Asymptomatic isolated retroperitoneal castleman's disease: a case report

Castleman's disease, giant lymph node hyperplasia, is a kind of benign lymphoproliferative disease with gentle behavior. Its etiology and prevalence are unclear. This rare disease is usually found in mediastinal area asymptomatically and incidentally. It is also rare to see this tumor in the retroperitoneum. In this study, we have introduced a 34-year-old woman who referred just with occasional abdominal pain caused by compressive symptoms. Laboratory findings only reported microcytic anemia [MCH: 18.5, MCV: 63, Hemoglobin 10.2 g/dl]. Chest and abdominal X-ray imaging showed no remarkable point. In abdominal ultrasonography, a solid and firm tumor with 12.2x5.3x6.6 cm was reported in patient's retroperitoneum. Patient's surgery was done and the tumor [covered by a fibrous thick capsule, with no bizarre appearance and bleeding] was completely removed. Pathologic examination indicated a Castleman's tumor, type of unicentric and hyaline-vascular. This item had been one of the rare reported items of Castleman's disease in the retroperitoneal space

Does serum N-terminal pro-brain natriuretic peptide level predict the severity of angiographic lesions in patients with acute coronary syndrome?

Serum N-terminal pro-brain natriuretic peptide [NT-proBNP], a polypeptide secreted by ventricular myocytes in response to stretch, was suggested as a predictor of adverse prognosis of the acute coronary syndrome [ACS]. We examined the association between NT-proBNP level and angiographic findings in ACS patients to determine whether it could be used as a predictor of the severity of angiographic lesions. This cross-sectional study was performed on 126 patients with chest pain or other ischemic heart symptoms suggestive of ACS. Venous blood samples were drawn to measure serum levels of NT-proBNP. Afterward, coronary angiography was performed and the patients were categorized into four groups according to the number of coronary vessels with significant stenosis. The severity of angiographic lesions was assessed with the Gensini scoring system. According to angiographic diagnosis, 11 [8.7%] patients had normal coronary arteries [no coronary artery disease [CAD]] and 115 [91.3%] had CAD, of whom 108 [85.7%] had obstructive CAD and 7 [5.6%] had minimal CAD. The serum NT-proBNP concentration was higher in the CAD group than in the non-CAD group [p value <0.01]. A progressive significant increase in the NT-proBNP concentration according to the Gensini score and the number of involved vessels was reported after adjustment for sex and age. Furthermore, the Receiver Operating Characteristic Curve [ROC] analysis indicated that an NT-proBNP cut-point of 400 pg/ml could predict obstructive CAD with a sensitivity of 65% and a specificity of 78%. Higher levels of NT-proBNP among our ACS patients were associated with the severity of angiographic lesions in terms of both the Gensini score and the number of involved vessels. This finding underscores the potential role of NT-proBNP in predicting the severity of CAD before performing angiography

Anaplastic large cell lymphoma associated with breast implant: a case report

Primary breast lymphoma represents less than 1% of all primary breast malignancies and most primary breast lymphomas are of B-Cell origin. The association of anaplastic lymphoma kinase [ALK] negative anaplastic large cell lymphoma [ALCL], a very rare form of primary breast lymphoma, with silicone-filled breast implants has been suggested and several case reports supported this proposal, especially in Western countries. Here we describe one of the first cases of primary breast ALK-negative ALCL in association with saline-filled silicone breast implants evaluated in Iran, where the rising number of breast reconstructive and aesthetic surgeries would commit both surgical pathologists and plastic surgeons to be familiar with this entity