Gezici süperfisiyel tromboflebit ile başvuran akut lenfoblastik lösemi olgusu
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Dosyalar
Tarih
2007
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Venöz tromboemboHzm ve maliyn hastalıklar arasında bir ilişki olduğu yapılan çalışmalarda gösterilmiştir. Maliyniteli olguların %5-10'unda; derin ven trombozu, arteriyel tromboz, gezici tromboflebit, pulmoner emboli ve non-bakteriyel trombotik endokardit gibi tromboembolik olaylar gelişmektedir. Genellikle ileri evre kanserlerde görülen tromboz bazen kansere ait bulgular ortaya çıkmadan ilk bulgu olarak da saptanabilir. Sağ ayak bileği travması sonrası başvuran, ateş ve hiperlökositoz görülerek yatırılan olguda sağ bacak diz üstü iç yan bölgede yüzeyel tromboflebit olduğu saptandı. Hastanın yapılan periferik yaymasında %90 blast formunda lenfositler görüldü. Periferik kandan yapılan immünfenotipleme sonucu Pre B hücreli ALL ile uyumlu bulundu (CD-19 %93.74, CDL5 %98.73,CD-34 %87.58, CD-22 %63.59, CD-10 negatif). Yapılan kemik iliği biyopsisinde pre B hücreli ALL tanısı teyit edildi. Pre B hücreli lösemi tanısı alan hastanın ikinci günde sol bacakta da tromboflebit gelişti. Antitrombin III (%95) ve fibrinojen (3.7g/dL) düzeyleri normal olan, derin ven trombozu saptanmayan olgu nadir görülmesi ve gezici süperfisiyel tromboflebit ile akut lenfoblastik lösemi arasındaki ilişkiyi düşündürmesi açısından sunulmaya uygun bulunmuştur.
The relationship between malignant diseases and venous thromboembolism was shown by different studies. In 10% of patients with malignancy thromboembolic events such as deep vein thrombosis, pulmonary emboli and nonthrombotic endocardit may occur. In high grade cancers, usually before the clinical findings, deep vein thrombosis may be diagnosed. The case who was admitted for right ankle trauma was hospitalized with fever and hyperleucocytosis. A peripheral blood examination revealed lymphocytosis with 90% blast cells. The patient was diagnosed as pre B-cell ALL by the immunophenotype (CD-19 %93.74, CD-45 %98.73, CD-34 %87.58, CD-22 %63.59, CD-10 negative). Pre B-cell ALL diagnosis was confirmed with bone marrow biopsy. The patient developed thrombophlebitis in left leg by the second day of the hospitalization. Antithrombin III (95%) and fibrinogen (3.7 g/dL) levels were in normal ranges and there was no evidence for deep vein thrombosis. The case is presented aş_it-,is d mre condition which indicates a possible association between migratory superficial thrombophlebitis and B-cell acute lymhoblastic leukemia.
The relationship between malignant diseases and venous thromboembolism was shown by different studies. In 10% of patients with malignancy thromboembolic events such as deep vein thrombosis, pulmonary emboli and nonthrombotic endocardit may occur. In high grade cancers, usually before the clinical findings, deep vein thrombosis may be diagnosed. The case who was admitted for right ankle trauma was hospitalized with fever and hyperleucocytosis. A peripheral blood examination revealed lymphocytosis with 90% blast cells. The patient was diagnosed as pre B-cell ALL by the immunophenotype (CD-19 %93.74, CD-45 %98.73, CD-34 %87.58, CD-22 %63.59, CD-10 negative). Pre B-cell ALL diagnosis was confirmed with bone marrow biopsy. The patient developed thrombophlebitis in left leg by the second day of the hospitalization. Antithrombin III (95%) and fibrinogen (3.7 g/dL) levels were in normal ranges and there was no evidence for deep vein thrombosis. The case is presented aş_it-,is d mre condition which indicates a possible association between migratory superficial thrombophlebitis and B-cell acute lymhoblastic leukemia.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
İzmir Tepecik Eğitim Hastanesi Dergisi
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Cilt
17
Sayı
3
