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Lang AS, Burkeholder SB, Park MH, Ordonez GA, Cooper B, Piñeiro LA, Stone MJ. Red Cell Aplasia and Monoclonal Gammopathy: Inhibition of Erythroid Progenitors by Patient IgG. Proc (Bayl Univ Med Cent) 2018. [DOI: 10.1080/08998280.1998.11930085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Amy S. Lang
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
| | | | - Michael H. Park
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
| | - Guido A. Ordonez
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
| | - Barry Cooper
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
| | - Luis A. Piñeiro
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
| | - Marvin J. Stone
- Department of Oncology and Baylor-Charles A. Sammons Cancer Center, BUMC
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Ladha A, Fudym Y, Gentile TC. Clinical Resolution of Red Cell Aplasia Associated del 17p Multiple Myeloma, When Treated With Bortezomib and Dexamethasone. J Hematol 2017; 7:29-31. [PMID: 32300408 PMCID: PMC7155860 DOI: 10.14740/jh356w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 12/01/2017] [Indexed: 11/18/2022] Open
Abstract
Red cell aplasia has been rarely described in association with multiple myeloma. We present a case of a 79-year-old female, who was initially diagnosed with iron deficiency anemia, which did not improve with iron supplementation and required blood transfusions. Bone marrow biopsy showed red cell aplasia associated with kappa light chain multiple myeloma with 14.8% plasma cells. Further tests showed 0.35 g/dL M protein, and kappa/lambda ratio was 131.84. Cytogenetic showed deletion 13q, deletion 17p, loss of 1p and gain of chromosome 5. Multiple myeloma directed treatment with bortezomib and dexamethasone was initiated. Patient had clinical resolution of anemia and did not require further blood transfusions. This is an intriguing case of red cell aplasia associated with poor risk multiple myeloma (del 17p), which showed clinical improvement in anemia with bortezomib-based therapy. This case highlights the role of clonal plasma cells proliferation in the pathogenesis of red cell aplasia as myeloma directed treatment helped patient to become transfusion independent.
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Affiliation(s)
- Abdullah Ladha
- Department of Hematology and Oncology, State University of New York (SUNY) Upstate Medical University, 750 E Adam St, Syracuse, NY 13210, USA
| | - Yelena Fudym
- Department of Pathology, State University of New York (SUNY) Upstate Medical University, 750 E Adam St, Syracuse, NY 13210, USA
| | - Teresa C Gentile
- Department of Hematology and Oncology, State University of New York (SUNY) Upstate Medical University, 750 E Adam St, Syracuse, NY 13210, USA
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Abstract
The diagnosis of thymic epithelial neoplasms is normally rendered after careful evaluation of their histologic features. In some cases, however, the morphological heterogeneity or overlap with neoplasms of other organ systems can lead to diagnostic uncertainty. On the basis of this, the use of immunohistochemical stains as a diagnostic adjunct has become a popular tool. Although undoubtedly, immunohistochemistry has its role in the diagnosis of difficult cases, to date there are no specific markers that would distinguish thymic epithelial neoplasms from other tumors and interpretation of immunohistochemical results should only ever be made in conjunction with accurate morphologic analysis and careful clinical evaluation. This article will review the current knowledge of the immunohistochemical phenotype of thymic epithelial neoplasms with particular emphasis on its use for diagnostic purposes and the latest advances in this field.
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Jeandel C, Gastin I, Blain H, Jouanny P, Laurain MC, Penin F, Saunier M, Nicolas JP, Guéant JL. Thymoma with immunodeficiency (Good's syndrome) associated with selective cobalamin malabsorption and benign IgM-kappa gammopathy. J Intern Med 1994; 235:179-82. [PMID: 8308482 DOI: 10.1111/j.1365-2796.1994.tb01053.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We have described the first case, to our knowledge, in which recurrent respiratory tract infections were the primary manifestation of thymoma with immunodeficiency (Good's syndrome) associated with cobalamin malabsorption and immunoglobulin M-kappa (IgM-kappa) M component. The intrinsic factor receptor activity was dramatically decreased in a mucosal homogenate prepared from ileal biopsies. This decreased activity could be the principal cause of the malabsorption of labelled cobalamin which was observed in the presence of intrinsic factor. However, it could be the consequence of the cobalamin deficiency, as it is known that a cobalamin deficiency can affect the assimilation of cobalamin, even in presence of exogenous intrinsic factor.
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Affiliation(s)
- C Jeandel
- Internal Medicine Service (Gerontology), Hospital de Brabois, Vandoeuvre les Nancy, France
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Vashi P, Patel B, Musson P, Fahrner J, Rosenbaum R. Corticosteroid-responsive pure red cell aplasia in chronic lymphatic leukemia. Am J Hematol 1987; 26:279-84. [PMID: 3674007 DOI: 10.1002/ajh.2830260310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Acquired pure red cell aplasia characterized by selective failure of erythropoiesis was seen in a 37-yr-old female patient with a diagnosis of chronic lymphatic leukemia (CLL). Though different immunosuppressive therapies have been tried in the past with variable response, there has been no case report of such favorable response to corticosteroids alone. We report this rare and unusual case of PRCA associated with CLL who responded to steroid therapy.
