Hairy cell leukemia

Clinical experiences on seven patients suffering from hairy cell leukaemia are presented. The disease was most often identified at age above 50 and was more frequent in men. Splenomegaly and infiltration of bone marrow or spleen with tartrat resistant acid phosphatase positive lymphoid cells were detected in all cases. Splenectomy resulted complete clinical remission in six and partial remission in one patient. Two patients have died. The mean survival time is five years. The surviving patients are in good clinical remission.     

Hairy cell leukemia: authors' own experience (1977-1998)]

Hairy cell leukaemia (HCL) is a rare, clinically and haematologically well characterised entity. The prognosis of patients with hairy cell leukaemia has significantly improved due to the new therapeutic approaches. Development of diagnostic and therapeutic methods, together with the analysis of their own hairy cell leukaemia patients, is reviewed by the authors. Between 1977 and 1998 twenty five patients (16 male, 9 female) were treated. The malignant cells were usually analysed by morphological and cytochemical methods and recently flow cytometric analysis could be performed in eight patients. Splenectomy with lethal outcome in six patients was performed in 21 cases. Approximately one third of patients received interferon, while 2-chlorodeoxyadenosine was given only to three patients. Favourable experiences obtained by splenectomy and efficacy of interferon treatment are emphasised, but according to the literature and their own results administration of purine analogues can be highly recommended in the future.     

Cytology and immunophenotype features of hairy cell leukemia: 6 cases

BACKGROUND: Hairy cell leukemia is a rare lymphoproliferative disorder. AIM: with cytological and immunophenotypic features. METHODS: We report 6 cases of hairy cell leukemia diagnosed in the Biological Department of Hematology at the Aziza Othmana Hospital of Tunis. RESULTS: Hairy cells was observed in blood smears of 5 cases. Flow cytometry analysis shown monoclonal a monoclonal population B while gatinting on the expression of the CD19 and SSC signal. The positivity of the CD103 is noted in 5 cases and the CD11c signal is intense in all the cases. CONCLUSION: Immunophenotype is of great interest in the diagnosis of hairy cell leukemia.     

Cardiac hydatid cyst (report of 8 cases)

Hydatic cardiac cyst (HCC) is a rare anomaly, characterized by wide spectrum of clinical presentations. Its diagnosis took large benefit from echocardiography progress. We aimed in this study to analyse epidemiologic aspect of HCC, as well as its diagnostic data, with special emphasize on echocardiography. Observations of 8 patients, admitted between 1991 and 2000 has been reviewed. Age average was 30 years (13 to 59). Main symptoms consisted of chest pain (62.5%) and dyspnea (35%). Chest X-Rays showed cardiac silhouette anomaly in 4 cases. Electrocardiogram showed sub-epicardical ischemia in 5 patients. HCC diagnosis was established by transthoracic echocardiography in all cases. It was located inside a cardiac chambers (n = 5), the interventricular septum (n = 2), and the pericardium (n = 1). HCC relation with adjacent cardiac structures was well defined by transoesophageal echocardiography performed in 7 cases. All patients underwent surgery with good immediate results. All patients were events free, with a mean follow-up of 25 months.     

Secondary plasma cell leukemia. Report of 2 cases

Plasma cell leukemia is considered as the leukemic variant of multiple myeloma. It is a rare entity. There are two forms: a secondary one following a known myeloma, the diagnosis of which is easy, and a primary one arising without a preceding phase of multiple myeloma. The diagnosis of the latter form is more difficult, a differential diagnosis has often to be discussed with other lymphoproliferative diseases. Prognosis is poor. We report 2 cases of secondary plasma cell leukemia diagnosed over ten years, among 59 of multiple myeloma cases. We describe the epidemiologic, clinical, biological and evolutionary characteristics.     

