We present a rare case associating inferior vena cava’s (IVC) complex variations. Anatomical, embryological and clinical aspects are discussed. Duplication’s discovery was fortuitous during an abdominal ultrasound a...We present a rare case associating inferior vena cava’s (IVC) complex variations. Anatomical, embryological and clinical aspects are discussed. Duplication’s discovery was fortuitous during an abdominal ultrasound and was confirmed by the CT scan. The latter also highlighted azygos continuation, retro aortic renal vein and an iliac venous anomaly. These variants are important to know in order to be able to differentiate them from lymphadenopathy, para-vertebral masses, and aortic pathologies. It is necessary to report them before any retroperitoneal surgery or interventional vascular procedure.展开更多
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, characterized by high clinical and biological heterogeneity. Patients typically present with progressive lymphadenopathy, extranodal disea...Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, characterized by high clinical and biological heterogeneity. Patients typically present with progressive lymphadenopathy, extranodal disease and may also experience fever, night sweats and unexplained weight loss. We report here the case of a 16-year-old female with osteoarticular pain, dizziness, and dyspnea on exertion. Clinical examination showed no lymphadenopathy. Complete blood count (CBC) revealed pancytopenia and marrow smears found to be hypocellular. Initial diagnosis favored secondary myelofibrosis. Diagnosis of bone marrow involvement by DLBCL was retained on bone marrow histology and immunohistochemistry which showed infiltration of large B lymphoid cells. The patient was treated by immunochemotherapy R-CHOP regimen. This case highlights a very rare and atypical circumstance of discovery of DLBCL with myelofibrosis as an initial symptom. Prognosis value of this presentation and management difficulties are also discussed.展开更多
Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing cou...Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line. It’s against this backdrop we perform this study to assess the efficacy of this CTD protocol in first line therapy. Methods: We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 50 patients with MM treated during the period range from 01 September 2018 and 01 July 2022 with the CTD protocol of cyclophosphamide (500 mg at D1, D8 and D15), dexamethasone (40 mg weekly) and thalidomide (100 mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan-Meier method. Results: The mean age was 62.3 ± 9.1 years and the sex ratio was 0.7. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 64%, of which 34% were in very good partial remission and partial remission in 12% of cases. Progression was noted in 4 patients. Treatment-related side effects were mainly peripheral neuropathy and anaemia in 3 patients respectively. The median survival was 38.4 months. The progression-free survival was 60%. An advanced age (≥65 years) is correlated with negative impact on survival (p = 0.04). Conclusion: Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low-income patients.展开更多
<b><span style="font-family:Verdana;">Introduction</span></b><span style="font-family:Verdana;">: Patients with multiple myeloma (MM) develop neurological</span>...<b><span style="font-family:Verdana;">Introduction</span></b><span style="font-family:Verdana;">: Patients with multiple myeloma (MM) develop neurological</span><span style="font-family:""><span style="font-family:Verdana;"> complications such as root and/or spinal cord compression in at least 5% of cases. The aim of this work is to describe the clinical and radiological features of root and/or spinal cord compression occurring during multiple myeloma. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted a retrospective study in the Clinical Haematology Department of Dalal Jamm Hospital and the National Blood Transfusion Centre, the Neurological Clinic of Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec Hospital in Dakar between January 2016 and December 2019. All patients whose multiple myeloma diagnosis was established according to the International Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular compression, were included in our study. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 29 patients were included. The average age was 54.31 years [32 - 76 years]. The sex ratio (M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the patients and spinal pains were reported by 93% of the patients. Neurological signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter disorders. The types of lesions showed by imaging were vertebral lysis in 100% of cases, vertebral compression in 37% of cases, and epidural infiltration in 34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%) had root compression, and 3 patients (10.34%) had 展开更多
文摘We present a rare case associating inferior vena cava’s (IVC) complex variations. Anatomical, embryological and clinical aspects are discussed. Duplication’s discovery was fortuitous during an abdominal ultrasound and was confirmed by the CT scan. The latter also highlighted azygos continuation, retro aortic renal vein and an iliac venous anomaly. These variants are important to know in order to be able to differentiate them from lymphadenopathy, para-vertebral masses, and aortic pathologies. It is necessary to report them before any retroperitoneal surgery or interventional vascular procedure.
文摘Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, characterized by high clinical and biological heterogeneity. Patients typically present with progressive lymphadenopathy, extranodal disease and may also experience fever, night sweats and unexplained weight loss. We report here the case of a 16-year-old female with osteoarticular pain, dizziness, and dyspnea on exertion. Clinical examination showed no lymphadenopathy. Complete blood count (CBC) revealed pancytopenia and marrow smears found to be hypocellular. Initial diagnosis favored secondary myelofibrosis. Diagnosis of bone marrow involvement by DLBCL was retained on bone marrow histology and immunohistochemistry which showed infiltration of large B lymphoid cells. The patient was treated by immunochemotherapy R-CHOP regimen. This case highlights a very rare and atypical circumstance of discovery of DLBCL with myelofibrosis as an initial symptom. Prognosis value of this presentation and management difficulties are also discussed.
文摘Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line. It’s against this backdrop we perform this study to assess the efficacy of this CTD protocol in first line therapy. Methods: We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 50 patients with MM treated during the period range from 01 September 2018 and 01 July 2022 with the CTD protocol of cyclophosphamide (500 mg at D1, D8 and D15), dexamethasone (40 mg weekly) and thalidomide (100 mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan-Meier method. Results: The mean age was 62.3 ± 9.1 years and the sex ratio was 0.7. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 64%, of which 34% were in very good partial remission and partial remission in 12% of cases. Progression was noted in 4 patients. Treatment-related side effects were mainly peripheral neuropathy and anaemia in 3 patients respectively. The median survival was 38.4 months. The progression-free survival was 60%. An advanced age (≥65 years) is correlated with negative impact on survival (p = 0.04). Conclusion: Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low-income patients.
文摘<b><span style="font-family:Verdana;">Introduction</span></b><span style="font-family:Verdana;">: Patients with multiple myeloma (MM) develop neurological</span><span style="font-family:""><span style="font-family:Verdana;"> complications such as root and/or spinal cord compression in at least 5% of cases. The aim of this work is to describe the clinical and radiological features of root and/or spinal cord compression occurring during multiple myeloma. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted a retrospective study in the Clinical Haematology Department of Dalal Jamm Hospital and the National Blood Transfusion Centre, the Neurological Clinic of Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec Hospital in Dakar between January 2016 and December 2019. All patients whose multiple myeloma diagnosis was established according to the International Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular compression, were included in our study. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 29 patients were included. The average age was 54.31 years [32 - 76 years]. The sex ratio (M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the patients and spinal pains were reported by 93% of the patients. Neurological signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter disorders. The types of lesions showed by imaging were vertebral lysis in 100% of cases, vertebral compression in 37% of cases, and epidural infiltration in 34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%) had root compression, and 3 patients (10.34%) had
