Navegando por Palavras-chave "Lymphoma"
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- ItemAcesso aberto (Open Access)Aplicação da ressonância magnética de corpo inteiro para o estadiamento e acompanhamento de pacientes com linfoma de Hodgkin na faixa etária infanto-juvenil: comparação entre diferentes sequências(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2011-02-01) Nava, Daniel [UNIFESP]; Oliveira, Heverton Cesar de [UNIFESP]; Luisi, Flavio Augusto [UNIFESP]; Ximenes, Andrea Regina Da Silveira; Lederman, Henrique Manoel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Clínica CentrusOBJECTIVE: To compare the performance of the T1, T2, STIR and DWIBS (diffusion-weighted whole-body imaging with background body signal suppression) sequences in the staging and follow-up of pediatric patients with Hodgkin's lymphoma in lymph node chains, parenchymal organs and bone marrow, and to evaluate interobserver agreement. MATERIALS AND METHODS: The authors studied 12 patients with confirmed diagnosis of Hodgkin's lymphoma. The patients were referred for whole body magnetic resonance imaging with T1-weighted, T2-weighted, STIR and DWIBS sequences. RESULTS: The number of lymph node sites characterized as affected by the disease on T1- and T2-weighted sequences showed similar results (8 sites for both sequences), but lower than DWIBS and STIR sequences (11 and 12 sites, respectively). The bone marrow involvement by lymphoma showed the same values for the T1-, T2-weighted and DWIBS sequences (17 lesions), higher than the value found on STIR (13 lesions). A high rate of interobserver agreement was observed as the four sequences were analyzed. CONCLUSION: STIR and DWIBS sequences detected the highest number of lymph node sites characterized as affected by the disease. Similar results were demonstrated by all the sequences in the evaluation of parenchymal organs and bone marrow. A high interobserver agreement was observed as the four sequences were analyzed.
- ItemSomente MetadadadosCefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison(Scientific Communications Int Ltd, 2009-04-01) Pires Pereira, Carlos Alberto [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; Carlesse, Fabianne Altruda; Vercillo Luisi, Flavio Augusto; Torres Barros da Silva, Katia Veronica; Martino Lee, Maria Lucia de; Universidade Federal de São Paulo (UNIFESP)Background and purpose: The empirical use of antibiotic therapy is widely accepted for patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients at high risk for complications is an appropriate alternative. However, few data are available for pediatric patients. The aim of this study was to compare the efficacy and safety of cefepime (CFP) monotherapy with ceftriaxone plus amikacin (CFT+AK) in children and adolescents with febrile neutropenia (FN).Methods: A prospective randomized open study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy was conducted. Patients were randomized to receive UP or CFT+AK. The randomization was based on number lists.Results: Fifty seven patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 episodes; CFT+AK, 63 episodes). The mean neutrophil count at admission to hospital was 118.6 cells/mm(3) for patients in the CFP group and 107 cells/mm(3) for patients in the CFT+AK group. The mean duration of neutropenia was 9 days for the UP group and 8 days for the CFT+AK group. Analysis of only the first episodes for each patient showed that UP treatment was successful for 65.5% of episodes and CFT+AK was successful for 64.3% of episodes. The overall rates of success with modification were 90% for the UP group and 89% for the CFT+AK group. No major treatment-emergent toxicity was reported.Conclusion: Monotherapy with UP seems to be as effective and safe as CFT+AK for initial empirical therapy in children and adolescents with FN.
