ABSTRACT
Chickenpox is an acute disease caused by the varicella-zoster virus (VZV), a herpesvirus that causes human infection worldwide. Primary VZV infection routinely occurs during childhood and is usually a self-limiting illness in immunocompetent children. However, chickenpox can be a severe disease in adolescents, adults, and immunosuppressed or immunocompromised patients. Although vaccination substantially attenuates disease manifestations, significant complications such as secondary soft tissue infection, encephalitis, and pneumonia can occur. We present a rare autopsy case of concurrent acute myocarditis and intussusceptions in a 3-year-old female child who presented with chickenpox followed by abdominal pain and sudden death. The present case emphasizes the potential for fatal complications of viral infections, which should be considered in cases of sudden unexpected infectious death in children.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Abdominal Pain , Acute Disease , Autopsy , Chickenpox , Death, Sudden , Encephalitis , Herpesvirus 3, Human , Immunocompromised Host , Intussusception , Myocarditis , Pneumonia , Soft Tissue Infections , Vaccination , Virus DiseasesABSTRACT
Nongestational choriocarcinoma differentiation is extremely rare in breast neoplasms. It is characterized by tumor cells similar to chorionic trophoblastic cells, which react with human placental lactogen and human chorionic gonadotropin (hCG). A 56-year-old woman presented with a palpable right breast mass without past history of trophoblastic tumors. An F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan revealed one focus with low accumulation of FDG in the right breast (maximum standardized uptake value, 1.98). The patient underwent a right mastectomy and biopsy of sentinel nodes. Microscopically, the tumor was a typical invasive ductal carcinoma with multiple foci of choriocarcinoma features. Immunohistochemistry showed that the tumor cells resembling choriocarcinoma were positive for hCG antibody, but negative for HER2/neu, estrogen receptor, and progesterone receptor. A pathologic diagnosis of breast carcinoma with choriocarcinomatous features was made. To our knowledge, this is the first report of invasive carcinoma with choriocarcinomatous features and an unusual finding of low accumulation in an F-18 FDG PET/CT scan in Korea.