Concomitant Cytomegalovirus Viraemia in Multisystem Inflammatory Syndrome in Adults (MIS-A) following COVID-19.

Multisystem inflammatory syndrome in adults (MIS-A) is recognised as an infrequent complication of coronavirus disease 2019 (COVID-19). This syndrome occurs following COVID-19 infection in some individuals and is characterised by inflammation of multiple organ systems, such as the heart, liver, bowel, and lymph nodes. Cytomegalovirus (CMV) viraemia is associated primarily with immunosuppression. In COVID-19 patients, it has been reported in severe and critical cases. We present a case of an adult patient diagnosed with MIS-A and concomitant CMV viraemia.

[Astrocytoma and epilepsy. Clinical case]. / Astrocitoma y epilepsia. Caso clínico.

BACKGROUND: Pilocytic astrocytoma is a rare tumour, usually occurring in paediatric ages, and mainly located in the posterior fossa. It can cause hydrocephalus and intracranial hypertension and, less frequently, seizures, or a focal neurological deficit. The main imaging study by magnetic resonance imaging, which shows a tumour with solid and cystic components without peri-lesional swelling. The election treatment is surgical, and the patient is considered cured if a total resection is accomplished. CLINICAL CASE: The case is presented of 22-year-old female patient with a supratentorial pilocytic astrocytoma and epilepsy. Histopathology reported a low grade glial proliferation, with an extensive fibrillar matrix, small cells without atypia, extensive calcifications and piloid areas consisting of bipolar fusiform cells, and some Rosenthal fibres. There were also spongiotic areas consisting of multipolar cells and associated microcysts. The final report was a pilocytic astrocytoma. CONCLUSIONS: Pilocytic astrocytoma is more frequent in paediatric patients and in the posterior fossa. The case presented is of a young female adult with supratentorial location, making it a special case. The surgery achieved a total resection. The long-term prognosis is good, but it is necessary to perform a follow-up, particularly in adult patients because of a higher risk of recurrence.

Sarcoma histiocítico. Estudio inmunohistoquímico de 6 casos / Immunohistochemical study of 6 cases of histocytic sarcoma

Introducción. El sarcoma histiocítco (SH) es una neoplasia poco frecuente con características morfológicas e inmunohistoquímicas de diferenciación histiocítica. Material y métodos. Presentamos 6 casos de SH. Se estudiaron cortes con hematoxilina y eosina y con inmunohistoquímica para CD45, CD163, CD68, lisozima, CD21, EMA, CD1a, S-100, CD20, Ki-67, HMB45 y CK AE1-3. Resultados. Cuatro pacientes fueron hombres y dos mujeres (edad promedio, 25,7 años; rango, 8 meses-64 años). Dos tumores se originaron en ganglios linfáticos, y los demás fueron extraganglionares (glándula parótida, meninges, tejidos blandos de tibia derecha y yeyuno). Los tumores estaban compuestos por células epitelioides medianas a grandes, pleomórficas, con abundante citoplasma eosinófilo, núcleos irregulares y nucléolos prominentes con áreas fusiformes focales y citofagocitosis. Las mitosis variaron con una media de 10 por campo de ×40. Un tumor presentó infiltrado inflamatorio prominente. Todos los tumores fueron positivos a CD45, CD163 y CD68 (KP1 y PGM-1), y 5 expresaron lisozima. Dos tumores fueron focal y débilmente positivos para S-100 y uno para CD1a; todos fueron negativos al CD 20, CD21, HMB45 y a CKAE1-3. Discusión. Para el diagnóstico de SH debe utilizarse CD45 además de dos antígenos asociados a macrófagos y ausencia de marcadores B, T, de melanoma y citoqueratinas(AU)

