Inflammatory myofibroblastic tumor is a rare benign lesion whose tumor origin is now proven. It represents 0.7% of all lung tumors. We report the case of a three-year-old child who suffered from a chronic cough with recurrent respiratory infections. Chest X-ray and computed tomography revealed the presence of a left lower lobe lung mass. After pneumonectomy, histological examination combined with immunohistochemical study discovered an inflammatory myofibroblastic tumor.The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8722069326962972.
Le syndrome d'activation macrophagique (SAM) est une atteinte multisystémique, liée à une intense activation du système immunitaire correspondant à une infiltration plus ou moins diffuse des tissus par des macrophages activés. Il associé des signes cliniques (fièvre, hépato splénomégalie, adénopathie) et des anomalies biologiques (bi ou pancytopénie, cytolyse hépatique, élévation des LDH, coagulopathie) à une hémophagocytose .Il peut être primaire chez l'enfant ou secondaire à diverses affections. Nous rapportons le cas d'un adolescent de 16 ans admis au service de pédiatrie pour leucopénie fébrile avec altération de l'état général et des lésions érythémateuses circulaires étendues au niveau des membres inférieurs. Le diagnostic de syndrome d'activation macrophagique était retenu devant les signes cliniques, biologiques et cytologiques compatibles. La biopsie cutanée de ces lésions était en faveur d'un lymphome T sous-cutané type panniculite. A travers ce travail nous insistons sur la particularité de cette observation clinique vu la rareté de ce type de lymphome T sous cutanée et beaucoup plus au cours de cette tranche d'âge, ainsi sur l'intérêt de penser au lymphome T sous cutanée devant un SAM qui pourrait mettre en jeu le pronostic vital, lorsque il est associé à des lésions sous cutanée érythémateuses.
AIM: The aim of the study was to improve the quality of pain management in Moroccan pediatric oncology units, the Moroccan Society of Paediatric Haematology/Oncology initiated a national quality improvement project in 2014 with the support of the Lalla Salma Foundation for Prevention and Treatment of Cancer.
METHODS: To assess the current situation of pain management in Moroccan pediatric oncology patients, two cross-sectional surveys were conducted, involving patient/parental proxies and health-care providers’.
RESULTS: The first survey concerned 108 care providers from five institutions. The second survey covered 155 children with cancer from the five Moroccan pediatric oncology units. Among them, 145 reported suffering from pain, which patients/families attributed to the underlying cancer (n = 85), to procedures and treatment (n = 46), or to both the cancer and procedures/treatment (n = 19). Procedural pain was mainly related to lumbar puncture and bone marrow aspirate. The majority of patients/parents reported that pain negatively impacted their emotional, physical, and social functioning. The majority of parents requested further information and communication about pain management.
CONCLUSION: Both health-care providers and families of children with cancer in Morocco report need for pain management improvement, including in institutional and educational practices. This current baseline data have informed the development of our ongoing project including continuing education, training, and practice policies development.
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