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Alampoondi Venkataramanan SV, George L, Sahu KK. Spontaneous Pneumorachis - A Case-Based Review. J Asthma Allergy 2021; 14:1539-1554. [PMID: 34955642 PMCID: PMC8694274 DOI: 10.2147/jaa.s325293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/17/2021] [Indexed: 12/26/2022] Open
Abstract
Pneumorachis is characterized by the presence of free air in the spinal canal. It is referred by different names in literature such as epidural emphysema, intraspinal air, intraspinal pneumoc(o)ele, spinal epidural and subarachnoid pneumatosis, spinal and epidural emphysema, aerorachia, pneumosaccus, air myelogram, etc. Pneumorachis can be broadly classified as traumatic, iatrogenic, or spontaneous. In this case-based review, we present a case of spontaneous pneumorachis secondary to asthma exacerbation. This is followed by a systematic review of all cases of spontaneous pneumorachis identified in PubMed. The aim of this review is to understand the pathophysiology, common causes and the management of spontaneous pneumorachis.
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Affiliation(s)
| | - Lovin George
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, USA
| | - Kamal Kant Sahu
- Department of Hematology and Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Sun X, Rong X, Nie H, Yan X. Isolated retro-orbital granulocytic sarcoma relapse of Acute Myeloid Leukemia after allogeneic hematopoietic stem cell transplantation: a case report. Eur J Ophthalmol 2020; 32:1120672120976551. [PMID: 33283547 DOI: 10.1177/1120672120976551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Granulocytic sarcoma (GS) is rare as an isolated presentation of relapse after allogeneic hematopoietic stem-cell transplantation (allo-HSCT), particularly in adult patients with acute myelogenous leukemia (AML). We report here the case of a 37-year-old man who developed a GS of the retro-orbital as an isolated manifestation of AML relapse 27 months after allo-HSCT. CASE REPORT A 37-year-old man was diagnosed with AML and subsequently received allo-HSCT after clinical chemical remission. The patient suddenly presented with painless exophthalmos of the left eye twenty-seven months after allo-HSCT. Orbital magnetic resonance imaging (MRI) revealed left retro-orbital masses. Histopathology revealed diffused infiltration of leukemic blasts. Further systemic investigation showed no leukemic involvement of his other organs. Isolated retro-orbital relapse of AML was diagnosed. Despite treatment using retro-orbital irradiation, the patient died 6 months after presentation. CONCLUSION Our patient had a poor survival prognosis, even with timely diagnosis and proper treatment. Although the ophthalmologist has a secondary role in the diagnosis and treatment of leukemia, a prompt recognition of the ocular manifestations and their significance as a sign of possible extramedullary lesion is crucial.
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Affiliation(s)
- Xiaona Sun
- Department of Ophthalmology, Peking University First Hospital, Peking University, Beijing, China
| | - Xin Rong
- Department of Ophthalmology, Peking University First Hospital, Peking University, Beijing, China
| | - Hongping Nie
- Department of Ophthalmology, Peking University First Hospital, Peking University, Beijing, China
| | - Xiaoming Yan
- Department of Ophthalmology, Peking University First Hospital, Peking University, Beijing, China
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Sahu KK, Sahu SA, Nageshwar P. Temporal region myeloid sarcoma: When to suspect and how to approach? Oral Maxillofac Surg 2020; 24:369-370. [PMID: 32399657 DOI: 10.1007/s10006-020-00847-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Kamal Kant Sahu
- Hemato-Oncology Division, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, 01608, USA.
| | - Shamendra Anand Sahu
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India
| | - Prashant Nageshwar
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Affiliation(s)
- K K Sahu
- Department of Medicine, Saint Vincent Hospital, Worcester 01608, MA, USA
| | - I Chastain
- Department of Medicine, Saint Vincent Hospital, Worcester 01608, MA, USA
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Sahu KK, Tsitsilianos N, Mishra AK, Suramaethakul N, Abraham G. Neck abscess secondary to pocket shot intravenous drug abuse. BMJ Case Rep 2020; 13:e234033. [PMID: 32193181 PMCID: PMC7101041 DOI: 10.1136/bcr-2019-234033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Nicholas Tsitsilianos
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Ajay Kumar Mishra
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | | | - George Abraham
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
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Sahu KK, Mishra K, Malhotra P. Extramedullary Deposits in Leukemia: Out of Blood but Not Out of Mind. J Microsc Ultrastruct 2020; 8:35-36. [PMID: 32166064 PMCID: PMC7045624 DOI: 10.4103/jmau.jmau_61_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, 01608, MA, USA
| | - Kundan Mishra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Pankaj Malhotra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Sahu KK, Mishra K, Malhotra P. Extramedullary Deposits in Leukemia: Out of Blood but Not Out of Mind. J Microsc Ultrastruct 2020. [PMID: 32166064 DOI: 10.4103/jmau.jmau_61_18.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, 01608, MA, USA
| | - Kundan Mishra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Pankaj Malhotra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Sahu KK, Sherif AA, Mishra AK, Lal A, Singh A. Testicular Myeloid Sarcoma: A Systematic Review of the Literature. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:603-618. [PMID: 31371220 DOI: 10.1016/j.clml.2019.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/15/2019] [Accepted: 04/23/2019] [Indexed: 02/07/2023]
Abstract
Myeloid sarcoma usually involves lymph nodes, and head and neck regions. Uncommon sites like testis and ovary are rarely involved and pose a diagnostic challenge. Nonspecific findings, difficulty in retrieving biopsy specimens, and associated infertility are few of the hurdles faced during diagnosis and treatment of testicular myeloid sarcoma. Our review is an attempt to study myeloid sarcoma involving testis.
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Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA.
| | | | - Ajay Kumar Mishra
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Amos Lal
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Abijai Singh
- Department of Hospital Medicine, Mon Health Medical Centre, Morgantown, WV
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Gautam A, Jalali GK, Sahu KK, Deo P, Ailawadhi S. Cardiac Myeloid Sarcoma: Review of Literature. J Clin Diagn Res 2017; 11:XE01-XE04. [PMID: 28511492 DOI: 10.7860/jcdr/2017/23241.9499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/23/2017] [Indexed: 11/24/2022]
Abstract
Granulocytic Sarcomas (GS) also called as Myeloid Sarcomas (MS) or chloromas are the representatives of extramedullary infiltrates of immature myeloid cells including myeloblasts, promyelocytes and myelocytes. Primary cardiac malignancies per se are rare and infiltration of cardiac muscles by secondary malignant cells is also an uncommon finding. Out of these cardiac tumors, contribution of Cardiac Myeloid Sarcoma (CMS) is even more smaller thereby limiting our knowledge about this rare entity. Because of its very lower incidence, an exact guideline for diagnosis and management is still missing and usually haematologists around the world are treating CMS based on their clinical acumen. Aim of this review is to briefly discuss the presenting clinical feature, differential diagnosis, diagnostic workup and management based on published articles related to CMS till date.
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Affiliation(s)
- Archana Gautam
- Junior Resident, Department of Internal Medicine, UCMS, New Delhi, India
| | - Ghazal Kooshk Jalali
- Senior Resident, Department of Internal Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Kamal Kant Sahu
- Senior Resident, Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Prateek Deo
- Junior Resident, Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Sikander Ailawadhi
- Senior Associate Consultant, Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida
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Myeloid Sarcoma Of Vulva: A Short Update. Indian J Hematol Blood Transfus 2016; 32:69-71. [PMID: 27408359 DOI: 10.1007/s12288-016-0662-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/16/2016] [Indexed: 12/27/2022] Open
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