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Vasculitis may accompany neoplasias and be of paraneoplastic type or associated with drugs used in patient treatment. We evaluated skin biopsies of twenty-eight cases with vasculitis accompanying leukemias reviewed and clinical outcome was evaluated. Eleven of the 28 cases had paraneoplastic vasculitis and 17 had vasculitis associated with various drugs including chemotherapy, cytokines and antibacterial agents. Paraneoplastic vasculitis was seen in 3 cases with chronic myelocytic leukemia in blastic phase, 5 patients with acute myeloblastic leukemia, and 3 with myelodysplastic syndrome. Drugs responsible for the 17 cases of vasculitis included hydroxyurea, vincristine, cytosine-arabinoside, methotrexate, all-trans retinoic acid, granulocyte-colony stimulating factor, interferon and antibiotics. Paraneoplastic vasculitis is not rare in leukemias and may be a manifestation of the blastic phase of chronic myeloid leukemia. Furthermore paraneoplastic vasculitis can be fatal in myelodysplastic syndromes and may be present clinically before the specific diagnosis is made. Drugs used in routine therapy may be the cause of the vasculitis, thus skin biopsy should be performed in all cutaneous lesions in patients with hemopoietic neoplasias.

Granulocytic sarcoma (GS) or chloroma is a neoplasia consisting of myeloid precursors in an extramedullary site. It is generally associated with myeloproliferative disorders especially with myeloid neoplasias. A young woman with huge abdominal mass due to GS associated with chronic myelocytic leukemia (CML) has been reported and literature is reviewed.

Cutaneous infiltrations in hemopoietic neoplasias are not uncommon. They are generally localized on the legs, arms, back, anterior chest, scalp and face. In rare cases specific infiltration of neoplastic cells is localized in the site of herpes zoster and herpes simplex scars. In this report a case with T cell lymphoma in leukemic phase with skin infiltration in the previous Varicella Zoster Virus (VZV) site of infection is reported and literature is reviewed.

Postmastectomy lymphedema (PML) is a morbid condition occurring in patients with breast carcinoma treated with radical/modified radical mastectomy. Postmastectomy angiosarcoma (PMA) is the most common neoplasia seen in these patients. Primary malignant lymphoma arising in PML is a rare neoplasia and 3 cases have been reported until now. In this report a patient with diffuse large cell lymphoma (DLCL) arising in PML is reported and the other three cases are reviewed.

All trans retinoic acid (ATRA) is the drug of choice in the treatment of acute promyelocytic leukemia (APL). Generally, it is well tolerated but it has some side-effects, some of which may be fatal. The most severe side-effect of ATRA is ATRA syndrome; the other side-effects are rather dermatologic. Among these vasculitis has not been reported so far. We detected fever and skin lesions in two patients treated with ATRA where histopathologic examination revealed necrotizing vasculitis. With cessation of ATRA and corticosteroid administration, the lesions healed and fever quickly disappeared.

We investigated the p53 protein expression in gastrointestinal lymphomas (GIL). Paraffin-embedded samples of 52 patients were examined for this purpose. The avidin-biotin Complex method was used for immunostaining. Nine of the 52 samples (17.3%) showed p53 staining. There was no relationship between the p53 protein expression and clinical characteristics, such as stage, disease localization and tumor burden. Complete remission was higher in patients not expressing this protein, and the p53 protein was more frequently expressed in intermediate and high grade histopathology than low grade lymphomas, but there was no statistically significant difference between the two groups (p = 0.008). Interestingly, patients expressing the p53 protein were younger than the ones not expressing it (30.7 +/- 14.1 vs. 43.6 +/- 15.7 years). We conclude that the p53 protein expression in GILs may be a poor prognostic indicator due to a lower response rate to chemotherapy.

We report the history of a 43-year-old man with a histopathologically confirmed invasive amebic abscess in his right hip. CT scan of the liver was normal. The amebic indirect hemagglutination (IHA) test was positive with a titer of 1/1,024. The patient developed acute renal failure and died within 48 h of admission with multiple organ failure due to sepsis.

In secondary amyloidosis (AA type), clinically significant cardiac and gastrointestinal involvement are uncommon, in contrast to the primary type. We report a case presenting with chronic diarrhea and cardiac manifestations who was diagnosed as having AA-amyloidosis with unknown predisposing illness based on endomyocardial, rectal and subcutaneous fat tissue biopsies.

Purpose: Tumor necrosis factor (TNF)-alpha is a multifunctional cytokine that influences the clinical outcome in a number of diseases. This study was undertaken to evaluate its role in the differential diagnosis of malignant and benign tumors and in the follow-up of patients. We also studied the correlation of TNF-alpha levels with the stage and differentiation of the diseases., Methods: In this study, serum levels of TNF-alpha are determined by the immunoradiometric assay method in 26 patients with head and neck cancer, and results are compared with 8 control patients with benign diseases. In both groups, serum samples were taken before and after the therapy. After centrifugation, the sera was stored at -70 degrees C until analyzed. TNF-alpha levels were measured by TNF-alpha immunoradiometric assay (IRMA) kit (Medgenix, Diagnostics SA, Belgium)., Results: The pretreatment mean value of TNF-alpha in the study group (814.1 pg/mL) was almost 100 times higher than in the control group (8.6 pg/mL) (P = .001). It was also noted that posttreatment mean value (94 pg/mL) was significantly lower than pretreatment mean value in the study group (P = .001). No statistically significant difference was found between serum TNF-alpha levels and the stage and differentiation of the tumor., Conclusion: The serum levels of TNF-alpha may be an efficient tumor marker in the diagnosis of patients with head and neck cancer.

Sweet's syndrome (SS) developed in two patients with acute myeloid leukaemia (AML) treated with granulocyte colony stimulating factor (G-CSF) for febrile neutropenia due to AML chemotherapy. Fever, painful skin and conjunctival lesions developed and neutrophilic infiltration was detected at biopsy specimens. Neutrophilia was not detected. Skin lesions regressed within 1-2 weeks and conjunctival lesions within 4 weeks following the cessation of G-CSF. We conclude that SS may be a complication of G-CSF therapy and tender skin and/or conjunctival lesions developing during G-CSF therapy should suggest the possibility of SS.

Tumor necrosis factor alpha (TNF-alpha) levels were measured by immunoradiometric assay in chronically hemodialyzed patients consisting of 9 males and 3 females aged between 14 and 60 years. TNF-alpha levels were 5.47-15.1 pg/ml (mean 9.76 +/- 6.63) before hemodialysis (HD), and 5.75-58.55 pg/ml (mean 22.15 +/- 15.14) after HD. According to these results TNF-alpha levels in chronically hemodialyzed patients were within normal limits, but after 4 h of HD, higher levels of TNF-alpha were found.

In a double-blind therapeutic trial, 32 patients suffering from severe tetanus were given prednisolone and 31 a placebo in addition to standard treatment. Mortality was lower in the prednisolone-treated group (31%) than in the placebo-treated group (55%). The women had more severe symptoms and a higher mortality than the men. The results suggest that the addition of a corticosteroid to standard treatment will lower mortality in tetanus, although meticulous nursing care is still the most important factor in treatment.