A Rare Case of Granular Cell Tumor in the Right Upper Lung of an Adolescent Patient.

Granular cell tumors (GCTs) are rare neoplasms of neuroectodermal origin characterized by large polygonal cells with abundant eosinophilic and granular cytoplasm. GCTs rarely affect the lungs, with only a few cases reported in the literature. The pathophysiology of this Schwann cell-derived condition is not well understood but is thought to be due to recurring genetic mutations. GCTs have been linked with Noonan syndrome. Here, we report the case of a 17-year-old caucasian male who presented with partial upper airway obstruction due to a GCT. This case promotes awareness among pathologists and clinicians for this condition in the workup of patients presenting with upper airway obstruction.

A Rare Case of Sarcoidosis Involving Male Breast Tissue.

Sarcoidosis is a multisystem, inflammatory granulomatous disease that rarely involves breast tissue. The pathophysiology of this chronic granulomatous condition is not well understood but is thought to be multifactorial, involving environmental influences causing an amplified immune response. A key histomorphology feature in sarcoidosis is the presence of non-necrotizing granulomas. In this case, we report a 41-year-old African-American man with a known history of sarcoidosis of the lung who presented with gynecomastia and bilateral breast tenderness with palpable nodules. Subsequent biopsy and microscopic examination of the breast nodules revealed diffuse involvement with non-necrotizing granulomas in both breasts. A final diagnosis of extensive sarcoidosis involving breast tissue was rendered after excluding other causes of non-necrotizing granulomas. The patient underwent a bilateral mastectomy to remove the breast nodules. This case discusses sarcoidosis involving an unusual site.

A Case Report of the Ongoing Management and Comorbidities of Loin Pain Hematuria Syndrome with an Unusual Presentation.

Loin pain hematuria syndrome (LPHS) is a rare chronic pain disorder that is poorly understood. LPHS presents as unilateral or bilateral flank pain with hematuria of unknown cause. The lack of knowledge surrounding pathogenesis and effective treatment has resulted in missed diagnoses as well as narcotic addiction in some patients. In this case, we describe the presentation and management of a 30-year-old female with a history of anxiety, depression, chronic pelvic bleeding, and pain recently diagnosed with LPHS after a total hysterectomy. She presented with ongoing pelvic pain symptoms with recent tachycardia, recurrent urinary tract infections, and nephrolithiasis. Loin pain hematuria presents as a particularly rare and difficult diagnosis to manage with multiple, sometimes unpredictable, comorbidities. This case serves as an example of a unique presentation with additional uncommon symptoms.

Assessing the need for knowledge on injury management among high school athletic coaches in South Dakota.

BACKGROUND: A lack of health coverage at athletic competitions and practices poses concern over the knowledge coaches have in providing adequate health care to high school (HS) athletes. Therefore, the purpose of this study was to determine the need for education of coaches in the prevention, assessment and management of sports-related injuries in South Dakota (SD). METHODS: Survey link e-mailed to 1,050 HS athletic head coaches in SD; 247 (23.5 percent) completed the prospective, web-based survey. RESULTS: Of the respondents, 74.91 percent reported HS enrollments less than 300, with 79.36 percent in rural/frontier counties and 28.74 percent in medically underserved areas. Coaches from 14 sports responded. The majority indicated they were responsible for the immediate medical care of athletes at practices (89.07 percent) and competitions (74.90 percent); and 79.76 percent of coaches agreed or strongly agreed they needed more injury management education. Results also indicated less than 50.00 percent had current certifications in CPR/BLS (46.65 percent) and first aid (47.4 percent). CONCLUSIONS: Due to the demand placed on head coaches to be the initial caregivers for injured athletes, there is a need for increased education of SD coaches related to the management of acute sports injuries. Additionally, policy changes may be indicated to address the lack of medical personnel available during HS athletic competitions and practices.