Primary Cutaneous Follicle Center Lymphoma of the Eyelid in a Young Man.

A 20-year-old male presented with a fast-growing nodule in his right inferior eyelid, no relevant history was obtained. Final histopathologic diagnosis of primary cutaneous follicle center lymphoma (CD20+, CD10+, bcl6+, bcl10+, mum1+, PAX5+, and bcl2-) was determined. The patient had a complete negative systemic work-up, and 3 cycles of consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy were completed. The initial histopathologic diagnosis had been a non-Hodgkin diffuse large B-cell lymphoma which is an infrequent lymphoma type for this location too. To our knowledge, this is the youngest person reported presenting with an eyelid primary cutaneous follicle center lymphoma.

Validation of a semiological maneuver for the evaluation of spastic dynamic clubfoot: an approach based on the judgment of experts in physical medicine and rehabilitation.

BACKGROUND: The evaluation of spasticity of the plantar flexors in dynamic clubfoot is difficult due to the almost invariable concomitance of Achilles clonus, which is a semiological artifact. No description was found in the literature of a technique for inhibiting or reducing the discharge generated by Achilles clonus to allow a correct assessment of spasticity in this segment. AIM: Validation of a semiological maneuver that reduces or eliminates Achilles clonus for the adequate evaluation of spastic dynamic clubfoot. DESIGN: Multicenter cross-sectional study. SETTING: The study was conducted by 12 experts in physical medicine and rehabilitation from various clinics and hospitals in Colombia. POPULATION: Thirty-five adults with dynamic spastic clubfoot and Achilles clonus secondary to upper motor neuron syndrome who attended outpatient consultation at physical medicine and rehabilitation services in eight cities Colombia from August 2020 to February 2021. METHODS: The usual method for examining spastic plantar flexors was compared to the proposed semiological maneuver to evaluate the proposed maneuver contributed to the reduction or elimination of Achilles clonus to allow a more accurate measure of spasticity in this segment. Four dimensions were evaluated by the experts: time required for application, simplicity, effectiveness and clinical utility. A cutoff point was established to identify whether the maneuver was unacceptable, acceptable or excellent. RESULTS: The application of the maneuver was able to reduce or eliminate Achilles clonus as a masking sign of spasticity in the plantar flexors in 100% of the patients and was considered excellent in 77.1% of the cases for the four dimensions evaluated. A decrease in the degree of spasticity of the plantar flexors was observed when the maneuver was applied. CONCLUSIONS: The proposed maneuver reduces or eliminates Achilles clonus, which could allow a more precise evaluation of spasticity in this segment. All of the experts recommended including the maneuver in routine examinations of this population. CLINICAL REHABILITATION IMPACT: Applying the proposed maneuver could improve the selection of patients with spastic dynamic clubfoot who require specific treatment.

Primary splenic angiosarcoma with capsular rupture and disseminated: a case report.

Primary splenic angiosarcoma is a malignant vascular neoplasm with a short-term fatal prognosis in most cases, with nonspecific symptoms and usually in advanced stages. We present the case of a 49-year-old man with clinical history of chronic diarrhea and weight loss, in which it was identifies splenomegaly. The histopathological study disclose the diagnosis of primary angiosarcoma of the spleen, with spread to the liver, lung, and lymph nodes. The patient was discharged after undergoing splenectomy, with palliative treatment. Because the rarity of this neoplasm, there is limited experience regarding the best management with a significant impact on patient survival.

El angiosarcoma esplénico primario es una neoplasia vascular maligna con un pronóstico mortal a corto plazo en la mayoría de los casos, que se presenta con síntomas inespecíficos y usualmente en estadios avanzados. Presentamos el caso de un hombre de 49 años, con historia de diarrea crónica y pérdida de peso, en el que se identificó esplenomegalia. El estudio patológico reveló el diagnóstico de angiosarcoma primario de bazo, con diseminación en hígado, pulmón y ganglios linfáticos. Debido a la rareza de esta neoplasia existe poca experiencia en relación con el mejor manejo con impacto significativo en la supervivencia de los pacientes.