ABSTRACT
Prostate lymphomas (LP) are rare, fewer than 300 cases have been reported in the literature. Each time they are a diagnostic surprise as is the case with our study that is typical, didactic and reports the thirteenth case of prostatic lymphoma in the marginal zone. The study involved a 65-year-old patient, with no particular previous history who presented with signs of prostatism lasting for 4 months, aggravated by the occurrence of acute urinary retention. The diagnosis of benign prostatic hyperplasia with normal prostate-specific antigen (PSA) level was easily made and the patient underwent transurethral resection. To our surprise, the histological study revealed a massive infiltration of prostatic tissue by a non-Hodgkin lymphoma (NHL), marginal zone lymphoma (MZL) subtype. According to Steuter, it was classified as prostatic lymphoma stage IVB with leukemic transformation. The patient has experienced remission for 18 months with normalization of LDH after R-chop therapy. Although rare, these sites of occurrence should be suspected, LDH assay should be systematic in patients with prostatic signs and normal PSA levels. Prognosis is variable, according to age, histologic type and evolutionary stage, however, the median overall survival is identical for primary and secondary forms.
Subject(s)
Lymphoma, B-Cell, Marginal Zone , Prostatic Neoplasms , Urinary Retention , Male , Humans , Aged , Urinary Retention/etiology , Prostatic Neoplasms/diagnosis , Prostate-Specific Antigen , ProstateABSTRACT
Pleuropulmonary blastoma is a rare intrathoracic tumor in children. It is associated with poor prognosis and diagnosis is based on histological examination. We conducted a didactic study involving a 3-year-old child with severe acute respiratory distress associated with hemothorax; radiological and thoracoscopic examination suggested malignant pleuropulmonary process. Anatomopathological examination with radio-clinical comparison allowed for the diagnosis of solid-cystic pleuropulmonary blastoma type II. Unfortunately, given the severity of the clinical features, the child died within a few weeks due to multiple organ failure. Pathologist experience is very important to recognize the disease and to start adequate treatment as soon as possible. This allows for a tumor regression rate up to 90% after neoadjuvant treatment and a 5-year survival rate of at least 53% for aggressive forms: solid and solido-cystic tumors.
Subject(s)
Lung Neoplasms , Pulmonary Blastoma , Humans , Child, Preschool , Lung Neoplasms/pathology , Pulmonary Blastoma/diagnosis , Pulmonary Blastoma/pathology , Neoadjuvant Therapy , RadiographyABSTRACT
OBJECTIVE: To describe the demographics, clinical presentation, proportion of co-infection with human immunodeficiency virus (HIV), and treatment of patients with ocular syphilis seen at the ophthalmology department of 2 tertiary centres in Montreal, Canada. DESIGN: Retrospective case series. PARTICIPANTS AND METHODS: A total of 169 eyes of 115 patients, seen between 2000 and 2015, with a positive syphilis treponemal serology and a likely syphilis-related ophthalmologic diagnosis. Subgroup analysis was performed between HIV-infected and HIV-uninfected patients. RESULTS: Mean age of onset was 55 years, and 79% were male. Mean presenting logMAR visual acuity was 0.7. HIV status was available for 66%, of whom 49% were HIV-infected. The anatomical ocular diagnoses included isolated anterior uveitis (18%) and posterior segment involvement (42%). Both eyes were affected in 47%. Lumbar puncture (LP) was performed in 55%, of whom 22% had a positive cerebrospinal fluid (CSF) Venereal Disease Research Laboratory (VDRL) test. Antibiotherapy, consisting of intravenous penicillin alone or in addition to intramuscular benzathine penicillin, was administered in 65 patients (69%). Treatment allowed a visual improvement of -0.23 logMAR. HIV-infected patients were younger men (p < 0.01) and had more abnormal CSF analysis (pâ¯=â¯0.02), but there were no statistically significant differences in the anatomical location of ocular inflammation or visual function improvement. CONCLUSIONS: Given its varied presentations, syphilis must always be part of the differential diagnosis of intraocular inflammation. HIV testing and an LP are required in the evaluation of ocular syphilis, which should be treated as neurosyphilis with the appropriate regimen.
