Diagnostic Accuracy of Immunologic Biomarkers for Accurate Diagnosis of Bloodstream Infection in Patients with Malignancy: Procalcitonin in Comparison with C-Reactive Protein.

PURPOSE: To calculate the diagnostic value of C-reactive protein (CRP) and serum procalcitonin (PCT) levels for the pathologic presence of microbes in the bloodstream of patients with malignancy, in comparison with blood culture. Methodology. Blood culture (by reference method) and assay results of PCT and CRP of febrile patients, with clinical suspicion to blood infections, were collected. Statistical aspects of PCT and CRP tests were evaluated. RESULTS: Data from 255 cases were gathered. The area under the curve for differentiating bacteremia from nonbacteremia for PCT (0.741) was superior to that of CRP (0.612). Amongst the different cutoffs of PCT and CRP, the cutoff of ≥1.17 ng/ml and >47 mg/l had the sensitivity of 75 and 58.3%, the best NPV of 91.5% and 81.3%, and the best specificity of 79.9% and 72.8%, respectively. Discussion. Despite statistically nonsignificant results, PCT seems to be a superior indicator to CRP for rejecting the presence of microorganism in bloodstream. For PCT, the cutoff value of 1.17 ng/ml (bacteremia from nonbacteremia) had the highest NPV value of 91.5% in malignant patients, suspicion of sepsis.

Small intestinal myxoma presented with bowel obstruction, a rare case report.

INTRODUCTION: Myxomas are rare benign mesenchymal neoplasms and mostly occur in cardiac atrium and with lower prevalence, appear in sinonasal tract, gnathic bone, skin and joints. Benign primary tumors of the small intestine are quite unusual accounting about 3% of all the gastrointestinal tract neoplasms. PRESENTATION OF CASE: In this report, we present a rare case of small intestinal myxoma in a 43-year-old man complicated by ileoileal intussusception causing bowel obstruction. The patient underwent segmental resection of small bowel and the histopathologic evaluation confirmed the diagnosis of small intestinal myxoma. DISCUSSION: Among benign primary neoplasms of small bowel, Solitary intestinal myxomas are extremely rare mostly locate in submucosal layer of gastric, small bowel and rarely in cecum. To our knowledge only 9 cases of small bowel myxoma is reported in the literature so far. CONCLUSION: This case report aware surgeons and pathologists about rare occurrence of intestinal myxomas as a differential diagnosis of intussusception.

Mixed mucinous cystadenoma with benign Brenner tumor in a huge ovarian mass, a case report and review of literature.

INTRODUCTION: Different groups of neoplastic and non-neoplastic conditions can involve the ovaries and the epithelial tumors such as mucinous and Brenner tumors are the most common neoplastic category. PRESENTATION OF CASE: This is a case report of a huge mucinous cystadenoma associated with benign Brenner tumor in 56 years old postmenopausal woman, who presented with a fast-growing abdominopelvic mass, and also review the reported articles about this rare occurrence. DISCUSSION: Mucinous neoplasms of the ovary represent 10%-15% of ovarian neoplasms and about 80% of them are benign. Brenner tumors are a relatively rare epithelial neoplasm of the ovary that usually affect postmenopausal women and most of them are benign. Coexistence of Mucinous cystadenoma with Brenner tumor is a rare mixed epithelial tumor of the ovary. CONCLUSION: This case report and review of article create awareness among the surgeons and pathologists about rare occurrence of combination of ovarian mucinous cystadenoma and benign Brenner tumor.

Association of soluble interleukin-2 receptor alpha with laboratory parameters and clinical findings of hemophagocytic lymphohistiocytosis patients: The first report from South of Iran.

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is caused by overactivation of immune system. Gene mutations, infections, malignant, and autoimmune trigger the development of the disease. MATERIALS AND METHODS: Clinical data and peripheral blood samples of 21 patients suspected of HLH were collected in Shiraz Medical Centers 2017-2018. Peripheral blood samples were analyzed for soluble interleukin-2 receptor alpha (sIL2Rα) marker (sCD25), and the results were compared with 36 normal controls as well as comparison with clinical findings and other laboratory parameters. RESULTS: Twenty-one patients (11 males and 10 females) with an average age of 5.2 were investigated. In this study, peripheral blood samples were taken from 16 newly diagnosed patients before treatment, and five were posttreatment blood samples. The mean sIL2Rα level before treatment in 16 patients was 9023 pg/ml. The mean peripheral blood sample of the 36 controls was 3025 pg/ml. The mean of the five posttreatment samples was 4198 pg/ml. Significant difference between pretreatment and the control group was observed. However, no significant difference was detected between after treatment samples and the control group. By comparing the sIL2Rα levels between patients with increased aspartate aminotransaminase (AST) and patients with normal AST level, there was a significant difference in the amount of IL2Rα level. CONCLUSION: This study highlights the importance of IL2Rα marker in the diagnosis and follow-up, during treatment and suppression. Furthermore, a significant difference with respect to AST level requires further investigation.