ABSTRACT
The infiltration of the bone marrow y non-hematopoietic cells is called myelophthisis. In patients with gastric cancer, this invasion is extremely infrequent and the survival is usually less than three months. We present the case of a 35-year-old man with bone marrow involvement secondary to diffuse gastric carcinoma of signet ring cells.
Se denomina mieloptisis a la infiltración de la médula ósea por células no hematopoyéticas. En pacientes con cáncer gástrico esta invasión es extremadamente infrecuente y la supervivencia suele ser menor a tres meses. Presentamos el caso de un hombre de 35 años con compromiso de la médula ósea secundario a un carcinoma gástrico difuso de células en anillo de sello.
Subject(s)
Anemia, Myelophthisic/diagnosis , Carcinoma, Signet Ring Cell/diagnosis , Stomach Neoplasms/diagnosis , Adult , Anemia, Myelophthisic/etiology , Carcinoma, Signet Ring Cell/complications , Carcinoma, Signet Ring Cell/drug therapy , Fatal Outcome , Humans , Male , Stomach Neoplasms/complications , Stomach Neoplasms/drug therapyABSTRACT
Se denomina mieloptisis a la infiltración de la médula ósea por células no hematopoyéticas. En pacientes con cáncer gástrico esta invasión es extremadamente infrecuente y la supervivencia suele ser menor a tres meses. Presentamos el caso de un hombre de 35 años con compromiso de la médula ósea secundario a un carcinoma gástrico difuso de células en anillo de sello.
The infiltration of the bone marrow y non-hematopoietic cells is called myelophthisis. In patients with gastric cancer, this invasion is extremely infrequent and the survival is usually less than three months. We present the case of a 35-year-old man with bone marrow involvement secondary to diffuse gastric carcinoma of signet ring cells.
Subject(s)
Humans , Male , Adult , Stomach Neoplasms/diagnosis , Carcinoma, Signet Ring Cell/diagnosis , Anemia, Myelophthisic/diagnosis , Stomach Neoplasms/complications , Stomach Neoplasms/drug therapy , Fatal Outcome , Carcinoma, Signet Ring Cell/complications , Carcinoma, Signet Ring Cell/drug therapy , Anemia, Myelophthisic/etiologyABSTRACT
Background: Leukoerythroblastosis, a non-specific and often short-lasting response of the bone marrow to different diseases such as malignancies or infections, is characterized by the presence in the peripheral blood of immature red and white cells. Methods: We present a case of leukoerythoblastosis occurring in a 24 months old Mozambican girl, in the context of a severe malaria episode and an associated urinary tract infection. Peripheral blood smear was used for diagnosis of malaria and leukoerythroblastosis. Enterobacter cloacae isolation and antibiotic susceptibility testing were performed by conventional microbiology. Results: Peripheral blood smear was positive for Plasmodium falciparum and showed a leukoerythroblastosis with red cell anisopoikilocytosis and left shifted neutrophils. Urine culture confirmed the presence of a multi-resistant E. cloacae. Treatment of underlying conditions resolved the leukoerythroblastic reaction. Conclusions: Leukoerythroblastosis may be related to different infectious diseases and may also appear in the context of severe malaria. Bacterial superinfection needs to be investigated.
Subject(s)
Anemia, Myelophthisic/diagnosis , Enterobacter cloacae/isolation & purification , Enterobacteriaceae Infections/diagnosis , Malaria, Falciparum/diagnosis , Plasmodium falciparum/isolation & purification , Urinary Tract Infections/microbiology , Anemia, Myelophthisic/drug therapy , Anemia, Myelophthisic/microbiology , Antimalarials/therapeutic use , Blood Transfusion , Child, Preschool , Ciprofloxacin/therapeutic use , Enterobacteriaceae Infections/drug therapy , Female , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/drug therapy , Humans , Malaria, Falciparum/drug therapy , Treatment Outcome , Urinary Tract Infections/diagnosis , Urinary Tract Infections/drug therapyABSTRACT
Primary splenic angiosarcoma is an extremely agressive and rare neoplasm. Manifestations as bone marrow invasion and coagulation disorders have been reported isolatedly. A 26 years-old woman presented with abdominal pain; several anemia and thrombocytopenia associated to leukoerythroblastic reaction were found in the laboratory. Consumpion coagulopathy signs and microangiopathy as schistocytes, prolonged prothrombine time, decreased fibrinogen and increased D dimer were also present. Imaging findings included a lobulated, enlarged spleen, with spontanously hyperdense areas, and heterogeneous nodules with intense, irregular enhancement after contrast administration. There were hepatic and pulmonary metastases, as well as bone lesions with conspicuous vessels. Clinical features of Kasabach-Merrit syndrome and imaging vascular neoplasm characteristics suggest a primary splenic angiosarcoma. Splenectomy and bone marrow biopsy confirmed the diagnosis of primary splenic angiosarcoma in metastatic stage.