- ItemAcesso aberto (Open Access)Classificação dos tumores hematopoéticos e linfoides de acordo com a OMS: padronização da nomenclatura em língua portuguesa, 4ª edição(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2011-12-01) Zerbini, Maria Cláudia Nogueira; Soares, Fernando Augusto; Morais, José Carlos; Vassallo, José; Velloso, Elvira Deolinda Rodrigues Pereira; Chauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]; Chiattone, Carlos Sergio; Aldred, Vera Lucia; Siqueira, Sheila Aparecida Coelho; Alves, Antonio Correa [UNIFESP]; Castelli, Jussara Bianchi; Oliveira, Claudia Regina Gomes Mendes Cardim de; Menezes, Yara de; Paes, Roberto Pinto; Universidade de São Paulo (USP); Hospital do Câncer A. C. Camargo Departamento de Anatomia Patológica; Universidade Federal do Rio de Janeiro Departamento de Patologia; Universidade Estadual de Campinas (UNICAMP); Hospital Israelita Albert Einstein Setor de Citogenética Laboratório Clínico; Universidade Federal de São Paulo (UNIFESP); Fleury Medicina Diagnóstica Laboratório de Citogenética; Santa Casa de São Paulo Faculdade de Ciências Médicas; Fleury Medicina Diagnóstica; Instituto Adolfo Lutz; Hospital Alemão Oswaldo Cruz; FCMSCSP Departamento de PatologiaINTRODUCTION: The World Health Organization (WHO) classification of hematopoietic and lymphoid tissue (4th edition, 2008) tumors constitutes an updated review of the 3rd edition published in 2001. The translation of the nomenclature used to describe the entities should be clear, precise and uniform so that clinicians, pathologists and researchers involved in the onco-hematopathological area may identify them accurately. OBJECTIVE: With this purpose, the authors present an updated proposal and a terminological standardization in Portuguese based on WHO/2008
- ItemAcesso aberto (Open Access)Histological classification of 1,025 cases of Hodgkin's lymphoma from the State of São Paulo, Brazil(Associação Paulista de Medicina - APM, 2005-05-01) Vassallo, José; Paes, Roberto Pinto; Soares, Fernando Augusto; Menezes, Yara; Aldred, Vera; Ribeiro, Karina De Cássia Braga; Alves, Antonio Correa [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Santa Casa de Misericórdia de São Paulo; Fundação Antônio Prudente Hospital do Câncer de São Paulo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE: It is currently asserted that, in industrialized countries, nodular sclerosis is the most frequent type of Hodgkin's lymphoma, in contrast to developing countries, where mixed cellularity and lymphocyte depletion are more frequently seen. The objective was to review histological data from cases of Hodgkin's lymphoma from São Paulo and Campinas cities. DESIGN AND SETTING: Cross-sectional histopathological analysis, in four university hospitals and one cancer care center. METHODS: 1,025 cases diagnosed as Hodgkin's lymphoma between 1990 and 2000 were collected from five institutions; 631 of them (61.5%) had been immunophenotyped using antibodies to CD20, CD3, CD15 and CD30. The relative frequencies of histological types (as informed by the contributing authors, who are hematopathologists in their institutions) were determined according to age and gender. RESULTS: The Hodgkin's lymphoma types were distributed as follows: lymphocyte predominance 4.8%, nodular sclerosis 69.2%, mixed cellularity 21.1% and lymphocyte depletion 4.6%. CONCLUSIONS: The controversy regarding the frequencies of Hodgkin's lymphoma types within the Brazilian setting seems to be due to the small number of cases in previous studies. The present data show a picture close to the situation in the industrialized countries.
- ItemAcesso aberto (Open Access)Multiple primary cutaneous plasmacytoma: first reported case in Brazil(Sociedade Brasileira de Dermatologia, 2012-08-01) Saback, Thais Lima [UNIFESP]; Botelho, Luciane Francisca Fernandes [UNIFESP]; Enokihara, Milvia Maria Simões Da Silva; Michalany, Nilceo Schwery [UNIFESP]; Floriano, Marcos César [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Primary cutaneous plasmacytoma is a rare disease characterized by monoclonal proliferation of plasma cells in the skin, in the absence of bone or systemic disease. It can be solitary or multiple, the latter being even more rare and presenting a higher mortality rate. We describe the clinical, histopathological and immunohistochemical aspects as well as the evolution of an 87-year-old female patient, diagnosed as having multiple primary cutaneous plasmacytomas.
- ItemAcesso aberto (Open Access)Oligella urethralis isolada em hemocultura de paciente internada no complexo HSP/UNIFESP(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2009-02-01) Raimundo, Luis Gustavo [UNIFESP]; Dinato, Leandro [UNIFESP]; Pinto, Fernando Pereira [UNIFESP]; Machado, Antonia Maria De Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)First time isolation of Oligella urethralis in two samples of peripheral blood detected by continuous metabolism monitoring methodology (Bactec 61650 system) and identified by the automatized Phoenix 61650 system (BD System) in patient with retro-peritoneal lymphoma with metastasis in the central nervous system at São Paulo hospital of Federal University of São Paulo (HSP/UNIFESP).
