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Background: During the last two years, the COVID-19 pandemic led to millions of disease-related deaths worldwide. The efforts of the scientific community facing this global challenge resulted in outstanding achievements. Thus, within one year, new mRNA-based vaccines against SARS-CoV-2 viral infection were released, providing highly efficient protection and showing a very good safety profile in the general population. However, clinical data collection after vaccination is a continuous process for the long-term safety of any new medical product. The aim of our paper is to present two cases of hematological malignancies: diffuse large B-cell non-Hodgkin lymphoma and T/NK-cell lymphoma, diagnosed shortly after the administration of the mRNA COVID-19 vaccine. Methods and Results: Case 1: A female patient was admitted with a suspicious cervical mass that emerged within one week after the administration of second dose of the BNT162b2 COVID-19 vaccine. Surgical removal followed by pathology assessment of the specimen confirmed the diagnosis of diffuse large B-cell non-Hodgkin lymphoma. Case 2: A male patient was admitted with multiple ulcerative oral lesions arising on the third day after the initial dose of the BNT162b2 COVID-19 vaccine. These lesions had a progressive character and during the following months were complicated with repetitive episodes of heavy oral bleeding, requiring blood transfusions. The incisional biopsy of the lesions and pathological assessment of the specimens confirmed the diagnosis of T/NK-cell lymphoma. Conclusions: The safety profile of the mRNA-based vaccines is an undeniable fact. In most cases, suspicions of potentially aggressive side effects were ruled out, proving to be transient post-vaccine reactions. Clinicians should remain alert to report any potentially aggressive manifestations emerging in the context of mRNA COVID-19 vaccination, such as these cases of hematological malignancies, in order to promote additional investigations on the particular mechanisms of action of COVID-19 vaccines and to provide the best medical care to the patients. [ABSTRACT FROM AUTHOR]

We report the case of a 79‐year‐old female patient previously treated for multiple myeloma that was referred to our hospital due to a growing painless right arm tumor. Imaging and pathology results confirmed the diagnosis of extramedullary plasmacytoma. The patient underwent external beam radiotherapy with complete clinical response at follow‐up. [ABSTRACT FROM AUTHOR]

