Paediatric Primary Pachymeningeal Xanthogranuloma with Scattered Foci Displaying Reticulohistiocytoma-like Features.

We report a unique case of a 4-year-old girl with an intriguing fibrohistiocytic tumour. Magnetic resonance imaging scans showed a dural mass of variegated intensity compressing the left occipital pole and apparently extending toward the superior sagittal sinus. Grossly, the cut surface of the surgical specimen was yellow, pale, and soft with reddish kernel-like crusts. Histologically, the yellow areas resembled cholesterol granulomas with widespread coagulative necrosis, cholesterol clefts, powdery calcification, foreign body-type giant cells, and foamy macrophages, while the scattered red spots contained numerous multinucleated giant cells of foreign-body and Touton types, the former with amphophilic to slightly eosinophilic cytoplasm. Immunoperoxidase reactions confirmed the expression of histiocytic markers and vimentin. As far as we know, no tumour displaying these peculiar morphological features has yet been described.

Fiebre entérica en fase de fastigium: notas epicríticas acerca de un caso de autopsia / Enteric fever in fastigium phase; epicritic notes on a necropsy case

La fiebre tifoidea es una enfermedad sistémica de etiología infecciosa ocasionada por el bacilo gramnegativo Salmonella typhi. Se presenta el caso de una mujer de 19 años quien comenzó con fiebre, dolor abdominal y diarrea; posteriormente cursó con insuficiencia hepática, necrosis tubular aguda, rabdomiolisis y trombocitopenia. Falleció a los 3 días del ingreso hospitalario. Los hallazgos de autopsia fueron: ulceración de placas de Peyer, inflamación y necrosis de ganglios linfáticos mesentéricos, úlceras puntiformes en colon, hepatización pulmonar, congestión hepática, esplénica y renal, así como hemorragias maculares en mesencéfalo y puente. Los cortes histológicos evidenciaron grupos de macrófagos alrededor de focos de necrosis (nódulos tifoideos) en diversas localizaciones: aracnoides, parénquima cerebral, pulmón, hígado, bazo, riñón y médula ósea. Estos hallazgos permitieron concluir el diagnóstico de fiebre tifoidea en fase de fastigium. La fiebre tifoidea presenta 5 fases cuya expresión morfológica es resultado de una serie de interacciones entre Salmonella typhi y el sistema fagocítico mononuclear del hospedero.

Typhoid fever is a multisystemic disease of infectious etiology with the gramnegative rod Salmonella typhi as its causative agent. We present the case of a 19 year old woman who started with fever, abdominal cramps and diarrhea progressing to hepatic insufficiency, acute tubular necrosis, rhabdomyolysis and thrombocytopenia dying three days after hospital admission. Autopsy findings were as follows: Peyer's patches ulcers, necrosis and inflammation of mesenteric lymph nodes, dotted ulcers in colon, lung hepatisation, hepatic, splenic and renal congestion, as well as purpuric lesions in mesencephalon and pons. Microscopic examination revealed macrophage clusters surrounding spots of necrosis (typhoid nodules) in the next locations: arachnoid mater, brain parenchyma, lung, liver, spleen, kidney and bone marrow. These findings supported a diagnosis of typhoid fever at fastigum stage. Typhoid fever goes through 5 consecutive stages whose morphological expression is product of several interactions between Salmonella typhi and the mononuclear phagocyte system of its host.

[Jejunal intussusceptions as a lead point ectopic pancreatic tissue in a 1-year-old male. Case report]. / Invaginación yeyuno-yeyunal secundaria a tejido pancreático ectópico en un lactante de un año de edad. Reporte de caso.

BACKGROUND: intussusception is the most common cause of acute bowel obstruction in infants and young children. Incidence has been reported as 1.5 to 4 cases per 1,000 live births. Most intussusceptions are ileocecocolic; jejunal intussusceptions in children is extremely rare. CLINICAL CASE: a 1-year-old male was admitted to the emergency department with diarrheal evacuations, without mucus or blood, crying and irritable. Previously he had melaena in one occasion. The abdomen was found soft and depressible and low pain. He was treated with ceftriaxone, omeprazole and metoclopramide. Two days after admission he had melaena and rectal bleeding. Plain abdominal radiography showed air fluid levels. Abdominal surgery was performed finding jejunal intussusceptions which were reduced. Demonstrable lesion as a lead point was a small tumor that was removed. The pathologist's report showed pancreatic islets cells. CONCLUSIONS: jejunal intussusceptions in children are extremely rare and occur at any age. Main symptoms are intermittent abdominal pain and vomiting. Ultrasonography is the study of choice. Often a lesion is demonstrable as a lead point for the intussusceptions and therefore requires open or laparoscopic surgery. In this case, it was unusual to have the presence of ectopic pancreatic tissue as a lead point.

[Oedematous ovarian fibroma with extensive cystic degeneration. A case report and literature review]. / Fibroma edematoso de ovario con extensa degeneración quística. Reporte de un caso y revisión de la bibliografía.

We have a patient with 34-years-old. Who's come to the gynecological emergency room, in the general hospital, Dr. Manuel Gea González, because she has colic abdominal pain with increasing intensity. The evolution was to develop acute abdominal pain. The location pain was in the inferior abdomen, predominantly in the left iliac foci, with nausea, no vomit and pondered lose, 4 kg in two months. This is associated with changes in the defecator pattern with tendencies to difficult evacuated. By other side she have irregular menstrual period. Rhythm 15 x 2 in the last two years. And we can touch a large tumoration 13 cm in diameter with regular borders, fixed to the uterus apparently, but no to profounder planes. The tumor is lateralized to the right and she has pain with mobilization, low transvaginal hemorrhage, no fetid and finally the patient developed an acute abdominal pain.