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Autoimmune Hemolytic Anemia preceding the Diagnosis of Primary Central Nervous System Lymphoma.

Farhangi H, Sharifi N, Ahanchian H, Izanloo A - Iran J Ped Hematol Oncol (2015)

Bottom Line: Brain MRI demonstrated some tumors in the frontal, parietal, and occipital lobe that corroborated the pathology results of primary central nervous system lymphoma for the patient.The patient was treated with high-dose of Methotrexate.Our result suggested regular and careful monitoring of patients with autoimmune hemolytic anemia in order to control the manifestations of concomitant disease such as lymphoma that may develop later.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Hematology-Oncology, Dr Sheikh Pediatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

ABSTRACT
In this study, a 2.5-year-old boy suffering from a febrile seizure with normal laboratory tests and a history of immune hemolytic anemia was examined. Brain MRI demonstrated some tumors in the frontal, parietal, and occipital lobe that corroborated the pathology results of primary central nervous system lymphoma for the patient. The patient was treated with high-dose of Methotrexate. Our result suggested regular and careful monitoring of patients with autoimmune hemolytic anemia in order to control the manifestations of concomitant disease such as lymphoma that may develop later.

No MeSH data available.


Related in: MedlinePlus

Microscopic view of tumor lesion which consists of malignant small-round cell tumors with extensive necrosis
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Figure 2: Microscopic view of tumor lesion which consists of malignant small-round cell tumors with extensive necrosis

Mentions: A 2.5- year old boy with a febrile seizure was admitted to the hospital. His healthy parents were first degree relatives and the patient had normal growth and developmental parameters. Physical examination revealed a low level of consciousness, left abducens nerve palsy, headache, incoordination and speech disorder. He was previously admitted to the hospital twice due to Immune Hemolytic anemiaonce at the age of 2 months, and later when he was 12 months old. He was treated with prednisolone. Laboratory results for complete blood count, sodium, potassium, blood sugar, calcium, urea, creatinine, liver function and albumin were normal. Direct coombs test was positive and the serum Immune globulin levels were normal, whenever there were anactivehemolysis.ELISA test results for Epstein–Barr virus and acquired immunodeficiency virus (HIV) were negative. Given his persistent drowsiness and recurrent seizures, brain CT scan was performed and a mass lesion in the parietal lobe was discovered. Further MRI investigation revealed multi-centric mass lesions in frontal, parietal and occipital lobes (Figure 1). Being suspected of PCNSL or cerebral metastases, the patient underwent open brain biopsy. Histopathologic examination of the brain lesion demonstrated an irregular fragmented tumorallesion with extensive vascular along with parenchymal necrosis with pleomorphic and hyperchrom nuclei. Instances of clear perinuclear hollow, focal calcification, and stromal fibrillar appearance were also observed (Figures2, 3&4). In the immunohistochemical study, the neoplastic cells were labeled Leukocyte Common Antigen (LCA) and CD20.Negative reactivity was also labeled glial fibrillary acid protein. These findings were consistent with the studies on PCNSL– diffuse large B cell lymphoma. There was nosign of systemic disease. Bone marrow aspiration, biopsy, CSF cytospin, abdomino-pelvic ultrasonographyand skeletal bone survey was all normal. Moreover, all immune system evaluations such as Immunoglobulins, B cell count and function, T cell count, subtypes and function, serum complement and neutrophils count and function were normal.


Autoimmune Hemolytic Anemia preceding the Diagnosis of Primary Central Nervous System Lymphoma.

Farhangi H, Sharifi N, Ahanchian H, Izanloo A - Iran J Ped Hematol Oncol (2015)

Microscopic view of tumor lesion which consists of malignant small-round cell tumors with extensive necrosis
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4402157&req=5

Figure 2: Microscopic view of tumor lesion which consists of malignant small-round cell tumors with extensive necrosis
Mentions: A 2.5- year old boy with a febrile seizure was admitted to the hospital. His healthy parents were first degree relatives and the patient had normal growth and developmental parameters. Physical examination revealed a low level of consciousness, left abducens nerve palsy, headache, incoordination and speech disorder. He was previously admitted to the hospital twice due to Immune Hemolytic anemiaonce at the age of 2 months, and later when he was 12 months old. He was treated with prednisolone. Laboratory results for complete blood count, sodium, potassium, blood sugar, calcium, urea, creatinine, liver function and albumin were normal. Direct coombs test was positive and the serum Immune globulin levels were normal, whenever there were anactivehemolysis.ELISA test results for Epstein–Barr virus and acquired immunodeficiency virus (HIV) were negative. Given his persistent drowsiness and recurrent seizures, brain CT scan was performed and a mass lesion in the parietal lobe was discovered. Further MRI investigation revealed multi-centric mass lesions in frontal, parietal and occipital lobes (Figure 1). Being suspected of PCNSL or cerebral metastases, the patient underwent open brain biopsy. Histopathologic examination of the brain lesion demonstrated an irregular fragmented tumorallesion with extensive vascular along with parenchymal necrosis with pleomorphic and hyperchrom nuclei. Instances of clear perinuclear hollow, focal calcification, and stromal fibrillar appearance were also observed (Figures2, 3&4). In the immunohistochemical study, the neoplastic cells were labeled Leukocyte Common Antigen (LCA) and CD20.Negative reactivity was also labeled glial fibrillary acid protein. These findings were consistent with the studies on PCNSL– diffuse large B cell lymphoma. There was nosign of systemic disease. Bone marrow aspiration, biopsy, CSF cytospin, abdomino-pelvic ultrasonographyand skeletal bone survey was all normal. Moreover, all immune system evaluations such as Immunoglobulins, B cell count and function, T cell count, subtypes and function, serum complement and neutrophils count and function were normal.

Bottom Line: Brain MRI demonstrated some tumors in the frontal, parietal, and occipital lobe that corroborated the pathology results of primary central nervous system lymphoma for the patient.The patient was treated with high-dose of Methotrexate.Our result suggested regular and careful monitoring of patients with autoimmune hemolytic anemia in order to control the manifestations of concomitant disease such as lymphoma that may develop later.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Hematology-Oncology, Dr Sheikh Pediatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

ABSTRACT
In this study, a 2.5-year-old boy suffering from a febrile seizure with normal laboratory tests and a history of immune hemolytic anemia was examined. Brain MRI demonstrated some tumors in the frontal, parietal, and occipital lobe that corroborated the pathology results of primary central nervous system lymphoma for the patient. The patient was treated with high-dose of Methotrexate. Our result suggested regular and careful monitoring of patients with autoimmune hemolytic anemia in order to control the manifestations of concomitant disease such as lymphoma that may develop later.

No MeSH data available.


Related in: MedlinePlus