Constrictive pericarditis can be a systemic manifestation of immune-mediated diseases. A timely diagnosis followed by ethiologic workup is essential for improving patient prognosis. A 67-year-old female patient who suffered multiple episodes of anasarca in the past two years was referred to our center for heart failure with preserved ejection fraction. She was previously investigated for autoimmune diseases based on persistent inflammatory syndrome and recurrent serositis. The physical exam showed systemic congestion, hepatomegaly, and jaundice. Sinus tachycardia and low voltage were observed on the ECG. Transthoracic echocardiography showed septal bounce, "annulus reversus" and "paradoxus", thickened pericardium without effusion, and a dilated inferior vena cava. Cardiac catheterization was performed, revealing equalization of diastolic pressures and square root sign, confirming constriction. A partial pericardiectomy was performed. The histopathologic study showed polyclonal plasma cells with frequent IgG plasma cells and a IgG4/IgG ratio of 40%, considered a mark of the IgG4 disease as causal. Multimodality imaging completed the clinical suspicion of constrictive pericarditis. Complex pathologic analysis of the pericardium led to considering a diagnosis of IgG4 disease, and the patient was referred to a tertiary center for diagnosis and adequate therapeutic management. Constrictive pericarditis can be an associated manifestation of IgG4-related diseases. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze a group of patients with chronic lymphoproliferative disorders associated with B, C, D hepatitis viral infection. This group of chronic lymphoproliferative disordered patients with associated hepatitis viral infection has been diagnosed and monitored in the Hematology Department of the University Emergency Hospital of Bucharest, between December 2007 and January 2009. Our study is meant to observe the influence of the viral infection on clinical and biological evolution of the enrolled patients. The diagnosis of the chronic lymphoproliferative disorder was based on the bone marrow / lymph node biopsy and flow-cytometry analysis. The positive diagnosis for hepatitis viral infection was established by ELISA serological tests and viremia was performed by TaqMan method at INBI "Matei Bals" Bucharest. The analyzed group is made up of 41 patients, 25/41 (60,97%) females and 16/41 (39,02%) males, with ages: 20-50 years old - 6/41 (14,63%), 51-70 years old - 23/41 (56,09%) and over 71 years old - 12/41 (29,26%) patients. The histological types of CLD: B-cell non-Hodgkin's lymphoma - in 28/41 (68,29%) patients, T-cell non-Hodgkin's lymphoma - 2/41 (4,87%) patients, Hodgkin's lymphoma - 2/41 (4,87%), chronic lymphocytic leukemia - 7/41 (17,07%), Waldenström disease - 2/41 (4,87%) patients. Regarding the type of CLD, 19/41 (46,34%) of the patients have an aggressive type of CLD and 22/41 (53,65%) a non-aggressive type of CLD. The hepatitis viral infection distribution in our patients: 14/41 (34,14%) have HBV infection, 24/41 (58,53%) have HCV infection, double/triple association of viral infection was found in 3/41 (7,31%) patients. Within HBV infection subgroup 9/14 (64,28%) patients have an aggressive type of CLD and 5/14 (35,71%) patients have a non-aggressive type, whereas within the group with HCV infection we found a different distribution: 9/24 (37,5%) patients with aggressive type and 15/24 (62,5%) with non-aggressive type of CLD. The clinical parameters monitored were: B signs were present in 19/41 (43,34%) patients, the superficial or profound adenopathies -were found in 29/41 (70,73%) patients, hepatomegaly - in 38/41 (92,68%) patients, splenomegaly - in 21/41 (51,21%) patients, extra-nodal involvements in 10/41 (24,39%) patients and most frequent in the non-aggressive type of CLD - 6/10 (60%) patients. The hematological and biochemical parameters were: the presence of anemia and thrombocytopenia - found in a small number of patients; lymphocytosis - positive in 33/41 (80,48%) patients, most with HCV infection and non-aggressive type of disease, the presence of autoimmune hemolytic anemia - in 4/41 (9,75%) patients, cryoglobulins - 8/41 (19,51%) patients, all with HCV infection; also the liver function was monitored. Antiviral therapy was administered to 12/41 (29,26%) patients - Lamivudine to 8/41 (19,51%) patients and Ribavirine/Interferon to 4/41 (9,75%) patients. Chemotherapy was given in 32/41 (78%) patients. Monoclonal antibodies anti CD20 (Rituximab) therapy was associated in 6/41 (14,63%) patients. Conclusions. A high incidence in female sex of over 50 years old was noticed. A strong association between B-cell chronic lymphoproliferative disorders and hepatitis viral infection B, C, D was revealed, the most frequent being the C hepatitis virus, associated with the non-aggressive type of CLD, extra-nodal involvement, splenomegaly, lymphocytosis, cryoglobulins, cytolysis and colestasis. The clinical and biological disease history will be monitored during chemotherapy and antiviral treatment. [ABSTRACT FROM AUTHOR]

Hairy Cell Leukemia is a chronic B cell disorder, it is charactherized by the presence of typical Hairy cells in the perypheral blood and marrow, pancitopenia and a variable degree of splenomegaly. The standard therapy consists of the nucleosides analogs dCF (2'deoxycoformicyn) and CdA (2-chlorodeoxy-adenosine), wich produce complete and durable remissions in the majority of patients. Splenectomy may still be used for HCL in the under specific circum-stances. Molecular diagnosis-PCR (Polimerase Chain Reaction) is more sensitive than Flowcytometry in detecting the Minimal residual disease. [ABSTRACT FROM AUTHOR]

Many malignant disorders can induce hematological features that perfectly mimic a hematologic disease. We present the case of a 45 years old female patient in which although the preliminary investigation suggested the diagnosis of erythroleukemia, the more detailed subsequent assays revealed that the hematological picture was the consequence of another neoplastic disease. [ABSTRACT FROM AUTHOR]