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IntroductionAneurysms are permanent dilatation of vessels by at least 1.5 times the normal diameter of adjacent artery.[1] They may be classified as true aneurysms, involving all three layers of the arterial wall, or pseudoaneurysms, which are contained by only part of the vessel wall or surrounding tissue. Morphologically, aneurysms can be saccular (localized outpouching of the vessel wall) or fusiform (circumferential dilatation).[2] Mycotic aneurysms, which account for only 0.7% to 3% of all aortic aneurysms, are primarily caused byStaphylococcus and Salmonella species, with the infrarenal abdominal aorta being the most common site affected.[3–5] Although the term ‘mycotic’ used historically suggests fungal etiology, it is a misnomer and applies to any aneurysms caused by infections.[6]Tuberculous aortic aneurysm (TBAA) is a rare but life-threatening extension of tuberculosis, typically arising from tuberculous aortitis, a very rare manifestation of extrapulmonary tuberculosis (TB), and is predominantly saccular (98%) and false (88%) in nature, with a high risk of rupture if left untreated.[7,8] Tuberculous aneurysms may develop through various mechanisms, including direct invasion from nearby TB lesions such as lymph nodes or abscesses, hematogenous spread through the vasa vasorum, lymphatic dissemination, or direct inoculation after trauma, with contiguous spread from adjacent infected tissues being the most common pathway, responsible for about 75% of cases.[9,10]Here, we report a case of tuberculous mycotic aneurysm of abdominal aorta, detected when being evaluated for disseminated pulmonary TB and tubercular meningitis.

A document by Mohammad Soheil Jouzani. Click on the document to view its contents.

A document by xuelong jiang. Click on the document to view its contents.

1-Introduction:Congenital pulmonary airway malformations (CPAMs) represent a well-known cluster of rare lung malformations affecting 1 in 2500 live births. CPAMs develop in the lung during intrauterine life and include Cystic Adenomatoid Malformation (CCAM), Bronchopulmonary Sequestrations (BPS), Congenital Lobar Emphysema (CLE) and Bronchogenic Cysts (BCS) [2].Among CPAMs, CCAMs are the most common, occurring in 1 in 10,000 live births [3]. They represent a heterogeneous group of cystic versus solid and mono versus rarely bilobar lung masses. CCAM Type 1 is characterized either by multiple cysts ranging 2–10 cm in size or a single large cyst, Type 2 which is characterized by multiple sub-centrimetric cysts together with Type 3 with single or multiple cysts < 2 cm, are the most frequent types [4].Historically, Ch’in and Tang first described CCAM as a distinct entity in 1949[5].Stocker in 2002 recommended the term congenital pulmonary airway malformation (CPAM) as being preferable to the term congenital cystic adenomatoid malformation, since the lesions are cystic in only 3 out of 5 types. They are adenomatoid in only 1 type (type 3)[4].The updated classification system of CPAM added types 0 and IV. Type 0 is very difficult to differentiate from bronchogenic cyst. The similarities between type IV and cystic pleuropulmonary blastoma may result in misdiagnosis [6][7].Most of the studies evaluated Staphylococcus aureus colonization exclusively in term infants. Colonization patterns in preterm infants are not well described. Infants who developed symptomatic MRSA infection during their Neonatal Intensive Care Unit (NICU) stay were of lower gestational ages and birth weights than those who did not develop infection. These more premature, low-birth-weight infants likely have mucosal and skin barriers that are more easily disrupted, or immune systems that are less mature than those of infants born at later gestational ages and larger birth weights [1]2- Case Presentation and History:Our patient was a product of a spontaneous twin pregnancy for a 28 year old mother, with a normal fetomaternal scan. No antenatal steroids were given due to emergency delivery by the Caesarean Section due to preterm labour. Antenatal Polymerase Chain Reaction (PCR) Screening for Maternal MRSA and Group B Streptococcus in our institution was negative. Our preterm baby girl was the second of a pair of twins, birth weight 1100 grams at birth, with an Apgar score of 6 and 7 at 1 and 5 minutes respectively. She was intubated due to Respiratory Distress Syndrome (Figure 1) and received one dose of Surfactant. The baby needed high Oxygen requirements, high Inspiratory Pressures, so a second dose of surfactant was given. She was extubated on day 5 of life to High Flow Nasal Cannula (HFNC).On day 17 of life, she had increasing intercostal recessions, fluctuating Oxygen saturation and mottling. Laboratory investigations including C Reactive Protein, Procalcitonin, Liver, Renal and Coagulation profiles had been collected in addition to both a Tracheal Aspirate and a Blood Culture.Hemodynamically our patient was stable, and no inotropes were used. An Echocardiogram showed a Large Patent Ductus Arteriosus which was managed with Paracetamol.Regarding her Nutrition, she received Total Parenteral Nutrition (TPN) until reaching full enteral feeds (feeds were stopped during periods of clinical deterioration and then resumed after stabilization.).She had Umbilical Venous and Arterial Catheters inserted after birth and removed by day 5 of life. A Percutaneous Inserted Central Catheter (PICC) was inserted thereafter on day 5 of life.

