Clinical and Pathological Findings on Intoxication by Yellow Phosphorus After Ingesting Firework Cracker: A Rare Case of Autopsy.

Yellow phosphorus is a toxic substance used in the production of firework cracker, fireworks, ammunition and agricultural dung. When ingested, it shows its effects mainly in the liver, the kidneys, and the brain. A four-year-old girl had died as a result of acute hepatic failure caused by ingesting a firework cracker. The case showed high levels of hepatic enzymes, along with non-specific signs such as nausea, vomiting and diarrhea. Autopsy revealed diffuse microvesicular steatosis in the liver and disseminated degeneration in the proximal tubules of the kidneys. In cases with concomitant hepatorenal failure and cardiovascular collapse, death is inevitable. However, when only hepatic failure develops, hepatic transplantation may be lifesaving. Although intoxication from ingesting yellow phosphorus has a very high rate of mortality, forensic cases are extremely rare in the literature.

Follicular dendritic cell sarcoma associated with hyaline-vascular Castleman's disease.

Follicular dendritic cell sarcoma (FDCS) of the head and neck region, associated with Castleman's disease (CD), is an extremely rare entity. To the best of our knowledge, we report the first case demonstrating the transformation of the former into the latter as documented in the same lymph node disection material. A 45-year-old female presented to our hospital with right sided neck swelling. Radiologic imaging showed a well defined 3.5 x 3.5 cm mass of soft tissue at the right side of the neck with multiple bilateral cervical lymph nodes. Excision of the right neck mass with lymph node disection was performed. Microscopic examination and immunohistochemical findings showed features of follicular dendritic cell sarcoma. The associated lymph nodes exhibited changes consistent with hyaline-vascular type CD, follicular dendritic cell hyperplasia and foci of overgrowth in which FDCS possibly evolved. This report confirms the evolving of FDCS in the setting of follicular dendritic cell hyperplasia occurring in Castleman's disease.

Effects of tolterodine and trospium chloride on renal damage induced by partial upper urinary tract obstruction.

OBJECTIVE: To examine the efficacy of trospium chloride and tolterodine on the renal parenchymal inflammatory process and upper urinary dilation in rats with chronic partial upper urinary tract obstruction. MATERIALS AND METHODS: A total of 32 rats were divided into 4 groups: group 1, control; group 2, obstruction; group 3, obstruction plus tolterodine; and group 4, obstruction plus trospium chloride. In all groups, except for group 1, partial upper urinary tract obstruction was induced by embedding the upper quarter of the right ureter into the psoas muscle for 14 days. At the end of the experiment, the rats were killed. The catalase, malondialdehyde, and protein carbonyl levels were determined in renal tissue. Tubular dilation and parenchymal inflammation were evaluated using hematoxylin-eosin staining. Smooth muscle actin and cytoglobin were examined with immunohistochemical staining. RESULTS: The obstruction group demonstrated severe pelvic dilation and parenchymal inflammation and increased smooth muscle actin staining in the wall of upper urinary tract (P <.05). The treatment of the rats with tolterodine and trospium chloride markedly attenuated the inflammatory alterations and reduced tubular dilation. This treatment also reduced elevated oxidative stress product levels and restored the depleted renal antioxidant enzyme. CONCLUSION: These findings imply that increased renal pelvic pressure can contribute to renal parenchymal injury in chronic pelvic upper urinary tract obstruction. Antimuscarinic medications such as tolterodine and trospium chloride exert renoprotective effects, probably by prevention of pelvic pressure increases.

Cystic adrenal lymphangioma--report of two cases and review of the literature.

Cystic adrenal lymphangiomas are very rare, benign vascular lesions. They are usually found during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. We report two cases of cystic adrenal lymphangiomas. They presented with flank discomfort, hypertension and flushing. Their laboratory findings were in normal limits. Radiologic imagings showed adrenal cystic neoplasm and the patients underwent adrenelectomy. Histopathologic examination and immunohistochemical findings were consistent with lymphangioma. Cystic lymphangiomas may imitate other adrenal neoplasms and must be kept in mind in the clinical and radiologic differential diagnosis of cystic adrenal lesions.