Acanthosis nigricans as a paraneoplastic syndrome. Case reports and review of literature.

Acanthosis nigricans (AN) is a skin disorder characterized by focal or diffuse hyperkeratosis symmetric hyperpigmentation of the skin and oral cavity mucosa. Various neoplasms, especially gastrointestinal adenocarcinomas are associated with acanthosis nigricans (AN malignant). Chemotherapy may cause regression of skin lesions. The etiology of AN is not clear. A role of growth factors such as melanocyte stimulating hormone alpha, transforming growth factor alpha, and insulin-like growth factor 1 has been discussed. Two cases of AN have been reported in this paper. Both have been associated with gastric adenocarcinoma. In the first case skin lesions were sensitive to chemotherapy (until cancer progression), while in the second case treatment had to be discontinued because of cardiotoxity without regression of skin lesions.

[Diagnostic difficulties in diagnosis of splenic abscesses]. / Trudnosci diagnostyczne w rozpoznawaniu. ropni sledziony.

We report an 18-year old patient with hypochromic anaemia and subfebriles states and long-persisting despite symptomatic treatment. On admission he presented body proportions similar to Marfan syndrome. Hypochromic anaemia and positive inflammatory markers were present along with negative results of serologic and microbiological assays. Hormonal parameters, as well as karyotype were normal. Among several imagining procedures, ultrasound and CT of the abdomen revealed areas in the spleen suggestive of proliferative disease or abscesses. Bone marrow examination was normal. Because of high probability of the disease limited to the spleen and deteriorating clinical state of the patient, splenectomy was performed. After the operation significant improvement of the health state of the patient was observed. Histopathological evaluation showed splenic abscesses. However, anamnesis and accessory examinations did not reveal their etiology. This report is an example of possible difficulties in diagnosing splenic abscesses, as well as supports grounds for surgical intervention in chosen cases.

Focal lesions in the ultrasonographic examination of the spleen as a symptom of various disease statuses: literature survey and case descriptions.

BACKGROUND: Ultrasonography (US) is an easy and non-invasive technique of visualizing spleen. Thanks to its repeatability, it plays an important role in the diagnostics of, among others, developmental anomalies, such as supernumerary or lobated spleens, as well as focal lesions. It is also used in monitoring the size of the spleen and it considerably facilitates diagnosis after certain injuries. Thanks to the application of the Doppler method, it also facilitates the diagnostics of pathologies within the spleen's vessels. CASE REPORT: This paper presents six different cases of focal lesions in the spleen, including lesions in the course of histiocytosis, in the course of sarcoidosis, as well as isolated abscesses of the spleen. The authors also present the case of a spleen with numerous metastatic lesions, the case of a near-splenic cyst, and the case of asymptomatic focal lesions of unknown origin. In all the presented cases, the lesions were accidentally revealed during ultrasonographic examination, which was the starting point for further diagnostics. CONCLUSIONS: Though rare, morphologic lesions in the spleen should always be taken into consideration when performing a routine ultrasonographic examination of the abdominal cavity, and the organ itself should not be ignored. US is a widely available, noninvasive, and useful method for diagnosing splenic abnormalities, including focal changes.

[Primary lymphoma of the thyroid--diagnostic and treatment problems. The case report]. / Pierwotny chloniak tarczycy--trudnosci diagnostyczne i terapeutyczne. Opis przypadku.

The authors present the case of primary malignant thyroid lymphoma and problems with distinguishing between Hashimoto's thyroiditis and primary thyroid lymphoma. Primary malignant thyroid lymphoma (PMTL) is a rare disease and difficult to diagnose. The appearance of PMTL may be preceded by Hashimoto's thyroiditis. The biopsy is useful but often only surgical treatment allows to establish diagnosis. The treatment of PMTL includes surgical treatment, chemo- and radiotherapy. The prognosis depends on the disease period.