3.Angioimmunoblastic T-cell lymphoma with autoimmune hemolytic anemia and pure red cell aplasia.
Fu-Xu WANG ; Xue-Jun ZHANG ; Ling PAN ; Shu-Kai QIAO ; Xiao-Ling GUO ; Zuo-Ren DONG
Journal of Experimental Hematology 2007;15(4):862-865
Angioimmunoblastic T-cell lymphoma (AILT) is a peripheral T-cell lymphoma often complicated autoimmune phenomena such as autoimmune cytopenia, and is a truly rare type of NHL. In order to investigate the clinical features, pathological manifestation of this lymphoma, and to explore its therapy protocol, a 37-years old patient with AILT was investigated. The routine blood examination, bone marrow smear, lymphonodus biopsy, Coombs test, flow cytometry for bone marrow mononuclear cells, serological test, immunochemistry method etc were performed for this patient. The results showed that the systemic lymphadenectasis and hepatosplenomegaly were seen in patient, the cervical lymphonode biopsy revealed AITL. The hematoglobin level and number of reticulocytes were very low. Coombs test was positive. Simultaneously, the bone marrow aspirate revealed erythroid aplasia. The warm type autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) were co-existed. After one course of chemotherapy with CHOP-E, infiltration sign of AITL patient with AIHA and PRCA disappeared. In conclusion, the AITL patient complicated with AIHA and PRCA was successfully diagnosed, the lymphonode biopsy and bone marrow smear showed more significant, the chemotherapy protocol of CHOP-E can give some effect to cure such angioimmunoblastic T cell lymphoma.
Adult
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Anemia, Hemolytic, Autoimmune
;
complications
;
diagnosis
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Humans
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Immunoblastic Lymphadenopathy
;
complications
;
diagnosis
;
Lymphoma, T-Cell
;
complications
;
diagnosis
;
Male
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Red-Cell Aplasia, Pure
;
complications
;
diagnosis
4.Renal tubular acidosis as an initial manifestation in children with malignant lymphoma.
Chinese Journal of Contemporary Pediatrics 2008;10(4):500-503
Primary renal lymphoma is one of the malignant lymphomas that initially presents in the extra lymphonode, which is rarely seen in children. This study reported two cases of primary renal lymphoma in children who were definitively diagnosed by renal biopsy. Renal tubular acidosis was the initial manifestation in both cases. They were referred to the hospital with chief complaints of polydipsia, polyuria, debilitation, vomiting and anemia. Imaging and laboratory examinations showed bilateral renomegaly, hypocalcemia, hypophosphatemia, and metabolic acidosis. One of the patients discontinued therapy. The other received chemotherapy including prednisone, vincristine, cytarabine and L-asparaginase, combined with intrathecal injections of methotrexate, dexamethasone and Ara-C and supporting treatment. Twenty-three days after treatment, polydipsia and polyuria were relieved, and acidosis, kaliopenia and anemia were improved in the patient. There were no abnormal findings in the renal B-ultrasound re-examination. It was concluded that when a patient is suspected of renal lymphoma, diagnostic puncture and renal biopsy should be performed early. Early combined therapeutics including chemotherapy, radiation therapy, surgery and supporting treatments may result in a favorable prognosis in patients with this disease.
Acidosis, Renal Tubular
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diagnosis
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etiology
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Child
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Humans
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Kidney Neoplasms
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complications
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Lymphoma
;
complications
;
Male
6.T-Cell Lymphoma Presenting as Painful Ophthalmoplegia.
Dong Sub LEE ; Kyung In WOO ; Hae Ran CHANG
Korean Journal of Ophthalmology 2006;20(3):192-194
PURPOSE: To present a case of peripheral T-cell lymphoma presenting as painful ophthalmoplegia. METHODS: A 61-year-old woman presented with a 2-week history of headache and eyeball pain. Examination showed mild exophthalmos, complete ophthalmoplegia, and ptosis of the left eye. Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response. Two months later, she revisited the clinic with exacerbated symptoms. Anterior orbitotomy and incisional biopsy was performed for the inferior rectus muscle lesion. RESULTS: Histopathologic examination revealed an infiltrate of atypical lymphoid cells between degenerative muscle bundles. It was consistent with peripheral T-cell lymphoma. A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month. CONCLUSIONS: T-cell lymphoma in the orbit can present as painful ophthalmoplegia and take a rapid clinical course. The disease should be regarded as one of the differential diagnosis for painful ophthalmoplegia refractory to corticosteroid therapy.
Tomography, X-Ray Computed
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Pain/diagnosis/*etiology
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Orbital Neoplasms/*complications/diagnosis
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Ophthalmoplegia/diagnosis/*etiology
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Middle Aged
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Lymphoma, T-Cell/*complications/diagnosis
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Humans
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Female
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Fatal Outcome
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Diagnosis, Differential
;
Biopsy
7.Newly Developed Multiple Myeloma in a Patient with Primary T-Cell Lymphoma of Bone.
Jun Eul HWANG ; Sang Hee CHO ; Ok Ki KIM ; Hyun Jeong SHIM ; Se Ryeon LEE ; Jae Sook AHN ; Duk Hwan YANG ; Yeo Kyeoung KIM ; Je Jung LEE ; Hyeoung Joon KIM ; Ik Joo CHUNG
Journal of Korean Medical Science 2008;23(3):544-547
Primary non-Hodgkin's lymphoma of bone (PLB) is rare, and generally presents as a single extensive and destructive bone lesion. Histopathologically, most cases present as diffuse large B-cell lymphoma, and T-cell lymphoma is rare. By contrast, multiple myeloma is a disease defined as the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. We report a case of multiple myeloma that developed during treatment of PLB in a type of T-cell. A 48-yr-old man was diagnosed as T-cell PLB, stage IE, 18 months ago. The patient received the chemoradiotherapy and salvage chemotherapy for PLB. However, the lymphoma progressed with generalized bone pain, and laboratory findings showed bicytopenia and acute renal failure. On bone marrow biopsy, the patient was diagnosed as having multiple myeloma newly developed with primary T-cell lymphoma of bone. In spite of chemotherapy, the patient died of renal failure.
Bone Neoplasms/*complications/diagnosis/therapy
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Fatal Outcome
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Humans
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Kidney Failure, Acute/etiology
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Lymphoma, T-Cell/*complications/diagnosis/therapy
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Male
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Middle Aged
;
Multiple Myeloma/*complications/diagnosis/therapy
8.A case of leukemia-associated arthritis: identification of leukemic cells in synovial fluid by light microscopy.
Sung Soo YOON ; Han Do YOUN ; Cheolwon SUH ; Yung Jue BANG ; Sung Jae CHOI ; Byung Kook KIM ; Noe Kyeong KOM ; Eui Chong KIM
Journal of Korean Medical Science 1987;2(4):255-258
One case of arthritis complicating leukemia is described in which leukemic cells were identified in synovial fluid by light microscopy. Although arthritis is a well-known manifestation of leukemia with an incidence of 13.5%, the pathogenesis often is unclear, and the direct demonstration of leukemic cells in synovial fluid has been very uncommon. A 16 year-old male patient was admitted due to left elbow joint pain and swelling. Synovial fluid examination revealed blast cells and this finding has directed to a final diagnosis of acute lymphoblastic leukemia.
Adolescent
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Arthritis/*etiology
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Humans
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Leukemia-Lymphoma, Adult T-Cell/*complications/diagnosis/pathology
;
Male