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Onisâi M, Vlădăreanu AM, Iordan I, Bumbea H, Găman M, Ciufu C, Voican I, Cîșleanu D, Vasile D, Marinescu C, Nicolescu A, Spînu A, Nistor R, Alexandru A. Primary, secondary or less frequent causes of immune thrombocytopenia: A case report. Exp Ther Med 2021; 22:1096. [PMID: 34504550 DOI: 10.3892/etm.2021.10530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/31/2021] [Indexed: 01/16/2023] Open
Abstract
Primary immune thrombocytopenia (ITP) is characterized by isolated low platelet count and it is a diagnosis of exclusion, contrasting to secondary ITP. Therefore, a positive diagnosis is difficult and requires extensive investigation. Some of the underlying conditions that are associated with ITP are lymphoproliferative disorders and infections, especially viral ones. In the present study, the case of a patient diagnosed with diffuse large B-cell lymphoma, who received chemotherapy and autologous hematopoietic stem cell transplantation is presented. After a complete remission of four years, the patient presented with sudden intense hemorrhagic syndrome and severely decreased platelet count. The most frequent causes of secondary ITP were excluded, including lymphoma relapse, and intravenous corticosteroids were started. However, shortly after hospital admission, the patient developed neuro-psychiatric anomalies, fever and pancytopenia, and West-Nile encephalitis was diagnosed. Although the initial development was favorable, he started to complain of progressive severe muscle weakness and eventually succumbed to infectious complications in the setting of prolonged hospitalization, corticotherapy, and immobilization.
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Affiliation(s)
- Minodora Onisâi
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ana-Maria Vlădăreanu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Iuliana Iordan
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Horia Bumbea
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihaela Găman
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristina Ciufu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Irina Voican
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania
| | - Diana Cîșleanu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniela Vasile
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristina Marinescu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Nicolescu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania
| | - Andreea Spînu
- Hematology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Hematology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Raluca Nistor
- Neurology Clinic, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Neurology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adrian Alexandru
- Department of Plastic Reconstructive Surgery, Emergency University Hospital, 050098 Bucharest, Romania.,Department of Plastic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Kurihara Y, Taoka K, Takagi E, Toyama K, Nakazaki K, Kurokawa M. Treatment of Secondary Immune Thrombocytopenia with Non-Hodgkin Lymphoma: A Case Report and Literature Review. Intern Med 2021; 60:1583-1588. [PMID: 33994446 PMCID: PMC8188037 DOI: 10.2169/internalmedicine.5611-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Secondary immune thrombocytopenic purpura (ITP) with non-Hodgkin lymphoma (NHL) is a rare disease. Although some treatment regimens are available for primary ITP, the treatment strategy for secondary ITP remains unconfirmed. We herein report a 79-year-old man who was diagnosed with secondary ITP with mantle cell lymphoma. Although intravenous immunoglobulin (IVIG) has been considered an effective option for secondary ITP, similar to the treatment of primary ITP, our patient did not benefit from IVIG. A literature review including the current report revealed that IVIG was ineffective in all treated patients. Secondary ITP with NHL should be treated differently from primary ITP.
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Affiliation(s)
- Yuya Kurihara
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazuki Taoka
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Eri Takagi
- General Education Center, The University of Tokyo Hospital, Japan
| | - Kazuhiro Toyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kumi Nakazaki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Japan
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Waidhauser J, Bornemann A, Trepel M, Märkl B. Frequency, localization, and types of gastrointestinal stromal tumor-associated neoplasia. World J Gastroenterol 2019; 25:4261-4277. [PMID: 31435178 PMCID: PMC6700699 DOI: 10.3748/wjg.v25.i30.4261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/22/2019] [Accepted: 07/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, increasing evidence of second neoplasms associated with gastrointestinal stromal tumors (GIST) has been found. Numerous case reports, mostly retrospective studies and a few reviews, have been published. To our knowledge, however, no systematic review or meta-analysis of the existing data has been performed so far. AIM To prepare a compilation, as complete as possible, of all reported second tumor entities that have been described in association with GIST and to systematically analyze the published studies with regard to frequency, localization, and types of GIST-associated neoplasms. METHODS The MEDLINE and EBSCO databases were searched for a combination of the keywords GIST/secondary, synchronous, coincident/tumor, neoplasm, and relevant publications were selected by two independent authors. RESULTS Initially, 3042 publications were found. After deletion of duplicates, 1631 remained, and 130 papers were selected; 22 of these were original studies with a minimum of 20 patients, and 108 were case reports. In the 22 selected studies, comprising a total number of 12050 patients, an overall rate of GIST-associated neoplasias of 20% could be calculated. Most second neoplasias were found in the gastrointestinal tract (32%) and in the male and female urogenital tract (30%). The specific risk scores of GISTs associated with other tumors were significantly lower than those without associated neoplasias. CONCLUSION In this first systematic review, we could confirm previously reported findings of a more than coincidental association between GIST and other neoplasias. The question whether there is an underlying causal association will need further investigation. Our data suggest that even GIST with a very low risk of disease progression should prompt screening for second neoplasia and subsequent frequent controls or extended staging.
