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At least 811 records · Page 45Linked to original sources
PubMed2003

Acute monocytic leukemia presenting as acute respiratory failure.

Acute respiratory failure revealing acute monocytic leukemia is rare. We report 20 patients admitted to the intensive care unit (ICU) with three remarkable features: (1) rapidly progressive respiratory distress revealing acute leukemia, (2) monocytic leukemia, and (3) respiratory status deterioration after chemotherapy initiation. The median age was 50 years (17-72 years), and respiratory symptoms started 2 days (0-15 days) before ICU admission. The median leukocyte count was 98,250/mm3 (800-529,000), with circulating monocytic cells in all of the patients but one. Bone marrow examination was diagnostic of monocytic leukemia in all patients. At presentation, respiratory rate was 33 (18-50) per minute, and PaO2 on room air was 44.5 mm Hg (30-60). Chest radiographs revealed unilateral alveolar infiltrates (n = 1), bilateral alveolar infiltrates with (n = 3) or without (n = 11) pleural effusion, or diffuse interstitial infiltrates (n = 5). Alveolar hemorrhage was the main bronchoalveolar lavage finding, with monocytic cells retrieved from four patients. Respiratory function deteriorated after cancer chemotherapy initiation in all patients. Of the 15 patients who required mechanical ventilation, 10 died. Leukemic pulmonary infiltration as the first manifestation of acute monocytic leukemia should be recognized, and intensive management should be provided in anticipation of the respiratory function deterioration seen consistently after chemotherapy initiation.

Acute Disease↗
PubMed1985

A case of congenital lymphoblastic leukemia: clinical course and significance of ultrasonography.

A case of congenital leukemia in which texture changes in ultrasonography were followed up is reported. The patient was a male infant hospitalized on day 22 after birth with multiple bluish skin nodules. Complete remission was achieved easily, but he relapsed early and died from the disease after six months. Because of L1 morphology the disease was classified as acute lymphoblastic leukemia, but the leukemic cells lacked the characteristics of lymphoid lineage on cytochemical, cytogenetic, immunological, and enzymological examination. Ultrasonography was considered a useful tool in the following respects for the treatment of the patient with congenital leukemia: The texture of the infiltration of leukemic cells into the liver was clearly visualized and changes in the images could be traced both in size and in number; the process of ventricular dilatation and brain atrophy were successively visualized.

Atrophy↗
PubMed1984

Plasma clearance and tissue distribution of partially thiolated polycytidylic acid and its degradation products in rodents.

Radioactive (35S-labeled) partially thiolated polycytidylic acid (MPC) was administered i.v. to male Sprague-Dawley rats. Blood samples were taken at various intervals, and the radioactivity in plasma was determined. The concentration of total radioactivity in plasma decreased rapidly postinjection, independently of the dose, and could not be readily resolved into a series of exponential terms with a high degree of confidence. Coadministration with polyinosinic acid in a 1:1 ratio significantly decreased the clearance of radioactive compounds from the plasma; moreover, the clearance of radioactivity decreased with increasing dose. Complexing with polyinosinic acid also decreased the rate of degradation of [35S]MPC as evidenced by an increase of the trichloroacetic acid-precipitable fraction (i.e., oligonucleotides larger than five to ten nucleotide units), from 0.45 to 0.92 of the total radioactivity in plasma 60 min postinjection. The plasma clearance and organ distribution of radioactivity following injection of [35S]MPC were determined in normal and leukemic RFM/Un mice. About 90% of the 35S radioactivity was removed from the plasma in 5 and 10 min, respectively, in these two groups of mice, and the residual plasma levels of radioactivity at any given time were twice as high in the leukemic group throughout an observation period of 1 hr. Organ distribution studies demonstrated significantly greater (per mg tissue) accumulation of radioactivity in the livers and spleens of the leukemic versus normal mice at all time points, while the corresponding data for the kidneys were similar for the two groups. Another study, comparing the radioactivity in suspended and washed spleen cells harvested 60 min postinjection, indicated that 4 to 10 times more MPC and/or 35S-labeled oligonucleotides were localized and bound intracellularly in the spleens of the leukemic mice. These studies of the pharmacokinetic properties and metabolic degradation of [35S]MPC suggest that this polynucleotide may be protected from degradation by complexing with polyinosinic acid and that preferential accumulation of [35S]MPC occurs in organs infiltrated by leukemic cells.

Animals↗
PubMed1998

Incidence and pattern of liver involvement in haematological malignancies.

