A Case of Childhood Typhoid Fever Complicated with Acute Nephritis

Typhoid fever can cause serious complications, such as enterobrosia, meningitis, pneumonia, myocarditis, hepatitis, osteomyelitis, and disseminated intravascular coagulation in 10-15% of the patients. Kidney complications are very rare, and a few cases have been reported in children. We are reporting a case of childhood typhoid fever complicated with acute nephritis present with albuminuria, hypertension, and renal failure.

An Adolescent Case of Castleman Disease of the Plasma Cell Type Treated with Radiotherapy / 임상소아혈액종양

Castleman disease (CD) is a disorder with distinct lymphoid hyperplasia of unknown origin, and it is rare in children. There are two major forms of CD: unicentric (localized) and multicentric. Pathologically, it can be categorized into three subtypes: hyaline- vascular, plasma cell, and mixed types. We experienced a 15-year-old boy with histopathologically proven mediastinal CD of the plasma cell type. He was referred to our hospital because of mediastinal widening in a chest x-ray found by chance. Surgery was performed to resect two right paratracheal masses and subtotal excision was done. As complete surgical resection was not possible, the patient subsequently received three-dimensional conformal radiation therapy (total 5,400 cGy in 27 fractions). The size of the mass decreased, and his clinical symptoms regressed without any side effects from radiotherapy. Here we report a case of unicentric plasma cell type CD, treated with radiotherapy due to incomplete surgical resection.

Correlation between Serum Cystatin C Levels and Clinical Parameters in Children with Urinary Tract Infections

PURPOSE: We aimed to investigate the correlation between serum cystatin C and clinical manifestations in pediatric patients with urinary tract infections (UTIs). METHODS: We studied 137 patients admitted with UTIs from June 2012 to May 2014. Depending on the presence of renal cortical defects on 99m Tc-dimercaptosuccinic acid scintigraphy, we classified patients into non-renal and renal defect groups. Laboratory and clinical parameters were analyzed, including the levels of serum cystatin C. The correlation between cystatin C and other variables was assessed. RESULTS: Serum cystatin C levels did not differ between the non-renal and renal defect groups. In both groups, serum cystatin C levels increased after 4-5 days of treatment, compared with the level at admission (P<0.001). However, mean levels were within normal ranges. The concentration of serum cystatin C positively correlated with serum creatinine and negatively correlated with age (P<0.05). In contrast, there was no correlation between serum cystatin C and other variables. CONCLUSION: Serum cystatin C does not appear to be a useful biomarker for renal defects in pediatric patients with UTIs. Further studies are necessary to conclude whether serum cystatin C is helpful in predicting deterioration in renal function in pediatric patients with UTIs.

Two Cases of Renal and Perinephric Abscesses in Children

Renal and perinephric abscesses are a rare but potentially fatal complication of urinary tract infection (UTI). Diagnosing renal and perinephric abscesses has been known to be difficult. These abscesses may occur when the appropriate antibiotic treatment for a UTI is delayed, or in cases with a congenital malformation of the urinary system, especially in children. In the present report, we describe 2 cases of renal abscesses with extra-capsular invasion in children with febrile UTI. A 4-month-old male infant with vesicoureteral reflux developed a renal abscess that infiltrated the perinephric area and the left psoas muscle, despite early antibiotic treatment. A 9-year-old boy with prolonged fever also showed a multi-loculated renal abscess that infiltrated the spleen and diaphragm. Both patients were successfully treated with appropriate antibiotics and percutaneous drainage.

An Adolescent Case of Castleman Disease of the Plasma Cell Type Treated with Radiotherapy / 임상소아혈액종양

Castleman disease (CD) is a disorder with distinct lymphoid hyperplasia of unknown origin, and it is rare in children. There are two major forms of CD: unicentric (localized) and multicentric. Pathologically, it can be categorized into three subtypes: hyaline- vascular, plasma cell, and mixed types. We experienced a 15-year-old boy with histopathologically proven mediastinal CD of the plasma cell type. He was referred to our hospital because of mediastinal widening in a chest x-ray found by chance. Surgery was performed to resect two right paratracheal masses and subtotal excision was done. As complete surgical resection was not possible, the patient subsequently received three-dimensional conformal radiation therapy (total 5,400 cGy in 27 fractions). The size of the mass decreased, and his clinical symptoms regressed without any side effects from radiotherapy. Here we report a case of unicentric plasma cell type CD, treated with radiotherapy due to incomplete surgical resection.

Deep Penetrating Benign Fibrous Histiocytoma of the Foot Associated with Throbbing Pain

Compared to cutaneous benign fibrous histiocytoma (BFH), deep-seated BFH is very rare and poorly recognized. Both cutaneous and deep-seated BFH are usually asymptomatic. We herein report a 25 year-old woman who presented with a painful mass in her foot that was poorly controlled by analgesics and associated with walking difficulty. After preoperative ultrasonographic evaluation, the mass was completely excised and histologic exam showed spindle cells loosely arranged in storiform architecture, with CD34-, desmin-, S-100-, focal CD68+, vimentin+, smooth muscle actin+, and factor XIIIa+. The patient was diagnosed with deep-seated BFH based on the histologic, radiologic and intraoperative findings.

Molluscum Contagiosum Presenting as a Cutaneous Horn

No abstract available.

CD8+ Lymphomatoid Papulosis

Lymphomatoid papulosis (LyP) is defined as a histologically malignant, but clinically benign condition. It can appear as erythematous pink to purple papules or nodules. Immunophenotyping studies of the lymphomatoid papulosis lesions have shown a predominance of a CD4 expression and negativity for CD8. However, a positive CD8 expression has rarely been reported for LyP. Herein we report on a case of CD8 positive lymphomatoid papulosis in a 43-year-old man. The patient presented with erythematous, asymptomatic papules on the left axilla and thigh. Histopathologically, there was a wedge-shaped infiltrate composed of a mixture of various cell types, including lymphocytes, histiocytes, neutrophils and large atypical lymphoid cells. Immunophenotyping revealed the neoplastic cells were positive for CD3, CD8 and CD30 and they were negative for CD4, CD20 and CD56.

Development of Dermatomyofibroma in a Male Infant

Dermatomyofibroma is a rare benign cutaneous mesenchymal neoplasm of the fibroblasts and myofibroblasts. The majority of dermatomyofibromas present as red-brown discolored plaques or nodules, commonly located on the shoulder, upper arm, axilla, neck, and/or upper trunk. These lesions develop most frequently in young female patients at a mean of 28-years-of-age. Herein, a case of dermatomyofibroma is reported that developed in an infant. A 4-month-old boy presented with an ill-defined bluish firm plaque on the trunk that developed 1 month after birth. Histopathologically, there was proliferation of bland-looking spindle cells with fascicular arrangement in the dermis and subcutaneous tissue. Immunohistochemistry showed that most of the tumor cells expressed diffuse positivity for vimentin and smooth muscle actin, but were negative for S-100 protein, desmin, and CD34.