Ryan A Denu, Daniel R Matson, Matthew J Davis, Natalie J Tedford, Christine E Brichta, Carol A Diamond, Margo L Hoover-Regan
{"title":"Association of Immune Thrombocytopenia and T-Lymphoblastic Lymphoma in a Pediatric Patient.","authors":"Ryan A Denu, Daniel R Matson, Matthew J Davis, Natalie J Tedford, Christine E Brichta, Carol A Diamond, Margo L Hoover-Regan","doi":"10.1155/2019/1425151","DOIUrl":"https://doi.org/10.1155/2019/1425151","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is characterized by isolated thrombocytopenia of unclear etiology. We present a unique case of an 8-year-old girl with chronic ITP who was subsequently diagnosed with T-lymphoblastic lymphoma at age 11. The clinical course was complicated by the occurrence of nonepileptiform events with bizarre behavior changes following the administration of nelarabine and intrathecal and high-dose systemic methotrexate. This case highlights an unusual co-occurrence of hematologic malignancy and chronic ITP in an otherwise healthy child. We speculate that underlying genetic or immunologic lesions may predispose a subset of pediatric ITP patients to the development of hematologic malignancies.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"1425151"},"PeriodicalIF":0.7,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1425151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37535925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura M Stanko, Vishnu Reddy, Fady M Mikhail, Nikolaos Papadantonakis
{"title":"Central Nervous System Double Relapse of Acute Promyelocytic Leukemia and Acute Myelomonocytic Leukemia.","authors":"Laura M Stanko, Vishnu Reddy, Fady M Mikhail, Nikolaos Papadantonakis","doi":"10.1155/2019/4907352","DOIUrl":"https://doi.org/10.1155/2019/4907352","url":null,"abstract":"<p><p>Relapse of acute promyelocytic leukemia (APL) and non-M3-acute myeloid leukemia in the central nervous system (CNS) are rare events. Here, we describe a case of simultaneous relapses of APL and acute myelomonocytic leukemia on the CNS of a patient after allogeneic bone marrow transplant. This extremely unusual case highlights the difficulties that CNS leukemia relapses pose in the post-transplant setting.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"4907352"},"PeriodicalIF":0.7,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4907352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37535927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sultan Aydın Köker, Alper Koker, Adem Yasin Köksoy, Yasemin Kayadibi, Ülkü Gül Şiraz, Emine Tekin
{"title":"An Unusual Presentation of T-Cell Lymphoblastic Lymphoma with Isolated Renal Involvement.","authors":"Sultan Aydın Köker, Alper Koker, Adem Yasin Köksoy, Yasemin Kayadibi, Ülkü Gül Şiraz, Emine Tekin","doi":"10.1155/2019/2802141","DOIUrl":"https://doi.org/10.1155/2019/2802141","url":null,"abstract":"<p><p>The clinical presentation of Non-Hodgkin lymphoma (NHL) is frequently associated with the involvement of the abdomen and mediastinal lymphadenopathies, but rarely the kidney, ovaries, and testicles. Here, we report a rare case of T-cell lymphoblastic lymphoma (T-LBL) presenting with bilateral nephromegaly without acute renal failure (ARF) as the first manifestation. A 30-month-old boy was admitted to the department of pediatric nephrology exhibiting abdominal distension. Physical examination revealed bilateral renal palpation up to the inguinal region. Elevated lactate dehydrogenase (LDH) levels were detected in his blood. Bilateral diffuse enlarged kidneys with increased hypoechogenicity were found on abdominal ultrasonography. In the next step, contrast-enhanced computed tomography showed diffusely enlarged kidneys, which were compressing the intestinal bowels and midline structures. Renal biopsy demonstrated precursor T-LBL. We wish to report our patient with renal T-LBL presenting with diffuse renal enlargement, which has rarely been reported in the literature.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"2802141"},"PeriodicalIF":0.7,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2802141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rui R He, Zacharia Nayer, Matthew Hogan, Raymund S Cuevo, Kimberly Woodward, David Heyer, Christine A Curtis, Jess F Peterson
