• 文章类型: Case Reports
    神经母细胞瘤是由FoxR2基因激活的罕见肿瘤,常见于儿科患者。由于这些肿瘤的新颖性,没有标准的诊断配置文件。然而,已发现它们表达Olig2,MAP2,SOX10,ANKRD55和突触素,它们可以通过磁共振成像(MRI)识别。化疗联合干细胞抢救和颅脑照射治疗可以改善非婴儿患者的预后。
    我们报告一例2岁患者,通过MRI成像和病理证实FoxR2基因激活,诊断为神经母细胞瘤。肿瘤被成功切除。然而,肿瘤不像大多数FoxR2神经母细胞瘤那样是高级别肿瘤。
    低级别FoxR2神经母细胞瘤的不寻常表现表明有必要对这些肿瘤的特征进行进一步研究。
    UNASSIGNED: Neuroblastomas are rare tumors activated by the FoxR2 gene commonly found in pediatric patients. Due to the novelty of these tumors, there is no standard diagnostic profile. However, they have been found to express Olig2, MAP2, SOX10, ANKRD55, and synaptophysin, and they can be identified with magnetic resonance imaging (MRI). Treatment with chemotherapy combined with stem cell rescue and craniospinal irradiation can improve non-infant patient outcomes.
    UNASSIGNED: We report a case of a 2-year-old patient who was diagnosed with a neuroblastoma through MRI imaging and pathology that confirmed FoxR2 gene activation. The tumor was successfully removed. However, the tumor was not high-grade like most FoxR2 neuroblastomas.
    UNASSIGNED: The unusual presentation of a low-grade FoxR2 neuroblastoma demonstrates the necessity to conduct further research into the characteristics of these tumors.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    2年前,一名55个月大的男孩被诊断出患有右肾上腺的IV期神经母细胞瘤(NB)。术前给予化疗,然后行腹膜后肿瘤切除和淋巴结清扫术。手术后,根据高危人群NB将患儿转入血液肿瘤科进行化疗,每6个月进行一次门诊随访。在术后第二年,腹部计算机断层扫描(CT)扫描显示肝脏右后叶上部有一个圆形低密度区,增强后静脉期明显不均匀增强,手术切除了,术后病理证实肝脏炎性肌纤维母细胞瘤(IMT)。患者术后未给予特殊治疗。在这项研究中,对术后肾上腺NB标本和肝脏IMT标本进行全转录组测序。这种不寻常的情况强调,即使没有已知的诱发因素,也需要密切监测NB幸存者的第二次肿瘤发展。
    A boy aged 55 months was diagnosed with stage IV Neuroblastoma (NB) of the right adrenal gland 2 years ago. Preoperative chemotherapy was given and he was then treated with retroperitoneal tumor resection and lymph node dissection. After surgery, the children were transferred to the Hemato-Oncology Department for chemotherapy according to the high-risk group NB, with outpatient follow-up every 6 months. In the second postoperative year, abdominal computed tomography (CT) scan revealed a rounded hypodense area in the upper part of the right posterior lobe of the liver, with marked inhomogeneous enhancement in the venous phase after enhancement, which was surgically resected, and postoperative pathology confirmed inflammatory myofibroblastic tumor (IMT) of liver. The patient was not given any special treatment after surgery. In this study, whole transcriptome sequencing was performed on the postoperative specimen of adrenal NB and the specimen of IMT of liver. This unusual case emphasizes the need for close monitoring of second tumor development in NB survivors even in the absence of known predisposing factors.
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  • 文章类型: Journal Article
    This case report presents the diagnostic features of isolated primary intraocular lymphoma, which was initially misdiagnosed as neovascular age-related macular degeneration. A comprehensive examination using ultrasound, optical coherence tomography, and fundus autofluorescence revealed changes characteristic of vitreoretinal lymphoma. Molecular genetic analysis of the vitreous body showed the presence of a MYD88 gene mutation and B-cell clonality by immunoglobulin heavy chain (IGH) gene rearrangement tests, which confirmed the diagnosis.