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Affiliation(s)
- P Vashi
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint 48503
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Müller-Hermelink HK, Marino M, Palestro G. Pathology of thymic epithelial tumors. CURRENT TOPICS IN PATHOLOGY. ERGEBNISSE DER PATHOLOGIE 1986; 75:207-68. [PMID: 3514160 DOI: 10.1007/978-3-642-82480-7_7] [Citation(s) in RCA: 74] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Thiagarajan D, Tawadros H, Dipaling S. Pure red blood cell aplasia complicating chronic lymphatic leukemia. Am J Med Sci 1983; 286:22-7. [PMID: 6614043 DOI: 10.1097/00000441-198309000-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
While the occurrence of autoimmune disorders such as hemolytic anemia and thrombocytopenia in chronic lymphatic leukemia (CLL) is well recognized, pure red blood cell aplasia (PRCA) complicating CLL is uncommon and intriguing. This is a report of the clinical course of a patient with B cell CLL who developed PRCA unresponsive to immunosuppressive therapy responsive to subsequent treatment with oxymethalone resulting in complete remission of PRCA.
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Min KW, Waddell CC, Pircher FJ, Granville GE, Gyorkey F. Selective uptake of 75Se-selenomethionine by thymoma with pre red cell aplasia. Cancer 1978; 41:1323-8. [PMID: 638996 DOI: 10.1002/1097-0142(197804)41:4<1323::aid-cncr2820410417>3.0.co;2-#] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Red cell aplasia and an enlarging anterior mediastinal mass developed in a patient being followed for thyroid carcinoma. Differential diagnosis included thymoma and metastatic thyroid carcinoma. Preoperative scanning demonstrated significant uptake of 75Se-selenomethionine whereas 67Ga-galiium citrate failed to visualize the mass. Subsequent thoracotomy revealed a lymphocytic thymoma which was resected, resulting in reversal of the red cell aplasia. The use of 75Se-selenomethionine scanning maybe a useful adjunct in the preoperative evaluation of suspected thymomas.
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Abstract
A case or primary poorly differentiated lymphocytic lymphoma of the ileum in a patient previously found to have an epithelial thymoma is described. While the frequency of malignancies of many types is increased in patients with thymoma, malignant lymphomas represent the most commonly associated tumor type. Lymphomas in these patients may devleop as a result of defective immunologic surveillance, impaired immunoregulation in partially immuno-deficient hosts, or by immunostimulation. The intestinal origin of the tumor in this case suggests that it may have developed as a result of local stimulation of lymphoid tissues by an antigen or antigens present in the intestinal contents.
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12
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Robins-Browne RM, Green R, Katz J, Becker D. Thymoma, pure red cell aplasia, pernicious anaemia and candidiasis: a defect in immunohomeostasis. Br J Haematol 1977; 36:5-13. [PMID: 871425 DOI: 10.1111/j.1365-2141.1977.tb05749.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Abstract
A clinicopathologic study of 65 patients with thymomas was performed. The most significant prognostic feature of the thymomas was the presence or absence of gross invasion of adjacent tissue. None of 37 patients with non-invasive thymomas died of tumor or had a recurrence. Invasive thymomas resulted in the death of 3 of 17 patients. Two others are alive with unresectable tumor, and one other patient died of myasthenia gravis with recurrent thymoma. The histologic type of thymoma had no value in predicting prognosis. Thirty-five patients had possibly associated syndromes. These syndromes, particularly myasthenia gravis and red cell hypoplasia, affected survival to an equal or greater extent than did the direct effects of the tumors.
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Rosner F, Grünwald H. Multiple myeloma terminating in acute leukemia. Report of 12 cases and review of the literature. Am J Med 1974; 57:927-39. [PMID: 4611209 DOI: 10.1016/0002-9343(74)90171-5] [Citation(s) in RCA: 142] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
MESH Headings
- Adult
- Aged
- Antineoplastic Agents/therapeutic use
- Bone Marrow/pathology
- Bone Marrow Cells
- Drug Therapy, Combination
- Female
- Hematocrit
- Hemoglobins/analysis
- Humans
- Immunoglobulins/isolation & purification
- Leukemia/chemically induced
- Leukemia/complications
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Leukocyte Count
- Male
- Melphalan/administration & dosage
- Melphalan/adverse effects
- Melphalan/therapeutic use
- Middle Aged
- Multiple Myeloma/complications
- Multiple Myeloma/drug therapy
- Prednisone/therapeutic use
- Remission, Spontaneous
- Syndrome
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Böttcher D, Maas D, Wendt F, Schubothe H. [Anemia caused by erythroblastopenia in adult age]. KLINISCHE WOCHENSCHRIFT 1970; 48:96-104. [PMID: 5286483 DOI: 10.1007/bf01484625] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Singh BN. Thymoma presenting with polyserositis and the lupus erythematosus syndrome. AUSTRALASIAN ANNALS OF MEDICINE 1969; 18:55-8. [PMID: 5776900 DOI: 10.1111/imj.1969.18.1.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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