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  • 1
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 4715-4715
    Abstract: Background: Retinal Vessel Thrombosis (RVT) is an ophthalmologic emergency that can result in permanent vision loss. The retinal vessels are considered a rare site for thrombosis, obligating physicians to evaluate the underlying cause. Classic risk factors include hypertension, cardiovascular disease, diabetes, and glaucoma. In addition, there is a variable degree of association with inherited and acquired thrombophilia. Our aim is to describe our experience with eleven patients (pts) evaluated for inherited and acquired thrombophilia who presented with RVT. Methods: Retrospective analysis. Results: We reviewed the medical records of 11 consecutive pts seen in our institution between 2001 and 2015 who were referred with the diagnosis of RVT. Eight out of eleven were females and three were males; median age was 47 years, with an age range from 30 to 78. Clinical presentation was transient visual loss in the affected eye in 10 pts and persistent conjunctivitis in 1 pt. Laboratory evaluation of thrombophilia in blood samples showed the following: 1 pt had both factor V Leiden mutation (heterozygous) along with prothrombin-20210A mutation (heterozygous); 3 pts had MTHFR gene mutations (two were heterozygous and one was homozygous); 1 pt had MTHFR gene mutation and positive lupus anticoagulant; 1 pt had antiprothrombin antibodies and homocysteinemia; 1 pt had factor V Leiden (heterozygous); 1 pt had factor V Leiden (heterozygous) and elevated factor VIII; 1 pt had protein S deficiency and elevated factor VIII; 1 pt had anticardiolipin antibodies; and lastly 1 pt had no laboratory abnormalities found. Conclusion: In our limited pt sample, we have found that retinal vessel thrombosis can be associated with inherited and acquired thrombophilia. The clinical implication of these findings remains incompletely understood and merits further research. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 2
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 4596-4596
    Abstract: Abstract 4596 Background: Localized Laryngeal Amyloidosis (LA) is a rare condition. There is limited understanding of its natural history. Our aim is to report the clinical evolution of a patient diagnosed with localized LA. Methods: Case report. Results: In May 2002, a 43-year-old gentleman presented with hoarseness and a CT scan of the neck showed a thickening of the right vocal cord with a mass that measured 2.9 × 1.2 cm in widest diameter. The patient had this mass removed surgically and the pathology showed a positive Congo red staining and a positive birefringence under polarized light, diagnostic of amyloidosis. No evidence of systemic amyloidosis or an overt B-cell lymphoma was found in this patient. Patient lost follow-up until October 2008 when he was found to have soft tissue induration around the left false vocal cord area. The biopsy showed again amyloidosis. Conclusions: LA recurrences can manifest several years after initial diagnosis. Long-term follow-up is essential. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 3
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 4633-4633
    Abstract: Background: Lymphoid tissue hyperplasia has been described in oncologic patients after receiving chemotherapy at different sites including: adenoids, tonsils, nasopharynx and thymus. Thymic hyperplasia has been reported more frequently in the pediatric age, associated most commonly with lymphomas. Biopsies of the thymic tissue show benign growth most likely due to a rebound effect after the chemotherapy treatments. Thymic hyperplasia occurring during cancer remission after chemotherapy treatment poses a diagnostic dilemma to clinicians. Our aim is to describe our experience with eight patients (pts) who were treated with chemotherapy and subsequently developed benign thymic hyperplasia. Methods: Retrospective analysis. Results: We reviewed the medical records of 8 consecutive pts seen in our two institutions between 2004 and 2015 who were referred with the diagnosis of breast cancer (7 pts) or lymphoma (1 pt). All pts were female; median age was 41 years, with an age range from 35 to 44. Each pt presented with benign thymic hyperplasia following the completion of chemotherapy treatments. The median time for diagnosis of thymic hyperplasia (demonstration of a new anterior mediastinal mass on follow-up CT scan) was 7 months following completion of chemotherapy, with a range of 1 to 11 months. In the first patient, the diagnosis was confirmed after thymic removal by thoracotomy and the remaining pts were followed up with serial computed tomography (CT) scans. All eight pts remain in complete remission from their primary cancers. Conclusion: Thymic hyperplasia following chemotherapy treatment is an unusual benign phenomenon that merits awareness by clinicians in order to prevent unnecessary invasive and risky procedures. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 4
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 5078-5078
