Squamous cell carcinoma of the tongue in a patient with Fanconi's anemia: a case report and review of the literature

Fanconi's anemia (FA) is an autosomal recessive disorder characterized by constitutional aplastic anemia and congenital abnormalities. Patients with this disorder are prone to develop leukemia. Besides the risk of squamous cell carcinoma (SCC), development especially in the head and neck region is also increased. Up to now 40 patients with FA have been reported to develop SCC, and in 14 of them the tongue was the primary site. All of the reported SCC in FA patients originated in mucosal and mucocutaneous sites, especially oral (n=25) and anogenital sites (n=8) and the esophagus (n=6), with the exception of two patients with multiple cutaneous involvement. We report a new case of SCC of the tongue in a patient with FA and review the previous SCC cases.     

Hepatocellular carcinoma and squamous cell carcinoma in a patient with Fanconi's anemia

Summary Acute leukemia, hepatocellular carcinoma, and squamous cell carcinoma have been reported in patients with Fanconi's anemia. We report on a 31-year-old woman who developed squamous cell carcinoma of the esophagus and hepatocellular carcinoma. Jaundice and hepatic tumor developed in 1981, after she had received oxymetholone for 10 years. Liver biopsy revealed peliosis hepatis. Androgenic therapy was stopped and the jaundice resolved. However, the hepatic tumor was observed to be unchanged. The patient died of disseminated squamous cell carcinoma, but no metastatic lesions from hepatocellular carcinoma were detected in the autopsy. The association of Fanconi's anemia and squamous cell carcinoma is reviewed, and the malignant potential of androgen-related hepatic tumors is discussed.     

Renin producing neuroendocrine pancreatic carcinoma--a case report and review of the literature.

A 44 year old male patient presented with severe hypertension. The diagnostic work-up revealed elevated levels of plasma renin activity (about 10 times the upper limit of normal) in the presence of normal plasma aldosterone levels and serum potassium concentrations. Renovascular disease was excluded by angiography. Selective renal vein sampling did not show any renin gradient. CT-scans of the abdomen demonstrated normal morphology of the kidneys and adrenals but revealed a big mass in the pancreatic corpus and tail with infiltration of the splenic vein and the presence of enlarged local lymph nodes. The endocrine nature of the pancreatic mass was further supported by a positive octreotide scintigraphy scan. Surgical removal of the tumor by left sided pancreatectomy combined with splenectomy resulted in rapid normalization of elevated renin concentrations as well as blood pressure. Histological examination of the tumor tissue revealed the presence of a neuroendocrine pancreatic carcinoma. Highly (x 70) elevated renin levels were detected by radioimmunoassay in the tumor tissue.To our knowledge this is the first renin-producing neuroendocrine pancreatic carcinoma described in the literature. The present paper describes the case in detail and reviews the available literature on clinical symptomatology, diagnosis and treatment of renin-producing tumors.     

再生障碍性贫血并发Sweet综合征1例报告并文献复习

目的:提高对再生障碍性贫血并发Sweet综合征的认识。方法:报告1例再生障碍性贫血并发Sweet综合征患者的临床资料,并作文献复习。结果:Sweet综合征可发生在未接受粒细胞集落刺激因子治疗的再生障碍性贫血患者中。结论:Sweet综合征并发再生障碍性贫血时粒细胞可减少,应用皮质类固醇治疗有效。     

