case_images: PMC7712095_01
case_images: Clinical and histopathological appearances. (a and b) HE staining results from thickened rectum showing adenocarcinoma. (c) Bone marrow cytology results showing increased plasmocyte. (d-g) Pathological and immunohistochemical results of bone marrow showing CD138 (+), CD38 (+), CD56 (partial +), Kappa (+), myelodysplastic activity and increased plasmocyte. (h) Excised rectal cancer.
case_images: j_med-2020-0136-fig001.jpg
case_images: PMC7712095_01_j_med-2020-0136-fig001.jpg
case_images: j_med-2020-0136_fig_001
case_images: Pathological results of thickened rectum showed adenocarcinoma (Figure 1a and b). Bone marrow cytology results showed increased plasmocyte (12.3% of karyocyte; Figure 1c). Pathological and immunohistochemical results of bone marrow showed CD138 (+), CD38 (+), CD56 (partial +), Kappa (+), Lambda (-), CD3 (-), CD19 (-), CD20 (-), myelodysplastic activity and increased plasmocyte (20-30% of karyocyte; Figure 1d-g). After consultation with cardiologists, anesthesiologists and oncologist, radical resection of rectal carcinoma (Hartmann) was performed (Figure 1h).
case_images: ECG of patient during treatment. (a) Normal ECG before atrial fibrillation and RR interval prolongation; (b) the first holt result showing atrial fibrillation occurring during thalidomide treatment; (c) the first holt result showing serious RR interval prolongation (RR interval = 5.2 s) during thalidomide treatment; and (d) atrial fibrillation did not disappear after withdrawal.
case_images: j_med-2020-0136-fig002.jpg
case_images: PMC7712095_01_j_med-2020-0136-fig002.jpg
case_images: j_med-2020-0136_fig_002
case_images: The hotter results showed atrial fibrillation with slow ventricular rate, RR interval prolongation (>2 s having 2,283 times, >3 s having 30 times, the longest RR interval being 5.2 s) and ventricular ectopic beat (Figure 2b and c). One month after discontinuation of thalidomide, RR interval returned to normal range, while atrial fibrillation did not disappear (Figure 2d).