神经纤维瘤病Ⅰ型伴急性髓系白血病1例

1病例资料 患儿,男,6岁,主因"面色发黄、乏力1个月"于2021年1月就诊于我院.患儿为第2胎第2产,生长发育无异常,平素体健.患儿父亲全身可见8块咖啡牛奶斑,最大者4.5 cm×2.5cm,左侧眼睑下垂,躯干部可扪及数个皮下结节.患儿姐姐全身皮肤同样可见咖啡牛奶斑.人院查体:重度贫血貌,全身皮肤可见20块咖啡牛奶斑...     

儿童急性淋巴细胞白血病伴白血病细胞噬血细胞现象1例

<正>急性淋巴细胞白血病细胞吞噬血细胞现象很少见,伴髓系表达的急性淋巴细胞白血病伴白血病细胞噬血现象文献中未见报道,本科收治1例现报道如下。     

急性淋巴细胞白血病1例

患儿,女,5岁,发热2d,体检:T39℃,神清,急性病容,咽部粘膜充血,余未见异常。WBC11.2×10~9/L,对症治疗后好转出院,出院后患儿又发烧,给抗感染等治疗效差,多次检查血常规,白细胞(14.3～16.5)×10~9/L,Hb(100～110)g/L,1周来胸痛及四肢疼痛,牙龈出血,鼻出血3次,全身处于衰竭状态,可疑白血病,再次住院。体检:     

急性淋巴细胞白血病误诊1例

患儿,女,9岁,因四肢、关节酸痛月余,伴发热、胸闷0.5d入院。T38℃,R26次/min,P170次/min,Bp14/7kPa。地中海贫血外貌,精神差,烦躁。全身皮肤粘膜明显苍白,两颌下、腹股沟淋巴结肿大,     

急性淋巴细胞白血病伴眼球突出一例

患儿 ,男 ,1 1岁 ,因“反复发热 ,大腿疼痛八个月 ,眼球突出八天”入院。患儿八个月前出现不规则发热 ,双大腿外侧肌肉疼痛 ,不能站立行走 ,局部无红肿 ,经当地医院抗风湿治疗三天好转 ,停药五天后复发 ,再次用药好转 ,如此反复。八天前双眼球突出 ,视力无改变。体格检查 :体温 38.5℃ ,脉搏 1 0 0次 /分 ,呼吸 2 4次 /分 ,神志清 ,贫血貌 ,全身未见皮疹、出血点。左右颈部及腹股沟触及六个蚕豆大小淋巴结 ,质中无触痛。双侧眼球突出 ,活动灵活。颈软 ,胸骨无压痛 ,心肺未见异常。腹软、肝脾肋下未触及。脊柱活动正常。四肢无畸形 ,各关节无…     

急性淋巴细胞白血病转型为急性髓细胞白血病1例

患儿 ,女 ,4岁 ,因反复发热 2个月、皮肤瘀斑 6d入院。入院查体 :体温 36 .7℃ ,脉搏 118次 /min ,呼吸 36次 /min ,体重 14kg ,神清 ,呼吸平稳 ,右前臂外侧可见约 1cm× 1cm瘀斑 ,浅表淋巴结无肿大 ,咽充血 ,扁桃体不大。双肺呼吸清 ,心率 118次 /min ,未闻及病理性杂音。腹平软 ,肝肋下3.0cm ,剑下 4 .5cm ;脾肋下、剑下 1.5cm ,质中 ,边缘锐 ;肠鸣音活跃 ,肌张力正常 ,双下肢无水肿。血WBC 3.1× 10 9/L ,Hb 76 g/L ,BPC 12× 10 9/L ,胸骨骨髓检查 :有核细胞增生活跃 ,以淋巴细胞为主 ,约 0 .985 ,原始 +幼稚淋巴细胞0 .5 5 5 ,该细…     

先天性急性非淋巴细胞白血病1例

患儿,男、出生4小时,因全身紫色皮疹4小时于2001年6月10日入院。患儿系第2胎第2产足月妊娠剖宫产。出生体重3 400g。无产伤及窒息史。出生时即发现全身皮肤遍布大小不等紫色小结节样皮疹。胎粪褐色。无呕血及尿血。父母非近亲结婚。母亲32岁,体健,否认孕期有服药史及毒物、放射线、宠物接触史,亦无感染及妊高征病史。第1胎为女孩,现11岁,体健。体检:神清,体温37℃,呼吸42次/min,脉搏126次/min,反     

先天性急性非淋巴细胞白血病1例

患儿,男、出生4小时,因全身紫色皮疹4小时于2001年6月10日入院.患儿系第2胎第2产足月妊娠剖宫产.     