    Представлено клиническое наблюдение, касающееся особенностей диагностики изолированной первичной внутриглазной лимфомы, которая первично расценена как влажная форма возрастной макулярной дистрофии. Комплексное обследование с применением ультразвукового исследования, оптической когерентной томографии и аутофлуоресценции глазного дна позволило выявить изменения, характерные для витреоретинальной лимфомы. Молекулярно-генетическое исследование стекловидного тела показало наличие мутации гена MYD88 и B-клеточную клональность по генам тяжелой цепи IgH, что подтвердило диагноз.
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  • 文章类型: Case Reports
    并发恶性肿瘤和IgA肾病很少见。尽管缺乏可靠的实验证据,对于癌症患者肾小球损伤的发展,有病理生理学的理论假设,比如异常的免疫活动。这里,我们描述了一名9岁儿童因肾病综合征入院。腹部影像学检查意外发现腹膜后肿瘤,手术切除后病理诊断为神经母细胞瘤。然而,肿瘤完全切除对肾病综合征的临床表现无影响,比如蛋白尿.单独使用皮质类固醇仅导致蛋白尿的部分消退,治疗一个月后出现耐药性。进行了进一步的肾脏活检,提示IgA肾病.在糖皮质激素和霉酚酸酯标准联合治疗10个月后,IgA肾病的临床缓解。这项研究代表了与IgA肾病相关的神经母细胞瘤的首例报告。我们推测IgA肾病的发病机制可能与神经母细胞瘤有关。尽管不能完全排除这两个条件的巧合。IgA肾病的标准治疗适用于伴随癌症的患者。
    Concurrent malignancy and IgA nephropathy are rare. Despite the lack of solid experimental evidence, there are theoretical hypotheses of pathophysiology for the development of glomerular damage in cancer patients, like aberrant immune activities. Here, we describe a nine-year-old child who was admitted due to nephrotic syndrome. Abdominal imaging examination accidentally revealed a retroperitoneal tumor, and surgical resection was performed with a pathological diagnosis of neuroblastoma. However, complete removal of the tumor had no impact on the clinical manifestation of nephrotic syndrome, like proteinuria. The use of corticosteroids alone only led to a partial resolution of proteinuria, and resistance developed after one month of treatment. A further kidney biopsy was performed, which suggested IgA nephropathy. Clinical remission of IgA nephropathy was achieved after standard combination treatment of corticosteroids and mycophenolate mofetil for 10 months. This study represented the first case report of neuroblastoma associated with IgA nephropathy. We postulated that IgA nephropathy pathogenesis might be associated with neuroblastoma, though a coincidence of these two conditions cannot be fully excluded. Standard treatment for IgA nephropathy is applicable for patients with concomitant cancer.
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  • 文章类型: Case Reports
    心肌病是与神经母细胞瘤相关的罕见但严重的并发症。在心力衰竭症状恶化之前,脑钠肽水平导致继发性扩张型心肌病的诊断。
    Cardiomyopathy is a rare but serious complication associated with neuroblastoma. The brain natriuretic peptide level led to a diagnosis of secondary dilated cardiomyopathy before the worsening of heart failure symptoms.
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  • 文章类型: Journal Article
    肺神经鞘瘤相对少见,而原发于肺的神经母细胞瘤样神经鞘瘤(neuroblastoma-like schwannoma)更是鲜有报道。本文搜集并回顾性分析1例发生于肺的神经母细胞瘤样神经鞘瘤。探讨其临床病理学、免疫组织化学及分子遗传学特征和鉴别诊断要点,并复习相关文献,以期提高对该特殊亚型神经鞘瘤的认识,防止漏诊和误诊。.
