Résumé
The secondary renal involvement of non-Hodgkin lymphoma is frequently encountered but primary renal lymphoma is extremely rare in children. We hereby present a rare case of primary renal diffuse lymphoma in a 3-year-old girl child who presented with bilateral renal masses. The tumour was initially diagnosed as bilateral Wilms’ tumour but on biopsy, it turned out to be non-Hodgkin's lymphoma. Primary renal lymphoma is an aggressive tumour with guarded prognosis. There are a variety of diseases which present as renal masses in children amongst which primary renal lymphoma is extremely rare. This article describes the clinical features and diagnostic features of primary renal lymphoma. Our report highlights the importance of keeping this neoplastic condition under consideration while evaluating children with renal mass .In order to distinguish primary renal lymphoma from other renal tumours, the authors have also described the clinical, imaging and pathological features of various other renal tumours prevalent in children.
Résumé
The epidermoid cysts are the most common cutaneous cysts and may develop from any parts of the human body. Primary epidermoid cyst with hypospadias in the penis is very rare. Here, we present the case of a slow growing, mobilized; non-tender frenulum of the penis mass in a 44-year-old male patient. Complete excision of the cyst was performed under spinal anesthesia. Histopathological examination confirmed the mass to be an epidermoid cyst. Care must be given during examination to rule out another entity. If there is any indication, complete excision and hypospadias repair is the best treatment
Résumé
Perforation peritonitis is treated with surgery and antibiotics. This study was conducted to identify bacterial and fungal microorganisms responsible for peritonitis in patients with hollow viscus perforation and to examine the influence of these microorganisms on the outcome. A prospective study was conducted from May 2005 to September 2006 involving 84 consecutive patients with spontaneous gastrointestinal perforation peritonitis, who were referred for surgery. Peritoneal fluid was analyzed by microbial culture and biochemical tests for bacteria and fungi. The Jabalpur Prognostic Score was calculated. Forty-two of the 84 patients had positive peritoneal fluid cultures. Escherichia coli was the most common bacterium (n=26) and Candida (n=13) the most common fungus isolated. Bacterial isolates were largely sensitive to amikacin while all the Candida isolates were sensitive to fluconazole. Mortality was significantly higher in patients with positive peritoneal cultures (15/42) compared with those with negative peritoneal cultures (0/42, p<0.001), and in patients with mixed bacterial and fungal-positive cultures (10/13) compared with those with isolated bacterial cultures (5/29, p<0.001). Using the Jabalpur Prognostic Score, positive fungal cultures were found to be associated with a significantly higher than expected mortality. Patients with gastrointestinal perforations and positive peritoneal cultures have a poor prognosis, which is significantly worsened by the association of positive fungal cultures. Early recognition and treatment of fungal infection is advisable.