Keywords: Primary Synovial Sarcoma, Bone, kidney transplant, immunosuppression, PET-CT

Primary Extramedullary Acute Promyelocytic Leukemia Presenting as Cauda Equina Syndrome: A Rare Case Report and Diagnostic ChallengeAmir Ali 1 , Marc Ringor 2 , Arbab Khalid 2, Diana Garcia 3, Ravishankar Konchada 4, Ramalingam Ratnasabapathy5, Yuna Chae 6, Arman Melikyan6, George Yaghmour 71 University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA2 Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada, USA3 Private Practice, Family Medicine Physician, Santa Maria, California, USA4 Radiology, St. Rose Dominican Hospitals, Las Vegas, Nevada, USA5 Medical Oncologist and Hematologist, Horizon Ridge Henderson, Henderson, Nevada, USA6 USC Mann School of Pharmacy, Los Angeles, California, USA7 Internal Medicine, Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California Norris Comprehensive Cancer Center, Los Angeles California, USA* Correspondence , George Yaghmour, USC Norris Blood and Marrow Transplant Program, 1441 Eastlake Ave, NTT suite 3467, Los Angeles, CA 90033. Email: George.yaghmour@med.usc.edu

A document by Camille Basurto. Click on the document to view its contents.

Title: Approach to peritoneal malignancies and Small round cell sarcomas

A document by B. Dhouha. Click on the document to view its contents.

Title PageIntracholecystic Papillary Neoplasm of the Gallbladder Neck with High-Grade Dysplasia: A Diagnostic and Surgical ChallengePradeep Yadav1, Sajan Yadav2, Kshitiz Parajuli2, Aron Neupane2, Amit Kumar Sah2, Neha Yadav31 Department of Surgery, Birat Medical College Teaching Hospital, Morang, Nepal2 Birat Medical College Teaching Hospital, Morang, Nepal3 Medical Officer, Nepal Medical College and Teaching Hospital, Kathmandu, NepalCorrespondence: Kshitiz Parajuli, Birat Medical College Teaching Hospital, Morang, Nepal Email: kshitizparajuli12@gmail.com, Phone: +977-9804044451.

Authors and Author ContributionsSaad Sidiq1sasidiq@utmb.edu; Conceptualization, Formal analysis, Visualization, Writing - original draft, Writing - review & editingAlexander Konopnicki1amkonopn@utmb.edu; Conceptualization, Formal analysis, Writing - original draft, Writing - review & editingKevin Pham1kevpham@utmb.edu; Conceptualization, Formal analysis, Writing - original draft, Writing - review & editingJeremy Bergman1jdbergma@utmb.edu; Conceptualization, Formal analysis, Writing - original draft, Writing - review & editingAman Srivastava1kssrivas@utmb.edu; Formal analysis, Writing - original draft, Writing - review & editingManaswitha Thota2manaswitha.thota@vcuhealth.org; Conceptualization, Formal analysisMathews Roy1matroy@utmb.edu; Conceptualization, Formal analysis, Writing - original draft, Writing - review & editingTravis Brachtenbach3tjbracht@utmb.edu; Supervision, Writing - review & editingTejo Musunuru3,4temusunu@utmb.edu; Supervision, Writing - review & editing1 Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States of America2 Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America3 Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, United States of America4 Department of General Oncology Division of Cancer Medicine, MD Anderson Cancer Center, Houston, TX, United States of America

A document by Amrit Neupane. Click on the document to view its contents.

Comorbidity of Cutis Verticis Gyrata in a Young Patient with Early Onset of Schizophrenia and Positive Familial HistoryElaheh Arabpour 1 | Reza Bidaki1,2 | Fatemeh Attari 3*1Research Center of Addiction and Behavioral Sciences , Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Email: dr.e.arabpour@gmail.com | 2Department of psychiatry, Research Center of Addiction and Behavioral Sciences, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Email: reza_bidaki@yahoo.com | 3Shahid Sadoughi University of Medical Sciences, International Campus, Yazd, Iran. Email: negin.attari@yahoo.com

Nodular fasciitis in breast in an elderly woman with a giant mass: a case report

IntroductionPigmented purpuric dermatosis (PPD), also known as capillaritis comprises a group of chronic inflammatory vascular disorders characterized by petechiae, red-brown macules and patches, often localized to the lower extremities. [1,2] Variations exist in the clinical presentation and histopathologic findings of PPD subtypes. First described in 1896, purpura annularis telangiectodes of majocchi (PATM) is a clinical variant of PPD known to affect mainly children and young adults, predominantly women. [3] Characteristically, PATM presents reddish-brown annular macules, with telangiectasia, and a centrifugal spread [2,4]. Although PATM is mainly confined to lower and upper extremities, we present a case of a generalized PATM, extending beyond the typical areas of involvement. This case is particularly noteworthy as it appears to be associated with the initiation of sertraline, suggesting a potential drug-induced etiology. Given the rarity of such presentation, this report aims to expand the clinical spectrum of PATM/PPD and provide insight into possible triggers.

jabbrv-ltwa-all.ldf jabbrv-ltwa-en.ldfIntroductionHydatid disease (HD) is a parasitic infection caused by the larval stage of Echinococcus granulosus and is endemic in regions with close contact between livestock and dogs, such as the Middle East, South America, Africa, and Central Asia [1–3]. The liver (70%) and lungs (20%) are the most affected organs[4–6]. However, unusual locations including the spleen, kidney, brain, bone, and soft tissues may also be involved[7,8].Soft tissue hydatid disease is rare and comprises only 0.5%–5% of all hydatid cysts [9]. The gluteal region is an extremely uncommon site and may be confused with lipomas, abscesses, or soft tissue tumors [10,11]. Subcutaneous HD without visceral involvement is referred to as primary soft tissue hydatidosis, and its diagnosis can be challenging due to its rarity and nonspecific presentation [12,13].This report presents a rare case of primary gluteal subcutaneous hydatid cyst in a young woman, highlighting the importance of clinical suspicion, imaging, surgical approach, and adjuvant medical therapy.

A document by Abel Wubie. Click on the document to view its contents.