A 61-year-old woman with adult T-cell leukemia/lymphoma

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

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Vitorino Modesto Dos Santos, Eduardo Flavio Oliveira Ribeiro, Priscilla Souza De Faria, Isabella Augusta Barros, Marcelo Martins Oliveira

Adult T-cell leukemia/lymphoma (ATL) is caused by human T-cell lymphotropic virus type-1 (HTLV-1) infection. Classification of ATL includes acute, chronic, lymphomatous and smoldering, and main features are hypercalcemia, organomegaly, bone, brain, lung, and skin changes. Elevated mortality rates of ATL may be due to the advanced age at diagnosis, because this malignancy can evolve unsuspected for decades before the first clinical manifestations. Palliative therapy, chemotherapy and stem cell transplantation are often utilized, but response to treatment is poor. The patient herein reported presented diffuse abdominal pain with duration of eight months in addition to ascites. The diagnosis of the acute leukemia type of ATL was done with base on clinical, laboratory and imaging findings. Gastrointestinal symptoms and ascites are uncommon first manifestations of ATL, and pose challenging diagnosis.

Corresponding author: Vitorino Modesto dos Santos, Professor, MD, PhD; e-mail: vitorinomodesto@gmail.com

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Dragos Catalin Jianu, Silviana Nina Jianu, Andrei Gheorghe Marius Motoc, Traian Flavius Dan, Marioara Poenaru, Sorina Taban, Octavian Marius Cretu

Carotid body paragangliomas (CBPGLs) are a rare neoplasms of the neuroendocrine system that affect the carotid glomus. The aim of this study is to improve their management in our Departments. This retrospective analysis reports family history, clinical presentation, imaging diagnostics, Shamblin classification, surgical treatment, complications, and the outcome of seven patients with CBPGLs. All lesions were represented by a painless cervical mass, with no functional or bilateral neck tumors. One patient had two different localizations (the second one was a glomus tumor of the right prelachrymal sac), and a family history for CBPGL. All neck tumors were diagnosed during duplex ultrasound corroborated by magnetic resonance imaging (MRI), and by magnetic resonance angiography (MR-A). They presented a diameter between 3 and 5 cm (MRI). Complete subadventitial resection of the tumor was performed in all patients, with no preoperative embolization in any of the cases. The CBPGLs were confirmed on histopathology and immunohistochemistry. Lymph node metastasis was not found in any of the cases. Mortality and perioperative stroke rates were null. Transitory cranial nerve deficit occurred in one case without permanent palsy. After a follow-up of three years in each patient, there were no signs of tumor recurrence in any of the cases. Relatively early diagnosis of CBPGL was possible in our seven patients using multidisciplinary management. Preoperative planning of the surgical procedure by integrated diagnostic imaging was essential in our study to operate only Shamblin group II tumors, minimizing the known risk of complications associated with large CBPGL (group III).

Corresponding author: Andrei Gheorghe Marius Motoc, MD, PhD; e-mail: amotoc@umft.ro

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