spectrum of muscle disorders diagnosed at King Hussein medical center: an 8 year experience

To report on the prevalence of various muscle disorders encountered at King Hussein Medical Center in terms of diagnosis, age and gender distribution. This is a retrospective study of 636 cases of suspected muscle diseases that were biopsied over a period of eight years at King Hussein Medical Center between January 2006 and December 2013. The biopsies were examined by several methods including Haematoxylin and Eosin stained frozen tissue sections, muscle enzyme histochemistry, immunohistochemistry, and electron microscopic examination. The different disease diagnoses that were encountered were classified and analyzed. A positive biopsy with significant changes was encountered in 437[68.7%] of the patients. There were 168 [26.4%] normal biopsies and 31 [4.8%] inadequate specimens. Of specimens with positive findings there were 169 [38.7%] cases of dystrophy, 72 [16.4%] cases of inflammatory myositis, 70 [16%] cases of neurogenic atrophy, 36 [8.2%] cases of congenital myopathy, 19 [4.3%] cases of mitochondrial myopathy, and 71 [16.2%] cases that were grouped together as having various other myopathic changes. A total of 272 positive biopsies belonged to male patients, and 165 belonged to female patients. The age range of patients varied from 1 month to 75 year old. Muscle biopsies are frequently encountered at King Hussein Medical Center practice. Accurate histopathologic diagnosis and classification of myopathies requires several advanced techniques which can only be carried out at a fully equipped laboratory center. In this study the largest groups of patients were diagnosed to with dystrophy, followed by inflammatory myositis and neurogenic muscular atrophy

Glucagonoma presenting as necrolytic migratory erythema in a long-standing type II diabetic patient

We report a case of glucagonoma in a 60-year old diabetic lady who was seen by a dermatologist for a superficial erythematous skin eruption with flaccid bullae over both legs of recent onset. These findings warranted further investigations that revealed a pancreatic mass lesion involving the distal body and tail with three metastatic deposits within the right lobe of the liver. Distal pancreatectomy and splenectomy were performed and histological examination of the excised specimen confirmed the diagnosis of pancreatic glucagonoma with liver metastasis. Blood sugar levels became more controlled postoperatively. The skin lesion disappeared completely six months after surgery. The lady enjoys fairly good health, and is maintained on Somatostatin analogues for control of metastasis that are stable after 18 months of follow up

Pathological study of benign and malignant salivary gland tumors

To carry out a retrospective analysis of all benign and malignant tumors of major and minor salivary glands which were diagnosed at King Hussein Medical Center during the years between 2000 and 2006. A total of 127 patients diagnosed to have salivary gland tumors were retrieved from our histopathology data records between 2000 and 2006. Most patients were originally treated at King Hussein Medical Center, and some at one of the peripheral military hospitals. All cases were analyzed according to their sex and age distribution as well as the frequency of various histopathological types and their anatomical sites. Of the 127 cases 84.3% of tumors were benign and 15.7% were malignant. The mean age of the benign neoplasms was 43.3 years, and most of these tumors were seen between the fourth and sixth decade of life. The mean age for the malignant neoplasms was 51.1 years, and most cases were in the sixth decade of life. There was a male predominance in both benign and malignant salivary gland neoplasms. Among the benign salivary gland tumors, the most frequent histological type was pleomorphic adenoma [57.9%] followed by Warthin's tumor [35.5%]. Adenoid cystic carcinoma and mucoepidermoid carcinoma were the most frequently encountered malignant tumors accounting for 90% of all malignant tumors. The most commonly involved salivary gland for benign and malignant tumors was the parotid gland. Of the minor salivary gland tumors, the most frequently affected site was the palate [65%], and the most frequent tumor encountered was pleomorphic adenoma [55%]. Salivary gland tumor is a subject of considerable interest because of its not uncommon occurrence and varied histological pattern. This study describes the pathological features of salivary gland tumors in Jordan. The findings are in agreement with results of most previously published research studies

Thyroiditis in a Jordanian cohort with goitre: results of fine needle thyroid aspirate

To determine the prevalence of cytologically proven thyroiditis among patients with goiter referred to Endocrine clinic at King Hussein Medical Center using fine needle thyroid aspirate and to assess thyroid status among those patients. Case study of patients who underwent fine needle aspirate thyroid biopsy for different types of goiter from January 1995 to June 2004 was conducted. Fine needle aspirate thyroid biopsy was taken using a 20cc syringe on a pistol gun apparatus under aseptic technique. All reports including the diagnoses of thyroiditis, autoimmune thyroiditis [Hashimoto's thyroiditis], lymphocytic thyroiditis, and focal thyroiditis were included. Thyroid function tests and thyroid antibodies were also reported in some patients. A total of 1934 patients underwent fine needle aspirate thyroid biopsy during the study period, 279 cases were excluded because of inadequacy of the sample, missing reports and repeated sample in some patients with the same diagnosis. Those actually included in the study were 1655 [females 1475, males 180, male: female ratio was 8:1]. Thyroiditis was reported in 323 patients [females 93.5%], giving a total prevalence of 19.5%; 11.7% for males and 20.5% for females. Hashimoto, lymphocytic and unclassified thyroiditis were found in 66.25%, 22.6% and 8.6% of the patients respectively. Hashimoto' and lymphocytic thyroiditis are the commonest causes of thyroiditis in Jordanian patients with goiter, females being affected more commonly than males. Fine needle aspirate thyroid biopsy of thyroid gland is an important tool of investigation for thyroid disorders in general and thyroiditis in patients with goiter. Long term follow up of patients with thyroiditis should be adopted