Background Orthokeratinized Odontogenic Cyst (OOC) is a rare, developmental odontogenic cyst which was considered in the past to be a variant of Odontogenic keratocyst (OKC) later renamed as keratocystic odontogenic tumor (KCOT). The treatment of OOC is by enucleation and the prognosis, following enucleation is excellent with a recurrence rate of less than 2%. On the other hand, OKC has a recurrence rate between 8 and 25% after enucleation. Thus it is important to differentiate between the two entities. Methods All cases reported in our section as OOC during the period 2013 to 2018 were retrieved from the surgical pathology files and slides were reviewed by the authors. All cases which met the histological criteria for OOC were included. Results A total of 10 cases were included. 70% patients were males, ages ranged from 23 to 60 years, with mean age of 38.9 years. 70% of cases were located in the mandible and 90% patients presented with swelling. Radiologically, 90% cases were unilocular, all were radiolucent lesions. Mean size was 4.0 cm. Histologically, all cases demonstrated the classic microscopic features. Follow-up was available in 8 patients. All were treated by enucleation. All 8 were alive with no recurrences over a follow-up period ranging from 7 to 62 months. Conclusions OOC has a better prognosis than OKC and needs to be differentiated from OKC due to differences in treatment and prognosis. Large majority of our cases presented with swelling and occurred in the mandibles of young males. All were radiolucent and most were unilocular. All were treated by enucleation and no recurrences occurred over follow up period ranging up to 62 months. Our findings were similar to those described in other published series.
The disc-macula: disc diameter (DM:DD) ratio is the ratio of the horizontal distance between the center of the optic disc and the macula to the mean diameter of the optic disc, as evaluated from fundus photographs. The diagnosis of optic nerve hypoplasia may be difficult in cases in which the optic discs are slightly reduced In size, or when the double ring sign is absent and the condition is bilateral. The DM : DD ratio was calculated for six eyes of five children with ophthalmoscopically obvious optic nerve hypoplasia, 12 eyes of six children in whom the diagnosis of optic nerve hypoplasia was equivocal (but established by visual field examination and retinal red free photography), 13 eyes of eight children with optic atrophy, and 25 eyes of 17 children with normal optic discs. The DM:DD ratio was found to be significantly higher for both groups with optic nerve hypoplasia than for those with optic atrophy and the normal controls. For practical purposes, when the DM:DD ratio Is greater than 3.0, the diagnosis of optic nerve hypoplasia should be seriously considered.
Primary testicular diffuse large-B cell lymphoma (DLBCL) is an uncommon and aggressive disease with predominant manifestation in the older age. Herein, we report a case of 47-year-old male patient who presented with three months history of left testis swelling. The patient underwent unilateral (left) radical orchiectomy. Histopathological examination revealed extensive involvement and replacement of testicular parenchyma by a tumor composed of large discohesive sheets of cells with pleomorphic, hyperchromatic nuclei and prominent nucleoli. Immunohistochemical (IHC) staining showed reactivity for LCA & Pan B (CD20) and negativity for OCT 3/4, SALL4 and Inhibin. Moreover, Pan T (CD3) highlighted reactive T-cells. These features rendered the diagnosis of DLBCL of testis. The hybrid 2-[fluorine-18] fluoro-2deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated two para-aortic FDG avid lymph nodes on the left side at the level of L2 vertebra. Presently, the patient has been planned for doxorubicin-based chemotherapy (i.e., cyclophosphamide, doxorubicin, vincristine and prednisone; CHOP) along with intrathecal Methroxate (MTX), which would presumably improve the prognosis. Our study would expand the pool of this uncommon tumor towards its better understanding.
The results of 62 repeat penetrating keratoplasties (41 eyes) over a 10-year period are presented. The common indications for the primary graft include herpes simplex keratitis, Pseudophakic bullous keratopathy, aphakic bullous keratopathy, Fuch's endothelial dystrophy, and chronic ulceration. All cases of pseudophakic bullous keratopathy had the iris-clip type of intraocular lens. Graft failure was attributed to rejection, endothelial failure, recurrent ulceration, herpes simplex keratitis, melting, trauma, and recurrent dystrophy. At the end of the study period 28 grafts (68%) were clear and 13 (32%) were opaque. Visual improvement occurred in 28 eyes (68%), deterioration in four (10%), and six (15%) remained unchanged (visual result was not available in three eyes). These data are encouraging in terms of visual outcome and graft clarity in cases of repeat penetrating keratoplasty. Comparison is made between the primary indications and outcome of these re-grafts and eyes requiring only one graft. Initial indications for grafting in both groups were similar, other than keratoconus, which was a significantly more common indication in eyes that required only one graft. Final visual results were better in those eyes undergoing only one graft, compared with those that required multiple surgery.
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