cell.
