Background
Pulmonary alveolar proteinosis is a rare interstitial lung disease characterized by accumulating surfactant materials in the alveoli. The autoimmune form is by far the most common in adults, while in the pediatric age group, the vast majority of cases are congenital. We report a case of an adolescent patient diagnosed with autoimmune pulmonary alveolar proteinosis, which is unusual in this age group.
Case presentation
A-15 year-old Saudi male presented to the emergency department with a history of shortness of breath and low oxygen saturation. High-resolution computed tomography of his chest showed a global crazy-paving pattern. Autoantibodies against granulocyte-macrophage colony-stimulating factor were detected in his serum. A diagnosis of the autoimmune form of pulmonary alveolar proteinosis was confirmed after excluding other possible causes. The patient improved after he underwent whole lung lavage under general anesthesia, and he was independent of oxygen therapy after 6 months of follow-up.
Conclusion
The autoimmune form of pulmonary alveolar proteinosis is rare in the pediatric age group and should be considered when no apparent cause of this disease was found. Whole lung lavage should be the first treatment modality offered in this setting with close follow-up and monitoring.
Objectives: To study the clinical pattern and histopathological features of testicular biopsies and orchiectomy specimens in patients presenting to a tertiary hospital. Methods: A 5 year retrospective study was conducted in histopathology section of Department of Laboratory Medicine, ACH from January 2014 to December 2018 on testicular tissue specimens (biopsies and orchiectomies). The histopathological diagnosis was made based on light microscopy followed by special stains and immunohistochemistry wherever indicated. Results: A total of 91 specimens were received in ACH during this 5 year period. The specimens comprised of cryptorchidism (16 cases), trauma (5 cases) , vascular lesionstesticular torsion (17 cases), inflammatory lesions (11 cases), Sertoli cell only syndrome (2 cases), spermatogenic arrest (3 cases), atrophy (3 cases), obstructive causes leading to infertility (3 cases), cyst (2 cases) , tumors (28 cases) and 1 was unremarkable .Inflammatory lesions were predominantly abscess (6 cases), granulomatous orchitis (5 cases).Tumors were classified into germ cell tumors-seminomas (10 cases), mixed germ cell tumors (9 cases) , teratomas (3 cases), embryonal carcinoma (2 cases), spermatocytic tumors (3 cases), Leydig cell tumor (1 case). Conclusions: The present study revealed that testicular masses were predominantly neoplastic mostly malignant primarily seen in age group 21-30 years with seminomas constituting 35.7 % of all tumors. Testicular torsion leading to ischemic necrosis were also seen in a large number of cases. Testicular biopsies might help in determining etiology of infertility which could be cryptorchidism, spermatogenic arrest, Sertoli cell only syndrome, atrophy and post testicular obstruction.
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