Linfangioma mesentérico en la edad pediátrica / Mesenteric Lynphangioma in the pediatric ages

Resumen Introducción: Dentro del espectro de las malformaciones congénitas con las cuales debe lidiar un cirujano pediatra, los tumores y malformaciones vasculares representan un grupo especial de entidades que continúan actualmente en estudio. Objetivo: Determinar las características clínicoquirúrgicas de una serie de dos casos con malformaciones de origen linfático. Presentacion de casos: Dos pacientes con edades pediátricas, 12 y 4 años, respectivamente, ingresaron en servicio de urgencia con signos de oclusión intestinal y lesiones tumorales quísticas abdominales que requirieron tratamiento quirúrgico con modalidades de técnicas quirúrgicas diferentes. La evolución final fue satisfactoria. Conclusión: Los linfagiomas intestinales forman parte de la gama de presentaciones clínicas de las malformaciones de origen linfático, con una incidencia baja pero que, dada su localización y síntomas, pueden requerir tratamiento quirúrgico de urgencia. Su evolución y resolución es satisfactoria, debido al bajo índice de recidiva tras la exéresis completa(AU)

ABSTRACT Introduction: Within the range of congenital malfomations that surgeons have to deal with, vascular tumors and malformations represent an special group of entities that are still under study. Objective: To determine the clinical-surgical characteristics of a series of two cases with congenital malformations of lymphatic origin. Cases presentation: Two patients of 12 and 4 years old respectively that were admitted in the Emergencies services in the Clinical-Surgical Hospital of Guayaquil, Ecuador, with manifestations of intestinal obstruction and abdominal cystic tumoral lesions that required surgical treatments with different techniques. Final evolution was satisfactory. Conclusion: Intestinal lymphoangiomas are part of the kinds of clinical presentations of lymphatic origin´s malformations. These have a low incidence but due to their localization and symptoms can require emergency surgical treatment. Their evolution and resolution is satisfactory due to the low index of recidive after complete exeresis(AU)

Nonadenomatous nonencapsulated thymic parathyroid tissue concomitant with primary hyperparathyroidism due to ectopic parathyroid adenoma / Tecido tímico paratireoidiano não edematoso e não encapsulado concomitante com hiperparatireoidismo devido a adenoma paratireoidiano ectópico

Primary hyperparathyroidism due to ectopic parathyroid adenoma is not infrequent. Primary hyperparathyroidism caused by unusual thymic nonadenomatous nonencapsulated parathyroid tissue has been reported before. Both can cause unsuccessful neck explorations. Here we presented for the first time a patient with hyperparathyroidism due to ectopic parathyroid adenoma concomitant to the presence of thymic nonadenomatous nonencapsulated parathyroid tissue.

O hiperparatireodismo primário devido a adenoma ectópico paratireoidiano não é raro. O hiperparatireodismo primário causado por tecido tímico paratireoidiano não edematoso e não encapsulado incomum já foi relatado anteriormente. Ambos podem levar à exploração cervical malsucedida. Apresentamos aqui, pela primeira vez, uma paciente com hiperparatireoidismo decorrente de um adenoma paratireoidiano concomitante com a presença de tecido tímico paratireoidiano não edematoso e não encapsulado.

Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.

CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

OBJECTIVE: To retrospectively compare the imaging characteristics of retropharyngeal density and associated findings for Kawasaki disease with those for non-Kawasaki disease, and identify the distinguishing features which aid the CT diagnosis of Kawasaki disease with retropharyngeal low density. MATERIALS AND METHODS: Among the enhanced neck CT performed in children less than 8-years old with clinical presentation of fever and cervical lymphadenopathy over a 6-year period, only cases with retropharyngeal low density (RLD) were included in this study. The 56 cases of RLD were divided into two groups; group A included cases diagnosed as Kawasaki disease (n = 34) and group B included cases diagnosed as non-Kawasaki disease (n = 22). We evaluated the CT features including the thickness of RLD and its extent into the deep neck spaces, as well as soft tissue change in the adjacent structure. We also scored the extent of RLD into the deep neck spaces and the soft tissue changes in the adjacent structure. RESULTS: The thickness of RLD was greater in group A than in group B (group A, 6.0 +/- 2.1; group B, 4.6 +/- 1.5, p = 0.01). The score of the RLD extent into the deep neck spaces was significantly greater in group A than in group B (group A, 2.3 +/- 1.3; group B, 0.8 +/- 1.0, p < 0.01). Also, the score of the adjacent soft tissue changes was greater in group A than in group B (group A, 2.0 +/- 1.1; group B, 1.0 +/- 1.0, p < 0.01). CONCLUSION: If children present with fever and cervical lymphadenopathy that display retropharyngeal low density with extension into more deep neck spaces as well as changes in more adjacent soft tissue, the possibility of Kawasaki disease should be considered.

A Case of Limited Wegener's Granulomatosis with Gastroenteritis and Mesenteric Lymphadenopathy / 대한소화기학회지

Wegener's granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis.

A Case of Limited Wegener's Granulomatosis with Gastroenteritis and Mesenteric Lymphadenopathy / 대한소화기학회지

Wegener's granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis.

Bandagem úmida empregada com baixa elasticidade no tratamento de úlcera em paciente com lipolinfedema / Damp low-stretch bandage employed in the treatment of an ulcer in patient with lipolymphedema

O lipedema é caracterizado pelo aumento bilateral e simétrico dosmembros inferiores, sem o acometimento dos pés, sinal de Stemmernegativo, podendo ocorrer hipotermia cutânea, alteração no suporteplantar e hiperalgesia. O objetivo do presente estudo é relatar umaforma incomum de lesão ulcerada em paciente com lipolinfedematratado com bandagem úmida empregada com baixa elasticidade.Paciente, do sexo feminino, de 50 anos, com história familiar delipedema refere vários episódios de erisipela em membro inferioresquerdo há cerca de 20 anos e com surgimento de úlceras de difícilcicatrização há mais de cinco anos. Foi tratada com bandagemúmida de baixa elasticidade e teve boa evolução com cicatrização da ferida. Lesões ulceradas são raras no lipolinfedema, porém a sua ocorrência esta associada com dificuldade na cicatrização.

Fine-needle aspiration cytology findings in human immunodeficiency virus lymphadenopathy.

Thirty-six human immunodeficiency virus (HIV)-positive patients with lymphadenopathy were subjected to fine-needle aspiration cytology (FNAC) over a period of 2 years. The maximum number of cases was reported in the age group of 21 to 30 years. Majority of the patients were males. The maximum number of cases had tuberculosis (58.3%) followed by reactive lymphadenitis (36.1%), non-Hodgkin's lymphoma (2.7%) and acute suppurative lymphadenitis (2.7%). FNAC is an important diagnostic tool in the evaluation of lymphadenopathy in HIV-positive patients.

Autoimmune lymphoproliferative syndrome (ALPS): a rare cause of immune cytopenia.

Autoimmune Lymphoproliferative syndrome (ALPS) is an inherited disorder manifesting with autoimmune cytopenia, lymphadenopathy and splenomegaly. The differential diagnosis includes infections, autoimmune disorders or malignancies. The disease is characterized by accumulation of double negative (CD3+ CD4- CD8-) T cells (DNT) in the peripheral blood. We describe a case and review the literature.

Rare case of pulmonary joint, cardiac and mediastinal involvement in rheumatoid arthritis with bronchial asthma and allergic rhinitis.

It is extremely uncommon to find a patient with rheumatoid arthritis with pulmonary and cardiac manifestations together with co-existent intrathoracic lymphadenopathy. We report the case of a 40-year-old female with rheumatoid arthritis with rheumatoid lung disease with severe aortic regurgitation, congestive heart failure, bronchial asthma and allergic rhinitis.

A thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy: a rare association.