{"title":"Immunotherapy- (Blinatumomab-) Related Lineage Switch of <i>KMT2A/AFF1</i> Rearranged B-Lymphoblastic Leukemia into Acute Myeloid Leukemia/Myeloid Sarcoma and Subsequently into B/Myeloid Mixed Phenotype Acute Leukemia.","authors":"Rui R He, Zacharia Nayer, Matthew Hogan, Raymund S Cuevo, Kimberly Woodward, David Heyer, Christine A Curtis, Jess F Peterson","doi":"10.1155/2019/7394619","DOIUrl":"https://doi.org/10.1155/2019/7394619","url":null,"abstract":"<p><p>The presence of <i>KMT2A/AFF1</i> rearrangement in B-lymphoblastic leukemia (B-ALL) is an independent poor prognostic factor and has been associated with higher rate of treatment failure and higher risk of linage switch under therapy. Blinatumomab has shown promising therapeutic results in refractory or relapsed B-ALL; however, it has potential risk of inducing lineage switch, especially in <i>KMT2A/AFF1</i> rearranged B-ALL into acute myeloid leukemia and/or myeloid sarcoma. We report a 40-year-old female with <i>KMT2A/AFF1</i>-rearranged B-ALL that was refractory to conventional chemotherapy. Following administration of blinatumomab, she developed a breast mass proven to be myeloid sarcoma, in addition to bone marrow involvement by AML. Approximately six weeks after cessation of blinatumomab, a repeat bone marrow examination revealed B/myeloid MPAL.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"7394619"},"PeriodicalIF":0.7,"publicationDate":"2019-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7394619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eleni Thodou, Maria Befani, George Triantafyllidis, Theodosia Choreftaki, George Kanellis, Nikolaos Giannakoulas
{"title":"Hodgkin Lymphoma Mimicking Inflammatory Breast Carcinoma: A Rare Case with Diagnostic Challenge and Novel Treatment.","authors":"Eleni Thodou, Maria Befani, George Triantafyllidis, Theodosia Choreftaki, George Kanellis, Nikolaos Giannakoulas","doi":"10.1155/2019/9256807","DOIUrl":"https://doi.org/10.1155/2019/9256807","url":null,"abstract":"<p><p>Extranodal Hodgkin lymphoma involving the breast is infrequent. Most cases reported in the literature were diagnosed by histology after lumpectomy. We present a Hodgkin lymphoma mimicking inflammatory breast carcinoma in a 57-year-old woman. The diagnosis was performed by fine-needle aspiration (FNA) of the breast lesion and the axillary lymph nodes with rapid on-site evaluation followed by immunocytochemistry, and it was confirmed by histology. The patient after first-line chemotherapy developed relapse/refractory disease. Salvage chemotherapy regimens were applied with poor results and severe toxicity. Total remission was achieved with monotherapy of brentuximab vedotin, a novel anti-CD30-targeted antibody drug conjugate. This is a unique case of breast HL with misleading clinical presentation initially diagnosed by cytology. FNA as a minimally invasive diagnostic tool was crucial in avoiding unnecessary breast surgery and further delay of chemotherapy. It is also the first report highlighting the importance of this novel immunotherapy in the management of refractory Hodgkin lymphoma with breast involvement.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"9256807"},"PeriodicalIF":0.7,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9256807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Extramedullary Manifestations of Chronic Myelomonocytic Leukemia: Do We Treat like an Acute Myeloid Leukemia?","authors":"Prasun Pudasainee, Bimatshu Pyakuryal, Yogesh Subedi, Jenisha Upadhyay, Subarna Adhikari","doi":"10.1155/2019/8360454","DOIUrl":"https://doi.org/10.1155/2019/8360454","url":null,"abstract":"<p><p>Chronic myelomonocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Extramedullary leukemic involvement is rarely a presenting feature of CMML. As there are no clear guidelines in regard to the treatment of patients with extramedullary manifestations, its management is challenging. In this report, we discuss the management of our patient who presented with submandibular lymphadenopathy and gingivitis and was diagnosed with CMML.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"8360454"},"PeriodicalIF":0.7,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8360454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prolonged Myelosuppression due to Progressive Bone Marrow Fibrosis in a Patient with Acute Promyelocytic Leukemia.","authors":"Yuta Inagawa, Yukiko Komeno, Satoshi Saito, Yuji Maenohara, Tetsuro Yamagishi, Hiroyuki Kawashima, Taku Saito, Keiko Abe, Kuniko Iihara, Yasumasa Hatada, Tomiko Ryu","doi":"10.1155/2019/1616237","DOIUrl":"https://doi.org/10.1155/2019/1616237","url":null,"abstract":"<p><p>A 34-year-old woman was diagnosed with acute promyelocytic leukemia. Chemotherapy was administered following the JALSG APL204 protocol. Induction therapy with all-trans retinoic acid resulted in complete remission on day 49. She developed coccygeal pain from day 18, which spread to the spine and cheekbones and lasted 5 weeks. She had similar bone pain on days 7-10 of the first consolidation therapy and on days 4-12 of the second consolidation therapy. Oral loxoprofen was prescribed for pain relief. On day 33 of the third consolidation, white blood cell and neutrophil counts were 320/<i>μ</i>L and 20/<i>μ</i>L, respectively. After she developed epigastralgia and hematemesis, she developed septic shock. Gastroendoscopy revealed markedly thickened folds and diffusely damaged mucosa with blood oozing. Computed tomography revealed thickened walls of the antrum and the pylorus. Despite emergency treatments, she died. Bacterial culture of the gastric fluid yielded <i>Enterobacter cloacae</i> and enterococci growth. Collectively, she was diagnosed with phlegmonous gastritis. Retrospective examination of serial bone marrow biopsy specimens demonstrated progressive bone marrow fibrosis, which may have caused prolonged myelosuppression. Thus, evaluation of bone marrow fibrosis by bone marrow biopsy after each treatment cycle might serve as a predictor of persistent myelosuppression induced by chemotherapy.