Subject(s)
Anemia, Myelophthisic/etiology , Hemangiosarcoma/complications , Kasabach-Merritt Syndrome/etiology , Splenic Neoplasms/complications , Adult , Anemia, Myelophthisic/diagnosis , Biopsy , Female , Hemangiosarcoma/diagnosis , Hemangiosarcoma/surgery , Humans , Kasabach-Merritt Syndrome/diagnosis , Splenectomy , Splenic Neoplasms/diagnosis , Splenic Neoplasms/surgeryABSTRACT
Megaloblastic anaemia due to vitamin B12 deficiency is rare in childhood. However, as most cases are due to maternal insufficiency, it is mainly seen in breastfed infants especially when the mother's socioeconomic status is low and the nutrition is not adequate. We present case of two Syrian refugee infants with severe vitamin B12 deficiency with pancytopenia, hepatosplenomegaly and leukoerythroblastosis.
Subject(s)
Anemia, Myelophthisic/etiology , Anemia, Pernicious/diagnosis , Hepatomegaly/etiology , Pancytopenia/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Refugees , Splenomegaly/etiology , Anemia, Myelophthisic/diagnosis , Anemia, Pernicious/complications , Diagnosis, Differential , Hepatomegaly/diagnosis , Humans , Infant , Male , Pancytopenia/diagnosis , Splenomegaly/diagnosis , Syria , TurkeyABSTRACT
The association of metastatic breast cancer presenting as thrombocytopenia and anaemia is demonstrated in the following case of a 79-year-old woman. Her main symptoms were abdominal pain, altered bowel habit and weight loss. Without a clear causative pathology, she underwent a CT scan which demonstrated multiple sclerotic bone lesions. With a raised CA15-3 and strong oestrogen receptor positivity on immunohistochemistry on a trephine bone marrow biopsy, a diagnosis of metastatic lobular breast cancer was made. Interestingly, only a small breast mass was noted on mammography. The patient was managed conservatively and initiated on supportive therapy. This case report summarises the varying presentation of bone marrow suppression secondary to metastatic infiltration, especially in the absence of classical symptoms associated with primary solid tumour. Accurate bone marrow analysis is also vital in establishing the final diagnosis.
Subject(s)
Anemia, Myelophthisic/diagnosis , Bone Marrow/pathology , Bone Neoplasms/secondary , Breast Neoplasms/pathology , Carcinoma, Lobular/secondary , Thrombocytopenia/diagnosis , Aged , Anemia, Myelophthisic/etiology , Axilla , Bone Neoplasms/diagnosis , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Carcinoma, Lobular/diagnosis , Female , Humans , Immunohistochemistry , Lymph Nodes/pathology , Lymphatic Metastasis , Mammography , Thrombocytopenia/etiologySubject(s)
Leukemia, Myelomonocytic, Juvenile/diagnosis , Parvoviridae Infections/diagnosis , Parvovirus B19, Human , Anemia, Myelophthisic/diagnosis , Anemia, Myelophthisic/therapy , Diagnosis, Differential , Diagnostic Errors , Humans , Immunoglobulins, Intravenous/therapeutic use , Infant , Leukocytosis/diagnosis , Leukocytosis/therapy , Male , Parvoviridae Infections/therapyABSTRACT
BACKGROUND: Leukoerythroblastosis is characterized by the presence of leukocytosis and erythroid and myeloid blast cells in the peripheral blood. The most common etiological factors of leukoerythroblastosis occurring during early childhood are viral infections, juvenile myelomonocytic leukemia, and osteopetrosis. To our knowledge, an association with parvovirus B19 infection has only been reported in a preterm infant. Human parvovirus B19 has been associated with red cell aplasia, leukopenia, and thrombocytopenia. CASE REPORT: The case of a very low birth weight preterm infant with transient leukoerythroblastosis associated with parvovirus B19 infection is described. CONCLUSIONS: Leukoerythroblastosis has to be kept in mind if a very high leukocyte count is detected in the neonatal period, and parvovirus B19 infection should be taken into consideration as the etiological factor for this entity.
