Brain abscess of unknown etiology in a 2-year-old child: a case report.

We present a case of brain abscess necroptically discovered in a 2-year-old child hospitalized in the Pediatrics Clinic of the "Filantropia" Municipal Hospital, Craiova, Romania. The family, with a poor financial situation, reports previous episodes that may be interpreted as comitial crises. Clinically speaking, he presents a height-weight hypertrophia, vitamin D loss rickets, and psychomotor retardation. At the objective examination, we found a weight of 10 500 g (!), second and third degree mesocardiac systolic beat and cardiomegaly in the thorax-cardiac-pulmonary X-ray examination. Despite the intensive treatment, death occurs few hours after hospitalization. During the autopsy, there is observed a partial dehiscence of the cranial arch sutures, with a 6/5 cm ovalary cavity in the parietal lobe, containing approximately 200 mL of yellow-green serous liquid, with uneven walls, but with no hemorrhagic or puss infiltrates. The heart is enlarged (in comparison to the general somatic development) of 9/7/4 cm, without any cardiac malformations. The microscopic examination showed degenerative neuronal and ischemic lesions on the left-brain hemisphere. Comparing to the data from specialty literature, we consider it as a yellow brain softening (according to Rokitansky's classification), most probably of an embolic cause.

Non-Hodgkin lymphomas of Waldeyer's ring.

Lymphomas represent malignant lymphoproliferative diseases and they are generally classified as Hodgkin's (HL) or non-Hodgkin malignant lymphomas (NHML). Head and neck lymphomas represent one of the most common sites of extranodal lymphomas, second after the gastrointestinal tract. Waldeyer's ring structures include the palatine tonsils, the nasopharyngeal lymphatic tissue, and the lingual tonsil. We investigated 38 patients with malignant lymphoma with ages ranging from 21 to 95 years, all localized in the Waldeyer's ring. Good knowledge of the clinical characteristics of these lymphomas and the methods to establish the differential diagnosis are essential for a correct therapy of the disease.

Spitz nevus with an uncertain malignant potential.

We present the case of 10-year-old girl who have had from birth a plane tumor, of tan color, 3-4 mm of diameter, localized on the face on the cutaneous part of the superior lip. This tumor has been stabile until 8-year-old. Then, after repeated sunlight exposures, the lesion has become more stark, hemispheric in shape, has increased in size becoming about 5-6 mm, with irregular borders, and after an accidental traumatism it began to bleed. We have performed the electroexcision of the lesion for diagnostic and therapeutic purpose. The histopathologic exam distinguished typical images of Spitz nevus on some of the histological sections but also of melanocytary tumor with uncertain malignant potential on the others where atypical mitoses localized in the deeper component of the tumor are being noticed. The immunohistochemical assessment of the tumoral cells showed positivity for the melanocytic markers HMB45 and Melan A, within junctional intraepidermic nevic cells and in the nevic cells from superficial dermis, and also for CD44 protein (belonging to the adhesion molecules family). However, cyclin D1 was positive in rare nevic cells, and the proliferation rate of the tumor was small, with a proliferation index for Ki67 lesser than 5%. The correlation between histopathological and immunohistochemical data conducive to final diagnosis of Spitz nevus with uncertain malignant potential. The clinical evolution confirmed the histopathological diagnosis by the fact that the patient did not presented clinical signs of local recurrences or metastasis at three years after the excision of the tumor.