Colosplenic fistula in a patient treated with interleukin-2 for malignant melanoma

Interleukin-2 (IL-2) therapy often causes gastrointestinal side effects and at least 8 cases of bowel perforation have been reported. The patient reported here developed a colosplenic fistula, diagnosed by CT, with no neoplastic involvement of these organs. Awareness of these complications of IL-2 can help lead to earlier diagnosis.     

Urinary bladder transitional cell carcinoma with trophoblastic differentiation

Transitional cell carcinoma (TCC) with trophoblastic differentiation (TD) is a newly recognized variant of urothelial cancer which produces placental proteins, predominantly beta-human chorionic gonadotropin (HCG). It has a poor prognosis. About 210 cases were described, mostly from North America, Europe and Japan. This is the first report of TCC TD in a resident of Israel's upper Galilee. A 69-year-old man whose urinary papillary bladder tumor was established cystoscopically, refused treatment and stopped follow-up. 3.5 years after his last visit, he returned and cytologic examination revealed malignant urothelial cells, while intravenous pyelography disclosed a urinary bladder defect. Cystoscopy showed numerous papillary masses dispersed over the bladder mucosa, which were resected transurethrally. Histopathologic examination revealed TCC grade III, stage A. Tumor cells were immunopositive for beta-HCG and human placental lactogen. 4 transurethral resections of large masses were performed within 2 months. Pulmonary metastases developed and the patient died 4 years after the detection of the urinary bladder tumor.     

Primary malignant lymphoma of the bladder: a case report

CONTEXT: Pharmaceutical samples are commonly used in ambulatory care settings. There is limited research on their use or impact on health care providers and patients. OBJECTIVE: To determine the extent of personal use of drug samples over a 1-year period by physicians and medical office staff. DESIGN, SUBJECTS, AND SETTING: An anonymous cross-sectional survey of all physicians, resident physicians, nursing staff, and office staff in a family practice residency. MAIN OUTCOME MEASURE: Quantity of drug samples taken for personal or family use. RESULTS: Of 55 surveys issued, 53 (96%) were returned. A total of 230 separate drug samples were reported taken in amounts ranging from 1 dose to greater than 1 month's supply. Two respondents reported no use of drug samples, while 4 respondents reported taking more than 10 different samples. CONCLUSION: Drug samples are commonly taken by physicians and office staff for personal and family use. The ethical implications of this practice warrant further discussion.     

Primary localization of malignant lymphoma in the urinary bladder?

The characteristics of post-task regression of accommodation to pre-task tonic accommodation (TA) levels have been examined in a number of studies to clarify the nature of the within-task facility for accommodative adaptation. Of special interest is the recent observation that significant attenuation of post-task regression occurs in late-onset myopes (LOMs) when compared with emmetropes (EMMs). These findings have led to speculation that such attenuation may reflect a deficit in inhibitory sympathetic innervation to ciliary smooth muscle in late-onset myopia and hence a predisposition to sustained accommodative adaptation which then acts as a precursor to the induced myopia. A consequence of this study was that post-task regression may have some value in predicting those individuals who may be susceptible to post-task accommodative hysteresis. A pre-requisite for such a predictive value is that for a given individual the variation in inter-trial regression patterns is not significant. The aim of this study is principally to investigate the inter-trial variability of post-task regression for individual subjects following a sustained near vision task, and to confirm further differences that have been reported between EMMs and LOMs with respect to the time course of post-task regressions. A modified Canon R1 infrared optometer was used to measure accommodation objectively throughout a near task and for 2 min post-task. Accommodative level was measured following 3 min fixation of a high contrast photopic Maltese cross target placed 3 D above the subject's baseline TA. Repeatability of post-task regression in 10 EMMs and 10 LOMs was assessed by taking measurements on three separate occasions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Thrombosis of the basilar trunk in a young woman previously treated by radiotherapy for malignant lymphoma

We report the case of a 23-year-old-woman, who had received mediastinal radiotherapy for non-Hodgkin lymphoma. Five years later, she presented a basal artery thrombosis. Arteriography showed an ectopic origin of the left vertebral artery on the aortic arch located within the irradiation field. This artery was irregular and narrowed up to 15 cm from its origin. All other cerebral arteries were normal. We reviewed the literature of other observations describing radiation-induced cervical arteritis.     

