Navegando por Palavras-chave "splenectomy"
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- ItemSomente MetadadadosPrimary splenic lymphoma in patient with hepatitis C virus infection: case report and review of the literature(Int College Of Surgeons, 2000-07-01) Matone, Jacques [UNIFESP]; Lopes, G. D.; Scalabrini, Milton [UNIFESP]; Ricca, Artur Berti [UNIFESP]; Sato, Nelson Yukitoshi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Primary splenic lymphoma is uncommon, constituting only 1-2% of all patients with malignant lymphoma. Despite the rarity of this malignancy, the number of primary splenic lymphoma being reported has increased due to its ambiguous definition used in the literature. We describe a case of a 41-year-old man with chronic hepatitis C virus infection presenting abdominal discomfort in the upper left quadrant, weakness, nausea and vomiting. Abdominal computed tomography revealed nodules in the congested splenic parenchyma. Splenectomy was performed and an analysis of the spleen diagnosed B-cell non-Hodgkin's lymphoma. Biopsy of the liver showed evidence of hepatitis C virus. Bone marrow biopsy revealed no tumor infiltration. The patient has been followed to date, has progressed quite well and remains essentially asymptomatic. Recently, an etiologically important role has been suggested for hepatitis C virus infection in the development of B-cell non Hodgkin's lymphoma. Lymphotropism of hepatitis C virus may play a pathological role in the development of non Hodgkin's lymphoma. It is important to add lymphoma to the list of differential diagnosis of extrahepatic disorders in patients with chronic hepatitis C virus infection.
- ItemSomente MetadadadosRefractory chronic GVHD emerging after splenectomy in a marrow transplant recipient with accelerated phase CML(Nature Publishing Group, 2003-08-01) Rodrigues, C. A.; Fermino, Fabiana Aidar [UNIFESP]; Vasconcelos, Yuri [UNIFESP]; Oliveira, JSR de; Universidade Federal de São Paulo (UNIFESP)We report a 39-year-old female patient who underwent HLA-identical sibling allogeneic BMT for CML in accelerated phase. Severe pancytopenia refractory to G-CSF associated with progressive splenomegaly and RBC/ platelet transfusion dependency were present from day + 60 after BMT. MRD assessed by FISH and RT-PCR multiplex for BCR-ABL rearrangement was negative, and complete chimerism was documented by VNTR on days + 100, + 180, + 360 and 2 years after BMT. Splenectomy was performed on day + 225 and pancytopenia resolved but chronic extensive graft-versus-host disease developed, with hepatic cholestasis, diffuse scleroderma and sicca-like syndrome. She was sequentially and progressively treated with different immunosuppressive therapy combinations with no clear benefit. On day + 940, she presented with infection over the previously present ulcers on both limbs, which culminated in septic shock and death on day + 1041. We conclude that, although splenectomy may reverse poor graft function after allogeneic BMT, hyposplenism may trigger or worsen chronic extensive GVHD leading to increased morbidity and mortality.