肺鳞癌并发嗜酸粒细胞型类白血病反应1例并文献复习

目的 提高临床医师对肺癌伴类白血病反应(leukemoid reaction,LR)的认识,减少漏诊、误诊.方法 报道中南大学湘雅二医院呼吸内科2011年10月收治的1例肺癌并嗜酸粒细胞型LR,对国内外文献共报道的55例肺癌伴LR的临床症状、外周血象、骨髓学特征、治疗及预后进行分析.结果 国内共报道了16例肺癌伴LR,国外近10年共统计和报道了39例肺癌伴LR.55例LR中仅3例为嗜酸粒细胞型,50例为中性粒细胞型,2例未报道具体类型.以“肺癌”和“类白血病反应”为主题词检索中国期刊网全文数据库,结果有相关文献12篇,共报道16例肺癌合并LR,有13例取得肺癌病理组织类型,14例行骨髓学检查.以“lung cancer”和“leukemoid reaction”加时间限制“10 years”在Pubmed里可检索到6篇相关文献,共统计39例肺癌并LR,均取得肺癌病理类型及骨髓学结果.以“lung cancer”和“eosinphil”为主题词检索Pubmed,无相关报道.结论 肺癌合并嗜酸粒细胞型LR尚属罕见.LR一般发生在肿瘤晚期,骨髓检查对其诊断很重要,一旦出现提示疾病预后差,大多在1～6个月内死亡.     

Laryngeal sarcocystosis accompanying laryngeal squamous cell carcinoma: case report and literature review

Laryngeal sarcocystosis is an uncommon zoonotic coccidian protozoal infestation of human beings. The authors reviewed the pathology of 1,063 laryngeal biopsies over the past 10 years (2000 to 2009). Only one case of laryngeal sarcocystosis accompanying laryngeal squamous cell carcinoma was identified. The overall prevalence of laryngeal sarcocystosis was 0.094%. The case was a 66-year-old man who presented with voice hoarseness for six months. Physical examination and computed tomography revealed an ulcerative exophytic mass on the right true vocal cord, suggestive of laryngeal carcinoma. He underwent a right frontolateral partial laryngectomy. Histopathology showed a nonkeratinizing squamous cell carcinoma with Sarcocystis spp in the vocalis muscle. He was followed up and enrolled in speech therapy. The authors briefly review the clinicopathologic features and pathogenesis of muscular sarcocystosis and concurrent laryngeal sarcocystosis and squamous cell carcinoma.     

Primary squamous cell carcinoma of the stomach: a case report with a review of Japanese and Western literature

A case of a 75 year-old male with primary squamous cell carcinoma of the stomach is reported. It is extremely rare to see squamous cell carcinoma developing in the stomach, without being accompanied by a component of adenocarcinoma. Up to the present, 18 Japanese and 62 Western cases of this type of carcinoma have been reported in the literature. The origin of this malignancy has not been well elucidated yet and thus, several plausible hypotheses have been proposed. In this presented case, the tumor consisted of only squamous cell carcinoma and the focus of squamous metaplasia was not found histologically in the adjacent mucosa. Therefore, it may be considered that the carcinoma arises from misplaced squamous cell nests of the stomach.     

Primary squamous cell carcinoma of the stomach: a case report and review of the literature

Primary squamous cell carcinoma of the stomach is extremely rare. To date, only 80 cases have been reported. A 65-year-old man with complaints of epigastric pain and cachexia for the past year is presented. He had a tumour with infiltration of the corpus and antrum of the stomach. The tumour was unresectable, and the patient died within 3 months.     

成人支原体肺炎并发溶血性贫血一例并文献复习

目的 提高临床医生对成人支原体肺炎并发溶血性贫血的认识.方法 报道1例成人支原体肺炎并发溶血性贫血病例,以mycoplasma pneumonia、hemolytic anemia、adult及case report为检索词,检索时限为1967年1月至2011年3月,通过PubMed检索系统进行检索;同时以“肺炎,支原体,溶血性贫血,成人”为检索词,检索时限为1978年1月至2011年3月,通过万方数据库对中文文献进行检索,共检索出相关临床资料完整的病例报告9篇.结合国内外文献报道的9例同类病例的临床资料进行分析.结果 患者女,29岁,因“发热伴咳嗽、咳痰15 d,血红蛋白下降2d”入院.X线胸片示左下肺渗出性病变,发病第14天外周血血红蛋白下降,最低至83 g/L,网织红细胞为0.04,同时室温下抽出的静脉血在试管中凝集,血清支原体抗体IgM阳性,冷凝集素滴度为1∶256.经抗感染治疗2周后血红蛋白含量恢复正常,肺部病变消失,诊断为支原体肺炎并发溶血性贫血.复习国内外文献报道的9例临床资料完整的成年病例,10例中男6例,女4例,年龄29 ～60岁,8例在发病第8～18天出现溶血性贫血,10例均出现血冷凝集素滴度增高(其中7例＞1∶1024),2例发生血管内栓塞.10例中9例痊愈,1例死亡.结论 支原体肺炎并发溶血性贫血多发生在发病第8～18天,与冷凝集素滴度增高相关,部分病例同时出现血管内栓塞.多数病例预后良好,少数重症病例预后不良.     