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  • 文章类型: Case Reports
    背景:玻璃体视网膜淋巴瘤(VRL)仍然是视网膜专家的诊断挑战。早期诊断和治疗对于更好的预后至关重要。一些诊断工具已被证明有助于VRL异常的识别。然而,扫频源OCT血管造影(SS-OCT-A)结果及其长期随访尚待探讨.
    方法:一名42岁男性左眼视力模糊2周。他否认有任何全身症状。进行了多模态成像检查,提高临床对VRL的怀疑,并指导随后的诊断程序。患者接受了治疗,三年后的最后一次FU访问中,眼底检查没有疾病迹象,肿瘤评估也没有。确定了一些新颖的SS-OCT-A特征,并在长期随访中检查了罕见报告的结果.在基线时,在表面的外视网膜板上检测到多个高反射改变,脉络膜毛细血管分析显示中央凹和旁凹区域的反射率较低。第一次演讲一个月后,在OCT上检测到多个垂直形状的高反射视网膜病变,这些病变出现在SS-OCT-A表面的视网膜中片上,是主要位于二级视网膜血管附近的高反射斑点。这些改变在治疗后显著减少。
    结论:SS-OCT-A可能是检测VRL的有用成像技术,为眼科医生提供其他发现,以帮助诊断和随访这种疾病。这可能有助于更及时和精确的诊断,及时治疗,和治疗反应监测。在这种情况下发现的原始方面可能为将来的研究提供依据,最终促进对疾病的更好理解。
    BACKGROUND: Vitreoretinal lymphoma (VRL) still represents a diagnostic challenge for retinal specialists. Early diagnosis and treatment are critical for a better prognosis. Several diagnostic tools have proven helpful in the identification of VRL abnormalities. However, swept-source OCT angiography (SS-OCT-A) findings and their long-term follow-up are yet to be explored.
    METHODS: a 42-year-old man presented with blurred vision in his left eye for 2 weeks. He denied any systemic symptoms. A multimodal imaging examination was performed, raising the clinical suspicion of VRL and guiding the ensuing diagnostic procedures. The patient underwent treatment and at the last FU visit three years later, no disease signs were present on fundus examination, nor on oncologic evaluation. Some novel SS-OCT-A features were identified, and uncommonly reported findings were examined over a long-term follow-up. At baseline multiple hyperreflective alterations were detected on the enface outer retina slabs and choriocapillary analysis revealed low reflectance areas in the foveal and parafoveal areas. One month after the first presentation, multiple hyperreflective retinal lesions in a vertical shape were detected on OCT which appeared on midretinal slabs of enface SS-OCT-A as hyperreflective spots mainly located near second-order retinal vessels. These alterations remarkably reduced after treatment.
    CONCLUSIONS: SS-OCT-A may be a useful imaging technique in the detection of VRL, providing ophthalmologists additional findings that assist the diagnosis and follow-up of this disease. This may prove useful for a more timely and precise diagnosis, prompt therapy, and treatment response monitoring. The original aspects found in this case may provide grounds for future studies, ultimately fostering a better understanding of the disease.
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  • 文章类型: Case Reports
    123I-间碘苄基胍(123I-MIBG)广泛用于神经母细胞瘤儿童的初始分期和反应评估。123I-MIBG的生理摄取发生在唾液腺中,肝脏,肾上腺,心肌,肠,和甲状腺。123I-MIBG不能穿过完整的血脑屏障。我们介绍了一个3岁男孩的罕见病例,该男孩患有神经母细胞瘤和脑膜转移,他接受了123I-MIBG扫描以进行疾病再诊断,显示大脑摄取异常。如果血脑屏障的破坏继发于转移或血脑屏障受损后,则可能会发生脑中MIBG的异常摄取。
    UNASSIGNED: 123I-meta-iodobenzylguanidine (123I-MIBG) is extensively used for initial staging and response evaluation in children with neuroblastoma. Physiological uptake of 123I-MIBG occurs in the salivary glands, liver, adrenal gland, myocardium, bowel, and thyroid gland. 123I-MIBG cannot cross an intact blood-brain barrier. We present the rare case of a 3-year-old boy with neuroblastoma and meningeal metastases who underwent an 123I-MIBG scan for disease restaging that showed abnormal brain uptake. Abnormal MIBG uptake in the brain can occur if there is disruption of the blood-brain barrier either secondary to metastases or after damage to blood-brain barrier.
