Tumor-like lesion due to Chagas' disease in a patient with lymphocytic leukemia

Massa cerebral devido a Doença de Chagas em paciente com leucemia linfocítica

Pedro Rippel Salgado Anthony Guerra Gorski Andréa Ribeiro Aleixo Eugênio Oliveira Martins de Barros About the authors

Abstracts

A 73 year-old white male, living in the interior of the state of Mato Grosso do Sul, in central Brazil, after an initial diagnosis of sinusitis was transferred to the neurology service with a 3-day evolution of intracranial hypertension. Exams showed lymphocytic leukemia and a tumor-like lesion, either an expanding inflammatory process such as an abscess or a neoplasm. Treatment with Ceftriaxone and Decadron was started and intracranial hypertension was controlled. Methotrexate was injected on the occasion of the next puncture considering a possible leukemia infiltration. Flagellate forms of T. cruzi were observed in the CSF and treatment with Benznidazole was started. After 4 days the CSF presented fractionated forms of trypomastigotes. The protein level was 27%. Signs of intracranial hypertension ceased. Tomography and magnetic resonance images showed an important reduction of the tumor-like lesion. The clinical condition of the patient improved.

Chagas' disease; Leukemia; Tumor-like lesion


Paciente masculino, 73 anos, do interior de Mato Grosso do Sul, com diagnóstico inicial de sinusite, evoluiu em 3 dias para quadro de hipertensão intracraniana severa. Transferido para o serviço de neurologia, os exames evidenciaram leucemia linfocítica e indicaram ainda processo inflamatório expansivo como abscesso ou tu mor (exame do liquor e tomografia). Instituiu-se Ceftriaxone e Decadron. Foi feita nova punção lombar, injetou-se metotrexate considerando possível infiltração leucêmica. No liquor observou-se formas flagelares de T. cruzi. Iniciou-se benzonidazol. Após 4 dias o liquor apresentou formas fracionadas de tripomastigotas. O nível de proteínas se estabilizou cm 27%. Cessou a sintomatologia da hipertensão. Tomografia e ressonância magnética posterior mostraram importante redução da formação tu-moral observada anteriormente. Houve melhora das condições clínicas do paciente.


TRYPANOSOMIASIS

Tumor-like lesion due to Chagas' disease in a patient with lymphocytic leukemia

Massa cerebral devido a Doença de Chagas em paciente com leucemia linfocítica

Pedro Rippel SalgadoI; Anthony Guerra GorskiII; Andréa Ribeiro AleixoIII; Eugênio Oliveira Martins de BarrosIV

IAssistant Professor of Neurology-UFMS - Universidade Federal de MS, Brazil

IIMedical Resident

IIIMedical Resident

IVAssistant Professor of Epidemiology - UFMS, Brazil

Correspondence to

SUMMARY

A 73 year-old white male, living in the interior of the state of Mato Grosso do Sul, in central Brazil, after an initial diagnosis of sinusitis was transferred to the neurology service with a 3-day evolution of intracranial hypertension.

Exams showed lymphocytic leukemia and a tumor-like lesion, either an expanding inflammatory process such as an abscess or a neoplasm. Treatment with Ceftriaxone and Decadron was started and intracranial hypertension was controlled.

Methotrexate was injected on the occasion of the next puncture considering a possible leukemia infiltration. Flagellate forms of T. cruzi were observed in the CSF and treatment with Benznidazole was started. After 4 days the CSF presented fractionated forms of trypomastigotes. The protein level was 27%. Signs of intracranial hypertension ceased. Tomography and magnetic resonance images showed an important reduction of the tumor-like lesion. The clinical condition of the patient improved.

Keywords: Chagas' disease; Leukemia; Tumor-like lesion.

RESUMO

Paciente masculino, 73 anos, do interior de Mato Grosso do Sul, com diagnóstico inicial de sinusite, evoluiu em 3 dias para quadro de hipertensão intracraniana severa.

Transferido para o serviço de neurologia, os exames evidenciaram leucemia linfocítica e indicaram ainda processo inflamatório expansivo como abscesso ou tumor (exame do líquor e tomografia). Instituiu-se Ceftriaxone e Decadron.

Foi feita nova punção lombar, injetou-se metotrexate considerando possível infiltração leucêmica.

No líquor observou-se formas flagelares de T. cruzi. Iniciou-se benzonidazol. Após 4 dias o líquor apresentou formas fracionadas de tripomastigotas. O nível de proteínas se estabilizou em 27%. Cessou a sintomatologia da hipertensão. Tomografia e ressonância magnética posterior mostraram importante redução da formação tumoral observada anteriormente. Houve melhora das condições clínicas do paciente.

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  • Correspondence to:
    Dr. Eugênio O.M. de Barros
    R. Quintino Bocaiúva, 298
    79050-110 Campo Grande, Mato Grosso do Sul, Brasil
  • Recebido para publicação em 01/03/1996

    Aceito para publicação em 11/07/1996

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    Correspondence to: Dr. Eugênio O.M. de Barros R. Quintino Bocaiúva, 298 79050-110 Campo Grande, Mato Grosso do Sul, Brasil

    Publication Dates

    • Publication in this collection
      22 Sept 2006
    • Date of issue
      Aug 1996

    History

    • Received
      01 Mar 1996
    • Accepted
      11 July 1996
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