RESUMEN
In the clinical course of a patient with progressive facial hemiatrophy associated with ipsilateral body atrophy (total hemiatrophy), signs and symptoms of localized scleroderma were noted. The patient subsequently was found to have Schönlein-Henoch purpura with renal involvement and, later, paroxysmal nocturnal hemoglobinuria. To our knowledge, such an association has not been reported before.
Asunto(s)
Hemiatrofia Facial/complicaciones , Glomerulonefritis/complicaciones , Hemoglobinuria Paroxística/complicaciones , Vasculitis por IgA/complicaciones , Esclerodermia Localizada/complicaciones , Adulto , Atrofia/complicaciones , Femenino , Glomerulonefritis/patología , HumanosRESUMEN
We investigated the ultrastructural changes in the hematopoietic microenvironment of the bone marrow obtained from 15 untreated patients with chronic myelocytic leukemia (CML) in the chronic phase by transmission and scanning electron microscopy using the cryofracture technique. Examination of the undecalcified bone marrow specimens confirmed extensive hyperplastic granulopoiesis. In the stroma, fat cells were scarce or absent. Macrophages were increased and scattered throughout the marrow. The cytoplasm contained abundant cellular debris and crystals of the Charcot-Leyden type. Slender reticular cells were inconspicuously located between proliferating myeloid cells. A few foci of fibrosis were occasionally observed. The sinus endothelium generally retained its continuity, and no features suggesting complete deterioration of the sinus were evident. However, certain alterations in the sinus wall were noted in the process of leukemia cell migration. Many cells migrated transcellularly into the circulation through transient large openings in the sinus endothelium.