Multifocal kaposiform hemangioendothelioma of soft tissue with bilateral pulmonary involvement in an adolescent / 소아과

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor of intermediate malignancy with resemblance to Kaposi sarcoma. It occurs predominantly in pediatric age groups as a cutaneous lesion with focal infiltration into the adjacent soft tissue and bone. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. KHE has been reported to occasionally occur in unusual sites such as the thymus, tonsils, larynx, paranasal sinuses, deltoid muscle, spleen, uterine cervix, thoracic spine, and even the breast. Multifocal KHE is an extremely rare entity with few reports available in the literature, none of which describes pulmonary involvement. Herein, we report a unique case of multifocal KHE in a 13-year-old boy presenting with a huge soft tissue mass in the upper extremity complicated by bilateral pulmonary nodules that developed into large, necrotic tumor masses.

Genetic diversity of pseudomonas aeruginosa strains isolated from hospitalized patients

Pseudomonas aeruginosa is one of the most common nosocomial pathogens often causing major problems in Intensive Care Units. This study aimed to investigate the genotypic diversity of Pseudomomas aeruginosa strains isolated from hospitalized patients in National Research Institute of Tuberculosis and Lung Disease [NRITLD] with random amplified polymorphic DNA [RAPD] method and also to determine the antibiotic resistance pattern. Seventy three P. aeruginosa isolates from different specimens were analyzed. These strains were isolated from patient admitted in Intensive Care Unit [ICU] [31], non-ICU inpatient [40], and two environmental specimens one from ventilator and one from soap specimen in ICU. All strains were identified with biochemical testing and antimicrobial susceptibility testing which carried out according to National Committee for Clinical Laboratory Standards [NCCLS]. Random Amplified Polymorphic DNA typing [RAPD] was used to study the genetic diversity of Pseudomonas aeruginosa using 2 sets of primers and electophoretic banding patterns were analyzed visually and by GelCompar ?? software. Phylogenic analysis of the RAPD pattern showed rates of genetic similarity ranging from 40-100%. Four epidemiologically and genetically related isolates [clones] each containing 2-3 isolates were identified. Most of them were from ICU. We detected high antimicrobial resistance rate to Chloramphenicol, Ceftriaxon, Cefepime, Ceftazidime [75-97%] and relatively low resistance rate to Imipenem, Amikacin, Ciprofloxacin and Gentamicin [42-53%]. Although a few epidemiologically related clones are found with RAPD method, most of the isolates are probably emanate from the host itself. There is also a high rate of antibiotic resistance especially in ICU

Rectal and appendiceal inflammatory myofibroblastic tumors

Inflammatory myofibroblastic tumors are neoplasms characterized by spindle cell proliferation and a fiboinflammatory vascular stroma. Herein, we presented the successful treatment of a rectal inflammatory myofibroblastic tumor in an 11-year-old boy who presented with diarrhea and abdominal pain of 11/2 months duration and an appendiceal inflammatory myofibroblastic tumor in a 29-year-old man presented with recurrent abdominal pain of two months duration with associated tenderness and rebound tenderness in the right lower abdomen. Histologically, our cases had inflammatory myofibroblastic tumors very similar to that of other sites; the spindle cells were positive for vimentin and muscle-specific actin

Proliferative Marker in distinction between benign and malignant mesothelial proliferations

Differentiation of benign from malignant mesothelial proliferations is a major problem in the pathology of the serosal membranes, particularly in small biopsy specimen. This study was conducted for the evaluation of proliferative marker for distinction between malignant mesothelioma [MM] and mesothelial hyperplasia [MH]. Thirty six cases of malignant mesothelioma [MM] with the mean age of 62.94 years [range: 36-80 years, M/F: 3.58] and 22 cases of mesothelial hyperplasia [MH] were evaluated for proliferative status by immunohistochemical [IHC] method with monoclonal antibody, Ki-S5 [Ki-67]; the labeling indices [LI] were evaluated. Average count revealed a significant increase in MM as compared with reactive MH [p value < 0.0001]. Considering a threshold of 9% for ki-67, a sensitivity of 88% and specificity of 94% were resulted. Proliferative marker of Ki-67 can be useful in distinction between malignant mesothelioma and mesothelial hyperplasia [p-value < 0.0001]