RESUMO
UNLABELLED: The association of HIV infection and lymphoma in patients attending at the South Health Metropolitan Reference Centre is presented. OBJECTIVE: To analyse its incidence, clinical and pathologic manifestations, treatment and outcome. PERIOD OF STUDY: January 1990 to December 2002. RESULTS: 14 cases were detected, 10 non Hodgkin lymphoma patients (7 with high malignancy and 50% in stages III-IVB) and 4 with Hodgkin lymphoma (3 with mixed cellularity, 2 in stage IVB). The annual incidence was 0.68%. Ten patients were classified under stage C3 of AIDS CDC criteria, the mean CD4 count was 139 cells/mm3 and mean CV was 5,32 log. Eighty six percent of patients presented with unique or multiples lymphonodes, with predominance of advanced lymphoma stage. Conventional CHOP chemotherapy was the treatment for high risk and extended non Hodgkin lymphomas and for extended Hodgkin lymphomas the ABVD protocol was administered. Six patients received antiretroviral therapy, 4 simultaneously with chemotherapy. Global mortality in this series was 71%, attributable to tumor disease per se or to sepsis. Four patients survived (18 to 50 months) in complete remission, 2 non Hodgkin lymphomas and 2 Hodgkin lymphomas. The low incidence of lymphoma and AIDS association and the high frequency of lymphomas with localized or generalized lymphonodes in this series are remarkable.
Assuntos
Linfoma Relacionado a AIDS , Linfoma não Hodgkin , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Contagem de Linfócito CD4 , Chile/epidemiologia , Feminino , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/epidemiologia , Humanos , Incidência , Linfoma Relacionado a AIDS/diagnóstico , Linfoma Relacionado a AIDS/tratamento farmacológico , Linfoma Relacionado a AIDS/epidemiologia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , Carga ViralRESUMO
The association of HIV infection and lymphoma in patients attending at the South Health Metropolitan Reference Centre is presented. Objective: to analyse its incidence, clinical and pathologic manifestations, treatment and outcome. Period of study: January 1990 to December 2002. Results: 14 cases were detected, 10 non Hodgkin lymphoma patients (7 with high malignancy and 50 percent in stages III-IVB) and 4 with Hodgkin lymphoma (3 with mixed cellularity, 2 in stage IVB). The annual incidence was 0.68 percent. Ten patients were classified under stage C3 of AIDS CDC criteria, the mean CD4 count was 139 cells/mm³ and mean CV was 5,32 log. Eighty six percent of patients presented with unique or multiples lymphonodes, with predominance of advanced lymphoma stage. Conventional CHOP chemotherapy was the treatment for high risk and extended non Hodgkin lymphomas and for extended Hodgkin lymphomas the ABVD protocol was administered. Six patients received antiretroviral therapy, 4 simultaneously with chemotherapy. Global mortality in this series was 71 percent, attributable to tumor disease per se or to sepsis. Four patients survived (18 to 50 months) in complete remission, 2 non Hodgkin lymphomas and 2 Hodgkin lymphomas. The low incidence of lymphoma and AIDS association and the high frequency of lymphomas with localized or generalized lymphonodes in this series are remarkable.
Se revisó la asociación de linfoma e infección por VIH en un complejo hospitalario de la Región Metropolitana Sur de Santiago de Chile, su incidencia, características clínicas y patológicas, terapia y evolución en 14 casos. La incidencia acumulada (enero 1990 y diciembre 2002) fue de 0,68 por ciento. Diez pacientes tenían linfoma no Hodgkin (siete de alto grado de malignidad y 50 por ciento en estadios III-IVB) y cuatro Hodgkin (tres con celularidad mixta, dos en estadio IVB). Diez pacientes con linfoma estaban en etapa C3 de SIDA según criterios del CDC, con un promedio de CD4 de 139 células/mm³ y carga viral de 212.600 copias de ARN/ml. Ochenta y seis por ciento tenía afección ganglionar, localizada o generalizada. El tratamiento de los linfomas no Hodgkin de alto grado y extendidos fue con quimioterapia CHOP convencional, y en los linfomas de Hodgkin avanzados se aplicó el esquema ABVD. Seis pacientes recibieron tratamiento antiretroviral, cuatro simultáneamente con quimioterapia. La mortalidad global fue de 71 por ciento, por progresión tumoral y/o sepsis. Cuatro pacientes sobreviven (18 a 50 meses) en remisión completa, dos linfomas no Hodgkin y dos Hodgkin. Se discuten la baja incidencia de la asociación linfoma y SIDA y la mayor frecuencia de linfomas con adenopatías localizadas o generalizadas.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Linfoma Relacionado a AIDS , Linfoma não Hodgkin , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Chile/epidemiologia , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/epidemiologia , Incidência , Linfoma Relacionado a AIDS/diagnóstico , Linfoma Relacionado a AIDS/tratamento farmacológico , Linfoma Relacionado a AIDS/epidemiologia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/epidemiologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , Carga ViralRESUMO
