Histiocytic medullary reticulosis following acute lymphoblastic leukemia

Starkie, C. M.; Kenny, M. W.; Mann, Jennifer; Cameron, A. H.; Hill, F. G. H.

doi:10.1002/1097-0142(19810201)47:3<537::aid-cncr2820470319>3.0.co;2-5

Cited by 38 publications

(4 citation statements)

References 14 publications

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“…Those patients have been most often treated with steroids or chemotherapy with controversial results [ 1,2]. Alpha-INF has been used in other lymphoproliferative disorders, such as angioimmunoblastic lymphadenopathy [3,4], but, to our knowledge, only one case of MCD with complete remission lasting 11 months after interferon therapy has been reported [5]. The peculiarity of our case is the long-term complete remission (32 months) after the discontinuation of treatment with the remarkable aspect of the normalization of the immunoglobulins.…”

Section: To Zhe Editor: Multicentric Castleman's Disease (Mcd) Is a Rmentioning

confidence: 85%

Histiocytosis and two classes of m‐proteinemia in pre‐treated Ph positive all

1995

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Section: To Zhe Editor: Multicentric Castleman's Disease (Mcd) Is a Rmentioning

confidence: 85%

Histiocytosis and two classes of m‐proteinemia in pre‐treated Ph positive all

1995

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“…The common causes are overt hemic malignancies, particularly malignant lymphoma (Economopoulos et al, 1979;Costa et al, 1980;Jaffe et al, 1983;Aronson et al, 1985;Liang et al, 1986;Ng et al, 1986;Chan et al, 1987) and acute lymphoblastic leukemia (ALL) (Liang et al, 1986;Takasaki et al, 1987). Many authors have commented that previous reports of ALL terminating in histiocytic medullary reticulosis (HMR) (Skarin et al, 1972; Chen et al, 1976; Griffin et al, Starkie et al, 1981Martelli et al, 1982), or MH (Skoog and Feagler, 1978;Trubowitz et al, 1980) are probably all examples of RHS. There have also been rare reports of chronic lymphocytic leukemia (CLL) (Manoharan et a/., 1981) and acute nonlymphocytic leukemias (Theodorakis et al, 1983;Castoldi et al, 1977) associated with a HMR-like syndrome.…”

Section: Discussionmentioning

confidence: 99%

Peripheral T‐cell lymphoma presenting as hemophagocytic syndrome

Chan

et al. 1989

Hematological Oncology

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Three patients with peripheral T-cell lymphoma presenting with pyrexia, wasting, hepatosplenomegaly and pancytopenia in the absence of myelophthisic lymphomatous involvement are reported. Early in the course of the disease when there was no significant lymphadenopathy, these cases created enormous diagnostic confusion. Although the clinical features were suggestive of malignant histiocytosis (MH), marrow findings showed phagocytic histiocytes which did not appear atypical, and the criteria for diagnosis of MH could not be satisfied. Lymph node enlargement was detected only after 14, 5, and 8 weeks from the onset of symptoms, and the diagnosis of T-lymphoma was then made on lymph node biopsies. Treatment with multiple agent chemotherapy was attempted. Two patients died 3 days and 11 weeks after treatment was started and the third was lost to follow-up. In contrast with most of the cases reported in the literature, our cases show that a reactive hemophagocytic syndrome can be an early and prominent manifestation of an underlying T-cell lymphoma. Differentiation from other causes of hemophagocytic syndrome can be difficult and lack of histological proof of malignancy in the initial stage often delays definitive diagnosis and treatment.

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“…In view of the short interval between the treatment of ALL and the emergence of THL, chemotherapeutic agents seem unlikely to be the direct cause of the second malignancy. There are many reported cases of benign and malignant proliferation of histiocytic cells after the treatment of ALL and lymphoma, some of them associated with certain viral infections [16][17][18][19][20][21][22]. It could be that the histiocytes undergo reactive or malignant transformation effected by chemotherapeutically destroyed leukemic cell.…”

Section: Brief Report True Histiocytic Lymphoma Following Acute Lymphmentioning

confidence: 99%

True histiocytic lymphoma following acute lymphoblastic leukemia

Wongchanchailert

Laosombat

2002

Med. Pediatr. Oncol.

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True histiocytic lymphoma (THL) is an uncommon type of non-Hodgkin lymphoma (NHL), the malignant cells of which originate from phagocytic histiocytes [1]. Using only histopathologic study, the diagnosis of THL has frequently been misinterpreted [2]. However, by the application of immunophenotypic technique for studying different cell lineages, many previously diagnosed THL have turned out to be Ki-1-positive anaplastic large cell lymphoma and high grade lymphoma of B or T cell origin [2,3]. The criteria generally used for diagnosis of THL is the reactivity of the malignant cells with the monocytemacrophage markers and lack of reactivity with B-and T-cell markers [2][3][4]. Using such immunophenotypic criteria, the incidence of THL studied retrospectively is only 0.2-0.6% of all cases of NHL [3,[5][6][7][8]. The common clinical feature of THL is a localized tumor that may or may not be disseminated. The usual organs of involvement are the skin, lymph nodes, gastrointestinal tract, and soft tissues [9][10][11][12]. Recently, the disease was reported to be a second tumor following completed treatment of lymphoblastic neoplasms [13]. Herein we report an additional patient with THL manifested during the maintenance chemotherapy for acute lymphoblastic leukemia (ALL).She was an 8-year-old girl who presented with a 2-week history of limping, low grade fever, and bruises. Hepatosplenomegaly, generalized lymphadenopathy and petechiae and ecchymoses on trunk and extremities were found on physical examination. The complete blood count showed hemoglobin 91.0 gm/L, white blood cells 41.3 Â 10 9 /L, 69% of which were blast cells and platelet count 88.0 Â 10 9 /L. Lymphoblasts of L 2 (FAB) morphology with positive PAS staining were found in bone marrow aspirate. The immunophenotypes revealed 10 and 5% positive CD 8 and CD 2 markers respectively. She was treated with the modified Children Cancer Study Group protocol for ALL with good response. Six months later, she developed right hip pain. An osteolytic lesion was found in the right upper femur on plain film. The whole body bone scan showed multiple areas of increased radioactivity in the right upper femur, right acetabulum, distal left femur, the left seventh posterior rib, distal left humerus, and both pubic bones. Bone biopsy of the right femur was reported to be benign fibrous histiocytoma. She was continued on the maintenance phase of chemotherapy for ALL. Four months later, she developed pain in the back and weakness of the lower extremities. MRI of the whole spine showed an extradural mass at T8-10 level with cord compression. She went on T8-10 laminectomy and total tumor removal. The pathologic report was THL with positive CD 68 marker and negative myeloperoxidase, LCA, CD 45, CD 3, CD 45 RO, CD 20, and S100 markers (Fig. 1). The electron microscopic study confirmed the diagnosis of histiocytic lymphoma. She was treated with the CHOP protocol. The tumor partially responded. A few months later, the tumor recurred locally and additional tumor masses were found in the lef...

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Histiocytic medullary reticulosis following acute lymphoblastic leukemia

Abstract: A 2-year-old male with acute lymphocytic leukemia died with histiocytic reticulosis 19 weeks later. A comparison with previously reported cases is made, and the relationship of ALL and HMR is discussed.

Cited by 38 publications

References 14 publications

Histiocytosis and two classes of m‐proteinemia in pre‐treated Ph positive all

Histiocytosis and two classes of m‐proteinemia in pre‐treated Ph positive all

Peripheral T‐cell lymphoma presenting as hemophagocytic syndrome

True histiocytic lymphoma following acute lymphoblastic leukemia

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