肺鳞癌结肠黏膜转移一例报告和文献复习

肺癌患者发生结肠转移非常罕见，患者一般无典型症状，晚期可出现腹痛、消化道出血、梗阻、穿孔等症状，并发症和死亡率较高，短期预后差。本中心报道一位63岁男性患者，以"间断咳嗽和右下腹隐痛"就诊，诊断肺鳞状细胞癌并纵隔淋巴结转移和结肠寡转移，经过PD-1免疫治疗，症状改善明显，目前仍在治疗和随访中。     

原发性肺鳞癌回盲部转移1例报道并文献复习

目的 提高对原发性肺癌消化道转移的认识。方法 报道1例原发性肺鳞癌回肓部转移的病例,并对肺癌胃肠道转移相关文献进行复习。结果56岁男性,突发右下腹疼痛伴咳嗽、咯痰,发现头顶部肿物1个月。以“急腹症”为首症就诊,手术病理证实为回盲部鳞癌、癌性穿孔,经支气管镜活检确诊为肺鳞癌,同时合并多部位转移。结论肺癌胃肠道转移较为少见...     

Red cell hypoplasia following autoimmune hemolytic anemia associated with T-CLL: report of a case and review of the literature

A 78-year-old woman, who had axillary lymphadenopathy but no hepatosplenomegaly, was admitted because of lymphocytosis. The leukocyte count was 18.1 x 10(9)/l with 72% abnormal cells. Neither anemia nor thrombocytopenia was present. Many abnormal cells and erythroblasts were seen in the bone marrow. These abnormal cells had irregular nuclei but no granules in the cytoplasm. The surface markers of these cells were positive for E-rosette, CD 2, CD 3, and Leu 7 but negative for CD 4, CD 8, CD 11 (OKM 1), CD 16 (Leu 11), and HLA-DR. The DNA analysis revealed the rearrangement of T-cell receptor beta-chain genes. Direct Coombs test was positive and red-cell life-span (51Cr) was T 1/2 = 19.5 days. The patient was diagnosed as having T-CLL with mild autoimmune hemolysis and was followed without treatment. Seven months later, the leukemia cells of peripheral blood increased to 62.6 X 10(9)/l and the frank autoimmune hemolytic anemia developed. After prednisolone, vincristine and cyclophosphamide were administered, leukemia cells of blood decreased. Anemia with reticulocytopenia, however, persisted and direct Coombs test became negative. In the bone marrow at that time, many neutrophils and megakaryocytes besides leukemia cells were preserved, but erythroblasts were hardly seen, namely a pattern of red cell hypoplasia was observed. The patient deteriorated rapidly and died 26 months after initial recognition of lymphocytosis. When complement was added, the patient's serum obtained during red cell hypoplasia but not during autoimmune hemolysis inhibited BFU-E and CFU-GM in in vitro colony assays. This case indicates that not only B-CLL but also T-CLL is accompanied by immune hematocytopenia.     

Megaloblastic anemia associated with psoriasis: case report and review of the literature.

A 68-yr-old male with severe psoriasis developed megaloblastic anemia due to folate deficiency 3 months after the cessation of low-dose methotrexate therapy. The mechanism of megaloblastic anemia in this case was suggested to be multifactorial. The case report and a review of megaloblastic anemia associated with psoriasis are presented.     

