1/31. Sinus polyp-associated soft tissue lesion and unilateral blindness: complications of extraction in leukemic patient.A case of an inflammatory polyp-associated lesion extending through an extraction socket appearing as an intraoral nodular lesion and unilateral blindness secondary to leukemic optic nerve head infiltration is reported. The patient was a 28-year-old male whose his upper first molar had been extracted fifteen days previously. The lesion was an asymptomatic soft tissue mass, red in color and hot tender to palpation, involving the alveolar ridge in the maxillary molar area. Although this is apparently a rare occurrence, the nature of the lesion was suggested by the history, clinical appearance, and radiographic findings. Excision of the inflammatory lesion was followed by complete healing with closure of the lesion. Unfortunately, the blindness was irreversible. The patient is still under leukemia therapy. review of the literature did not yield any other such cases. The role of oral lesions as a diagnostic indicator and the importance of dental surgeons in the diagnosis of leukemic patients are discussed. It is concluded that proper precautions and meticulous early diagnosis are required in these patients and that dental practitioners should be aware of the diagnostic features and possibilities of oral complications associated with leukemia.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/31. Peri-optic nerve infiltration during leukaemic relapse: MRI diagnosis.BACKGROUND: A 10-year-old boy with a history of acute lymphoblastic leukaemia (ALL), but without previous evidence of central nervous system involvement, presented with seizures 3 years after complete remission. MATERIALS AND methods: MRI showed bilateral enlargement of the optic nerves despite normal ophthalmological examination. RESULTS: Only the third cerebrospinal fluid examination showed 2 % blasts without concomitant bone-marrow infiltration. Enlargement of the optic nerves was consistent with bilateral leukaemic peri-optic nerve infiltration. The appearances returned to normal after chemotherapy. CONCLUSION: The optic nerves are a potential site of relapse in patients with systemic and meningeal ALL, even in the absence of ophthalmological signs.- - - - - - - - - - ranking = 8keywords = nerve (Clic here for more details about this article) |
3/31. adult T-cell leukemia showing different immunophenotypes in invaded organs.We report here a case of adult T-cell leukemia (ATL) who presented acute renal failure and skin eruption. Renal and skin biopsies showed diffuse invasion of ATL cells. Furthermore, the surface phenotype of tumor cells taken from the bone marrow (BM) or peripheral blood (PB)(CD4-CD8-) differed from that of cells taken from the kidney or skin (CD4 CD8-). These findings suggested that CD4-CD8-ATL cells in the BM and PB had differentiated to CD4 CD8- cells in the kidney and skin.- - - - - - - - - - ranking = 0.19184583584093keywords = organ (Clic here for more details about this article) |
4/31. hemorrhage in the oculomotor nerve as a complication of leukemia.Oculomotor paralysis of a patient with leukemia was revealed at autopsy to be caused by a hemorrhage in the oculomotor nerve. In a 63-year-old woman with pre-B-cell acute lymphatic leukemia, leukemic invasions occurred in her spinal cord and right oculomotor nerve during a hematological remission state. The oculomotor palsy was aggravated to complete paralysis during a leukemic relapse, which lasted until her death. An autopsy revealed a hemorrhage along with leukemic cells in the right oculomotor nerve at the segment in the upper orbital fissure. Although hemorrhagic oculomotor paralysis is a very rare complication, reports of its occurrence will likely increase with improved survival times of leukemia patients due to advances in chemotherapy.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
5/31. Precursor T-cell acute lymphoblastic leukemia/lymphoma involving the uterine cervix, myometrium, endometrium, and appendix.This report presents a case of precursor T-cell acute lymphoblastic leukemia/lymphoma (ALL) involving the uterine cervix, myometrium, endometrium, and appendix. The patient was a 38-year-old woman with a history of ALL who had been in remission for 4 years following chemotherapy. The malignant lymphoid infiltrate was characterized by blasts, showing scant cytoplasm, irregular hyperchromatic nuclei, and occasional prominent nucleoli. They were immunoreactive for CD45RB, CD3, CD43, CD34, and focally for TdT. Curiously, the blasts replaced the endometrial stroma and spared the associated epithelium. The patient was again treated with chemotherapy but her disease did not respond. She succumbed to her disease approximately 10 months after her initial evaluation for symptoms related to ALL relapse. Precursor T-cell ALL most commonly presents as a mediastinal mass in adolescent males. Although any organ may be affected, involvement of the female reproductive organs is rare. This case shows some of the varied manifestations of precursor T-cell ALL and highlights the necessity of considering the female reproductive tract as a possible location of relapsing disease.- - - - - - - - - - ranking = 0.095922917920464keywords = organ (Clic here for more details about this article) |