Background: Amyloidosis is characterized by the extracellular deposit of an insoluble fibrillar protein that leads to tissue atrophy and necrosis. Aim: To report the clinical features of cases of amyloidosis diagnosed in a public hospital in Santiago, Chile, from 2000 to 2004. Material and methods: Retrospective review of all pathology reports of biopsies obtained from 2000 to 2004. In all cases reported as "amyloidosis", the clinical features of such patients were obtained from their medical records. Results: The medical records of 11 patients with amyloidosis were obtained (aged 35 to 71 year old, seven females). Seven had a systemic and four a localized disease. Six patients had primary amyloidosis and in one, it was secondary to a disseminated tuberculosis. Five patients with the generalized disease consulted for anarsarca, three for weight loss and 2 for chronic diarrhea. Patients with localized disease consulted for tonsil enlargement, dysphonia and skin lesions. Five patients with generalized disease had renal involvement and five had cardiac involvement. Three patients had malabsorption. Conclusions: The most common presentation of systemic amyloidosis is anasarca and renal involvement is common.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amiloidose/patologia , Nefropatias/patologia , Hepatopatias/patologia , Dermatopatias/patologia , Amiloidose/classificação , Autopsia , Biópsia , Eletroforese das Proteínas Sanguíneas , Vermelho Congo , Síndromes de Malabsorção/patologia , Síndrome Nefrótica/patologia , Estudos RetrospectivosRESUMO
Entre las nuevas y re-emergentes enfermedades infecciosas que amenazan a la humanidad, y como resultado de este caso clínico, se hace una revisión bibliográfica acerca de leptospirosis insistiendo en la necesidad de tenerla in mente en el diagnóstico diferencial de un cuadro febril con ictericia.
Assuntos
Adolescente , Humanos , Masculino , Leptospira/isolamento & purificação , Doença de Weil/patologia , Evolução FatalRESUMO
We report preliminary results of treatment of Hodgkin disease according to the National Protocol on Antineoplastic Drugs. 37 males and 22 females with a median age of 34 years (range 16 to 76) were treated. Patients with stages I or II received radiotherapy alone or chemotherapy (C-MOPP) followed by radiotherapy. Patients with stages III or IV received radiotherapy and chemotherapy or alternating courses of D-MOPP and ABVD. Complete remission was observed in 74% of 39 patients completing full therapy. Complete remission was more common in patients with nodular sclerosis without B symptoms and under 45 years of age. Actuarial survival at 22 months was 79%, significantly higher for patients with nodular sclerosis compared to patients with lymphocytic depletion. Different treatments in patients at stages I an II or III and IV gave comparable results. Complications included infection with the Chickenpox-Zoster virus, pneumonia and fever of Unknown origin. Mortality was associated to older age, complications of treatment or failure to comply with therapy
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Doença de Hodgkin/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/mortalidade , Doença de Hodgkin/radioterapia , Análise Atuarial , Terapia Combinada , Esquema de Medicação , PrognósticoAssuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Indução de Remissão , Risco , Taxa de Sobrevida , Análise Atuarial , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Programas Nacionais de SaúdeAssuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Trombocitopenia/induzido quimicamente , Leucemia Mieloide Aguda/mortalidade , Neutropenia/induzido quimicamente , Análise Atuarial , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Indução de Remissão , Infecções/etiologia , Prognóstico , Taxa de SobrevidaAssuntos
Adolescente , Adulto , Humanos , Masculino , Feminino , Doença de Hodgkin/terapia , Dosagem Radioterapêutica , Doença de Hodgkin/mortalidade , Taxa de Sobrevida , Seguimentos , Terapia Combinada , Estadiamento de Neoplasias , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêuticoRESUMO
De acuerdo a la clasificación FAB se reseñan las características citológicas y citoquímicas de los Síndromes mielodisplásticos primarios representados por la anemia refractaria simple; la anemia refractaria con sideroblastos en anillo; la anemia refractaria con exceso de blastos; la anemia refractaria con exceso de blastos en trasformación y la leucemia mielomonocítica crónica. Se discuten los problemas existentes en el manejo diagnóstico y la importancia pronóstica de esta clasificación
Assuntos
Humanos , Masculino , Feminino , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/classificaçãoRESUMO
1. La serie mostró un 70% (42 de 60) de seguimiento conocido y un 38,3% de seguimiento mayor que un año (23 de 60) 2. Se evidenciaron infecciones respiratorias leves en el 45,5% (15 de 33) 3. Los grupos esplenectomizados por hipertensión portal y púrpuras trombocitopénicos idiopáticos presentaron mayor morbilidad y mortalidad que el grupo esplenectomizado con diagnóstico anatomopatológico de bazo normal. 4. No se evidenciaron infecciones siderantes postesplenectomía en la serie