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"1616237"},"PeriodicalIF":0.7,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1616237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The First Case of E-Cigarette-Induced Polycythemia.","authors":"Marika Okuni-Watanabe, Keiji Kurata, Kimikazu Yakushijin","doi":"10.1155/2019/2084325","DOIUrl":"https://doi.org/10.1155/2019/2084325","url":null,"abstract":"<p><p>A 71-year-old male smoker was referred to our hospital because of increased hemoglobin and hematocrit. At initial consultation, his hemoglobin and hematocrit levels were 21.8 g/dl and 64.8%, respectively. Other laboratory data and his cardiopulmonary functions were almost normal, and JAK2 V617F mutation was negative. He had smoked about 25 cigarettes per day for 50 years until the age of 70, when he switched from conventional smoking to electronic cigarettes (e-cigarettes). We requested that he quit e-cigarette use. Thereafter, his hemoglobin and hematocrit gradually decreased and normalized. Here, we report the first case of e-cigarette-induced polycythemia.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"2084325"},"PeriodicalIF":0.7,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2084325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Secondary Squamous Cell Carcinoma of the Tongue Complicated with Bronchiolitis Obliterans as a Manifestation of Graft-versus-Host Disease following Peripheral Blood Stem Cell Transplantation.","authors":"Kengo Hashimoto, Toru Nagao, Shin Koie, Satoru Miyabe, Terumi Saito","doi":"10.1155/2019/6015803","DOIUrl":"https://doi.org/10.1155/2019/6015803","url":null,"abstract":"<p><p>Peripheral blood stem cell transplantation (PBSCT) has increasingly been used for hematologic cancer therapy, resulting in improved survival rates. However, risks include graft-versus-host disease (GVHD) and secondary solid tumors. Here, we describe a case of tongue squamous cell carcinoma (SCC) complicated by bronchiolitis obliterans (BO) following PBSCT. A 42-year-old man with a history of acute lymphocytic leukemia treated with PBSCT presented with multiple white lesions and erosions on the tongue and buccal mucosa that are compatible with oral chronic GVHD (NIH criteria: score 2). The lesions were presented for 8 years. The patient had a history of BO manifested as GVHD. During follow-up, an exophytic mass was rapidly developed on the left dorsum of the tongue. Biopsy of this lesion confirmed SCC (cT2N0M0). Pulmonary function testing for general anesthesia was almost normal. Hemiglossectomy, supraomohyoid neck dissection, and tongue reconstruction were performed. Thirteen months after surgery, the patient showed neither recurrence of tumor nor progression of oral GVHD. However, the patient died of respiratory failure due to repeated pneumothoraxes and deterioration of BO.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"6015803"},"PeriodicalIF":0.7,"publicationDate":"2019-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6015803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case of Stroke from Cerebral Vasculitis following Carfilzomib, Lenalidomide, and Dexamethasone Therapy in a Patient with Relapsing Multiple Myeloma.","authors":"Deborah Osafehinti, Kaveh Zivari","doi":"10.1155/2019/5180424","DOIUrl":"https://doi.org/10.1155/2019/5180424","url":null,"abstract":"<p><p>Lenalidomide, a synthetic derivation of thalidomide, in recent years, has been the backbone of multiple myeloma treatment leading to improved survival. Common adverse effects from lenalidomide-based regimens include hypertension, heart disease, and venous thromboembolism. Hence, thromboprophylaxis is recommended to reduce the risk of stroke. We report a case of stroke from cerebral vasculitis in a patient receiving carfilzomib, lenalidomide, and dexamethasone for relapsing multiple myeloma, not previously published. Medical oncologists should be aware of other causes of stroke among multiple myeloma patients receiving a lenalidomide-based regimen to prevent its occurrence.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2019 ","pages":"5180424"},"PeriodicalIF":0.7,"publicationDate":"2019-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5180424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}