Primary Hodgkin Lymphoma of the Breast: A Case Report and Literature Review Examining the Use of Different Chemotherapy Regimens.

Primary classic Hodgkin lymphoma (HL) of the breast is a rare type of breast disease. The diagnosis is mostly confirmed by an excisional biopsy. The first line of treatment commonly used for Hodgkin lymphoma is doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Our case report is about a 48-year-old lady who was diagnosed with bilateral breast Hodgkin lymphoma following an excisional biopsy and was treated with brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (BV-AVD). The patient responded positively after the initiation of the regimen. There is scarce data on the classic Hodgkin lymphoma of the breast, and even with the wide use of first-line treatment using ABVD, the disease is still difficult to manage. Hence, patients with breast masses should be screened for classic HL of the breast, and larger studies are needed to establish specific treatment guidelines concerning HL of the breast to prevent relapse and other complications.

Sepsis Associated With Aggressive Cutaneous Angiosarcoma.

Cutaneous angiosarcoma is an aggressive tumor most commonly presenting on the head and neck. In this case report, we describe the presentation of sepsis secondary to an aggressive and rapidly expanding wound, located in a sun-protected area on the body, in a patient with multiple concurrent comorbidities. Treatment was tailored toward targeting the causative organisms, as well as identifying the histologic morphology of the pathologic legion. Histopathology and immunohistochemistry were used to confirm the diagnosis of cutaneous angiosarcoma, and the patient-centered decision surrounding palliative chemotherapy is outlined.

An Atypical Presentation of Burkitt Lymphoma Presenting As Large Intra-abdominal Masses Compressing Multiple Organs With Peri-Pericardial Involvement in an HIV Patient: A Case Report and Literature Review.

Many types of malignancies have been associated with immunodeficiency states, especially patients who are HIV positive. Burkitt lymphoma (BL) is one of those malignancies associated with HIV and it presents in three varieties. The endemic form is primarily seen in children, and it is associated with the Epstein-Barr virus (EBV). In this form, patients with Burkitt's present with a large jaw mass. The second variety is seen in older adults. These patients usually present with abdominal and pelvic masses. This subtype is more prominent in the United States. The third variety of BL is seen in patients who are HIV positive. In this case report, we present an atypical presentation of BL secondary to undiagnosed HIV/AIDS with a very large tumor burden causing compressive symptoms. This case will further guide healthcare professionals in diagnosing BL, which presents uniquely in high-risk populations. This report will also serve as a review of the diagnosis and treatment options of BL.

Iron-Deficiency Anemia in an Elderly Caucasian Female: An Unusual Colonoscopic Finding.

Iron-deficiency anemia (IDA) is common in the elderly population. It is usually the result of chronic gastrointestinal diseases which could lead to iron losses, malabsorption, or both. IDA is most often the result of chronic gastrointestinal blood loss caused by esophagitis, gastritis, ulcer, colon cancer, pre-malignant polyps, or angiodysplasia. We are presenting a unique case that describes the unusual finding of intestinal helminthiasis in an elderly patient during endoscopic evaluation for IDA. It also touches on the risk factors, clinical manifestations, diagnosis, and treatment of enterobiasis.

A New Solution to a Rare Problem of Implantable Cardiac Device Hypersensitivity.

For this research, we have considered a case of a man aged 60 years who developed painless fluid accumulation in the implantable cardiac defibrillator (ICD) pocket site. The cardiovascular implantable electronic device initially appeared to be infected, but it was eventually determined that the cause was an allergic reaction, and a novel solution was implemented. For patients with nickel allergies, treatment typically includes avoiding nickel or replacing with gold-plated devices with new leads. Because of the subclavian vein thrombosis, the gold-plated generator was not replaced. ICD generators were covered with antibiotic-coated envelopes while waiting for the replacement. Hypersensitivity to cardiac devices was effectively treated with this technique. By routinely using the envelope, the very rare incidence of device hypersensitivity could further be reduced.

Rare but Fatal Case of Cavitary Pneumonia Caused by Alcaligenes Faecalis.

Alcaligenes faecalis is a gram-negative bacterium that is commonly found in the environment. This pathogen is usually transmitted in the form of droplets through ventilation equipment and nebulizers, but transmission through direct contact has also been documented in few case reports. This pathogen can cause rare but fatal infections including appendicitis, abscesses, meningitis, bloodstream infection, endocarditis, and post-operative endophthalmitis. Pan drug resistance to all commercially available antibiotics has been emerging globally. We present the case of a 66-year-old male who had respiratory failure along with multiple comorbidities. A large cavitary lesion caused by pan drug-resistant Alcaligenes faecalis was found on chest imaging. Despite the treatment with broad-spectrum antibiotics, the clinical outcome was very poor.

Elevated troponin in patients with acute stroke - Is it a true heart attack?

Although the prognostic value of a positive troponin in an acute stroke patient is still uncertain, it is a commonly encountered clinical situation given that Ischemic Heart Disease (IHD) and cerebrovascular disease (CVD) frequently co-exist in the same patient and share similar risk factors. Our objectives in this review are to (1) identify the biologic relationship between acute cerebrovascular stroke and elevated troponin levels, (2) determine the pathophysiologic differences between positive troponin in the setting of acute stroke versus acute myocardial infarction (AMI), and (3) examine whether positive troponin in the setting of acute stroke has prognostic significance. We also will provide an insight analysis of some of the available studies and will provide guidance for a management approach based on the available data according to the current guidelines.

Menopausal hormone treatment in postmenopausal women: risks and benefits.

Our objectives in this review were to examine the relevant menopausal hormone treatment (MHT) trials in postmenopausal women during the past 3 decades, provide an insight analysis of these studies from a clinical point of view, determine the efficacy and applicability of hormone therapy in the prevention of cardiovascular diseases, and provide suggestions on the use of MHT as a cardiovascular disease prophylaxis based on the available data. MHT may have a more complicated role in cardiovascular protection, and there is a need for further research to elucidate the dose and type of estrogen, its route of administration, the time of MHT initiation, and the preventive role of MHT in women's health.