Hodgkin lymphoma and secondary metachronous tumors

State University medical and Pharmaceutical ’’Nicolae Testemitanu”, Chisinau, Republic of MoldovaIntroduction: Hodgkin lymphoma is a malignant tumor of the lymphatic system. Hodgkin's disease occurs predominantly in young adults and is one of the most curable malignancies. With current treatment approaches, most patients achieve a lasting complete remission, but there is a high risk of developing in these patients’ secondary malignant tumors, and the mortality is associated with both radiotherapy and chemotherapy. Purpose and objectives: Researching metachronous malignancies in patients with Hodgkin lymphoma and studying the frequency of their occurrence, depending of the age, sex, clinical stages, histological forms, the administrated treatment for Hodgkin lymphoma and also the time period for developing secondary malignancies. Materials and Methods: Our study is based on 53 patients diagnosed and treated for Hodgkin Lymphoma in Oncological Institute of Republic of Moldova, all the patients where in complete remission when they developed secondary malignancy. In our study where 22 men and 31 women, with ages between 4 and 81 years. Results: According to our study the number of patients diagnosed with Hodgkin's was the highest in the age o f 11-21 for women (24,5%) and 21-31 for men (24,5%). The mix cellular form of tumors was the most frequent (43,39%). The metachronous tumors are mostly revealed in the stage IIA (39, 62%) of the disease. Our research carried out that there is a prevalence of a combined chemo-radiotherapy method of treatment (52.83%). The maximum risk of developing secondary metachronous tumors occurs over 11 to 20 years (46%), and the most frequently diagnosed tumors where lung cancer (22,64%), gastric cancer (16,98%), breast cancer( 13,20%). Conclusions: After treatment for Hodgkin's lymphoma in patients may develop secondary metachronous tumors that occur more frequently in women aged 21-40 years at diagnosis of Hodgkin lymphoma. Metachronous secondary tumors are identified mainly in patients diagnosed with stage IIA Hodgkin lymphoma, histological variant most commonly diagnosed as mixed cellularity. The method of treatment was chosen for the majority of patient’s chemo-radiotherapeutic. Period of development of secondary tumors is 11-20 years after treatment for Hodgkin's lymphoma. Secondary malignancies after Hodgkin Lymphoma can have different location

Kerion Celsi caused by Microsporum canis – clinical cases

Generalităţi. Au fost analizate 21 de fişe de observaţie clinică a bolnavilor, trataţi în anii 2000-2015, în spitalul Dermatologie şi Maladii Comunicabile pentru Tinea capitis infiltrativ-purulentă, provocată de Microsporum canis. Rezultate. Total bolnavi – 21, dintre care fetiţe – 7, băieţi – 14. Repartizarea conform vârstei a fost următoarea: până la 1 an – 1, 1-3 ani – 6, 4-7 ani – 11 şi 8-9 ani – 3 pacienţi, vârsta medie constituind 4 ani. Majoritatea pacienţilor erau din mediul rural (80%). La 15 pacienţi, durata maladiei a variat între 2-4 săptămâni, iar la 6 pacienţi – între 1 şi 3 luni. Majoritatea pacienţilor (17) au fost depistaţi în perioada vară-toamnă. Tratamentul ambulator, anterior spitalizărilor în clinica noastră, a inclus: corticosteroizi topici – 13 cazuri, antibiotice – 15 cazuri. Au fost înregistrate următoarele maladii concomitente: anemie nutriţională – 9 , enterobioză intestinală – 7 cazuri. Tabloul clinic, la internare, prezenta formaţiuni pseudotumorale multiple de tip Kerion Celsi (14 cazuri), cu aspect acut inflamator, purulent, zemuire pronunţată, cu dimensiuni între 2-3 şi 10-15 cm în diametru, cu margini regulate şi bine delimitate, dureroase la palpare. Erupţii solitare cu acelaşi aspect s-au observat la 7 pacienţi. Fluorescenţa verde-pal a fost identificată la 7 pacienţi, utilizând lampa Wood. Adenopatia regională (retroauriculară, cervical-posterioră, submandibulară) a fost semnalată la 16 pacienţi. Diagnosticul clinic a fost completat cu cel paraclinic prin prezenţa artrosporilor de tip Microsporum şi filamentelor miceliene scurte în materialul recoltat. La toţi pacienţii a fost identificată cultura Microsporum canis. Pacienţii au fost supuşi tratamentului corespunzător: Grizeofulvină (20 mg/kg corp/zi), keratoplastice (ung. Ichtiol 10%, ung. Levomycol), coloranţi anilinici (liquori Castellani, sol. Albastru de metilen 2%), tinctură de Iod 2-5%. Alopecia cicatricială reziduală s-a constatat la 6 copii. Concluzii. Cazurile clinice aduse în discuţie confirmă prezenţa micozelor de tip Kerion Celsi, provocate de Microsporum canis, la copiii cu un fundal morbid predispozant. Depistarea tardivă şi tratamentele neadecvate ale pacienţilor sunt soldate frecvent cu sechele sub formă de alopecie cicatricială. Menţionăm, totodată, raritatea formelor descrise.Overview. Were analyzed 21 clinical observation sheets of patients treated in the years 2000-2015 in Hospital of Dermatology and Communicable Diseases for infiltrative-purulent Tinea capitis caused by Microsporum canis. Results. Total number of patients – 21, of which girls – 7, boys – 14. Age distribution was as follows: up to 1 year old – 1, 1-3 y.o. – 6, 4-7 y.o. – 11 and 8-9 y.o. – 3 patients, average age being 4 years. Most patients came from rural areas (80%). The duration of disease in 15 patients was observed 2-4 weeks, in 6 patients – 1 to 3 months. Most patients (17) were found summer-autumn. The treatment before hospitalization included: topical corticosteroids – 13 cases, antibiotics – 15 cases. Among concomitant diseases were recorded: nutritional anemia – 9, intestinal enterobioza – 7 cases. The clinical features on admission included multiple pseudotumoral formations Kerion Celsi with a purulent acute-inflamatory aspect, pronounced press, having sizes 2-3 up to 10-15 cm in diameter with regular edges, well defined, painful on palpation. Unique eruptions with the same clinical features were observed in 7 patients. The pale-green fluorescence with Wood lamp was identified in 7 patients. Regional limph nodes (retroauricular, posterior cervical, submandibular) were detected in 16 patients. The clinical diagnosis was completed with the paraclinical one: the presense of arthrospores type Microsporum and short mycelial filaments in the collected material. In all patients was identified Microsporum canis culture. The treatment included: Grizefulvine (20mg/kg/day), keratoplastiks (ung. Ichtiol 10%, ung. Levomycol), aniline dyes (Liq. Castellani, Sol. Methilene blue 2%), iodine tincture 2-5%. The residual scar alopecia was observed in 6 children. Conclusions. Clinical cases brought to discussion confirm the presence of forms of Kerion Celsi type caused by Microsporum canis in children with predisposing morbid background. Late detection and improper treatment of patients commonly are resulting sequelae in the form of scar alopecia. Must be mentioned the rarity of described cases