    Abstract: Introduction: Venous thrombosis is a well documented adverse effect in about one percent of patients treated with tamoxifen. Although the precise role of elevated factor VIII in defining venous thrombotic risk is not well understood, current data suggest that factor VIII is an independent risk factor for venous thrombosis. Methods: Case report. Results: In May 2011, a 76-year-old male underwent right modified radical mastectomy in May 2011. Tumor was a 2.5 cm well-differentiated, invasive ductal carcinoma, with lymphatic invasion present and widely negative surgical margins. The patient (pt) had one ipsilateral axillary lymph node (out of 26 sampled) with two microscopic foci ( 〈 1 mm) of metastatic ductal carcinoma. Additional evaluation on the mastectomy specimen showed that estrogen and progesterone receptors were strongly positive, Ki-67 was 25% and HER-2/neu showed negative (0 expression) by immunochemistry. The patient had no family history of venous thromboembolic events, and he had never smoked. His past medical history was significant for hypothyroidism and hypertension, both under good control. In June 2011 pt was started on adjuvant Tamoxifen 20 mg daily. In July of 2013 pt started with diffuse, ill-localized abdominal pain. No associated abdominal cramping, fever or nausea. No evidence of melena or rectorrahgia. An abdominal magnetic resonance imaging showed the presence of a superior mesenteric vein thrombosis. Tamoxifen was at that time discontinued and pt was started on enoxaparin 1 mg/Kg twice a day, with complete resolution of his symptoms within 7 days. Pt remained anticoagulated with enoxaparin for six months. After discontinuation of anticoagulation, radiologic and laboratory evaluation showed no evidence of underlying hypercoagulable state except for an elevation of serum factor VIII ( 〉 150 IU/dl) that has persisted during his follow-up. Conclusions: Our case supports the notion that high levels of factor VIII are a risk factor for venous thrombosis. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 5
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 4865-4865
    Abstract: Abstract 4865 Background: Although not a common presentation, Hodgkin's lymphoma (HL) can first manifest as an enlarged axillary lymph node. We report a case of a patient diagnosed with nodular sclerosing HL, presenting as an abnormal axillary lymph node incidentally noted during routine mammogram. Case report: A 79 year-old asymptomatic female was referred to our center after being discovered a 3 cm left axillary lymph node detected during a routine screening mammogram. Except from the enlarged left axillary lymphadenopathy, the remaining physical exam was within normal limits. An ultrasound-guided fine needle biopsy revealed histologic features consistent with Hodgkin's lymphoma, nodular sclerosing type. Immunostains confirmed the presence of Reed Sternberg cells that were positive for CD 30, focally positive for CD 15, and negative for CD 20 and EMA. Bilateral bone marrow showed no evidence of HL involvement. A positron-emission tomography detected abnormal uptake in multiple enlarged lymph nodes above and below the diaphragm, and in the thoracic spine, at T9, T11 and T12 vertebral body levels. The patient was successfully treated with doxorubicin-based combination chemotherapy regimen. Conclusion: There are multiple clinical presentations for Hodgkin's lymphoma. Routine mammograms can aid in the detection of cancer types other than breast cancer. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
    Online Resource
    Online Resource
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 11 ( 2007-11-16), p. 4443-4443
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 4443-4443
    Abstract: Background: Although the association of sarcoidosis and malignancy has long been described (Brincker, Br J Cancer 1972), so far only 3 patients (pts) have been documented to have developed sarcoidosis during or immediately after chemotherapy for non-Hodgkin lymphoma (NHL) (Kornacker et al. Ann Hematol 2002; Hollister et al. J Clin Oncol 2005). Methods: Case report. Results: A 50 year-old male with 2-month history of back pain and 20 pound weight loss had a soft tissue mass in the lumbar area biopsied. The pathology revealed a diffuse large B-cell lymphoma. Bone marrow biopsy showed no abnormalities. Computed tomography (CT) and [18F] fluorodioxyglucose positron emission tomography (PET) revealed large bilateral pulmonary masses and extensive periaortic lymphadenopathy. Treatment consisted of chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab every 21 days. 11 days after completion of the 4th cycle, the pt was hospitalized with febrile neutropenia, and received intravenous cefepime and vancomycin with growth-factor support. Pt was released from the hospital on day 20th of the cycle with a white cell count of 15 thousand / uL, mostly neutrophils, and negative blood, sputum, and urine cultures. Because of persistent fever (38.5 °C) and non-productive cough 3 weeks after discharge, CT studies were obtained. In the chest there was no evidence of the previously noted lung masses, and there was the presence of new bilateral diffuse pulmonary infiltrates. Abdominal CT demonstrated near complete resolution of the periaortic lymphadenopathy. A transbronchial biopsy and a bronchoalveolar lavage were obtained, revealing the presence of non-caseating granulomas, and no evidence of malignancy, mycobacteria, or fungal micro-organisms. The serum level of angiotensin-converting enzyme was markedly elevated (112; normal range 9–67). At this point the pt was diagnosed with symptomatic pulmonary sarcoidosis and he was treated with oral prednisone. Follow-up CT evidenced a complete resolution of the pulmonary infiltrates. No further chemotherapy was administered. After a subsequent follow-up of 14 months, the pt remains in complete remission by clinical, serological, and radiographic (CT and PET) criteria. Conclusions: The diagnosis of new radiographic changes in pts with NHL receiving chemotherapy needs to be histologically confirmed.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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