Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 50, Issue 3
Displaying 1-12 of 12 articles from this issue
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Picture in Clinical Hematology No.35
Feature articles: A review of changes introduced by the new WHO classification (4th edition) of myeloid neoplasms
The 70th Annual Meeting of the Japanese Society of Hematology
Symposium 1
Case Reports
  • Primary intraocular lymphoma invaded to the central nervous system after successful treatment with intraocular methotrexate injection
    Ken WATANABE, Ayako ARAI, Hiroshi TAKASE, Hidemi TAKAHASHI, Yoichi IWA ...
    2009 Volume 50 Issue 3 Pages 182-186
    Published: 2009
    Released on J-STAGE: April 07, 2009
    DOIhttps://doi.org/10.11406/rinketsu.50.182
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    A 57-year-old man was admitted to our hospital because of persistent blurred vision for 5 months. He had opacity in the vitreous body and white lesions in the retina of the right eye. Although cytological examinations of the vitreous samples revealed Class II, the diagnosis of primary intraocular lymphoma (PIOL) was made by detecting both IgH rearrangement by PCR and an elevated ratio of IL-10/IL-6 concentration in the vitreous sample. Systemic examinations were performed simultaneously and no extra-ocular involvement was detected. Intravitreal methotrexate (MTX) injections were effective and the lesions disappeared following injections. Two months later (10 months after appearance of the right eye lesion), however, the same lesions appeared in the left eye. Cytological examinations of the left vitreous sample revealed Class V by detecting large abnormal lymphocytes. Although intravitreal MTX injections were also effective, central nervous system (CNS) involvement appeared only 2 months after the left eye lesions appeared. Open biopsy was performed and a diagnosis of diffuse large B-cell lymphoma was made. Despite starting with high-dose MTX, he died of CNS disease 1 year and 8 months after onset. Diagnosis of PIOL is difficult. Since local treatment was considered insufficient, an optimal treatment strategy for PIOL should be established.
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  • Primary osseous lymphoma with pathological fracture during therapy
    Yuichi MURAKAMI, Jun YAMANOUCHI, Taichi AZUMA, Yuichi IKEDA, Hiroshi N ...
    2009 Volume 50 Issue 3 Pages 187-191
    Published: 2009
    Released on J-STAGE: April 07, 2009
    DOIhttps://doi.org/10.11406/rinketsu.50.187
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    A 66-year-old woman was aware of a cervical tumor in May 2007. She was hospitalized in June 2007 because her cervical tumor had increased. A biopsy was performed and a diagnosis of CD20-positive diffuse large B-cell lymphoma was obtained. Ga-67 scintigraphy showed abnormal accumulation in the right clavicle, right femur, right knee joint, right ankle joint, and the left tibia and fibula; however, no abnormality was detected on plain radiography and CT scan, whereas MRI showed that the right femur had a low signal on the T1-weighted image, and high and low signals on the T2-weighted image. CHOP therapy was begun, and the right cervical tumor promptly reduced. She was administered rituximab seven days after initiation of the treatment. When standing up from the toilet at midnight, she suffered fractures of the left tibia and fibula, and the right neck of the femur. These regions were identical to the sites with abnormal accumulation on Ga-67 scintigraphy, so we supposed them to be chemotherapy-associated pathologic fractures. This case is reported because primary bone lymphoma is rare and followed an unusual course of pathologic fracture under treatment.
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  • Therapy-related acute myeloid leukemia with 11q23 abnormality due to paclitaxel coexisting with bone marrow metastasis of breast cancer
    Makoto SAITO, Akio MORI, Tatsuro IRIE, Masanori TANAKA, Masanobu MORIO ...
    2009 Volume 50 Issue 3 Pages 192-196
    Published: 2009
    Released on J-STAGE: April 07, 2009
    DOIhttps://doi.org/10.11406/rinketsu.50.192
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    Among cases of therapy-related acute myeloid leukemia (t-AML) due to DNA topoisomerase II inhibitors, 11q23 abnormality is often detected. The usefulness of paclitaxel as a key drug in chemotherapy for breast cancer has been demonstrated. Few studies have reported t-AML due to paclitaxel. In this study, we report a patient who developed t-AML with 11q23 abnormality and bone marrow metastasis after breast cancer treatment with paclitaxel. The patient was a 61-year-old female who developed breast cancer at the age of 54 years. Four years after resection, lung and bone metastases were detected. Weekly therapy with paclitaxel at 80 mg/m2 was administered for 10 weeks (total dose: 1,200 mg), and radiotherapy was performed; thereafter, the extent of bone metastasis increased. Pancytopenia was noted 3 years after paclitaxel therapy. Bone marrow aspiration suggested AML (M4) with (11;19)(q23;p13) chromosome abnormalities. Histopathologically, bone marrow metastasis from breast cancer was detected in the same bone marrow specimen. This patient had not received any other anticancer drugs. Based on the clinical course, t-AML may have developed after paclitaxel therapy.
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  • Long-term remission of non-Hodgkin lymphoma secondary to the treatment for essential thrombocythemia
    Yoshitsugu KUBOTA, Masato WAKI
    2009 Volume 50 Issue 3 Pages 197-202
    Published: 2009
    Released on J-STAGE: April 07, 2009
    DOIhttps://doi.org/10.11406/rinketsu.50.197
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    A 45-year-old woman was diagnosed with essential thrombocythemia (ET) in August 1987 and received treatment with alkylating agents (total administration dose, busulfan 378 mg, MCNU 700 mg) because of a history of myocardial infarction. In June 2000, anemia gradually progressed. A few blast cells were detected in the peripheral blood at that time. Since bone marrow biopsy revealed myelofibrosis, she received anabolic hormone therapy. She was admitted to our hospital for an evaluation of abdominal distension in February 2003. Swelling of a large paraaortic lymph node of 6 cm in diameter was detected by CT scan. Lymph node biopsy revealed diffuse large B-cell lymphoma. Lymphoma cells were positive for CD10, CD19, CD20 and κ-chain. The clinical stage was I. Complete remission has been achieved for 57 months after treatment with combination chemotherapy combined with rituximab followed by local radiation therapy. Non-Hodgkin lymphoma secondary to ET is a rare event. Such cases should therefore be accumulated to evaluate the mechanism of onset and clinical characteristics of lymphoma secondary to ET.
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