An 18-year-old boy presented with a rare association of a thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy. He was put on a Category I regimen with standard short course daily chemotherapy of four anti-tubercular drugs under the National Tuberculosis Programme. After a six-month of anti-tubercular treatment (ATT), the boy showed clinical and bacteriological improvement. The thyroid scan with Technetium 99 (Tc 99) and the chest skiagram also became normal.

A Case of Severe Protein-losing Enteropathy as a Late Complication of Pelvic Irradiation

Department of Protein-losing enteropathy is the manifestation of a diverse set of disorders, and it is characterized by the excessive loss of plasma proteins into the affected portions of the gastrointestinal tract, and this results in hypoalbuminemia. We report here on a case of severe protein-losing enteropathy with the typical clinical features of hypoalbuminemia, dependent edema and increased alpha 1-antitrypsin (alpha1-AT) clearance, as measured by using 24hr stool testing. The associated disorder with the protein-losing enteropathy of our case was radiation enterocolitis and lymphatic obstruction that was due to radiation treatment and lymph node dissection in the remote past for the treatment of uterine cervical carcinoma. Our case suggests that chronic radiation enterocolitis can result in irreversible injury to the intestinal mucosa and a protein-losing enteropathy, which can bring about a very poor quality of life and even the loss of life.

Sinus histiocytosis with massive lymphadenopathy: complicated by autoimmune hemolytic anemia.

Sinus histiocytosis with massive lymphadenopathy is a rare histiocytic disorder with very few case reports in Indian literature. Immunological abnormalities have been documented in few cases. We report one such case of a child presenting with generalized lymphadenopathy and complicated by autoimmune hemolytic anemia, suggestive of an associated immune dysfunction.

Vascular transformation of sinuses in lymph nodes associated with myelodysplastic syndrome--a case report.

We describe a case of plexiform variant of vascular transformation of lymph nodes sinuses in association with myelodysplastic syndrome. The patient had repeated bacterial infections and terminal fungal infection and dies after a protracted illness of seven years.

A clinico-epidemiological perspective of lymphatic filariasis in Satyabadi block of Puri district, Orissa.

BACKGROUND & OBJECTIVES: Lymphatic filariasis is a major public health problem in the coastal district of Orissa. However, no systematic studies have been done to document the prevalence of microfilaraemia/disease in different regions of the State. Therefore, the present cross sectional study was undertaken during 1996-97 to obtain information on the clinical and epidemiological status of the disease in Satyabadi block area of Puri district, known to be endemic for filariasis. METHODS: Night blood smear survey and clinical examinations were performed on 4646 individuals aged 0-> or = 60 yr from systematically selected households of 17 randomly selected villages of the Block. Microfilaraemia was detected by thick drop technique using 20 microliters of peripheral blood and microfilariae (mf) density by nucleopore filtration technique collected during 1900-2300 h. RESULTS: The prevalence of microfilaraemia was observed to be 14.8 per cent; 13.3 per cent Wuchereria bancrofti, 1.4 per cent Brugia malayi and 0.09 per cent had mixed infections. Geometric mean microfilaraemia density (infected persons only) was found to be 1288 per ml in case of W. bancrofti and 204 per ml in case of B. malayi. The disease rate was observed to be 19.8 per cent; 12.85 per cent had acute manifestations and 6.97 per cent had chronic manifestations. INTERPRETATION & CONCLUSION: The rate of acute disease manifestations was observed to be significantly higher (P < 0.001) than chronic manifestations. There was a male preponderence among the affected individuals (P < 0.001). The interesting observations of the study were the occurrence of occult filarial manifestations viz., tropical pulmonary eosinophilia (TPE) in 0.47 per cent cases and other associated manifestations like asymptomatic microscopic haematuria, monoarticular arthritis and filarial associated respiratory diseases in 0.50, 0.24 and 0.19 per cent of cases respectively. The present study indicates that the area is highly endemic for lymphatic filariasis with active transmission.