The incidence and pattern of liver involvement in 127 liver specimens (2 biopsy and 125 autopsy specimens) from cases of acute myelogenous leukaemia (25), chronic myelogenous leukaemia (7), acute lymphatic leukaemia (5), chronic lymphatic leukaemia (9), multiple myeloma (25), low-grade non-Hodgkin's lymphoma (25), high-grade non-Hodgkin's lymphoma (24) and myeloproliferative diseases (7) were investigated histologically and immunohistochemically. Liver infiltration was found frequently in chronic leukaemia and myeloproliferative diseases (80-100%), acute leukaemia (60-70%) and non-Hodgkin's lymphoma (50-60%), but was significantly less common in multiple myeloma (32%) than in any of the other diagnostic groups. Hepatomegaly was found in over 50% of cases in all the diagnostic groups, but was not always associated with infiltration. Diffuse, non-destructive infiltration was most common: in acute myelogenous leukaemia, both the portal triads and sinusoids were usually involved; in chronic myelogenous leukaemia, multiple myeloma and myeloproliferative diseases, infiltration was mainly sinusoidal; and in lymphatic leukaemia and non-Hodgkin's lymphoma the portal triads were mainly involved. Nodular infiltration was seen in multiple myeloma and non-Hodgkin's lymphoma. The primary tumours and liver infiltrates generally exhibited the same immunophenotype, although reactivity with the antibody L26 (CD20) was only found in the primary lesion in many high-grade B-cell lymphomas. Thus, liver involvement is common in haematological malignancies, but the incidence and pattern of infiltration vary amongst the different types.

Antigens, Neoplasm↗
PubMed1998

Simultaneous leukaemic infiltrate and cholesteatoma in the same temporal bone.

Leukaemic relapse in the ear is very rare. We report a case of relapse of acute lymphoblastic leukaemia in the left ear. The patient presented with an aural polyp and ipsilateral facial palsy. The temporal bone showed simultaneous leukaemic infiltrate and cholesteatoma. To our knowledge, this is the first case reported with such pathology.

Child↗
PubMed2006

[Expression of SDF-1alpha and its receptor CXCR4 in acute leukemias and their relationship with extramedullary infiltration].

The study was aimed to explore the expression of stromal cell derived factor-1alpha (SDF-1alpha) and its receptor CXCR4, and their relationship with the extramedullary infiltration in acute lymphoblastic, grannulocytic and monocytic leukemia. 66 cases of acute leukemia included 31 cases of acute lymphoblatic leukemia (ALL), 20 cases of acute grannulocytic leukemia (M(2)) and 15 cases of acute monocytic leukemia (M(4)+M(5)). There were 41 cases with extramedullary infiltration and 25 cases without-extramedullary infiltration. Enzyme-linked immunoabsorbent assay (ELISA) and flow cytometry were used to determine expression of SDF-1alpha and CXCR4 respectively on leukemia cells in peripheral blood and bone marrow of different groups. The results showed that average plasma level of SDF-1alpha in the ALL, M(4)+M(5), M(2) patients and the normal control were 1317.87 +/- 220.76, 1339.79 +/- 187.06, 1063.70 +/- 190.74, 1908.34 +/- 135.55 (pg/ml) respectively. The average levels in the ALL, M(4)+M(5) and M(2) patients groups were lower than those in normal control group. Both levels in ALL and M(4)+M(5) patient groups were higher than that in M(2) patient group. The average levels of SDF-1alpha in patient group with extramedullary infiltration and patient groups without-extramedullary infiltration were 1252.49 +/- 263.12, 1234.91 +/- 185.50 (pg/ml) respectively. The former seemed as if higher than the latter, but without statistical significance. The MFI of CXCR4 expression in ALL, M(4)+M(5), M(2) patient group were 78.47 +/- 33.96, 67.21 +/- 24.29, 41.66 +/- 17.18, respectively. CXCR4 expression in ALL and M(4)+M(5) patient groups were higher than that in M(2) patient group (P > 0.05). There was no significant difference between the ALL and M(4)+M(5) patient group (P > 0.05). The MFI of CXCR4 expression in patients with extramedullary infiltration and patients without extramedullary infiltration were 81.72 +/- 27.63, 36.94 +/- 11.86 respectively. The former was higher than the latter (P < 0.05). It is concluded that the higher expression of CXCR4 on acute lymphoblatic and monocytic leukemia cells may be one of the molecular mechanisms of extramedullary infiltration in both kinds of leukemia. The average plasma levels of SDF-1alpha decreased in leukemia patients and this decrease not related to the extramedullar infiltration, which may be due to the SDF-1alpha local expression in the organ infiltrated.

Acute Disease↗
PubMed1993

Molecular diagnosis of lymphocytic infiltrates of the skin.

