Schistosomiasis and associated iron-deficiency anaemia presenting decades after immigration from sub-Saharan Africa.

Chronic schistosomiasis and its intestinal manifestations can lead to anaemia. However, schistosomiasis resulting in anaemia is rare in the UK. This report aims to raise awareness of schistosomiasis in immigrants to the UK and prevent missed diagnosis.

Leishmania spp. in Perianal Adenoma in a Dog: A Case Report.

The coexistence of Leishmania and neoplasia is rarely reported in humans or animals. An 11-year-old intact male mixed-breed dog was presented with a well-demarcated perianal nodule. Cytologic and histopathologic examinations were consistent with the diagnosis of perianal gland adenoma with the presence of Leishmania amastigotes. The dog was considered to be in leishmaniasis stage C (clinically diseased) based on clinical signs, laboratory findings, and serological status. A novel finding in this case report was the presence of Leishmania within the perianal adenoma, probably resulting from an atypical dissemination of the parasites.

Two case reports of pituitary adenoma associated with Toxoplasma gondii infection.

The involvement of the pituitary in cases of toxoplasmosis has been described in the literature only rarely. This is the first report to describe pituitary adenoma in association with Toxoplasma gondii infection. The two patients were 43 and 19 year old women. Radiological examination revealed tumours in the sellar region. Microscopically, the tumours consisted of small homogeneous polygonal or round cells. Toxoplasma cysts were found among the tumour cells, a finding confirmed by Toxoplasma gondii specific antibody immunohistochemistry. The association between pituitary adenoma and toxoplasma raises the possibility that T gondii might be involved in the development of certain cases of pituitary adenoma.

Congenital hyperthyroidism caused by a solitary toxic adenoma harboring a novel somatic mutation (serine281-->isoleucine) in the extracellular domain of the thyrotropin receptor.

Activating somatic mutations in the thyrotropin (TSH) receptor have been identified as a cause of hyperfunctioning thyroid adenomas, and germline mutations have been found in familial nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. All mutations reported to date have been located in the transmembrane domain. We now report an example of an activating mutation in the extracellular, TSH-binding domain, found in a male infant with congenital hyperthyroidism due to a toxic adenoma. The pregnancy was remarkable for fetal tachycardia. Scintigraphic studies demonstrated a large nodule in the right lobe, and a hemithyroidectomy was performed at the age of 2 yr. Direct sequencing of the TSH receptor gene revealed a mutation in one allele resulting in a substitution of serine281 by isoleucine (Ser281--> Ile) in the extracellular domain. The mutation was restricted to the adenomatous tissue. Expression of the Ser281--> Ile mutation in vitro revealed an increase in basal cAMP levels. Affinity for TSH was increased by the mutation. These findings demonstrate that activating mutations can also occur in the extracellular domain of the TSH receptor, and support a model in which the extracellular domain serves to restrain receptor function in the absence of TSH or antibody-induced conformational changes.

Histological classification of schistosomal egg induced polyps of colon and their clinical significance. An analysis of 272 cases.

272 cases of schistosomal egg induced polyps collected from mass-screening for colorectal carcinoma in Jiashan County were divided into 3 types: fibrous type (FT), mixed type (MT) and epithelial proliferative type (ET). The ET was characterized by crypt elongation, hypertrophy, variation in size, disorderly arrangement, as well as the high percentage of atypical hyperplasia (64.9%). The coexistence and transition between inflammatory reactive hyperplastic and neoplastic crypts were noticed. By HID/AB staining, sialomucins were increased in ET, CEA and PNA receptors detected by the ABC method were present in 18/20 and 6/18 of ET respectively. The mucin expression of ET was similar to that of adenomas. It is likely that a spectrum of ET, atypical hyperplasia and adenoma may exist. We suggest that the patients with ET, especially those with atypical hyperplasia, should be regarded as "risk group", and close follow-up is needed.