6/31. low back pain and myalgias in acute and relapsed mast cell leukemia: a case report.Mast cell leukemia is a rare, severe disease that may manifest through an array of clinical presentations, including vasomotor flushing and hypotension. Leukemic infiltrate of muscle and bone may rarely occur, resulting in nonspecific myalgias, bony pain, and neuropathic pain secondary to compression of nerves by bone. Mast cell leukemia as a clinical entity has not been well described. We present the case of a 25-year-old man with a remote medical history of germ cell tumor who was initially diagnosed with mast cell leukemia after presenting with low back pain. One and a half years later, the patient presented with a chief complaint of back pain and myalgias and was found to have relapsed mast cell leukemia. Medical management and, specifically, rehabilitation of these patients can be extremely difficult. This report shows the complex management of patients with mast cell leukemia.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
7/31. trismus in a 6 year old child: a manifestation of leukemia?trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/31. trigeminal nerve involvement in T-cell acute lymphoblastic leukemia: value of MR imaging.A 30-year-old male with T-cell acute lymphoblastic leukemia presented with facial numbness. Neurological examination revealed paresthesia of the left trigeminal nerve. cerebrospinal fluid (CSF) cytology showed no atypical cells. gadolinium-enhanced magnetic resonance (MR) imaging demonstrated enlargement and enhancement of intracranial portions of the left trigeminal nerve. The abnormal MR imaging findings almost completely resolved after the chemotherapy. gadolinium-enhanced MR imaging is not only a useful procedure for the early diagnosis of cranial nerve invasion by leukemia but it might be helpful to follow the changes after the treatment.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
9/31. Bilateral optic nerve infiltration in central nervous system leukemia.PURPOSE: To report the case of a 58-year-old man with sequential bilateral retrolaminar leukemic infiltration of the optic nerves who presented with normal-appearing optic nerves and no optic nerve enhancement. DESIGN: Interventional case report. methods: A 58-year-old man with chronic myelogenous leukemia (CML) developed progressive vision loss to no light perception in both eyes over four days. The patient received 14 doses of external beam irradiation and 10 cycles of intrathecal cytarabine. Despite treatment, he developed optic nerve pallor, and visual acuity remained no light perception in both eyes. CONCLUSIONS: In a patient with leukemia, leukemic optic nerve infiltration may occur even with normal-appearing optic nerves and a normal magnetic resonance image. It is important to maintain a high clinical suspicion for optic nerve infiltration so that prompt local irradiation may be initiated.- - - - - - - - - - ranking = 11keywords = nerve (Clic here for more details about this article) |
10/31. Acute myeloid leukemia mimicking primary testicular neoplasm. Presentation of a case with review of literature.We describe a new unique case of acute myeloid leukemia (AML) in a 21-yr-old male presenting with abdominal pain, bilateral testicular masses and gynecomastia. Further work-up with computed tomography of the chest, abdomen and pelvis revealed massive retroperitoneal, peripancreatic and mediastinal lymphadenopathy, suggesting primary testicular neoplasm. The patient was subjected to right orchiectomy that showed infiltration of testicular tissue with malignant cells, originally misinterpreted as undifferentiated carcinoma. immunohistochemistry studies, however, showed these cells to be strongly positive for myeloperoxidase and CD45, indicating a myeloid cell origin. bone marrow (BM) aspirate and biopsy demonstrated replacement of marrow with immature myeloid cells. Both the morphology and immunophenotype of the blast cells were consistent with AML type M4 (acute myelo-monocytic leukemia), using French-American-British (FAB) classification. The patient received standard induction chemotherapy with cytosine arabinoside (ARA-C) and daunorubicin followed with two cycles of consolidation therapy with high dose ARA-C, which resulted in remission of BM disease and resolution of lymphadenopathy and left testicular masses. After the second cycle of consolidation therapy, the patient developed sepsis that was complicated by refractory disseminated intravascular coagulopathy. He expired with a clinical picture of multiple organ failure. The unique features of this case are presented and the related literature is reviewed.- - - - - - - - - - ranking = 0.047961458960232keywords = organ (Clic here for more details about this article) |
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