Coupled column chromatography in chiral separation of salmeterol

The neuromuscular hamartoma (also referred to as the neuromuscular choristoma or benign triton tumor) is a rare developmental lesion composed of mature elements of both striated muscle and nerve. To date, less than 20 cases have been reported in the English language literature. The majority of these have involved large nerves, such as the sciatic or brachial plexus, but cutaneous lesions have also been reported. We report 2 cases that involve the head and neck and that are among the few described in this location. The majority of cases have been described in infants and young children. However, 1 of our cases (and at least 1 previously reported case) occurred in an adult. While surgical excision has been the most widely used form of therapy, a few cases have been complicated by and/or associated with a second lesion, such as a fibromatosis or lymphangioma.     

Partners for two decades: AOA and the National High Blood Pressure Education Program

A case of a single molluscum contagiosum occurring on the surface of a preexisting soft fibroma in an adult patient is reported. The most common clinical form of this viral lesion is multiple grouping papules with a central umbilication and its histologic feature is characteristic. Previous cases of mollusca combining with other lesions have been rarely described. Our lesion was probably due to its localization on the soft fibroma, whose exophytic growing represented a favoring factor for trauma and the consequent occurrence of the viral disease.     

Metanephric adenoma of the kidney: a case report

Metanephric adenoma (MA) of the kidney is an uncommon benign epithelial tumor of the kidney that presents at any age. The histology of the lesion is well established, but the imaging findings have been described in only a few cases. We report the sonographic and computed tomographic appearance of MA in a 9-year-old girl to increase awareness among radiologists of this entity. Its recognition may facilitate nephron-sparing surgery.     

A case of chromophobe renal cell carcinoma with sarcomatoid foci and a small daughter lesion

Chromophobe renal cell carcinoma (RCC), which has recently been recognized to be a distinct type of RCC, comprises approximately 5% of renal cell tumors. It has been hypothesized that the cells that comprise chromophobe RCC show a phenotype similar to that of intercalated cells of the collecting duct. Although the number of research reports on this type of tumor has recently been increasing, only nine cases of chromophobe RCC showing sarcomatoid transformation have been described. Herein, a case of chromophobe RCC with sarcomatoid foci and a small daughter lesion is reported.     

Cystic lymphangioma of the spermatic cord. Report of a new case

We report a new case of spermatic cord lymphangioma in a young patient. It is a rare tumor of the lymphatic system. Only eleven cases have been reported in literature. This lesion tends to recur despite surgical ablation. The pathogenesis of this lesion is still controversial.     

Transverse lesion of the cord syndrome in chondrodystrophic dwarfs (author's transl)

More than 70 transverse lesion of the cord syndromes in chondrodystrophic dwarfs have been described in the literature. 43 of these were adequately described and/or accessible for the authors. In 22 cases, a mechanical cause (including 14 lesions of the intervertebral disk) was directly responsible and, in 14 cases, no direct spinal cord suppression was found. In the latter group, 10 had a negative myelography, 3 positive and 1 case myelography was not performed. Of the 12 laminectomized cases, only 3 made a good recovery, 4 showed severe deterioration and 2 conservatively treated cases (including the case described here) were clearly improved. Of the 16 laminectomized cases with limited mechanical impediment, 8 showed good results, 3 indifferent and 5 unknown. The cause of the vascular myleopathy was assumed to be a combination of the narrowness of the bony vertebral canal and an increasing kyphotic process. The authors suggest that laminectomy for tranverse lesion of the cord syndrome in dwarfs should be made only after several controls and an established stop correlating with the location of the neurological lesions. We reject decompression laminectomy for vascular myleopathy because of the already endangered vascular situation and the poor results. We prefer orthopedic measures.     

Respiratory kinesitherapy. For whom? Why do it?

Intussusception of the appendix vermiformis in adults is an uncommon event. The combination of a mucinous cystadenoma with an intussuscepted appendix is extremely rare. Clinical symptoms are nonspecific; in most cases the correct diagnosis is not made before surgical exploration. With the radiologic and endoscopic presentation of a polypoid lesion of the caecum, a neoplasm is often considered. Endoscopic appendectomy or disinvagination by enema have been described. Thus the definitive therapy is surgery and depends on the histological diagnosis.     

