Subject(s)
Aorta, Abdominal/diagnostic imaging , Aorta, Thoracic/diagnostic imaging , Diagnostic Errors/prevention & control , Fluorodeoxyglucose F18 , Multimodal Imaging/methods , Vasculitis/diagnostic imaging , Aged , Aorta, Abdominal/pathology , Aorta, Thoracic/pathology , Biopsy, Needle , C-Reactive Protein/analysis , Follow-Up Studies , Humans , Magnetic Resonance Angiography/methods , Male , Positron-Emission Tomography/methods , Prednisone/therapeutic use , Quadriplegia/diagnosis , Quadriplegia/therapy , Rare Diseases , Risk Assessment , Role , Severity of Illness Index , Tomography, X-Ray Computed/methods , Treatment Outcome , Vasculitis/drug therapyABSTRACT
Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign proliferation of breast stromal cells with a complex pattern of interanastomosing spaces lined by myofibroblasts. The exact etiology is still unknown, but a proliferative response of myofibroblasts to hormonal stimuli has been postulated. PASH is a relatively common incidental finding in breast tissue removed for other reasons and rarely manifests as a localized mass. Fewer than 150 cases of tumoral PASH have been reported since it was first described in 1986. Although PASH tends to grow over time, most lesions are cured by surgical excision and the prognosis is excellent. We report an unusual case of bilateral axillary tumoral PASH in a 44-year-old man. Awareness of this disease is important when considering the differential diagnosis of axillary masses. To our knowledge, only one other case of unilateral axillary tumoral PASH in a male patient has been described in English and this is the first case of PASH occurring in male bilateral axillary gynecomastia.
Subject(s)
Angiomatosis/complications , Angiomatosis/surgery , Axilla , Breast Diseases/complications , Breast Diseases/surgery , Gynecomastia/etiology , Gynecomastia/surgery , Hyperplasia/complications , Hyperplasia/surgery , Mastectomy/methods , Thoracic Surgical Procedures/methods , Adult , Angiomatosis/diagnosis , Angiomatosis/pathology , Breast Diseases/diagnosis , Breast Diseases/pathology , Diagnosis, Differential , Gynecomastia/diagnosis , Gynecomastia/pathology , Humans , Hyperplasia/diagnosis , Hyperplasia/pathology , Male , Treatment OutcomeSubject(s)
Cytomegalovirus Infections/diagnosis , Cytomegalovirus/immunology , Stomach/pathology , Wiskott-Aldrich Syndrome Protein/genetics , Wiskott-Aldrich Syndrome/diagnosis , Blood Platelets/pathology , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/pathology , Cytomegalovirus Infections/physiopathology , Cytomegalovirus Infections/therapy , DNA Mutational Analysis , Eczema , Ganciclovir/administration & dosage , Gastrointestinal Hemorrhage , Genetic Predisposition to Disease , Hematemesis , Humans , Immunoglobulins, Intravenous/administration & dosage , Infant, Newborn , Male , Otitis Media, Suppurative , Platelet Transfusion , Sequence Deletion , Stomach/virology , Thrombocytopenia , Wiskott-Aldrich Syndrome/complications , Wiskott-Aldrich Syndrome/pathology , Wiskott-Aldrich Syndrome/physiopathology , Wiskott-Aldrich Syndrome/therapyABSTRACT
The experience of childhood cancer can be one of the most severe stressors that parents endure. Studies using illness-specific measures of parental stress indicate that moderate-to-severe parenting stress is quite common in the first year of childhood cancer treatment, and as many as 5% to 10% of these parents go on to develop posttraumatic stress disorder. This review of the literature suggested that although parenting stress symptoms may be relatively transitory for most parents dealing with childhood cancer, the impact of these stress symptoms on parent and child functioning is substantive and worthy of therapeutic attention. The stresses entailed in childhood cancer should be viewed as complex and varied across stages of diagnosis and treatment. Factors associated with increased risk of parental posttraumatic stress symptoms include poor social support, adverse experience with invasive procedures, negative parental beliefs about the child's illness and/or associated treatment, and trait anxiety. For those parents with risk factors that might forebode more severe and enduring stress reactions to their children's cancer, therapeutic strategies are proposed to ameliorate their stress and reduce the development and/or maintenance of posttraumatic stress symptoms.
Subject(s)
Neoplasms/psychology , Parent-Child Relations , Parents/psychology , Stress, Psychological , Adult , Anxiety , Attitude to Health , Child , Culture , Female , Humans , Male , Mental Health , Patient Compliance , Social Support , Treatment OutcomeABSTRACT
We report on a child with a family history of autoimmune defects, who presented at the age of 3(1/2) years with alopecia and Graves disease. He subsequently developed vitiligo and psoriasis. At 9(1/2) years, he developed an autoimmune form of Lambert-Eaton Myasthenic syndrome (LEMS) with a significant elevation of glutamic acid decarboxylase (GAD) autoantibodies. Shortly thereafter he developed chronic urticaria. HLA associations were present for Graves disease, vitiligo, psoriasis, and IgA deficiency. There was also evidence of autoimmunity involving the pancreatic islet cells and gastric parietal cells.
