Intraductal papilloma of the male breast.

We report the case of a 29-year-old male patient who presented with a painless lump of his left breast that was found to be an intraductal papilloma. This is an extremely rare, but benign disease in the male breast. We subsequently discuss radiologic tests and treatment options.

[A paradox: sarcoidosis in an HIV-positive patient]. / Een paradox: sarcoïdose bij een hiv-positieve patiënt.

BACKGROUND: In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by an overwhelming immune response to an already present or to a new agent. CASE DESCRIPTION: We describe the case of a 47-year-old HIV-positive patient, who presented with an exacerbation of his sarcoidosis nine months after initiation of ART. Based on the time course and the dynamics of the CD4+ lymphocyte count, this presentation of disease can be placed in the context of IRIS. CONCLUSION: The presentation or exacerbation of sarcoidosis after initiation of antiretroviral therapy in HIV-positive patients with a low CD4+ count at start of therapy can be placed in the context of IRIS.

[Eosinophilia and a solid tumour: ovarian sarcoma]. / Eosinofilie bij een solide tumor: ovariumsarcoom.

A 50-year-old woman developed blood eosinophilia during admission to hospital in connection with abdominal symptoms. Eosinophilia is associated with a broad variety of diseases. The major causes of eosinophilia, i.e. an allergic reaction, a parasitic infection and a haematological malignancy, were ruled out. An ultrasound of the abdomen showed a large tumour in the lower abdomen which, because of the patient's history, was attributed to a uterine myoma. Later, this tumour proved to be a mesenchymal malignancy, and surgery was performed to remove it. Histopathology confirmed a high grade sarcoma which had its origin in the right ovary. It is known that eosinophilia can be a paraneoplastic sign of several carcinomas, but it has only infrequently been described in sarcomas. The pathophysiology of tumour-associated eosinophilia is unknown.