Histological evaluation of mitotic and apoptotic index, Ki67, and p53 expression in repeated biopsies contributes to predicting the value of the actual treatment and may be useful to institute alterations in therapy.
An 11-year-old boy with Klinefelter syndrome had Castleman disease (CD) of plasma cell type develop. Nonregulated antibody production mimicked systemic lupus erythematosus (SLE). Hepatitis C virus (HCV) infection caused significant disease worsening. The patient was treated with a daily dosage of 2 million units/m2 of IFN-alpha. Dramatic clinical improvement and decreasing autoimmune phenomenon were observed. HCV RNA were cleared. Hypergammaglobulinemia did not change. The boy has been living for 8 years with his disease. Plasma cell type CD can mimic collagenosis. Disease worsening is caused by HCV, though it can be reversed with IFN-alpha. Klinefelter syndrome may be a genetic susceptibility factor for CD in some cases.
About ten cases of filariosis have recently been recorded in the Hungarian medical literature, six of them caused by Dirofilaria repens. Dirofilaria repensis a mosquito-transmitted filaroid worm in the subcutaneous tissue of dogs and cats in the temperate areas of the Old World. It accidentally infects man, too, and can remain unidentified due to physicians, poor knowledge of the parasite. In the last two years six new Dirofilaria repensinfections have been found in various parts of the country: five localised dermally and one in the deep tissues. Two of the cases might have been acquired in Italy during summer travels. Four patients, however, have never been abroad, these cases must be considered autochtonous infections. The thickness of the multilayered cuticle of the worm, diameter of the body and the size, form and number of the longitudinal ridges on its surface are used in the histological diagnosis of the the parasite.
Considering the data and including two patients of the authors, there exist only 18 authentic cases of primary malignant melanoma of the lower respiratory tract and/or the lung. The tumor was localized
in the endobronchial space in 7 cases and only once in the trachea. Endobronchial localization, together
with the involvement of the surrounding lung tissue, was found in two cases, whereas in 8 patients,
the tumor was found exclusively in the lung parenchyma. Successful resection could be
performed in 14 of the 18 cases. Survival was influenced primarily by operability, and on actual size
and extension. The authors question the role of the obduction in the diagnostic criteria, because most
of the survivors, even up to ten years postsurgery were considered primary. Apart from the various
imaging methods, diagnostic endoscopy (i.e., bronchoscopy) and the histology of the biopsy material
are major aides in the diagnosis of primary character, location, and operability, as well as in the
elaboration of the surgical plans, than it is usual in cases of other tumors.
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