Download - Leucemia Caso Clínico
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8/3/2019 Leucemia Caso Clnico
1/27
LEUCEMIA: CASO
Francismar Prestes LealMdico HematologistaDocente da UNING
Maring, Paran
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8/3/2019 Leucemia Caso Clnico
2/27
OBJETIVOS Definir leucemia
Classificar leucemia
Entender patognese/fisiopatologia
Listar exames para o diagnstico
Compreender manejo bsico
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8/3/2019 Leucemia Caso Clnico
3/27
Caso Clnico
MFS, mulher de 27 anos, chegou ao PS passandomal, sendo rapidamente cadastrada pelarecepo e atendida pelo mdico de planto
Referiu muito cansao, sonolncia e sangramentos
pelo nariz e pela boca, alm de muitas manchasna pele
Relatou que tudo comeou h poucos dias, mas quepiorou muito hoje
Sentiu tambm, h poucas horas, tremores de frio
Negou qualquer doena prvia, pessoal ou familiar
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8/3/2019 Leucemia Caso Clnico
4/27
Caso Clnico
Exame fsicomostrou:
Prpura
(petquias,hematomas eequimoses)
Epistaxe bilateral Gengivorragia
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8/3/2019 Leucemia Caso Clnico
5/27
Caso Clnico
O fgado e o bao pareceram levementeaumentados de tamanho
Dados vitais aferidos pela enfermagemrevelaram aumento da FC, da FR e da T,sem alterao da PA
Restante do exame fsico nada mostrou
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8/3/2019 Leucemia Caso Clnico
6/27
Caso Clnico
Exames complementares foram solicitadosna urgncia, o que foi prontamenteatendido pelo laboratrio
Hemograma foi liberado, aps reviso pormdico hematologista: Hb 7 g/dL, Ht 21% (n/n)
Leuccitos 3.000/mm3
(algumas clulas deaspecto blstico e com bastes de Auer) Plaquetas 30.000/mm3
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8/3/2019 Leucemia Caso Clnico
7/27
Caso Clnico: SP
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8/3/2019 Leucemia Caso Clnico
8/27
Caso Clnico
Coagulograma mostrou leveprolongamento dos tempos decoagulao (TAP e TTPa) e queda do
fibrinognio srico
Exame de urina revelou hematria
Demais exames: semparticularidades
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8/3/2019 Leucemia Caso Clnico
9/27
Caso Clnico
Extenso laminar daaspirao da medulassea esternal (coradacom MGG) mostrou:
Hipercelularidade Predomnio (>70%)
de promielcitoshipergranulares
Bastes de Auer
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8/3/2019 Leucemia Caso Clnico
10/27
Caso Clnico
Testes Citoqumicosdo mesmo material
mostraram: Peroxidase +++ SBB +++
CAE +++ PAS +
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
11/27
Caso Clnico
Testes Citoqumicos domesmo materialmostraram:
Peroxidase +++ SBB (Negro do Sudo
B) +++
CAE +++ PAS +
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
12/27
Caso Clnico
Testes Citoqumicosdo mesmo material
mostraram: Peroxidase +++ SBB +++
CAE (Cloroacetatoesterase) +++ PAS +
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=h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8/3/2019 Leucemia Caso Clnico
13/27
Caso Clnico
Testes Citoqumicos domesmo materialmostraram:
Peroxidase +++ SBB +++ CAE +++
PAS (cido Peridicode Schiff) +
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR 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8/3/2019 Leucemia Caso Clnico
14/27
Caso Clnico
Aps a contagem de500 clulasmedulares (lminacorada com MGG),viu-se que os
promielcitosrepresentavam78% das clulas
nucleadas:
LMA M3
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=h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8/3/2019 Leucemia Caso Clnico
15/27
Caso Clnico
Parte do mesmomaterial foi enviadapara fenotipagem,revelando:
Positividade paraCD11, CD13, CD15 eCD33
Negatividade para
CD10, CD14, CD20 eHLA-DR
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=h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8/3/2019 Leucemia Caso Clnico
16/27
Caso Clnico
Citogentica da
MO revelou:
t(15;17)
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
17/27
Caso Clnico
Estudos de biologiamolecular
confirmaram:
Mutao genticaPML-RARa (genede fuso)
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8/3/2019 Leucemia Caso Clnico
18/27
Caso Clnico
Diagnstico final:
Leucemia Aguda
Leucemia Aguda Mielide
Leucemia Aguda Promieloctica (M3)
LMA M3, com t(15;17)
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
19/27
Caso Clnico
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
20/27
Caso Clnico
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8/3/2019 Leucemia Caso Clnico
21/27
Caso Clnico
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
22/27
Caso Clnico
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
23/27
Caso Clnico
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
24/27
Caso Clnico
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BR -
8/3/2019 Leucemia Caso Clnico
25/27
Caso Clnico
Assim, a equipe desade fechou odiagnstico:
LMA M3, t(15;17)/PML-RARa
Foi iniciado tratamentoadequado e com altacurabilidade
http://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http://www.accentu8dental.com.au/attachments/Image/Oral%2520Diseases/Spontaneous%2520gingival%2520bleeding%2520of%2520same%2520patient%2520with%2520cirrhosis.JPG&imgrefurl=http://www.accentu8dental.com.au/page41.php&usg=__-iZWdzSh1PNwsmMl69x5NcM0b80=&h=264&w=424&sz=28&hl=pt-BR&start=4&tbnid=tLLAefUzwopCcM:&tbnh=78&tbnw=126&prev=/images%3Fq%3Dbleeding%2Boral%2Bleukemia%26gbv%3D2%26hl%3Dpt-BRhttp://images.google.com.br/imgres?imgurl=http:/