RESUMO
As demências rapidamente progressivas são condições que impactam a vida do paciente, entretanto nem sempre são consideradas durante a investigação da síndrome demencial. Este relato descreve uma paciente portadora de artrite reumatoide em uso crônico de corticoterapia que evoluiu com um quadro de demência rapidamente progressiva no período de cinco meses. Durante a investigação, evidenciou-se o linfoma primário de sistema nervoso central como causa de sua síndrome demencial. Faz-se importante destacar que o uso prolongado de corticoide pode estar associado a um estado de imunossupressão, o que é fator de risco para o surgimento do linfoma de sistema nervoso central.
Rapidly progressive dementias are conditions that worsening the patient's life; however they are not always considered during the investigation of dementia syndrome. This report describes the case of a patient with rheumatoid arthritis and chronic use of corticosteroid therapy, who developed rapidly progressive dementia within 5 months. During the investigation, the primary lymphoma of the central nervous system was evidenced as the cause of its dementia syndrome. Importantly, prolonged use of corticosteroids may be associated with a state of immunosuppression, which is a risk factor for the onset of central nervous system lymphoma.
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Linfoma de Células B/complicações , Demência/complicações , Demência/diagnóstico , Linfoma/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Neoplasias do Sistema Nervoso Central , Corticosteroides/uso terapêutico , Testes de Estado Mental e DemênciaRESUMO
BACKGROUND: The advent of antiretroviral therapy increased the life expectancy of human immunodeficiency virus (HIV)-positive patients and, consequently, the morbidity and mortality due to neoplasms. Plasmablastic lymphoma is one such neoplasm that generally presents with involvement of the oral cavity; cases of extra-oral involvement are rare. CASE REPORT: We report a case of plasmablastic lymphoma in a 46-year-old woman for whom the initial clinical manifestation was a painless perineal tumor accompanied by fecal incontinence. CONCLUSIONS: The possibility of this neoplasm should be considered in patients with HIV/acquired immune deficiency syndrome (HIV/AIDS) because its early diagnosis is essential so that the start of the treatment is not delayed.
Assuntos
Neoplasias do Ânus/diagnóstico , Infecções por HIV/complicações , HIV , Neoplasias de Plasmócitos/diagnóstico , Neoplasias do Ânus/complicações , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Linfoma Relacionado a AIDS/diagnóstico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias de Plasmócitos/complicaçõesRESUMO
BACKGROUND: Burkitt lymphoma rarely affects the central nervous system and ocular region. Under these conditions, computed tomography and (particularly) magnetic resonance imaging of the skull increase the diagnostic accuracy, as they objectively show the topography of lesions and the effect of neoplasia on structures. CASE REPORT: We report here the case of a 17-year-old male whose initial clinical manifestations were related to neurological impairment and to the ocular musculature and ocular innervation. The diagnosis of Burkitt lymphoma with leukemization and infiltration of the central nervous system was confirmed. CONCLUSIONS: In this case, it is important to recognize that the neuroimaging findings were fundamentally important in indicating the initial form of the disease and in directing the appropriate clinical management.
