RESUMO
Bone marrow necrosis (BMN) is mostly diagnosed at postmortem examination. It has been observed in association with acute leukemia and other malignant diseases. We report here BMN in two patients with acute myeloid leukemia (AML) and one with acute lymphocytic leukemia (ALL) in whom the diagnosis was made while alive. Two patients died because of intracranial bleeding. One with AML (M5) developed BMN one week after he was treated with a second course of chemotherapy: he had a complete recovery and remains in remission almost five years after the diagnosis. We conclude that antemortem diagnosis of BMN is technically difficult, but as it is not always associated to a fatal prognosis, an early diagnosis and vigorous supportive therapy should be attempted.
Assuntos
Medula Óssea/patologia , Leucemia Monocítica Aguda/patologia , Leucemia Promielocítica Aguda/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Exame de Medula Óssea , Hemorragia Cerebral/etiologia , Evolução Fatal , Feminino , Humanos , Leucemia Monocítica Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Necrose , Dor/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Indução de RemissãoRESUMO
The pulmonary hypoplasia with bronchoesophageal fistula is a rarely-seen disease which can be confused with total pulmonary agenesis. This case study concerns to one day old male newborn which was hospitalized in our hospital with respiratory difficulties, accompanied by pulmonary opacity of the right side. After having carried out diagnosis studies, including bronchography, we concluded that it was a case of pulmonary agenesis. The patient died from persistent pulmonary hypertension. The anatomopathologic diagnosis, was right pulmonary hypoplasia with bronchoesophageal fistula. This pathology originated during early embryonic stage when the bronchoplastic and esophagoplastic tissue are incompletely separated an thus a fistula between the esophagus and the principal bronchus is formed. The presence of a fistula could not be proven by bronchography. However, esophagography or esophagoscopy would have proven the presence of the fistula.