N形回肠膀胱替代术的应用研究(附8例报告)

目的 评价N形回肠膀胱替代的疗效. 方法 男性膀胱恶性肿瘤患者8例,腹膜外切除膀胱前列腺,截取35～40cm回肠纵形切开后N形折叠形成贮尿囊,以改良乳头法将两侧输尿管分别移植于N形新膀胱的上臂的两侧,贮尿囊底部与尿道4～6针吻合,将贮尿囊完全置于腹膜外. 结果 本组8例手术时间6～7h,术中平均出血500ml,术后随访2～27个月,平均13个月,原位回肠新膀胱控尿、排尿良好,术后静脉尿路造影、B超检查未见上尿路扩张,膀胱造影未发现输尿管返流,血生化检查正常,未发现新膀胱或尿道肿瘤复发. 结论 N形回肠膀胱替代术手术时间短,操作简单,创伤轻,并发症少;新膀胱容量大,内压低,顺应性好,功能接近于正常膀胱,保持原位排尿,明显提高了患者术后的生活质量,值得临床推广应用.     

Acute nonlymphatic leukemia among deck officers on coastal tankers: a report of two cases

Deck officers on coastal tankers may be exposed to high concentrations of cargo vapors during loading and tank-cleaning operations. Two cases of acute nonlymphatic leukemia are described. Both men had worked as chief officers on coastal tankers transporting benzene and other petroleum products.     

胰岛细胞瘤17例诊治分析

目的　探讨胰岛细胞瘤的诊断和治疗。方法　回顾分析 17例胰岛细胞瘤患者的临床资料 ,分析其临床表现、治疗方法和治疗效果。结果　 17例患者中 12例胰岛细胞瘤者手术 9例 ,术后血糖全部恢复正常 ;5例无功能胰岛细胞瘤中 3例为恶性 ,2例为良性 ,手术后均无复发或转移。结论　胰岛细胞瘤容易误诊误治 ,早期诊断是关键 ,手术切除可取得良好效果。     

一起职业接触性有机磷农药急性中毒8例调查报告

目的 通过对一起职业接触性有机磷农药急性中毒事故情况进行调查分析,为制定预防措施提供科学依据.方法 采用流行病学调查方法,结合临床表现和实验室检测,对中毒患者使用药物抢救治疗效果进行调查分析.结果 8例有机磷农药急性中毒患者中,5例经住院抢救治疗后康复出院,3例中毒患者因来不及送医院抢救治疗,在家中死亡.结论 违规购买使用国家明令禁止使用的剧毒农药是造成本次中毒事故发生的主要原因,应加强农业、安监、公安、卫生等部门联合监督执法,加强农药安全监管,坚决取缔违法生产、销售、使用已明令禁止的剧毒农药,同时,应广泛开展有机磷农药安全使用知识的宣传教育,提高广大人民群众农药安全使用的意识,严防农药中毒事故的发生.     

Hairy cell leukaemia and occupational exposure to benzene.

OBJECTIVES: The role of occupational exposures in hairy cell leukaemia (HCL) was investigated through a multicentre, hospital based, case-control study. This paper analyses the role of exposure to benzene in HCL. METHODS: A population of 226 male cases of HCL and 425 matched controls were included in the study. Benzene exposure was evaluated by expert review of the detailed data on occupational exposures generated by case-control interviews. RESULTS: No association was found between HCL and employment in a job exposed to benzene (odds ratio (OR) 0.9 (95% confidence interval (95% CI) 0.6-1.3)). The sample included 125 subjects, 34 cases (15%), and 91 controls (21%) who had been exposed to benzene, as individually assessed by the experts, for at least one hour a month during one of their jobs. Benzene exposure was not associated with a risk of HCL (OR 0.8 (0.5-1.2)). No trend towards an increase in OR was detected for increasing exposures, the percentage of work time involving exposure to > 1 ppm, or the duration of exposure. No findings suggested a particular risk period, when the OR associated with the time since first or last exposure, or since the end of exposure, were examined. CONCLUSIONS: In conclusion, with the low exposures prevalent in the sample, the study did not show any association between benzene exposure and HCL.     

Aleukemic leukemia cutis preceding acute monocytic leukemia: a case report

Aleukemic leukemia cutis is an extremely rare clinical presentation in patients who eventually develop acute leukemia, usually of monocytic lineage. This condition is associated with a very poor prognosis and is often difficult to diagnose. We report a case of a 33 years old female with leukemia cutis preceding the onset of acute monocytic leukemia by four months. The patient received induction and consolidation chemotherapy followed by allogeneic bone marrow transplant and has been free of disease for six years. To our knowledge, this is the first documented case in Puerto Rico with the diagnosis of leukemia cutis preceding acute monocytic leukemia.