急性淋巴细胞白血病腮腺浸润1例

3岁男孩,因间断发热、双侧腮腺肿大28d,诊断流行性腮腺炎,收住传染病院。经用抗病毒、抗感染及支持疗法等治疗疗效欠佳,体检发现患儿精神萎靡,面色苍白,全身浅表淋巴结、双侧腮腺、肝脏、脾脏均肿大。血常规:Hb67g/L,RBC2.23×10~(12)/L,WBC11.8×10~3/L,No.01,L     

手镜形急性淋巴细胞白血病1例

患儿,女10岁。因面色苍白、乏力、食欲差1个多月而于1989年1月8日入院。体检:发育营养中等,贫血外貌,皮肤无出血点。淋巴结不大,心音于胸骨左缘第3、4肋间可闻Ⅱ～Ⅲ级收缩期吹风样杂音,肺正常。腹软、肝肋下0.5cm,脾不大。血红细胞1.41×10~(12)/L,血红蛋白46g/L,血小板110×10~9/L,白细胞12.3×10~9/L,中性0.64,淋巴0.33,幼稚细胞0.03。骨髓:有核细胞增生极度活跃,淋巴系列高度增生,以原、幼淋巴细胞为主(51.5%),其中75%呈     

急性淋巴细胞白血病继发粒细胞肉瘤一例

患儿男,12岁.因“急性淋巴细胞白血病6年半,停药2年5个月,发现左侧睾丸肿大1d”于2003年7月入院.患儿6年半前(1997年1月27日)在我院因“间断发热10d,发现面色苍白皮肤出血点3d”入院,血常规示外周血幼稚细胞0.55,骨髓原始淋巴细胞 幼稚淋巴细胞0.945,糖原染色(PAS)0.1,过氧化物酶染色(POX)(-),单抗CD5( )、CD7( )、CD34( )、CD38( )、CD13(-)、CD33(-),确诊为急性淋巴细胞白血病(ALL)T细胞表型.     

Ulcerating molluscum contagiosum in a boy with relapsed acute lymphoblastic leukemia

Molluscum contagiosum is an infectious disease presenting with flesh-colored, dome-shaped, umblicated papules. A few atypical presentations have been reported in immunodeficient patients. A 5-year-old boy with acute lymphoblastic leukemia, presented with bright white-colored papular lesions with no umblications on the chin during his continuation chemotherapy. Increased number of the lesions covered almost his entire chin in months. Topical therapies did not improve the lesions. After his bone marrow relapse, induction chemotherapy was withheld because of bronchopneumonia after febrile neutropenia. After initiation of a combination of systemic parenteral antibiotic and antifungal therapies, his parents squeezed one of his papular lesions. Meanwhile, systemic acyclovir was added to his therapy, because of herpes labialis. Despite the large spectrum of his therapies, in 1.5 months, this small lesion progressed to a large lesion with erythematous ground and a central ulceration. Etiology of the lesion could not be enlightened until a skin biopsy that was compatible with the molluscum contagiosum. A partial resolution was achieved by cryotherapy. In conclusion, molluscum contagiosum may present as an ulcerating lesion during childhood leukemia treatment. A skin biopsy should be performed for the accurate diagnosis of atypical cutaneous lesions in immunocompromised patients.     