BACKGROUND: Advances in our understanding of the molecular genetics of lymphocyte antigen receptors (B-cell immunoglobulin and T-cell antigen receptor), have led to the application of molecular biologic techniques to molecularly characterize lymphocytic infiltrates of the skin. Molecular diagnosis refers to the application of these techniques as a diagnostic aid in the clinicopathologic evaluation of cutaneous lymphocytic infiltrates. OBSERVATION: Molecular studies have clinical application in the determination of lineage and detection of retroviruses in cutaneous lymphoid neoplasms, distinguishing between lymphoproliferative and reactive infiltrates, and staging and monitoring response to therapy in cutaneous T-cell lymphoma. Southern blot analysis of immunoglobulin and T-cell antigen receptor gene rearrangements may fail to aid the clinician in establishing a diagnosis of a cutaneous malignancy due to the limits of detection sensitivity in minimally infiltrated lesions (eg, parapsoriasis and patch-stage mycosis fungoides) or the still uncertain prognostic significance of clonality in benign cutaneous diseases (eg, follicular mucinosis, pityriasis lichenoides et varioliformis acuta, lymphomatoid papulosis, and cutaneous lymphoid hyperplasia). CONCLUSIONS: Molecular studies have enormous research value, providing new means to explore the pathogenesis and clonal evolution of lymphoproliferative skin diseases. Presently, however, they have limited applications as an independent diagnostic tool. As our understanding of the clinical and biologic significance of the molecular detection of clonal lymphocyte populations in the skin expands and as the application of polymerase chain reaction amplification provides us with greater detection sensitivity and specificity, the clinical utility of molecular diagnosis of lymphocytic infiltrates of the skin will be enhanced.

Antibodies, Monoclonal↗
PubMed1996

[Adult T-cell leukemia with diffuse panbronchiolitis-like lung infiltration].

A 46-year old man was admitted complaining of dyspnea. Physical examination revealed superficial lymph nodes swelling, and coarse crackles over the lung. Chest X-ray film showed diffuse small granular shadows, suggesting diffuse panbronchiolitis (DPB). Peripheral blood smears showed cells with flower like nuclei. HTLV-I antibody was positive in the serum. He was diagnosed as having adult T-cell leukemia (ATL). Transbronchial lung biopsy showed diffuse infiltration of mononuclear cells around bronchioalveoli. The mononuclear cells stained positively for Pan T, CD2, CD3, CD4, CD5, CD25, and DNA from the cells showed HTLV-I provirus monoclonal integration. This is a rare case of ATL accompanied by DPB-like bronchioalveolar ATL cell infiltration.

Antigens, CD↗
PubMed2003

Primary non-Hodgkin lymphoma of skeletal muscle coexistence with cutaneous infiltration.

This report describes a non-Hodgkin lyphoma case presenting with skeletal muscle and cutaneous involvement. A 75 year-old man was admitted to hospital with mass in the right upper extremity and skin lesions on the back of his trunk. Excisional mass biopsy was reported immunohistopthologically as large B-cell lymphoma. Primary extranodal lymphoma arising from skeletal muscle and concomitant skin infiltration of other body localization is not common. So this case was represented and relevant literature was reviewed.

Aged↗
PubMed1996

Granulocytic sarcoma of the chest wall at site of Hickman catheter tract.

Insertion of a Hickman central venous catheter before administration of induction chemotherapy is a common practice in treatment of patients with acute myeloblastic leukemia (AML). Granulocytic sarcoma associated with AML may be the initial clinical manifestation of newly diagnosed or relapsed AML, heralding systemic involvement by weeks to months. A case of granulocytic sarcoma of the chest wall occurring as subcutaneous nodules along a scar of a previous Hickman catheter tract in a 45 year old female patient with AML is described. The patient who was in first complete remission, developed granulocytic sarcoma simultaneously with complaints associated with leukemic CNS infiltration. This is the second case described of granulocytic sarcoma of the chest wall at the site of a Hickman catheter tract. The simultaneous CNS and chest wall manifestations raise the interesting question whether both sites behaved as sanctuaries for resistant leukemic cells, in this case.

Antineoplastic Agents↗
PubMed1995

Sudden increase in intraocular pressure as an initial manifestation of myelodysplastic syndrome.

PURPOSE/METHODS: We studied a rare initial manifestation of myelodysplastic syndrome in an 82-year-old woman who had acute secondary glaucoma in the right eye and mature cataracts in both eyes. RESULTS/CONCLUSION: Therapy with glaucoma control medications and cataract extraction in the right eye resulted in expulsive hemorrhage and subsequent enucleation of the right eye. After cataract extraction, examination of the left eye disclosed a central serous retinal detachment and hemorrhage. Histopathologic analysis of the right eye demonstrated myelocytic and lymphocytic infiltration.

Aged↗