RESUMO
Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma characterized by the proliferation of small B-lymphocytes in the bone marrow that produce monoclonal immunoglobulin M (IgM). We describe two patients with WM who presented with neurological symptoms due to infiltration of lymphoplasmacytoid tumor cells in the central nervous system, a condition known as Bing-Neel syndrome. A literature review revealed that this syndrome is rare and commonly missed in clinical practice due to its variable presentation and a lack of awareness or knowledge. Brain and spinal magnetic resonance imaging may show a focal mass or diffuse infiltration. The diagnosis of Bing-Neel syndrome requires proof of IgM or lymphoplasmacytoid cells in cerebrospinal fluid or in a brain biopsy. Treatment with intravenous and/or intrathecal chemotherapy and cranial radiotherapy is described in literature with generally poor outcome, although a combination of these therapies seems to improve outcome. Nevertheless, insufficient data are currently available to make general treatment recommendations.
Assuntos
Macroglobulinemia de Waldenstrom/diagnóstico , Macroglobulinemia de Waldenstrom/imunologia , Macroglobulinemia de Waldenstrom/terapia , Idoso , Idoso de 80 Anos ou mais , Linfócitos B/patologia , Medula Óssea/patologia , Córtex Cerebral/patologia , Tratamento Farmacológico , Feminino , Citometria de Fluxo , Humanos , Hidrocefalia/etiologia , Hidrocefalia/patologia , Imunoglobulina M/metabolismo , Imageamento por Ressonância Magnética , Masculino , Mutação/genética , Fator 88 de Diferenciação Mieloide/genética , Fator 88 de Diferenciação Mieloide/metabolismo , Radioterapia , Medula Espinal/patologia , Macroglobulinemia de Waldenstrom/genéticaRESUMO
Food powders are used in everyday life in many ways and offer technological solutions to the problem of food production. The natural origin of food powders, diversity in their chemical composition, variability of the raw materials, heterogeneity of the native structures, and physicochemical reactivity under hydrothermal stresses contribute to the complexity in their behavior. Food powder agglomeration has recently been considered according to a multiscale approach, which is followed in the chapter layout: (i) at the particle scale, by a presentation of particle properties and surface reactivity in connection with the agglomeration mechanisms, (ii) at the mechanisms scale, by describing the structuration dynamics of agglomerates, (iii) at the process scale, by a presentation of agglomeration technologies and sensors and by studying the stress transmission mode in the powder bed, and finally (iv) by an integration of the acquired knowledge, thanks to a dimensional analysis carried out at each scale.