Life-threatening hypercalcemia complicated by pancreatitis in a child with acute lymphoblastic leukemia

The authors describe a 9-year-old girl with precursor-B acute lymphoblastic leukemia (ALL) who presented with dehydration and severe hypercalcemia. She had received oral vitamin D and calcium supplementation for 4 days, the last dose 48 hours prior to admission, and required pediatric intensive care unit (PICU) hospitalization for management of the hypercalcemia and safe initiation of induction chemotherapy. Her clinical course was complicated by pancreatitis, disseminated intravascular coagulation, pleural effusion, and focal seizures. Although the exact mechanism of hypercalcemia was not elucidated, it was likely related to the underlying ALL, without dismissing the prior vitamin D and calcium supplementation as a possible contributing factor. The hypercalcemia resolved with specific antileukemic therapy along with supportive care and administration of calcitonin. Hypercalcemia is an uncommon metabolic abnormality in children with ALL, but it can be life-threatening. Children with ALL should be referred to tertiary-care institutions with PICU and subspecialty support because serious metabolic and other complications can occur before or after the administration of chemotherapy.     

Pediatric acute lymphoblastic leukemia complicated by secondary hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) may be familial or secondary to infections, malignancies, metabolic disorders. Infectious causes are mostly viral and EBV is the mostly frequently seen etiologic agent. In this case, we report a child with acute lymphoblastic leukemia (ALL), who had three episodes of secondary HLH, possibly due to two different viral etiologies, namely CMV and RSV together with her malignancy, during her induction‐consolidation treatment. Pediatr Blood Cancer 2009;53:491–492. © 2009 Wiley‐Liss, Inc.     

急性淋巴细胞白血病化疗后出现B淋巴前体细胞增多1例

No abstract available

     

儿童急性淋巴细胞白血病并发糖尿病一例

患儿女,13岁。主因“发热头晕伴纳差,乏力皮肤瘀斑7d”于2002年6月7日入院。患儿无糖尿病家族史及既往糖尿病史。体检：贫血貌,肝大,浅表淋巴结轻度增大。血象示原 幼淋为8％;骨髓象示原 幼淋为86％;单抗示普通B淋巴细胞表型。故诊断为急性淋巴细胞白血病(简称急淋,ALL)。确诊后拟用长春新碱(VCR) 柔红霉素(DNR) 左旋门冬酰胺酶(L-ASP) 地塞米松(D EX),即VDLD EX方案诱导。化疗前空腹静脉血糖5．38mmol／L。     

儿童急性淋巴细胞白血病化疗后合并肺部感染的临床特征

目的分析化疗后合并肺部感染的急性淋巴细胞白血病(ALL)患儿的临床特征,为ALL合并肺部感染的早期诊断提供依据。方法对115例次化疗后合并肺部感染且行肺部CT的ALL患儿(108例)进行回顾性分析,收集患者一般临床资料及肺部螺旋CT结果,探究肺部感染发生的危险因素,以及病原体与肺部CT的影像学特点。结果儿童ALL化疗后的肺部感染77.4%发生于诱导缓解阶段,多发生于化疗后的31~60?d,以粒缺患儿所占比例(67.0%)最高。病原学拟诊或确诊的41例肺部感染患儿以细菌感染(36%)与真菌感染(41%)的发生率较高。细菌或真菌感染所致肺部病变CT表现的差异无统计学意义(P0.05)。结论 ALL患儿在化疗诱导缓解阶段,尤其是粒细胞缺乏时肺部感染发生率高。细菌和/或真菌是主要病原体,难以根据肺部影像学改变明确肺部感染的性质。     

Rhinocerebral mucormycosis in a boy with recurrent acute lymphoblastic leukemia: long-term survival with systemic antifungal treatment

Rhinocerebral mucormycosis is rare in hematologic malignancies and usually leads to death within weeks. In contrast, chronic rhinocerebral mucormycosis takes a slowly progressive course and has not been reported in hematologic malignancies in children so far. The authors report the long-term survival of a boy with rhinocerebral mucormycosis in a relapse of acute lymphoblastic leukemia after allogeneic cord blood transplantation. The disease started acutely but took a chronic course thereafter. No surgical debridement was performed because of extensive involvement of the sinuses, orbits, and cerebrum. His long-term survival of 15 months is attributed to the long-range administration of liposomal amphotericin B, early neutrophil recovery, and slow progression of the relapsing acute lymphoblastic leukemia.