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Affiliation(s)
- Johanna Waidhauser
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Anne Bornemann
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Martin Trepel
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
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Wang W, Li P. Coexistence of colon adenocarcinoma, diffuse large B-cell lymphoma, and myelodysplastic syndrome: A case report. Medicine (Baltimore) 2019; 98:e16742. [PMID: 31464903 PMCID: PMC6736455 DOI: 10.1097/md.0000000000016742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Cases of coexistence of 2 cancers, such as colorectal cancer and diffuse large B-cell lymphoma (DLBCL), colorectal cancer and myelodysplastic syndrome (MDS), and DLBCL with MDS, have been reported, whereas the coexistence of 3 different cancers in a patient is extremely rare. Here we report a case of co-occurrence of colon adenocarcinoma, DLBCL, and MDS in a 78-year-old Chinese man. PATIENT CONCERNS He presented to our hospital with palpable lumps in the abdomen without any of the following symptoms including abdominal pain, fever, contact pain, tenesmus, changes in bowel habits and shape, nausea, and vomiting. DIAGNOSES The patient was first diagnosed with sigmoid colon adenocarcinoma and DLBCL in the right ascending colon using enhanced computed tomography, colonoscopy, and immunohistochemistry. After resection of the sigmoid adenocarcinoma and DLBCL, MDS was diagnosed according to the results of routine blood tests, bone marrow aspiration smear, and flow cytometry. INTERVENTIONS Overall, the patient was treated with surgical resection of the sigmoid adenocarcinoma and DLBCL of the colon, combined with 4 cycles of chemotherapies targeting MDS. OUTCOMES Blood test results and follow-up indicated that the treatment regimen showed promising outcomes. LESSONS In conclusion, a case of synchronous existence of colon cancer, DLBCL, and MDS is reported, which suggests that careful attention should be paid clinically to checking the state of bone marrow for elderly cancer patients. Efforts are also needed to establish an effective system for distinguishing the origin of multi-existent cancers and to develop effective therapeutic regimens for multi-existent cancers with fewer side effects.
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Ono K, Onishi Y, Kobayashi M, Ichikawa S, Hatta S, Watanabe S, Okitsu Y, Fukuhara N, Ichinohasama R, Harigae H. Successful Treatment of Aggressive Mature B-cell Lymphoma Mimicking Immune Thrombocytopenic Purpura. Intern Med 2018; 57:2573-2579. [PMID: 29607959 PMCID: PMC6172554 DOI: 10.2169/internalmedicine.0560-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A 55-year-old woman suffered from hemorrhagic tendency. She had severe thrombocytopenia without any hematological or coagulatory abnormalities, and a bone marrow examination revealed an increased number of megakaryocytes without any abnormal cells or blasts. No lymphadenopathy or hepatosplenomegaly was observed on computed tomography. She was initially diagnosed with immune thrombocytopenic purpura (ITP). None of the treatments administered for ITP produced a response. However, abnormal cells were eventually found during the third bone marrow examination. The pathological diagnosis was mature B-cell lymphoma. Rituximab-containing chemotherapy produced a marked increase in the patient's platelet count, and her lymphoma went into complete remission.
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Affiliation(s)
- Koya Ono
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Masahiro Kobayashi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Satoshi Ichikawa
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Shunsuke Hatta
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Shotaro Watanabe
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Yoko Okitsu
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
| | | | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Hospital, Japan
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Chang J, Chen Q, Jian Y, Wei P, Yang GZ, Wang Y, Fang XY, Sun QM. Simultaneous occurrence of splenic diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report. Diagn Pathol 2018; 13:61. [PMID: 30144813 PMCID: PMC6109455 DOI: 10.1186/s13000-018-0741-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 08/16/2018] [Indexed: 12/01/2022] Open
Abstract
Background Although the primary malignant spleen tumor is relatively rare, lymphoma is the most common splenic malignancy. It can have quite different clinical manifestations that usually lead to relatively poor outcomes, and thus early and accurate diagnosis are of utmost importance. Case presentation The present study reports a case of a 67-year-old female with high fever, abnormal spleen (diagnosed by PET/CT) and no obvious lymph node enlargement. After being subjected to splenectomy, the patient was diagnosed with splenic diffuse large B cell lymphoma coexisting with gastrointestinal stromal tumor in the stomach. Conclusions To our knowledge, splenic lymphoma accompanied by gastrointestinal stromal tumor in the stomach is rarely reported. This case report discusses the diagnosis and case management of a patient referring to the existing literature.
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Affiliation(s)
- Jing Chang
- Department of Internal Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Gong-Ti South Road 8#, Chao-Yang District, Beijing, China
| | - Qing Chen
- Department of Internal Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Gong-Ti South Road 8#, Chao-Yang District, Beijing, China
| | - Yuan Jian
- Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ping Wei
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang-Zhong Yang
- Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiang-Yang Fang
- Department of Internal Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Gong-Ti South Road 8#, Chao-Yang District, Beijing, China
| | - Qian-Mei Sun
- Department of Internal Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Gong-Ti South Road 8#, Chao-Yang District, Beijing, China.
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