A Cervical Thymic Cyst in an Adult Female; A Case Report and Comprehensive Literature Review.

Introduction: Cervical thymic cyst accounts for (0.3-1) % of cervical cysts in children and are usually present during the first decade of life with few reported cases in adults. Herein, we present a 34-year-old female with a cervical thymic cyst. We conducted a review of all the previously reported cases as well. Case presentation: The patient complained of an anterolateral neck swelling that was noticed one year ago. It was a soft, fluctuant, mobile, non-tender swelling in the midline and the right side of the lower neck. Neck ultrasonography revealed a large thin-walled cyst, with no internal septa, echoes, or solid parts. Post-contrast MRI of the neck showed a well-defined, oblong-shaped, lobulated cystic lesion just beneath the strap muscle. The cyst extended caudally to the superior border of the anterior mediastinum at the level of the upper border of the manubrium sterni. The patient underwent excision of the swelling under general anesthesia via Kocher's collar neck incision. Connection with the thymus gland was detected behind the manubrium sterni which was separated. Pathological examination showed prominent thymic tissue confirming the diagnosis of a cervical thymic cyst. Conclusion: Adult cervical thymic cyst is very rare with a few cases reported in the literature. Surgical excision in symptomatic patients is the treatment of choice. Paper's main novel aspects: • A rare presentation of a cervical thymic cyst in an adult. • A comprehensive literature review including all the previously reported cases in one table.

Implications of narrowband ultraviolet B treatment on psoriasis severity and serum levels of angiopoietin-2: A cross-sectional controlled study.

BACKGROUND: Psoriasis is a chronic inflammatory hyper proliferative skin disease. Angiogenesis play an important role in Psoriasis pathogenesis, occurring even before plaque formation. Angiopoietins play an important role in angiogenesis and hence are described as angiogenic factors. AIMS: To evaluate serum levels of angiopoeitin 2 (Ang-2) following treatment with narrowband ultraviolet B (NBUVB) in patients with moderate-severe plaque psoriasis and correlate it to psoriasis area and severity index (PASI). PATIENTS/METHODS: This cross sectional study included 38 patients complaining of moderate to severe plaque psoriasis and 38 healthy controls. Psoriasis area and severity index (PASI) was determined and was correlated to serum levels of Ang-2 before and after treatment with NBUVB. RESULTS: PASI scores and serum values of angiopoietin 2 demonstrated a significant difference between the baseline and at the end of the 12 weeks NBUVB treatment. A statistically significant positive correlation was established between psoriasis severity and Ang-2 serum levels before and after treatment. CONCLUSION: The study demonstrated a potential contribution of Ang-2 in the pathogenesis of psoriasis, as well as its usefulness as a biomarker of psoriasis severity.

Therapeutic implications and role of serum sphingolipids on psoriasis severity after narrow band ultraviolet B treatment: A cross sectional controlled study.

Sphingolipids (SLs), are structural components of the skin that contribute to the regulation of the proliferation and differentiation of keratinocytes as well as regulation of the skin epidermal barrier. A prospective cross sectional comparative controlled study was designed to evaluate the serum level of sphingosine 1 phosphate (S1P) and ceramide (CER) before and after narrow band ultraviolet B (NBUVB) in psoriatic patients. The study included 32 patients presented with psoriasis and 32 healthy age and sex matched control volunteers. (S1P and CER) levels were measured before and after NBUVB sessions for psoriatic patients and their levels were correlated to psoriasis area and severity index (PASI) improvements. PASI scores and serum values of the studied sphingolipids demonstrated a significant difference between the baseline and at the end of the 12 weeks NBUVB treatment. A statistically significant positive correlation was established between psoriasis severity and S1P serum levels before and after treatment while no correlation was observed between psoriasis severity and CER serum levels. Decreased total CER and increased S1P serum levels reflect altered sphingolipid metabolism in psoriasis and can be predictors of disease severity.