Lymphoid cell maintenance, at early stages of differentiation, was significantly promoted by BM-MSC in normal and leukaemic cells. Co-cultures also modulated the expression of antigens associated with the B-ALL asynchronous phenotype as CD10 co-expressed with CD19 and CD20. To our knowledge, this is the first time that CD10, CD19 and CD20 leukaemic antigens have been reported as being regulated by BM-MSC.
Los tumores de mediastino conforman un grupo heterogéneo de enfermedades. La localización de la masa se relaciona con las características clínicas y la aparición de complicaciones. Las masas malignas del mediastino anterior más frecuentes en niños son las neoplasias de precursores linfoides tipo leucemia/linfoma linfoblástico T, el linfoma de Hodgkin y los tumores germinales. El manejo de la urgencia oncológica producida por el efecto compresivo de la masa requiere una evaluación exhaustiva y una rápida intervención, que permita salvaguardar la vida del paciente sin sacrificar el tratamiento óptimo posterior. El síndrome de la vena cava superior, el taponamiento cardiaco y otros hacen parte de las urgencias mecánicas más frecuentes. Se presenta el caso de un niño de ocho años de edad con síntomas respiratorios y presencia de masa en el mediastino anterior, confirmada por citometría de flujo como linfoma linfoblástico, que requirió manejo con esteroides y quimioterapia para citorreducción y mejoría de las complicaciones.Palabras clave: tumor de mediastino, citometría de flujo.
Malignant tumors of the mediastinum in children: an urgent clinical problemMediastinal tumors represent a heterogeneous group of diseases. The location of the mass is related to the clinical features and complications. Malignant masses of the anterior mediastinum are most frequent in children of precursor lymphoid neoplasms type leukemia/lymphoma, T lymphoma, Hodgkin's lymphoma and germ-cell tumors. The emergency management of cancer caused by the compressive effect of the mass requires a comprehensive assessment and rapid intervention in order to preserve the patient's life without sacrificing the optimal treatment later on. The superior vena cava syndrome, cardiac tamponade, and others are part of the most common mechanical emergencies. We present the a case of an 8 years old boy with respiratory symptoms, and the presence of an anterior mediastinal mass confirmed by flow cytometry as lymphoblastic lymphoma, who required treatment with steroids and chemotherapy for cytoreduction and improvement of complications.Key words: mediastinal neoplasms, flow cytometry.Se presenta el caso de un paciente de ocho años de edad que presentó, un mes antes del diagnóstico, pérdida de peso de cuatro kilogramos en dos semanas, sudoración nocturna, tos, edema facial y palpebral; fue manejado con antitusivos. El cuadro se agudizó en una semana y presentó disnea.En el examen físico de ingreso se encontró palidez, adinamia y disminución de la entrada de aire al pulmón derecho. En la radiografía de tórax se reportó derrame pleural bilateral y el diagnóstico de ingreso fue neumonía complicada, por lo que se inició terapia con ceftriaxona y vancomicina.El paciente requirió asistencia respiratoria mecá-nica por falla respiratoria y se atendió en la unidad pediátrica de cuidados intensivos. En el ecocardiograma se encontró derrame pericárdico de más de 80%, que se manejó con pericardiocentesis, y se practicaron repetidas torancentesis por presencia de derrame pleur...
Flow cytometry (FCM) was implemented in 2008 at the Pontificia Universidad Javeriana and later at the Hospital Universitario San Ignacio to examine special samples of patients with hematological malignancies and solid tumors other than bone marrow and peripheral blood for diagnosis and monitoring. This study describes the main findings of special sample evaluation over a six-year period. In all, 1070 samples of body fluids from patients with benign and malignant diseases were examined by FCM. These samples were stabilized with TransFix TM and stained with six-color immunophenotyping panels. Samples included cerebrospinal fluid, bronchoalveolar lavage, pleural fluid, pericardial fluid and ascite fluid from patients with acute and chronic leukemia, myelodysplastic syndromes, lymphomas, myeloma, autoimmune diseases, immunodeficiencies and solid tumors, among others. Flow cytometry provided important information for the classification and detection of minimal numbers of tumor cells in leukemia and lymphoma cases. This work represents the first national report describing FCM implementation in special samples for diagnosis and clinical monitoring of patients with malignant and benign pathologies. Consequently, over the last decade, use of commercially available cell stabilization solutions has been recommended. These solutions can preserve PB and cerebrospinal fluid (CSF) samples over time periods greater than one week after collection [4, 8 -9]. This stabilization preserves cellularity and integrity of both cell surface and intracellular antigens [9].
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