Asunto(s)
Anemia Hemolítica/etiología , Proteínas del Citoesqueleto , Eliptocitosis Hereditaria/complicaciones , Neuropéptidos , Talasemia beta/complicaciones , Adulto , Eliptocitosis Hereditaria/genética , Femenino , Globinas/genética , Glicoforinas/genética , Heterocigoto , Humanos , Masculino , Proteínas de la Membrana/genética , Espectrina/genética , Talasemia beta/genéticaRESUMEN
A Philadelphia-positive ALL in an adult occurring 21 years after the initial diagnosis is reported here. This case raises the question as to whether or not this event is a relapse or a new leukemia. A possible role of interferon-alpha previously administered to the patient for a chronic viral hepatitis is discussed too.
Asunto(s)
Linfoma de Burkitt/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Adulto , Antivirales/efectos adversos , Diagnóstico Diferencial , Resultado Fatal , Hepatitis C/tratamiento farmacológico , Hepatitis Crónica/tratamiento farmacológico , Humanos , Interferón-alfa/efectos adversos , Interferón-alfa/uso terapéutico , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Recurrencia , Factores de TiempoRESUMEN
A case of CLL with two different cellular populations is reported. A 50-year-old man was evaluated for persistent absolute lymphocytosis. A peripheral blood smear revealed numerous small lymphocytes (83% of white blood cells counted). Frequent Grumpecht shadows were present, too. On bone marrow aspirate smears lymphocytes comprised 85% of the total cells counted, and the bone marrow biopsy showed a mixed nodular-interstitial infiltration pattern. The immunophenotypic study showed two different leukemic populations. The first one (comprising 79% leukemic cells) was CD5+, CD19+, CD10-, CD20+, CD18-, CD22-, CD23+ +, lambda dim, and FMC7-. The second population (comprising 21% leukemic cells) was CD5+, CD19+, CD10-, CD20+, CD18+, CD22+, CD23+, lambda+ +, and FMC7+. Gene rearrangement studies detected the germline and one rearranged band in Jk blot with each restriction endonuclease. In the Jh blot the germline and two rearranged bands were detected with EcoRI and BamHI and three rearranged bands with HindIII. The JBI/JBII blot detected only the germline band. The detection of three rearranged bands was interpreted as evidence of the presence of at least two monoclonal populations of cells with the same light chain restriction.
Asunto(s)
Leucemia Linfocítica Crónica de Células B/patología , Células Clonales , Reordenamiento Génico de Linfocito B , Reordenamiento Génico de Linfocito T , Humanos , Inmunofenotipificación , Leucemia Linfocítica Crónica de Células B/genética , Leucemia Linfocítica Crónica de Células B/inmunología , Masculino , Persona de Mediana EdadRESUMEN
We describe a woman with lymphoid interstitial pneumonia diagnosed by open lung biopsy following a profile of unproductive cough, weakness and bilateral lung infiltrates. The patient was also diagnosed as having common variable immunodeficiency based on hypogammaglobulinemia, repeated sinusitis and persistent diarrhea. Exfoliative cytology of pleural effusion revealed the development of non-Hodgkin's lymphoma. We review the associations among these processes and consider the suggestion made by other authors that lymphoid interstitial pneumonia be considered a prelymphomatous process.