Graft-versus-host disease. Case report and discussion

The graft-versus-host disease reaction is an immunologic consequence resulting from the grafting of immunocompetent cells from one individual to an immunocompromised host. The oral manifestations of this disease process include severe oral pain, xerostemia, ulcerative lesions, and mucositis. With appropriate history and diagnostic testing, these lesions can be differentiated from other oral diseases having similar clinical appearance.     

Acute schistosomiasis with brain involvement. Case report]

A case of acute schistosomiasis with magnetic resonance images (MRI) of the brain suggestive of demyelinating lesions, pyramidal disorder in the lower limbs and normal cerebrospinal fluid is presented. Diagnosis could be established by detection of antibodies on blood and cerebrospinal fluid. Schistosoma mansoni involves the spinal cord more often than the brain. Praziquantel associated to prednisolone was effective in this case. There are few reports of brain involvement with S. mansoni, but its prevalence is probably greater. Due to the paucity of studies, its pathophysiology and therapeutics remain to be better clarified. The immune and MRI aspects are emphasized.     

Recurrent torticollis due to cervical osteochondroma. Case report and review of the literature]

A patient is presented who had bilateral abductor vocal fold paralysis pathologically proven to be due to multiple system atrophy (MSA) in the absence of other neurological features. MSA is a degenerative neurological condition that includes olivopontocerebellar atrophy, Shy-Drager syndrome and striatonigral degeneration. The usual predominant features of MSA are cerebellar ataxia, autonomic dysfunction and Parkinsonism. Stridor is present in over one third of patients and has been reported previously as a presenting symptom in MSA: however previously reported patients have always gone on to develop other neurological symptoms. The usual investigations of bilateral abductor vocal fold paralysis caused by MSA will not reveal the pathological process and we believe that magnetic resonance imaging (MRI) of the medulla and brain stem and autonomic function tests are probably the investigations of choice. It is a worthwhile exercise attempting to identify MSA as the cause of stridor as the prognosis is good in the medium term if appropriate support is offered.     

HELLP syndrome. Case report

Genitourinary sarcomas are very rare entities. This paper contributes one case report of an undifferentiated pelvic fibrosarcoma in a 53-year old patient. It also includes some observations on the clinical development, complementary studies used, difficulties for the pathoanatomical diagnosis and treatment issues.     

Metastatic oligodendroglioma. Case report

We report a case of remote metastasis of oligodendroglioma. Similar cases are reported in the literature for malignant cerebral tumors. Our case seems rather different because of low grade histology. Potential malignancy was evidenced only by further investigations with labeling indexes.     

Oncotic aneurysm. Case report

The author describes a case of intracerebral and subarachnoid hemorrhage associated with an intracranial aneurysm caused by a metastatic tumor. The aneurysm formation is explained as being result of tumor cells invading the vessel wall while still preserving the arterial circulation.     

Kenny-Caffey syndrome. Case report

We investigated whether survival was related to recent childbirth or parity in a cohort of 540 women diagnosed with breast cancer before the age of 45 years who were followed for up to 14 years. Women who had given birth within 2 years before their diagnosis of breast cancer were at increased risk of dying, compared with nulliparous women, with an adjusted relative risk of 3.1 (95% confidence interval = 1.8-5.4). There was a moderate association of parity with mortality, with an adjusted relative risk of 1.8 (95% confidence interval = 1.2-2.9) for women with three or more births, compared with nulliparous women.     

Case report: Avoidance conditioning therapy of an infant with chronic ruminative vomiting.

Reports the treatment of a 9-mo-old infant whose life was seriously endangered by persistent vomiting and chronic rumination. An aversive conditioning paradigm, employing electric shock, significantly reduced the frequency of this maladaptive response pattern in a few, brief treatment sessions. EMG records were used in assessing response characteristics of the emesis, and in determining the shock contingencies used in therapy. Cessation of vomiting and rumination was accompanied by weight gains, increased activity level, and general responsiveness to people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Secondary" chondrosarcoma of the hand. Case report and review of the literature]

The expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin is important for the regulation of the leucocyte traffic into and in inflammatory dermatoses. ICAM-1, VCAM-1 and E-selectin were initially identified as cell-surface proteins, but recent evidence suggests that they also exist in a soluble form. The collection of human afferent lymph exclusively deriving from a selected skin area allows insight into local pathomechanisms as well as signal transmission in skin disorders. In the present study we measured the concentrations of the soluble adhesion molecules (sAM) sICAM-1, sVCAM-1 and sE-selectin in human skin lymph derived from normal untreated skin, irritant contact dermatitis (CD) and the induction and elicitation phases of allergic CD. The strong elicitation reactions of allergic CD produced an increase in sAM output to about three times the baseline values but in the weaker irritant CD we observed no increase at all. In the induction phase of allergic CD the concentrations during the first 9 days of the experiment remained unchanged, as in the lymph derived from normal untreated skin, but were slightly increased thereafter. To our knowledge, no in vivo data exist on the local involvement of sAM in irritant and allergic CD in humans. Our results provide evidence of increased concentrations of sAM mainly in strong allergic CD.     

Disseminated pulmonary ossification. Case report

Metaplastic pulmonary ossification is usually described as dendriform or nodular in patients with chronic inflammatory lung disease or long-standing pulmonary edema. We present a case of dendriform pulmonary ossification found accidentally at autopsy in a 66-year old man. In addition, some of the theories relating to the development of this rare phenomenon are discussed.     

Primary splenic pregnancy. Case report

A patient with a primary splenic pregnancy is described.     

Optic nerve ganglioglioma. Case report

Gangliogliomas of the optic nerve are extremely rare. The case is reported of a 38-year-old man who presented with a visual field deficit and was discovered to have an optic nerve ganglioglioma. The possible embryological origins of this neoplasm, its histological and immunohistochemical features, and its appearance on magnetic resonance imaging are examined. The prognoses of optic nerve glioma and of gangliogliomas occurring elsewhere in the nervous system are compared.