Incremental benefit of three-dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery.

Left atrial appendage aneurysm (LAA AN) is a rare disease entity, which can be congenital or acquired in nature. We report an adult patient with LAA AN presenting with anginal chest pain in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over the two-dimensional (2D) technique in providing a more comprehensive assessment of the lesion. A literature review of the salient features of LAA AN is also provided in a tabular form.

Prosthetic mitral inflow mimicking severe aortic regurgitation (revisited). An echocardiographic challenge.

Assessing aortic regurgitation (AR) severity in patients with mitral valve prosthesis may pose an echocardiographic challenge. We present a case of mild AR in whom difficulty occurred in judging its severity due to eccentric mitral prosthetic inflow signals filling practically completely the proximal left ventricular outflow tract in diastole mimicking severe AR. Frame-by-frame analysis of two-dimensional transthoracic echocardiographic images using a small sector depth and width was helpful in clarifying the true severity of AR.

CD98 expression is decreased in papillary carcinoma of the thyroid and Hashimoto's thyroiditis.

AIMS: CD98 is a component of the large neutral amino acid transporter (LAT), which is a cell surface amino acid transporter. CD98 also binds to and activates beta(1)-integrin, promoting anchorage-independent growth. CD98 expression is increased in a variety of carcinomas but its distribution in the normal and neoplastic thyroid gland has not been reported. The aim was to examine the immunohistochemical expression of CD98 in normal and diseased thyroid tissue. METHODS AND RESULTS: One hundred and forty thyroid cases were selected from the archives of the Department of Pathology, including normal controls, neoplasms (follicular adenoma, follicular carcinoma and papillary carcinoma) and non-neoplastic conditions (multinodular goitre, Graves' disease and Hashimoto's thyroiditis). Immunohistochemistry for CD98 was performed and each case was scored for proportion of cells and intensity of immunoreactivity. In normal thyroid, there was moderately strong expression of CD98 in the lateral cell membranes of follicular cells. A similar pattern of expression was seen in follicular adenoma, minimally invasive follicular carcinoma, multinodular goitre and Graves' disease. In most cases of papillary carcinoma and in the inflamed areas of Hashimoto's thyroiditis, expression of CD98 was decreased. CONCLUSIONS: CD98 expression is down-regulated in thyroid papillary carcinoma; this may relate to the better prognosis associated with many of these tumours.

Intraventricular hemorrhage in ICSI twin pregnant woman with thrombasthenia: A rare case report.

Intraventricular hemorrhage is bleeding into the fluid-filled areas (ventricles) inside the brain. The condition occurs most often in babies that are born premature, growth restricted and twins pregnancies. Abnormal platelets number or functions are responsible greatly for this condition. We presented here a pregnant woman had thrombasthenia at 28 weeks of gestation with ultrasound findings of intraventricular haemorrhage in her both ICSI twin's fetuses.

Repair of very severe tricuspid regurgitation following detachment of the tricuspid valve.

We report on the case of 5-year-old girl with severe tricuspid regurgitation following previous repair of double outlet right ventricle with subaortic ventricular septal defect, performed through trans-atrial approach using detachment of tricuspid valve leaflet. The severe tricuspid regurgitation was found to be due to dehiscence at the site of the previous detachment and was repaired using a pericardial patch. In this report, we discuss the relative merits and risks of using this technique.

Trends and Challenges in Pathology Practice: Choices and necessities.

The way we provide healthcare is influenced by ongoing experiences, increased knowledge, new discoveries and scientific as well as technological advances. The rapid pace of important developments that have taken place in recent years have significantly influenced our choices of the ways we provide our health service. Like other medical specialties, pathology and its practice have had to respond to the rising needs and challenges within the health service in general and those facing the speciality in particular. This article addresses some of the challenges, particularly those which are unique to pathology. It discusses the choices that are available to different pathology departments depending on their individual circumstances.