We report a case of
Toxocara canis infection manifested by persistent eosinophilia, pulmonary nodules on CT scan, and myocardial manifestations in a 38-year-old man who was a dog trainer. ...Toxocariasis is not common in adults and rarely affects the heart.
Acute myeloid leukemia (AML) is a morphologically diverse group of hematopoietic malignancies characterized by proliferation of immature cells that arise in the myeloid progenitor cells of the bone ...marrow. It shows cutaneous lesions relatively rarely. The most common cutaneous manifestation is the appearance of one or several tumors. An association of AML with skin involvement and trisomy 8 has rarely been reported. We present the case of a 74-year-old woman that presented with fatigue, nausea, dyspnea, and night sweats. On physical examination we found no hepatosplenomegaly, peripheral lymphadenopathy, or skin abnormalities. Hematological examination revealed Hb: 8.4 g/dl, PLT: 35,000/ml, WBC 105,000/ml, and blasts 51%. Bone marrow aspiration showed blasts 88%. Cytogenetic findings in the marrow showed trisomy 8. The patient received 3 courses of systemic chemotherapy with aracytin and idarubicin and then, while she was in remission, multiple red nodules developed on the upper and lower limbs. A skin nodule from the right arm was excised and histology showed a diffuse infiltration of the dermis consisting of large cells with round to oval nuclei and little basophilic cytoplasm. Immunohistochemistry was performed and the neoplastic cells showed strong positivity for MPO but were negative for LCA. Accordingly, a diagnosis of AML involving the skin was made. The patient received another course of systemic chemotherapy with aracytin and idarubicin and is in good condition.
The myelodysplastic syndromes (MDS) remain challenging to the clinician in terms of diagnosis and management. The diagnosis is essentially one of exclusion in first ruling out other disorders that ...can also cause peripheral blood/bone marrow cell dysplasia and cytopenias. Recent studies implicate extensive apoptosis as the explanation of the paradoxical observation of marrow hyperplasia, but peripheral blood cytopenia. The clonal nature of MDS places it also at continual risk for transformation to acute leukemia. Predicting overall survival as well as the risk of acute myeloid leukaemia (AML) transformation has been improved by the development of the International Prognostic Scoring System (IPSS). Management of MDS can now be based on the patients respective prognostic subgrouping. Low-risk patients should be considered for hematopoietic growth factor singly or in combination, while high-risk patients should be offered AML-induction therapy or novel therapeutic agents. Common complications are neutropenias with recurrent infections and red cell transfusion dependence. Future advances upon understanding the molecular details of the MDS clone should ultimately improve the care of patients with MDS.
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