Introduction: Due to the beginning of the use of immunophenotypic and cytogenetic techniques, new nosological forms of lymphoproliferative diseases have appeared over the past few decades. According to the WHO classification (2008), today there are more than 50 known lymphoproliferative diseases. Case Presentation: We present the case of a 51-year-old man with lymphoproliferative syndrome. Our patient underwent morphological and immunohistochemical investigations of biopsy materials from the right inguinal lymph node. The morphological picture was characteristic for small cell lymphoma. Immunophenotypically, tumor proliferate cells expressed CD20, CD76b, CD5, and cyclin D, and the tumor immunophenotype matched mantle cell lymphoma. Discussion: At the present stage of the development of medicine, the diagnosis of lymphoproliferative diseases is based on the clinical picture of the disease with the definition of localization and characteristics of the tumor process, morphological study of tumor tissue and cells, and immunophenotypic and/or cytogenetic analyses are mandatory to determine the final diagnosis.
Anaplastic pancreatic carcinoma is a very rare histological subtype of pancreatic cancer, which is characterized by a more aggressive course than for conventional ductal adenocarcinoma. In this article, we consider the features of the clinical course, the difficulties of diagnosis in connection with the absence of pathognomonic signs of pancreatic cancer, and the morphological picture of this disease in a patient 60 years of age. This clinical case clearly demonstrates the complexities of the pancreatic carcinoma diagnosis, fast disease progression, and extremely unfavorable prognosis. It is important for clinicians to remember that this pathology often has a subclinical course, and the oncomarker levels are not always true.
The authors discuss etiology, pathogenesis, and diagnostics of acute aortic syndrome characterized by the lesion of the aortic wall and report a case of this condition with a strikingly dramatic clinical picture with reference to its etiological causes (arterial hypertension and atherosclerosis), risk factors, clinical course, difficulty of diagnostics and treatment. This observation confirms the necessity of timely diagnostics and treatment of aortic syndrome for the prevention of severe vascular complications.
Hereditary hemochromatosis (HH) is a disease with an autosomal recessive hereditary type, stipulated by the genetic defect that leads to a high intestinal absorption of iron and primary accumulation in the parenchymal cells of the liver and other organs. This is the most common hereditary disease among White population, the frequency is about 1 case per 250 people. The prevalence of HH is inhomogeneous, people from countries in Northern Europe, especially Scandinavian, are more susceptible to this disease. Mutations of the HFE gene account for approximately 90% of HH cases. In HH excess iron deposits mainly in the cytoplasm of parenchymal cells of various organs and tissues: in the liver, pancreas, endocrine glands, skin and joints. The clinical picture of HH is characterized by the classical triad development: cirrhosis of the liver, diabetes mellitus (DM) and hyperpigmentation. HH may also manifest itself as various endocrinopathies (hypofunction of hypophysis, adrenal glands, thyroid gland, arthropathy, cardiomyopathy). Diagnostics of HH is based on the determination of the iron metabolism values: serum iron, transferrin saturation, the amount of ferritin, the genetic tests, liver biopsy data are used to confirm the diagnosis. Despite the fact that HH is a well-studied disease, in some cases it is complicated to diagnose it. Developed posthemorrhagic anemia in a patient is one of such reasons when the iron metabolism test is not informative.
The development of microcirculatory disorders is considered to be one of the earliest changes in the cardiovascular system with a combination of arterial hypertension (AH) and obesity. The rheological properties of blood play a significant role in the system of microcirculation. An important place in changing the rheological characteristics of blood is largely assigned to erythrocytes. Aggregation of erythrocytes is closely related to the magnitude of the surface-bound charge of their membranes or zeta potential of erythrocyte membranes. Purpose. To study the state of compound zeta potential of erythrocyte membranes in patients with hypertension and obesity. Material and methods. The study included 112 patients with AH and Index of Mass Corporal more than 30 kg/m2 (main group); the control group consisted of 25 people without AH and obesity. All patients of the main group received standard antihypertensive, lipid-lowering and hypoglycemic therapy to achieve the target levels of the indices under correction. Results. The level of compound zeta potential of erythrocyte membranes in patients with AH and obesity was significantly lower than in the control group and amounted to 1.57 ± 0.06 × 107 and 1.67 ± 0.03 × 107, respectively (p < 0.05). At the same time, in patients of the main group with an increase in AH, lower indices were noted. In patients with AH and obesity, a significant inverse correlation was found between the compound zeta potential of erythrocyte membranes and the degree of hypertension, which indicates a negative effect of hypertension on the rheological properties of blood at the microvasculature level. A correlation analysis was carried out to evaluate the association between Index of Mass Corporal and zeta potential of erythrocyte membranes in obese hypertensive patients. A negative direct correlation was revealed (r = 0.7, p < 0.05). Conclusion: a decrease in the total charge of erythrocytes can be considered as an early sign of microrheological disorders in patients with a controlled course of arterial hypertension and obesity.
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