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  • 文章类型: Case Reports
    背景:神经母细胞瘤扩增序列(NBAS)相关疾病是一种常染色体隐性遗传疾病,已报道了广泛的临床症状。然而,自身免疫介导的溶血性贫血(AIHA)在NBAS疾病中很少报道。
    方法:现在21岁的男性港口杂合变异c.6840G>A和c.335+1G>A,被发现生长迟缓,低球蛋白血症,B淋巴细胞减少症,视神经萎缩,水平眼球震颤,从小就有轻微的脾肿大和肝肿大。该病例在童年时期的血红蛋白水平和血小板计数正常。他首先在成年期发展了AIHA,然后在AIHA治疗期间出现了血小板减少症。明显的低丙种球蛋白血症和B淋巴细胞减少症的潜在机制难以捉摸。除了双等位基因NBAS突变,还检测到ANKRD26(c.2356C>T)基因中的种系突变。因此,在这种情况下,可能是自身免疫或ANKRD26突变介导的血小板减少症。
    结果:他最初接受类固醇和间歇性静脉注射免疫球蛋白补充治疗。治疗后,他反应良好,血红蛋白和血清胆红素恢复正常.但患者随后除AIHA外还出现了严重的血小板减少症。然后,除了类固醇升级外,还每天给他服用avatrombopag。他再次对新的治疗方法作出反应,随着血红蛋白水平和血小板计数回到正常范围。现在,他正在每周降级avatrombopag和低剂量类固醇维持。
    结论:此病例的表型表明c.3351G>ANBAS变体可能是致病性的,而c.2356C>TANKRD26变体是不可能的致病性的。即使在NBAS病患者中发生,AIHA也可能对类固醇反应良好。
    BACKGROUND: Neuroblastoma amplified sequence (NBAS)-associated disease is an autosomal recessive disorder and a broad spectrum of clinical symptoms has been reported. However, autoimmune mediated hemolytic anemia (AIHA) is rarely reported in NBAS disease.
    METHODS: A now 21-year-old male harbors heterozygous variants of c.6840G>A and c.335 + 1G>A and was found had retarded growth, hypogammaglobulinemia, B lymphopenia, optic atrophy, horizontal nystagmus, slight splenomegaly and hepatomegaly since childhood. This case had normal hemoglobin level and platelet count in his childhood. He developed AIHA first in his adulthood and then thrombocytopenia during the treatment of AIHA. The mechanism underlying a case with pronounced hypogammaglobulinemia and B lymphopenia is elusive. In addition to biallelic NBAS mutations, a germline mutation in the ANKRD26 (c.2356C>T) gene was also detected. So either autoimmune or ANKRD26 mutation-mediated thrombocytopenia is possible in this case.
    RESULTS: He was initially managed with steroid and intermittent intravenous immunoglobulin supplement. After treatment, he responded well with a normalization of hemoglobin and serum bilirubin. But the patient subsequently experienced severe thrombocytopenia in addition to AIHA. He was then given daily avatrombopag in addition to steroid escalation. He responded again to new treatment, with the hemoglobin levels and platelet counts went back to the normal ranges. Now he was on de-escalated weekly avatrombopag and low-dose steroids maintenance.
    CONCLUSIONS: The phenotype of this case indicates that c.335 + 1G>A NBAS variant is probably a pathogenic one and c.2356C>T ANKRD26 variant is improbably a pathogenic one. AIHA may respond well to steroid even when happened in patients with NBAS disease.
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