Primary focal segmental glomerulosclerosis: clinical course and response to therapy

Primary focal segmental glomerulosclerosis (FSGS) is a lesion associated with a poor prognosis and results in end-stage renal disease after 5 to 10 years. Based on past experience, many nephrologists have considered primary FSGS a lesion that is steroid resistant and therefore are reluctant to offer steroids as treatment. Recent data, however, have demonstrated that patients with primary FSGS have a response to steroid therapy that is considerably better than had been described. Thus, it may be that nephrologists have been more "steroid reluctant" than the lesion is steroid resistant. To better understand this issue we review the clinical course and response to therapy in patients with primary FSGS.     

Adenomatoid tumor of the heart: report of a case

We report a case of an adenomatoid tumor involving the heart. The lesion was found incidentally at the time of cardiac surgery, measured 1.0 cm, and was poorly demarcated from the adjacent myocardium. Microscopically, the tumor consisted of aggregates of relatively large, epithelioid cells that coalesced to form tubular spaces and occasionally branched into anastomosing channels. The neoplastic cells were strongly immunoreactive with antibodies against cytokeratin. The pathologic features of this unusual cardiac tumor are diagnostic of an adenomatoid tumor, a relatively rare benign neoplasm of mesothelial origin usually found in association with the genital tract. Although rare cases of adenomatoid tumors found outside of the genital tract have been described, including two recently reported pleural tumors, it has not been described to involve the heart.     

Two families with Alport's syndrome

Alport's syndrome is a hereditary disease striking cochlea, eye and kidney. The diseased women usually have a nonlethal degree of the kidney disease, but the prognosis for the men is worse. They often die from renal failure before the age of 35. Most cases of hearing loss occurs in men. The hearing loss is progressive after the age of 10. Audiological tests are characteristic for a cochlear lesion. The debut of the disease usually appears in the post natal period giving microscopic haematuria. It can, however, occur later with haematuria and proteinuria. The hearing loss may be the first symptom, which is an observandum to otologists. Two families with Alport's syndrome are described. The patients have been examined concerning kidney disease, audiological and vestibular pathology. The hereditary pattern is described.     

Unusual fibro-osseous lesion of the spinal cord with positive staining for glial fibrillary acidic protein and radiological progression: a case report

A rare intradural lesion of the lumbar spine producing leg pain and minimal neurological deficits is described in a 48-year-old man. Previous reports of similar lesions have been described under the designation "fibro-osseous lesions" and "calcifying pseudoneoplasms." This is the first report of an unusual fibro-osseous lesion with an intradural spinal location as well as the first to show immunohistochemical positivity for glial fibrillary acidic protein (GFAP) within cellular components of this process and crystal formation suggestive of calcium pyrophosphate. This case also shows radiographic progression suggesting the possibility that this entity may be a form of low grade neoplasm.     

Metastasis of carcinoma of cervix uteri to convexity meningioma

A cerebral collision tumor in which a convexity meningioma was invaded by a metastatic squamous cell carcinoma of the cervix uteri is described. This is the first time such a lesion has been reported to invade a cerebral meningioma. The patient lived three active years postoperatively until the lesion recurred. Her status then deteriorated, and she died five years after the operation. This was a longer follow-up than any among the other 17 cases of carcinomatous metastases to meningiomas found in the literature.     

Multiple sclerosis as a cause of partial complex epilepsy

INTRODUCTION: Although the epileptic seizures (ES) have been described on patients with multiple sclerosis (MS), the causal relationship is not clear. Seizure's prevalence in this illness is low and their apparition concerning the MS course is variable, but more common after MS diagnosis. The predominant crises are generalized or partial with secondary generalization; the partial complex seizures have rarely referred. CLINICAL CASES AND CONCLUSIONS: We presented two patients with ES in the MS course. In the first case is arrived to MS diagnosis upon appearing the crisis, having presented two previous cerebral lesions in another level. In both cases demyelinating lesion was located in the temporal lobe, agreeing with EEG anomaly and seizures type.     