- ItemAcesso aberto (Open Access)O papel da expressão de Bcl-2 em material obtido por PAAF no diagnóstico de doenças linfoproliferativas B(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2008-12-01) Lourenço, Carolina Escaramuzi [UNIFESP]; Kimura, Elisa Y. S. [UNIFESP]; Sandes, Alex Freire [UNIFESP]; Alves, Antonio Correa [UNIFESP]; Colleoni, Gisele Wally Braga [UNIFESP]; Barreto, Wolney Góis [UNIFESP]; Etto, Leina Y. [UNIFESP]; Yamamoto, Mihoko [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The diagnosis of lymphoproliferative disorders (LPD) is routinely made through histological and immunohistochemical analysis of lymph nodes. Immunophenotyping by flow cytometry (FC) is a sensitive and fast tool, which may be applied in samples obtained through fine needle aspiration for the diagnosis of LPD. Bcl-2 is a proto-oncogene that appears in several LPD and it has a significantly high expression in follicular lymphomas. OBJECTIVES: to diagnose LPD in FNA samples through morphology and flow cytometry immunophenotyping. MATERIAL AND METHODS: Samples from 25 patients with lymphadenopathies and 2 reactive tonsils were studied through morphology and immunophenotyping. The antigens expressions were evaluated by using a screening panel of monoclonal antibodies (CD3, CD4, CD8, CD19, light chains kappa; and lambda), followed by CD5, CD10, CD11c, CD23, CD79b, sIgM, FMC-7 and Bcl-2 when required. The results were compared with histology. RESULTS:Four out of 25 samples were reactive processes and 21were B-LPD. In all cases there was consistency with histological results. The mean fluorescence intensity of Bcl-2 in Follicular Lymphoma (19.92) was higher compared with other lymphoproliferative diseases (11.93) and controls (3.49) (p = 0.032). CONCLUSION: Fine needle aspiration of lymph nodes associated with cytomorphology and flow cytometry immunophenotyping allows a fast differentiation between reactive processes and B lymphoproliferative cases. The high expression of Bcl-2 by cytometry shows its usefulness in the diagnosis of the most frequent type of B-LPD. Fine needle aspiration sampling requires training and more than one aspiration is recommended.
- ItemSomente MetadadadosPerfil dos pacientes onco-hematológicos do pronto socorro do Hospital São Paulo(Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Jorge, Iago Farias [UNIFESP]; Riera, Rachel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To develop a profile with clinical, epidemiological and laboratory data of non-critical onco-hematological patients at the Emergency Department (ED) of São Paulo’s Hospital. Methods: It’s a retrospective and observational study of oncohematological patients admitted between March 2015 and December 2017 to the Internal Medicine’s unit at the ED of São Paulo’s Hospital, located in São Paulo. The patients were selected by the medical staff on duty and the patients’ data were obtained from electronic medical records. The inclusion criteria were: being over 18 years of age, in-hospital stay of at least 48 hours and confirmed diagnosis of hematological cancer. The clinical history, vital signs and complementary exams were obtained from electronic medical records. Results: There were 22972 hospitalizations in the ED, 125 of them were of onco-hematological patients at the Internal Medicine’s unit. Men represented 53.6% of the sample and the average age was 56 years. The frequency of the main onco-hematologic diagnoses was leukemia with 38,4%, lymphoma with 36.8%, multiple myeloma with 20.8% and myelodysplastic syndrome with 4%. The main reason for hospitalizations was to treat infeccious complications, with 40% of the cases and pulmonary was the most frequent focus. It was observed that 24% of patients had creatinine levels above 1.5 mg/dL, 34% were hyponatremic, 24% were hypercalcemic and 83% of the patients had at least one cytopenia. Of the 125 patients, 16% died during the hospital stay, and all deaths were attributed to septic shock. Conclusions: Most hospitalizations of onco-hematological patients in the HSP’s ED were from men, with a mean age of 56 years. Most of these patients had disturbances in at least one vital sign or level of consciousness upon admission. One out of three patients had hyponatremia while most of them had disturbances in hematimetric indexes, with at least one cytopenia. Management of infectious complications was the most common cause of hospitalization. During this hospitalization, 16% of the patients died, and the mortality after 6, 12 and 18 months of follow-up was 36%, 46% and 50%, respectively.