Primary mediastinal pleomorphic rhabdomyosarcoma: a case report

To report a rare case of pleomorphic rhabdomyosarcoma which occurred in the mediastinum of a 34-year-old man. A young male labourer presented with dyspnoea on exertion. A large mediastinal mass was detected on chest CT scan. The chest surgeons advised against open biopsy. His alpha-fetoprotein was 22,000 IU/l; based on this the diagnosis of a germ cell tumour was made and the patient was treated with a bleomycin/etoposide/cisplatin regimen. He left for his native country where an open biopsy from the mediastinum was taken and reported as pleomorphic rhabdomyosarcoma. He was given five courses of chemotherapy with doxorubicin, etoposide, and ifosfamide with mesna protection without much relief. The inoperable disease occupied the whole of the right chest and mediastinum. The enormous size of the radiation field made radiotherapy prohibitive. Finally, the patient opted for symptomatic treatment and left for his native place. This case is presented because of its difficulty in management and rarity

Static image telepathology in routine surgical pathology diagnosis: a report on the first experience in the arab word from Kuwait

Telepathology [TP] diagnosis is currently practiced in several countries. The present study presents the first documented experiment of static-image TP in Kuwait and the Arab world. Materials and Paraffin or frozen tissue sections of 100 cases of routine surgical pathology consisting of 40 malignancies, 10 benign neoplasms and 50 nonneoplastic conditions were studied. Diagnostic microscopic images captured by a microscope-attached digital camera were selected by a pathologist in each case and sent with the clinical history to a second pathologist via E-mail across the Internet. The diagnosis was sent back to the referring pathologist via E-mail. The specificity, sensitivity and diagnostic accuracy of TP was calculated. For malignant versus benign lesions, the diagnostic accuracy was 97% with 3 false-negative and no false-positive results [100% specificity]. Correct diagnosis by exact category was 92%. The deferral rate awaiting special stains was 5%, immunohistochemistry 6%, and extra images 2%. In 2 cases [2%], there was a request for original tissue glass slides. A simple E-mail-based TP system provides a high diagnostic accuracy for routine surgical pathology diagnosis. It can be utilized either as a primary or a secondary diagnostic tool