Follicular tumidus retro-auricular lichen planus (author''s transl)

Referring to three comparable cases, a new form of lichen planus is described. This form is characterized by a prominent lesion, violaceus in color or pigmented, with white yellowish specks mimicking milia. The histologic picture of lichen follicularis, the presence of typical papules of lichen distant from the retro-auricular lesion make it possible to consider this clinical aspect as a variety of lichen planus.     

Tumour development, histology and grade of breast cancers: prognosis and progression

A case of giant cell tumor localized in the proximal end of the right tibia, initially treated by simple curettage is described. After 11 years there was local recurrence, confirmed anatomopathologically, observed during wide resection and reconstruction by arthroplasty plus homoplastic grafting. After a few months there were metastatic lesions in the left parietooccipital and right retroorbitary area. Biopsy of the parietooccipital lesion showed giant cells in a sarcomatous stroma. The patient died after several attempts at chemotherapy. Even if only sporadic cases have been described of late recurrences and of extrapulmonary metastases for giant cell tumors, the case presented here is exceptionally rare. The factors that influence recurrence of these tumors and their ability to metastasize is discussed.     

Retrograde gastric mucosal prolapse as a cause of haematemesis

Three cases of haematemesis associated with alcohol abuse are described. Early fibreoptic endoscopical examination in each showed a focal, well demarcated area of gastric mucosal haemorrhage, close to the oesophagogastric junction. Two patients showed prolapse of the lesion into the lower part of the oesophagus, and the third had coexistent Mallory-Weiss tears. Our observations suggest that forceful vomiting is responsible for this lesion, by causing abrupt retrograde gastrooesophageal prolapse. The prognosis of the lesion appears good.     

Conservative treatment of fresh subcutaneous rupture of the Achilles tendon

Primary malignant melanoma of the uterine cervix in a 70-year-old Negro female is reported. Only 9 other cases have been reported in the literature. The diagnosis, prognosis, and modern trends in therapy for this lesion are discussed.     

Adenomatoid odontogenic tumour. Review of literature and report of 30 cases from India

Thirty cases of adenomatoid odontogenic tumour (AOT) from the files of Dept. of Oral Pathology, Dr. R. Ahmed Dental College, Calcutta are presented along with a through review of the literature for the lesion. The higher occurrence in males than females are being reported for the first time. Patterns of eosinophilic material have been recognised and represented diagrammatically. Very few cases have been reported from India and by far this is the largest series of AOT from this country.     

Spindle-cell hemangioendothelioma with monomelic and multifocal form in a child

BACKGROUND: Spindle-cell hemangioendothelioma is a soft tissue skin tumor recently identified histologically. It can occur at all ages but generally is seen in young adults. The lesion usually occurs as a subcutaneous mass involving the limbs. CASE REPORT: A particular case of spindle-cell hemangioendothelioma was observed in an 18-month-old child. The lesions progressed with a monomelic distribution on the upper limb. Histological diagnosis of spindle-cell hemangioendothelioma was achieved at the age of 6 years. DISCUSSION: The age of the patient and the monomelic distribution is particular in this case of spindle-cell hemangioendothelioma, inciting a nosological discussion on this disease and other vascular tumors of childhood and the relationship of these types of lesions with Maffucci's syndrome. Although no anomalies have been detected to date, radiological surveillance is needed as cases of Maffucci's syndrome associated with spindle-cell hemangioendothelioma is described in the literature.     

Rathke's cleft cyst

Two cases of Rathke's cleft cyst which produced symptoms of compression of the optic chiasm are described. The first case has been followed for five years since the operation. No evidence of recurrence has been noticed. The prognosis after a partial removal of the cyst wall seems to be good with this lesion. In the second case, there was clinical and laboratory evidence of hypopituitarism and the CT scan revealed suggestive findings to differentiate the cyst from a pituitary adenoma.