Hemophagocytic lymphohistiocytosis: a rare complication of autologous stem cell transplantation

Vol. 57 No. 2 Suppl., 2016
This supplement was not sponsored by Outside Organizations.


Andrei Colita, Anca Colita, Camelia-Marioara Dobrea, Alina Daniela Tanase, Carmen Saguna, Cecilia-Gabriela Ghimici, Raluca Mihaela Manolache, Silvana Angelescu, Doina Barbu, Florentina Gradinaru, Anca Roxana Lupu

Hemophagocytic lymphohistiocytosis (HLH) is a very severe and rare syndrome of pathologic immune activation characterized by cytopenia and clinical signs and symptoms of extreme inflammation. HLH is usually fatal without treatment so that accurate and timely diagnosis is very important. The syndrome occurs as a familial disorder (familial HLH - FLH) or as an acquired condition (secondary - sHLH) in association with a variety of pathologic states: infections, rheumatologic, malignant or metabolic diseases. Malignancy associated HLH is primarily reported in T/NK (natural killer)-cell malignancies but also in B-cell neoplasms and other types of cancer. HLH has also been reported in rare cases as a highly fatal and difficult to diagnose complication of stem cell transplantation (SCT). In this paper, we present the case of a young male patient who underwent autologous SCT as consolidation therapy for a T/NK-cell lymphoma, complicated with graft failure due to HLH. The patient was successfully treated with corticosteroids, Etoposide, Cyclosporine and immunoglobulins. As a particularity, he developed a second B-cell neoplasia a few months after SCT.

Corresponding author: Andrei Colita, MD, PhD; e-mail: andreicolita@yahoo.com

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Emil Radu Iacob, Calin Marius Popoiu, Alexandra Nyiredi, Laurentiu Mogoanta, Oana Badea, Eugen Sorin Boia

Mesenchymal hamartoma of the liver (MHL) is a benign and rare hepatic lesion, with an uncertain etiology and a potential for developing into an undifferentiated distant embryonal sarcoma after an incomplete resection. It mainly presents as progressive abdominal distension with normal blood works. Most cases are diagnosed in the first two years of life, with a higher frequency in boys and on the right liver. We report the case of a mesenchymal hamartoma of the left liver in an 18-month-old girl, with a rough evolution and a literature review. There were performed an abdominal computed tomography (CT) scan and resection of the lesion. The macroscopic and histological examination described a 16.5x17.9x10.5 cm multicystic mass as a MHL lesion. MHLs may have a malignant potential and in the clinical presence of a neoplastic syndrome there requires a good diagnosis and drastic surgical treatment.

Corresponding author: Calin Marius Popoiu, Associate Professor, MD, PhD; e-mail: mcpopoiu@yahoo.com

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