RESUMEN
A 57-year-old postmenopausal woman with end-stage liver disease secondary to alcoholic cirrhosis, esophageal varices, severe alcoholic cardiomyopathy, and metrorrhagia causing persistent anemia despite multiple transfusions presented with heavy vaginal bleeding. The patient underwent two uterine artery embolizations with proximal coils instead of directed particles due to difficult anatomy but the bleeding continued despite these interventions. Since she was a poor surgical candidate for hysterectomy, the decision was made to attempt achievement of hemostasis via ethanol injection into the uterine cavity. The patient's bleeding ceased, her hemoglobin and hematocrit stabilized post-procedure, and she was discharged home in stable condition.
Asunto(s)
Técnicas de Ablación/métodos , Etanol/uso terapéutico , Leiomioma/terapia , Embolización de la Arteria Uterina/métodos , Hemorragia Uterina/terapia , Comorbilidad , Contraindicaciones , Femenino , Humanos , Histerectomía , Leiomioma/complicaciones , Persona de Mediana Edad , Hemorragia Uterina/etiologíaRESUMEN
BACKGROUND: Small lymphocytic lymphoma is a relatively rare B-cell non-Hodgkin lymphoma that is considered to be the tissue equivalent of the much more common entity chronic lymphocytic leukemia. Cutaneous manifestations of small lymphocytic lymphoma are infrequent and the literature regarding them sparse. We describe here a case of a patient with a history of small lymphocytic lymphoma who developed perniosis-like features of the digits. CASE PRESENTATION: An 86-year old male patient with previously diagnosed small lymphocytic lymphoma developed painful erythematous swelling of the periungual area of his fingers and toes. This was associated with a dense dermal infiltration of CD5-positive B-lymphoid cells consistent with his low-grade B-cell lymphoma. Although partially refractory to local radiotherapy, the painful swelling of the fingers and toes resolved fully following systemic therapy with chlorambucil and rituximab. CONCLUSIONS: This unusual cutaneous manifestation of a lymphoma and the favourable response to systemic therapy may be instructive for the management of other patients who develop similar perniosis-like features.