Multiple Myeloma With Leptomeningeal Involvement: A Study of Three Cases Exploring Diagnosis and Treatment Challenges.

Central nervous system (CNS) involvement in multiple myeloma (MM) is a rare but serious complication that poses significant diagnostic and therapeutic challenges. This article presents three cases of leptomeningeal involvement in patients with MM, highlighting the diverse clinical presentations, diagnostic approaches, and treatment strategies employed. The first case is a 54-year-old female who, after initial treatment and autologous hematopoietic stem cell transplant, developed CNS disease.

Acute Liver Failure in Hemophagocytic Lymphohistiocytosis Secondary to Metastatic Renal Cell Carcinoma: A Diagnostic Dilemma.

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive hematologic disorder involving hyperstimulation of immune responses and severe inflammation. HLH has been well documented in lymphoid cancers and leukemias, but more rarely in solid tumors. The non-specific clinical characteristics of HLH can cause a diagnostic dilemma and delay in proper treatment, resulting in poor outcomes.

CD30+ Lymphoproliferative Disorders as Potential Candidates for CD30-Targeted Therapies.

Context.—: In the early 1980s, a monoclonal antibody termed Ki-1 was developed against a cell line derived from a patient with Hodgkin lymphoma. This antibody detected a limited number of benign activated lymphocytes in lymphoid tissue, whereas in Hodgkin lymphoma it appeared to be nearly specific for Reed-Sternberg cells and their mononuclear variants.

Acceleration of diabetic wound healing with adipose-derived stem cells, endothelial-differentiated stem cells, and topical conditioned medium therapy in a swine model.

Objective: The purpose of our study was to investigate the effect of adipose-derived stem cells (ASCs), endothelial-differentiated ASCs (EC/ASCs), and various conditioned media (CM) on wound healing in a diabetic swine model. We hypothesized that ASC-based therapies would accelerate wound healing.

Methods: Diabetes was induced in four Yorkshire swine through intravenous injection of streptozotocin.

Cerebral phaeohyphomycosis in a patient with neurosarcoidosis on chronic steroid therapy secondary to recreational marijuana usage.

Cerebral phaeohyphomycosis is often a fatal disease that typically takes a hematogenous spread after inhalation or accidental skin inoculation of pathogens. We present a patient with a history of heavy marijuana smoking while being on chronic steroid therapy for treatment of neurosarcoidosis who was found to have multiple brain abscesses from Curvularia sp. This is a ubiquitous soil-dwelling dematiaceous fungus that is generally thought to affect solely plants, but there is increasing evidence in the literature of it affecting humans and animals.

Platelet refractoriness in acquired hemophagocytic syndrome.

Background: Acquired hemophagocytic syndrome (AHPS) is a severe inflammatory disorder often caused by Epstein-Barr virus (EBV). Proliferation of activated macrophages produces uncontrolled cytokine production. Thrombocytopenia is common in AHPS, previously attributed to inadequate or ineffective marrow platelet (PLT) production.

International normalized ratio versus plasma levels of coagulation factors in patients on vitamin K antagonist therapy.

Context: The key question when managing patients on warfarin therapy who present with life-threatening bleeding is how to use the international normalized ratio (INR) to best direct corrective therapy. The corollary question for the clinical laboratory is at what level will the INR reflect a critical value that requires notifying the clinician.

Objective: To determine the levels of vitamin K-dependent factors over a range of INR values.

Does routine repeat testing of critical values offer any advantage over single testing?

Context: Before being communicated to the caregiver, critical laboratory values are verified by repeat testing to ensure their accuracy and to avoid reporting false or erroneous results.

Objective: To determine whether 2 testing runs offered any advantage over a single testing run in ensuring accuracy or in avoiding the reporting of false or erroneous results.

Design: Within the hematology laboratory, 5 tests were selected: hemoglobin level, white blood cell count, platelet count, prothrombin time, and activated partial thromboplastin time.

Prolonged hemophagocytic lymphohistiocytosis syndrome as an initial presentation of Hodgkin lymphoma: a case report.

Introduction: Hemophagocytic lymphohistiocytosis is an immune-mediated syndrome that typically has a rapidly progressive course that can result in pancytopenia, coagulopathy, multi-system organ failure and death.

Case Presentation: A 57-year-old Caucasian woman was referred in fulminant hemophagocytic lymphohistiocytosis, with fever, pancytopenia, splenomegaly, mental status changes and respiratory failure. She was found to have stage IV classical Hodgkin lymphoma, in addition to Epstein-Barr virus and cytomegalovirus viremia.

An evaluation of the performance of Sysmex XE-2100 in enumerating nucleated red cells in peripheral blood.

Context: Automated methods of enumerating nucleated red blood cells (NRBCs) in blood are gaining acceptance in many laboratories.

Objective: To evaluate the performance of Sysmex XE-2100 in enumerating NRBCs in peripheral blood.

Design: Automated relative number of NRBCs per 100 white blood cells (NRBC%) results for a total of 460 specimens run on the XE-2100 were compared with manual NRBC% results obtained by performing a 100-cell differential on a Wright-stained smear prepared from each specimen.

Gliosarcoma arising from an anaplastic ependymoma: a case report of a rare entity.

We report the first case of a gliosarcoma arising from an anaplastic ependymoma and the second case of gliosarcoma arising from any type of ependymal neoplasm. The patient was a 48-year-old woman with a solid and cystic, peripherally enhancing, 7-cm right frontal mass lesion. Histologically, the lesion displayed characteristics of anaplastic ependymoma (grade III, World Health Organization scale).