RESUMO
Malignant pleural effusion in myeloma is a rare terminal event with 91 cases reported so far. Majority of the patients survive less than 4 months. We are presenting a short series of four such cases, who had a good clinical response to combination chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Mieloma Múltiplo/tratamento farmacológico , Derrame Pleural Maligno/tratamento farmacológico , Idoso , Dexametasona/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vincristina/uso terapêuticoRESUMO
Metastasis from colorectal carcinoma occurs by either lymphatic or hematogenous spread. The most common sites of colorectal metastasis are the liver and lung. Involvement of the skin, muscles and bones are quite rare. The prognosis in such patients is usually poor. Herewith, we are reporting a case of colonic carcinoma who had cutaneous metastasis, muscular involvement and diffuse skeletal metastasis. At the end, she had brain metastasis, but liver and lung involvement was not observed till the end.
Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Colorretais/patologia , Neoplasias Musculares/secundário , Neoplasias Cutâneas/secundário , Adulto , Neoplasias Encefálicas/terapia , Feminino , Humanos , Neoplasias Musculares/terapia , Neoplasias Cutâneas/terapiaRESUMO
AIM: To assess HIV associated tuberculosis in a high tuberculosis prevalence setting and its status in the clinical case definition of AIDS. METHODS: All HIV patients attending the infectious disease clinic, Varanasi, India between January 2001 and December 2003 were included in the study. They were stratified into three distinct immunological categories depending on their CD4 levels in accordance to Centers for Disease Control (CDC) classification. Tuberculosis of different organs was defined as detailed below. RESULTS: Tuberculosis was the commonest opportunistic disease, seen in 163 patients. Of these, 68 had exclusively pulmonary tuberculosis, 55 extrapulmonary disease, and 40 the disseminated form. Pulmonary and extrapulmonary tuberculosis had low positive predictive value (PPV) (51% and 42%) for CD4 levels of <200 when compared with the disseminated form (specificity 87% and PPV 75%). Among 86 patients with radiological evidence of tuberculosis, typical radiological features of post-primary tuberculosis were present in 60 cases (70%). Other features such as effusion (14 patients, 16%) and miliary shadows (12 patients, 14%) were comparatively rare. CONCLUSION: Keeping pulmonary and extrapulmonary forms of tuberculosis in AIDS defining illness should be reconsidered. In a similar way tuberculosis in HIV patients from areas endemic with tuberculosis occurs in patients with a wide range of immune status and has a better prognosis than other AIDS defining illnesses. Therefore the inclusion of tuberculosis in clinical case definition of AIDS is not justified.