Subject(s)
Anemia, Myelophthisic/etiology , Infant, Premature, Diseases/etiology , Infant, Very Low Birth Weight , Parvoviridae Infections/complications , Parvovirus B19, Human , Anemia, Myelophthisic/diagnosis , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/virology , Male , Parvoviridae Infections/virologyABSTRACT
Rectal carcinoma is uncommonly associated with systemic metastases in the absence of liver metastases, reflecting the predilection for spread via the portal system. Occasionally, isolated lung metastases are seen, which are usually attributed to spread via the portosystemic anastomoses in the distal rectum. However, myelophthisis is an unreported complication of rectal cancer as an isolated form of systemic failure. We present a case of fatal myelophthisis associated with otherwise localized rectal carcinoma secondary to metastatic rectal cancer. This observation led to the hypothesis that spread to the bone marrow occurred via a "third circulation," the Batson plexus, a network of deep pelvic veins with rich anastomoses to the vertebral plexus.
Subject(s)
Adenocarcinoma, Mucinous/secondary , Anemia, Myelophthisic/diagnosis , Bone Marrow Neoplasms/secondary , Rectal Neoplasms/pathology , Adenocarcinoma, Mucinous/complications , Anemia, Myelophthisic/etiology , Bone Marrow Neoplasms/complications , Fatal Outcome , Female , Humans , Lumbar Vertebrae/pathology , Middle Aged , Neoplasm Metastasis , Pelvic Bones/pathology , Rectal Neoplasms/surgery , VeinsABSTRACT
PURPOSE: The diagnosis of transient erythroblastopenia of childhood (TEC) is usually straightforward, with temporary cessation of red blood cell production resulting in normocytic normochromic anemia, reticulocytopenia, and bone marrow erythroblastopenia. We describe here a case of TEC presenting with features of leukoerythroblastic anemia. To our knowledge, this is the first such report for TEC. PATIENT AND METHODS: The case of a 1-year-old girl is described who had a leukoerythroblastic anemia. Bone marrow examination and clinical course indicated that the anemia had a benign etiology-TEC. RESULTS: The patient presented with anemia, leukocytosis, and a left shift, with metamyelocytes, myelocytes, myeloblasts, and nucleated red cells in the circulation. There was no apparent viral etiology, and the bone marrow aspirate findings were consistent with a recovering marrow. After transfusion, the patient had an uneventful recovery from TEC. CONCLUSION: TEC can cause leukoerythroblastic anemia. TEC with this presentation is clinically similar to TEC without leukoerythroblastosis, but other causes of leukoerythroblastosis need to be excluded.
Subject(s)
Anemia, Myelophthisic/diagnosis , Anemia/diagnosis , Erythroblasts , Anemia/physiopathology , Anemia/therapy , Female , Humans , InfantABSTRACT
Se presenta una paciente de 65 años de edad, con imagen tomográfica tumoral en lóbulo anterosuperior de pulmón izquierdo, que al resecarse se comprobó que era un nódulo de mediastino de 5 cm de diámetro, sin atipías, pero con infiltración linfoide. A continuación presentó linfocitosis de 10 meses de evolución seguida de anemia hemolítica. Luego de 2 años de remisión clínica se presentó con anemia aguda diagnosticada como Aplasia Pura Roja. Sus patologías revirtieron con corticosteroides. Se hace una actualización acerca de los vínculos entre las enfermedades de la médula ósea y la inmunopatología. (AU)
Subject(s)
Humans , Female , Aged , Red-Cell Aplasia, Pure/diagnosis , Red-Cell Aplasia, Pure/therapy , Anemia, Myelophthisic/diagnosis , Anemia, Myelophthisic/therapy , Adrenal Cortex Hormones/therapeutic use , Thymoma/diagnosis , Thymoma/therapy , Mediastinum/pathology , CD4-CD8 Ratio , Hematologic Diseases/diagnosis , Hematologic Diseases/therapyABSTRACT
Se presenta una paciente de 65 años de edad, con imagen tomográfica tumoral en lóbulo anterosuperior de pulmón izquierdo, que al resecarse se comprobó que era un nódulo de mediastino de 5 cm de diámetro, sin atipías, pero con infiltración linfoide. A continuación presentó linfocitosis de 10 meses de evolución seguida de anemia hemolítica. Luego de 2 años de remisión clínica se presentó con anemia aguda diagnosticada como Aplasia Pura Roja. Sus patologías revirtieron con corticosteroides. Se hace una actualización acerca de los vínculos entre las enfermedades de la médula ósea y la inmunopatología.
