1.A Case of Pulmonary Microsporidiasis in an Acute Myeloblastic Leukemia (AML) -M3 Patient.
Suleyman YAZAR ; Bulent ESER ; Saban YALCIN ; Izzet SAHIN ; A Nedret KOC
Yonsei Medical Journal 2003;44(1):146-149
Reported here is a case of microsporidiasis that occurred in an acute myeloblastic leukemia (AML) -M3 patient who underwent chemotherapy. Fever, cough, expectorate and dyspnea were observed during the therapy. Since this case was considered as adult respiratory distress syndrome due to the chest X-ray and arterial blood gas findings, the male patient was bounded to a mechanical ventilator. As coagulation tests showed compatible findings with disseminate intravascular coagulation (DIC), it was thought to be a case of sepsis originating from the lungs and DIC. Pseudomonas aeruginosa and Staphylococcus aureus were found in the sputum of the patient. Although he was given combined antibiotic therapy, there was no reduction in the fever. A bronchoalveolar lavage (BAL) sample was taken and Microsporidia sp. was found upon staining with Giemsa. The patient died due to sepsis and DIC just before receiving therapy for microsporidiasis. Pulmonary infection with Microsporidia, although classically occurring in patients with HIV infection, may occur rarely in leukemia patients, especially if previously treated with systemic immune suppression. This case reinforces the need to consider Microsporidia as a possible pathogen in immunocompromised patients with pulmonary infections.
Diagnostic Errors
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Fatal Outcome
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Human
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Immunocompromised Host
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Leukemia, Myelocytic, Acute/*complications
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Lung Diseases, Parasitic/*complications/diagnosis
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Male
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Microsporidiosis/*complications/diagnosis
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Middle Aged
2.Acute Lymphoblastic Leukemia Associated with Brucellosis in Two Patients with Fever and Pancytopenia.
Bulent ESER ; Fevzi ALTUNTAS ; Isin SOYUER ; Ozlem ER ; Ozlem CANOZ ; Hasan Senol COSKUN ; Mustafa CETIN ; Ali UNAL
Yonsei Medical Journal 2006;47(5):741-744
Brucellosis is a disease involving the lymphoproliferative system, which may lead to changes in the hematological parameters; however, pancytopenia is a rare finding. However, malignant diseases in association with brucellosis are rarely the cause of pancytopenia. Herein, two cases with fever and pancytopenia, diagnosed as simultaneous acute lymphoblastic leukemia and brucellosis are presented. Anti-leukemic therapy and brucellosis treatment were administered simultaneously, and normal blood parameters obtained. The first patient is in complete remission; the other recovered from the brucellosis, but later died due to a leukemic relapse.
Pancytopenia/diagnosis/*etiology/therapy
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Leukemia, Lymphocytic, Acute/*complications/pathology/therapy
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Humans
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Fever
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Female
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Brucellosis/*complications/diagnosis/therapy
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Adult
3.Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas in Central Anatolia, in Turkey.
Bulent ESER ; Bunyamin KAPLAN ; Ali UNAL ; Ozlem CANOZ ; Fevzi ALTUNTAS ; H Ismail SARI ; Ozlem ER ; Metin OZKAN ; Can KUCUK ; Makbule ARAR ; Sebnem GURSOY ; Mustafa CETIN
Yonsei Medical Journal 2006;47(1):22-33
Primary gastrointestinal lymphoma is a common presentation of non-Hodgkin's lymphoma. The main controversy arises when many aspects of its classification and management are under discussion, particularly regarding roles for surgical resection. The aim of this study was to evaluate clinicopathologic characteristics and the therapeutic outcome of primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 74 patients who were presented to our center with histopathological diagnosis of primary gastro-intestinal non-Hodgkin's lymphoma between 1990 and 2001. All patients have been staged according to Lugano Staging System. For histopathological classification, International Working Formulation was applied. The treatment choice concerning the surgical or non-surgical management was decided by the initially acting physician. Treatment modalities were compared using the parameters of age, sex, histopathological results, stage, and the site of disease. Of the 74 patients, 31 were female and 43 were male, with a median age of 49 years (range 15-80). The stomach was the most common primary site and was seen in 51 of 74 patients (68.9%). The intermediate and high grade lymphomas constituted 91.9% of the all cases. In a median follow-up of 29 months (range 2-128), 20 out of 74 patients died. There was a three year overall survival rate in 65.4% of all patients. The three year overall survival rate was better in stage I and II1 patients who were treated with surgery plus chemotherapy (+/-RT) than those treated with chemotherapy alone (93.7% vs. 55.6%, p<0.05). The stage and presence of B symptoms affected the disease free survival and overall survival significantly, but the histopathologic grade only affected the overall survival. On the basis of these results, we suggest that surgical resection is necessary before chemotherapy in early stage (stage I and II1) patients with gastrointestinal non-Hodgkin's lymphomas because of the significant survival advantage it would bring to the patient.
Turkey/epidemiology
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Treatment Outcome
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Survival Rate
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Retrospective Studies
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Neoplasm Staging
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Middle Aged
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Male
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Lymphoma, Non-Hodgkin/mortality/*pathology/*therapy
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Humans
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Gastrointestinal Diseases/mortality/*pathology/*therapy
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Female
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Combined Modality Therapy/adverse effects
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Aged, 80 and over
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Aged
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Adult
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Adolescent
4.Coincidence of three solid tumors in a patient with multiple myeloma.
Muzaffer KEKLIK ; Serdar SIVGIN ; Kemal DENIZ ; Halit KARACA ; Olgun KONTAS ; Suleyman BALKANLI ; Celalettin EROGLU ; Ummuhan ABDULREZZAK ; Gulfugan KUZU ; Leylagul KAYNAR ; Mustafa CETIN ; Ali UNAL ; Bulent ESER
Chinese Medical Journal 2013;126(6):1186-1187