The development of malignant rhabdoid tumor in a patient with Beh?et's disease treated with ciclosporin

PURPOSE: To describe a risk of malignant neoplasm in patients with Beh?et's disease treated with ciclosporin. METHODS: Case report. RESULTS: A patient with Beh?et's disease who was treated with ciclosporin developed a mass in his right femur. Histological examination revealed this mass was a malignant rhabdoid tumor. CONCLUSION: This is the first known case of malignant tumor developing in a patient with Beh?et's disease treated with ciclosporin. This case underscores the importance of assessing possible risks in the treatment of Beh?et's disease with ciclosporin.     

Contrast media induced irreversible acute renal failure in a patient treated with intraperitoneal cisplatin

Mycobacterium tuberculosis strains were identified using paper strips for niacin technique; these paper strips were made at the National Reference Laboratory on Tuberculosis and Mycobacteria of the IPK. Results were compared with the conventional niacin technique and a 100% of coincidence was obtained; advantages, sensitivity and firmness of this method are reported.     

Rhabdomyolysis after infection and taking a cold medicine in a patient who was susceptible to malignant hyperthermia

OBJECTIVE: To investigate the role of human parvovirus B19 (Parvo B19), cytomegalovirus (CMV) and human papilloma virus (HPV) viruses in the aetiopathogenesis of spontaneous abortions. STUDY DESIGN: Abortion material from 102 cases of women with spontaneous abortions were analysed for the presence of Parvo B19, CMV and HPV DNA using the polymerase chain reaction (PCR) technique. Serological assays were used for the detection of specific IgM and IgG antibodies against Parvo B19 virus and CMV in the maternal sera. RESULTS: Parvo B19 virus genome was detected in two cases of spontaneous abortion, by PCR amplification, while CMV and HPV genomes were not observed. Serological markers were indicative for Parvo B19 virus and CMV infection in ten and four cases, respectively. CONCLUSIONS: PCR is a useful method for investigating the viral contribution to the aetiopathogenesis of spontaneous abortions and for detecting the viral genome in the abortion material. This study of 102 cases of spontaneous abortion does not implicate CMV and HPV in the aetiopathogenesis of spontaneous abortion, although it indicates a possible abortional role for Parvo B19 virus.     

Long-term cure of a malignant lymphoma of the pleural cavity treated by irradiation

Malignant lymphomas arise in the pleura in association with a long-standing chronic tuberculous pyothorax. We report a case of a non-Hodgkin's lymphoma of the pleural cavity, inoperable because of local invasion into thoracic wall, who has survived more than 6 years without recurrence. This patient represents the longest reported survival after radiation therapy alone. Radiotherapy holds an important role in the treatment of locally advanced lymphoma of the pleural cavity.     

Matched unrelated allogeneic bone marrow transplantation for recurrent malignant lymphoma in a patient with X-linked lymphoproliferative disease (XLP)

A 14-year-old male and a maternally related cousin were diagnosed with X-linked lymphoproliferative disease (XLP) after developing recurrent B-NHL, characterized by long disease-free intervals and absence of an increased chemoresistance of the recurrent lymphomas. The demonstration of different clonal IgH gene rearrangements in two of the lymphomas from one of the patients further supports that the lymphomas were clonally unrelated. The cousin underwent matched related BMT, whereas the proband received a deliberately delayed MUD BMT in third CR. Both are in CR 68 months and 21 months, respectively, post-BMT. Delaying BMT probably contributes to reducing treatment-related morbidity. We suggest MUD BMT as a feasible curative strategy for XLP patients with B-NHL lacking matched related donors.