Cochlear implants: Visual evoked potentials study.

Cochlear implants (CIs) are a successful alternative in cases with severe-to-profound HL. In these individuals, visual cross-modal re-organization can occur because of hearing loss where the visual cortex will recruit auditory cortical areas for visual processing. OBJECTIVES: This work is designed to study visual evoked potentials (VEPs) in children fitted with CIs in comparison to normal hearing children. METHOD: This work included 2 groups of children: Group I included 20 normal hearing children and study group included 25 children fitted with unilateral CIs. All cases were subjected to Thorough otological history. Check up on CIs performance using physical check and Aided sound field examination, ophthalmic examination and Pattern Visual Evoked Potentials (pVEPs). RESULTS: Both groups showed no significant difference as regard age or sex. And both had normal ophthalmic examinations. Children of the study groups showed satisfactory aided response. As regard pVEPs, the study group showed significant higher P100 amplitude in comparison to the control group. CONCLUSION: This study showed that deafness could induced cortical organization in the visual cortex and not limited to the auditory cortex only.

"Triple hit" lymphomas: A retrospective cytology case series of an uncommon high grade B-cell malignancy with C-MYC, BCL-2 and BCL-6 rearrangements.

The Revised fourth Edition World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues suggests novel categories, including "high grade B-cell lymphoma with MYC and BCL2 and BCL6 gene rearrangements." These diseases are known colloquially as "double hit" and "triple hit" lymphomas. The "first-hit" in these cases is the harboring of a MYC rearrangement. Concurrent derangements of BCL2 and BCL6 can be the "second-hit" or "third-hit." To our knowledge, this is the first report of "triple-hit" lymphomas in cytology specimens. The files of the Cleveland Clinic (January 2007 through December 2017) were searched for all "triple hit" lymphomas. Four cases met inclusion criteria (cytology slides in files and histologically confirmed "triple hit" lymphoma). All slides were reviewed. The mean age was 65 years, with a male predominance. All patients presented at advanced stage and showed progressive disease despite therapy. FISH studies (histologic sections) confirmed translocations of MYC (8q24), BCL2 (18q21) and BCL6 (3q27) in all patients. All cases were characterized by high cellularity, dispersed cells, presence of stripped nuclei, lymphoglandular bodies, apoptotic bodies, cytomegaly, nucleomegaly, nuclear envelope irregularities, macronucleoli (most often single), recognizable mitoses and presence of cytoplasmic vacuoles (variable). The WHO recommends that all large B-cell lymphomas be investigated using cytogenetic or molecular techniques. Concurrent inhibition of MYC and BCL2 is a potentially effective treatment strategy for triple hit lymphomas, and an expanding literature exists regarding predictive biomarkers and therapeutic regimens. It is our intention to raise awareness of this uncommon mature B-cell neoplasm within the cytodiagnostic community.