Ticlopidine-induced aplastic anemia and quick recovery with G-CSF: case report and literature review

We report here a case of ticlopidine-induced aplastic anemia that responded to G-CSF and review the literature. An 83-year-old woman was started on ticlopidine for coronary artery disease after an episode of upper gastrointestinal bleeding secondary to aspirin. She developed aplastic anemia seven weeks after initiation of ticlopidine. She was hospitalised and received empiric antibiotic therapy and granulocyte colony stimulating factor (G-CSF). Her bone marrow started to recover quickly, and white blood cell and platelet counts returned to normal within three weeks. A review of medical literature revealed 20 similar cases of ticlopidine-induced aplastic anemia resulting in death in seven cases. G-CSF has been used previously with variable success. Ticlopidine is associated with serious, sometimes fatal hematological side effects. This risk should be seriously taken into consideration when prescribing ticlopidine. G-CSF may be helpful in the treatment of ticlopidine-induced aplastic anemia.     

Liver cell adenoma： A case report with clonal analysis and literature review

We report a case of liver cell adenoma (LCA) in a 33-year-old female patient with special respect to its clonality status, pathogenic factors and differential diagnosis. The case was examined by histopathology, immunohistochemistry and a clonality assay based on X-chromosomal inactivation mosaicism in female somatic tissues and polymorphism at androgen receptor focus. The clinicopathological features of the reported cases from China and other countries were compared. The lesion was spherical, sizing 2 cm in its maximal dimension. Histologically, it was composed of cells arranged in cords, most of which were two-cell-thick and separated by sinusoids. Focal fatty change and excessive glycogen storage were observed. The tumor cells were round or polygonal in shape, resembling the surrounding parenchymal cells. Mitosis was not found. No portal tract, central vein or ductule was found within the lesion. The tumor tissue showed a positive reaction for cytokeratin (CK) 18, but not for CK19, vimentin, estrogen and progesterone receptors. Monoclonality was demonstrated for the lesion, confirming the diagnosis of an LCA. Clonality analysis is helpful for its distinction from focal nodular hyperplasia.     

Solitary pancreatic metastasis from squamous cell lung carcinoma: A case report and review of literature

BACKGROUNDPancreatic metastases from squamous cell lung carcinoma (SCLC) are unusual. These lesions are often asymptomatic and detected incidentally or during follow-up investigations, occasionally several years after removal of the primary tumor.CASE SUMMARYA 56-year-old male with SCLC developed jaundice 1 mo after the cancer diagnosis. An abdominal computed tomography (CT) scan showed a mass in the pancreatic head with distention of both intra- and extrahepatic biliary ducts. Endoscopic retrograde cholangiopancreatography and sphincterotomy were performed first, culminating with plastic biliary stent placement. Cytological examination of the pancreatic mass sample collected by fine-needle aspiration (FNA) under endoscopic ultrasound (EUS) guidance revealed the presence of malignant cells compatible with well-differentiated squamous cell carcinoma. After liver function normalized, chemotherapy was initiated with carboplatin and paclitaxel; however, 4 d later, the patient presented dysphagia. Cervico-thoraco-abdominal CT showed tracheoesophageal fistula and stent migration. After replacement with a 10 cm/10 mm uncovered metallic biliary stent and treatment of the tracheoesophageal fistula with a fully covered esophageal stent, the patient was able to start oral feeding progressively. He died 9 mo after the initial diagnosis.CONCLUSIONThe diagnosis of pancreatic metastasis from SCLC is challenging for clinicians. EUS-FNA is the primary exam for confirmatory diagnosis.     

Hemolytic anemia in native valve infective endocarditis: a case report and literature review

Hemolytic anemia is a rare manifestation of infective endocarditis. A 19-year-old man with a small ventricular septal defect developed right-sided infective endocarditis with huge vegetations involving the tricuspid valve, the ventricular septal defect, and the pulmonary valve. Intravascular hemolysis was suggested by the presence of numerous fragmented erythrocytes, giant platelets and polychromasia of the red blood cells. The direct Coombs test was positive, and there were spherocytes and splenomegaly, findings that suggested an immune-mediated mechanism also played a role in the hemolysis. The hematological picture persisted despite antibiotic therapy and recovered only after surgical removal of the vegetations, tricuspid and pulmonary valvectomy, and patch closure of the ventricular septal defect.