• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.43-46
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• 2016

We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, $2,020cells/{\mu}L$; hemoglobin, 10.2 g/dL; platelets, $52,000cells/{\mu}L$), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of histiocytes and marked hemophagocytosis; based on these findings, she was diagnosed with hemophagocytic lymphohistiocytosis. Polymerase chain reaction (PCR) with both the bone marrow aspiration and sputum samples revealed the presence of Mycobacterium tuberculosis. Antitubercular therapy with immune modulation therapy including dexamethasone and intravenous immunoglobulin was initiated. The results of all laboratory tests including bone marrow biopsy and PCR with both the bone marrow aspiration and sputum samples were normalized after treatment. Thus, early bone marrow biopsy and the use of techniques such as PCR can avoid delays in diagnosis and improve the survival rates of patients with tuberculosis-associated hemophagocytic lymphohistiocytosis.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.247-251
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• 2000

A male German Shepherd dog, $2{\frac{1}{2}}$years of age, was admitted with sudden anemia, weakness, hyperpyrexia, anorexia and lethargy. The patient showed hypoplastic anemia, thrombocytopenia, absolute and relative lymphocytosis, absolute and relative granulocytopenia, hypoalbuminemia, slight hepatic disorder, slight azotemia, hematuria and proteinuria by the screening examination. The bone marrow aspiration smear showed high cellularity, severs infiltration of lymphoblasts and prolymphocytes, and mitotic figures of lymphoid cells. The liver aspiration smear demonstrated infiltration of lymphoblasts. Acute lymphoblastic leukemia was diagnosed as none of the superficial lymph nodes showed enlargement and marked functional disorder of important organs other than the liver was not found. The patient was treated with vincristine, cyclophophamide, predniosolone for chemotherapy and blood transfusion and either ampicillin or cefoperazone for supportive treatment. But the patient did not show marked remission and died 9 days after the start of the chemptherapy. The necropsy was not permitted.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.298-304
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• 1993

To estimate the bone marrow involvement of leukemia, we peformed scintigraphies using $^{99m}Tc$ antimony sulfide colloid and Gallium-67. Total 13 patients were included and obtained 14 study sets of $^{99m}Tc$ antimony sulfide colloid and gallium-67 and compared with bone marrow aspiration biopsy and clinicolaboratory datas. $^{99m}Tc$ Antimony scan showed localized defect in 4 patients who had relapse. No false positive or negative results were observed. Gallium 67 showed localized increased uptake in 2 of 4 relapsed patients. Therefore, bone marrow scan is useful for the evaluation of marrow infiltration in ieukemic patients.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.256-260
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• 2002

Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.85-89
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• 1999

An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was Irregularly destroyed and filled with gray-white cheesy material and necrotic bone bedris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.

• Journal of Yeungnam Medical Science
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• v.38 no.3
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• pp.245-250
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• 2021

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome-HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m²/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.203-208
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• 2023

A 13-year-old neutered male mixed-breed dog presented with generalized lymphadenopathy and erythematous cutaneous lesions in the ear pinnae. Fine-needle aspiration cytology of the lymph nodes revealed small to intermediate lymphocytes with a "hand mirror" configuration as the predominant cell type. Histopathological analysis of the lymph node showed an infiltrate of CD3-positive small lymphocytes compressing the follicles against the capsule owing to neoplastic cell expansion. Flow cytometric analysis revealed a homogeneous population of CD3+/CD4-/CD5+/CD8-/CD21+/CD34-/CD45- cells in both the peripheral blood and aspirated lymph nodes, which supports the diagnosis of T-zone lymphoma. Laboratory tests revealed lymphocytosis (14,144 cells/µL) in the peripheral blood. However, contrary to expectations, the bone marrow examination revealed no evidence of lymphocytic infiltration. T-zone lymphoma is an indolent lymphoma with a long survival period, and knowledge of its characteristics may affect disease staging and prognosis evaluation. Therefore, peripheral blood count as a sole screening tool for bone marrow metastasis should be used with caution.

• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.121-126
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• 1993

Amyloid tumor is a tumorlike localized deposit of amyloid which is encountered occasionally in association with multiple myeloma and various chronic inflammatory diseases. This report describes a case of solitary amyloid tumor of the neck which was the presenting symptom arising in association with multiple myeloma. A 56-year-old woman complained of a palpable neck mass and fine needle aspiration was done. Multiple myeloma was diagnosed on the basis of the bone marrow biopsy and monoclonality of kappa light chain. The histologic and cytologic features of the amyloid appear to be characteristic and may allow a definitive diagnosis to be made on needle aspiration biopsy.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.65-67
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• 2005

Intracranial chloroma may occur in leukemia, although they are rare. A 23-year-old female complained diplopia. Brain magnetic resonance MR imaging showed tumors in the both cavernous sinus, both tentorial and anterior falx. Gamma-Knife radiosurgery was performed with maximal dose; 20Gy, marginal dose; 10Gy. Peripheral blood smear revealed leukemia, and bone marrow aspiration biopsy showed acute lymphocytic leukemia. Two weeks later, MR image for the stereotactic biopsy noticed markedly decreased tumor size. Biopsy result was lymphocytic leukemia. She received conventional radiation therapy, chemotherapy, and bone marrow transplantation. Brain involvement by acute lymphocytic leukemia is very rare. Even though chloroma are sensitive to radiation therapy, prognosis is poor because of the gravity of the underlying disease and association with impending blast transformation. The authors reports a intracranial chloroma by acute lymphocytic leukemia.

• Korean Journal of Bronchoesophagology
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• v.11 no.1
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• pp.21-24
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• 2005

Acute lymphocytic leukemia(ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Currently, only $20-30\%$ of adults with ALL are cured with standard chemotherapy regimens. It is very important risk factor whether to failure to achieve complete remission within 4 weeks or not. The relapse of leukemia is usually classified as hematologic and extramedullary relapse, and extramedullary leukemic infiltration is rarely observed in patients with ALL. In October 2004, a 23-year-old man presented with painless enlargement of both parotid glands. He was diagnosed as ALL(L2 subtype) one month ago, and he gained complete remission with induction chemotherapy. Fine needle aspiration cytology and bone marrow biopsy revealed extramedullary and hemtologic remission. To our knowledge this is the first report of extramedullary relapse in the parotid in ALL.