Introduction. Histiocytic sarcoma (HS) is a rare malignant neoplasm showing the morphologic and immunohistochemical features of histiocytic differentiation. Material and methods. We present 6 cases of HS diagnosed in 4 female and 2 male patients with ages ranging from 8 months to 64 years (medium age of 25.7 years). Sections were stained with hematoxylin and eosin and immunohistochemistry was performed using CD45, CD163, CD68, lysozyme, CD21, EMA, CD1a, S-100, CD20, Ki-67, HMB45 and CK AE1-3. Results. Two tumours arose from lymph nodes and 4 were extranodal (parotid gland, meninges, soft tissues and jejunum); all were composed of sheaths of medium to large pleomorphic epithelioid cells with abundant eosinophilic cytoplasm, irregular nuclei and prominent nucleoli with focal spindle cell features and cytophagocytosis. Mitotic features varied from case to case with a medium of 10 per 10 HPF. All tumours were positive for CD45, CD163 and CD68 (KP1 and PGM-1), 5 expressed lysozyme, 2 showed weak focal positivity for S-100 and 1 for CD1a. All were negative for CD 20, CD21, HMB45 and CK AE1-3. Discussion. It is important that the diagnosis of HS be based on immunohistochemical markers that should include CD45 plus two specific macrophage-associated antigens and the lack of the B-cell, T-cell, as well as cytokeratins and melanoma markers(AU)

Multiple desmoplastic cellular neurothekeomas localized to the face of a 16-year-old boy.

Cellular neurothekeomas are relative uncommon benign dermal tumors of uncertain histogenesis. Most commonly they arise as a solitary papule or nodule on the head and neck or upper trunk of young adults with a slight female predominance. There has been only 1 previous report of multiple neurothekeomas. The patient described herein was a 16-year-old otherwise healthy boy who presented with approximately 30 facial papules that arose over the course of 6 months and progressively enlarged. Histologically, all lesions were composed of spindled to epithelioid cells, but varied in the degree of cellularity and dermal sclerosis. Immunohistochemical staining showed that the cells of interest expressed S100A6, vimentin, CD63 (NKI/C3), PGP 9.5, and factor XIIIa and were negative for CD68, glial fibrillary acid protein (GFAP), S-100, HMB-45, epithelial membrane antigen, actin, and CD57 consistent with a diagnosis of multiple desmoplastic cellular neurothekeomas.

Multiple desmoplastic cellular neurothekeomas localized to the face of a 16-year-old boy.

Cellular neurothekeomas are relative uncommon benign dermal tumors of uncertain histogenesis. Most commonly they arise as a solitary papule or nodule on the head and neck or upper trunk of young adults with a slight female predominance. There has been only 1 previous report of multiple neurothekeomas. The patient described herein was a 16-year-old otherwise healthy boy who presented with approximately 30 facial papules that arose over the course of 6 months and progressively enlarged. Histologically, all lesions were composed of spindled to epithelioid cells, but varied in the degree of cellularity and dermal sclerosis. Immunohistochemical staining showed that the cells of interest expressed S100A6, vimentin, CD63 (NKI/C3), PGP 9.5, and factor XIIIa and were negative for CD68, glial fibrillary acid protein (GFAP), S-100, HMB-45, epithelial membrane antigen, actin, and CD57 consistent with a diagnosis of multiple desmoplastic cellular neurothekeomas.

Abdominoplasty with anchor plication and complete lipoplasty.

BACKGROUND: Combined abdominoplasty and lipoplasty is fequently performed to achieve improved body contour in a single surgical session. OBJECTIVE: We describe a procedure that combines vertical and transverse plication of the abdominal fascia with lipoplasty of the anterior abdominal wall. METHODS: Lipoplasty of the anterior abdominal wall was performed using a superwet technique. The amount of extracted fat ranged from 200 to 6000 mL. Abdominoplasty was performed using traditional methods. Plication of the abdominal fascia combined the traditional longitudinal method with a half-moon plication, located in the lower abdomen. RESULTS: Seventy-six women ranging in age from 20 to 62 years underwent combined abdominoplasty and lipoplasty between January 2002 and January 2003. Patient satisfaction was rated as excellent in 74 cases. Patient satisfaction was rated as good in the other 2 cases, in which the only patient complaint was hypertrophy of the scar, which improved over time with the use of massage. Seromas developed in 8 patients (10.52%) and were treated successfully by syringe extraction. CONCLUSIONS: Benefits of combining abdominoplasty with lipoplasty include reduction of abdominal flap volume, improvement in the final quality of the scar, and improved tissue contraction. The anchor plication reduces strain in the abdominal fascia and also diminishes the vertical abdominal diameter, facilitating the descent of the flap.