Neurological complications of first 100 orthotopic liver transplantation patients in southern Iran.

Neurological complications which are responsible for significant mortality and morbidity after orthotopic liver transplantation have been reported in 8.3% to 47% of cases in various series. This prospective study was performed to investigate the prevalence and characteristics of neurological complications in the first 100 patients who have undergone orthotopic liver transplantation from 1993 to 2004. Neurological symptoms and signs as well as routine laboratory tests, including complete blood cell counts, electrolyte levels, drug levels, microbiologic and serological studies, brain computed tomography scans, magnetic resonance imaging, and electrodiagnostic studies were reviewed in all patients. Follow-up periods were from 2 months to 10 years. Nineteen patients of mean age of 34.9 years developed neurological complications after orthotopic liver transplantation. The most common neurological symptoms and signs were confusion (42.1% of cases with neurological complications), convulsions (36.8%), and hallucinations (31.6%). Hepatic encephalopathy (31.6%) and drug toxicity (26.2%) were the most common neurological syndromes. The mortality rate was significantly higher among patients with neurological complications. Compared to other centers, neurological complications were less common in our center.

Papillary Hürthle cell carcinoma (Warthin-like tumor) of the thyroid. Report of a case with fine needle aspiration findings.

BACKGROUND: Papillary Hürthle cell carcinoma with lymphoplasmacytic stroma is a newly recognized variant of papillary carcinoma of the thyroid gland. Fine needle aspiration findings reveal some points that have not been reported previously. CASE: A 50-year-old female presented with a left lobe thyroid mass. Fine needle aspiration of the nodule yielded cellular smears, mostly in large and small papillary clusters of Hürthle cells, with nuclear grooves and rare nuclear inclusions in a lymphoplasmacytic background. Isolated Hürthle cell and multinucleated giant cells were also seen. Histopathologic examination of the 3-cm-diameter nodule showed papillary Hürthle cell carcinoma with lymphocytic stroma, or "Warthin-like tumor" of the thyroid, with capsular invasion. CONCLUSION: The presence of papillary clusters with nuclear features of papillary carcinoma and oxyphilic cytoplasm in a lymphoplasmacytic background should raise the diagnosis of Warthin-like tumor of the thyroid.