Diffuse Proliferation Research Articles

Urinary protein and renal pathological features in children with immunoglobulin A vasculitis with nephritis and hypercoagulability

To study the association of hypercoagulability with urinary protein and renal pathological damage in children with immunoglobulin A vasculitis with nephritis (IgAVN). Based on the results of coagulation function, 349 children with IgAVN were divided into a hypercoagulability group consisting of 52 children and a non-hypercoagulability group consisting of 297 children. Urinary protein and renal pathological features were compared between the two groups, and the factors influencing the formation of hypercoagulability in children with IgAVN were analyzed. Compared with the non-hypercoagulability group, the hypercoagulability group had significantly higher levels of urinary erythrocyte count, 24-hour urinary protein, urinary protein/creatinine, urinary immunoglobulin G/creatinine, and urinary N-acetyl-β-D-glucosaminidase (P<0.05). The hypercoagulability group also had a significantly higher proportion of children with a renal pathological grade of III-IV, diffuse mesangial proliferation, capillary endothelial cell proliferation, or >25% crescent formation (P<0.05). The multivariate logistic regression analysis showed that capillary endothelial cell proliferation and glomerular crescent formation >25% were associated with the formation of hypercoagulability in children with IgAVN (P<0.05). The renal injury in IgAVN children with hypercoagulability is more severe, with greater than 25% crescent formation and increased proliferation of glomerular endothelial cells being important contributing factors that exacerbate the hypercoagulable state in IgAVN.

Clinical characteristics and surgical outcomes in pediatric progressive restrictive strabismus

Objective: To investigate the clinical features, imaging manifestations, histopathological characteristics, and surgical outcomes in pediatric progressive restrictive strabismus. Methods: A retrospective case series study was conducted, including data from 9 cases (9 eyes) of pediatric progressive restrictive strabismus treated at Tianjin Eye Hospital from June 2017 to October 2022. The study compared the degree of globe protrusion in both eyes, changes in eyelid fissure height during internal and external rotation in the primary gaze, summarized clinical characteristics, and analyzed intraoperative conditions, surgical outcomes and postoperative histopathological results of strabismus correction surgery. Statistical analysis was performed using Wilcoxon signed-rank test and Friedman two-way analysis of variance. Results: All 9 cases involved unilateral onset, with 4 males and 5 females. Three cases affected the right eye, and six affected the left eye. Onset age ranged from 2 to 40 months. The degree of globe protrusion in the affected eyes was 13.00 (12.00, 13.00) mm for the right eye and 12.00 (12.00, 13.50) mm for the left eye, with no statistically significant difference (Z=-1.00, P=0.317). There were no significant changes in eyelid fissure height during internal rotation [8.00 (7.25, 8.00) mm], primary gaze [7.50 (7.00, 8.00) mm], and external rotation [8.00 (7.75, 8.00) mm] in the affected eyes (χ²=1.00, P=0.607). No apparent abnormalities were observed in head CT or MRI scans, serum, or immunological tests. However, orbital CT or MRI scans indicated thickening of different extraocular muscle bellies. Six out of nine cases underwent strabismus correction surgery, and postoperative examination revealed restriction in eye movement despite achieving orthophoria in the primary gaze. Tissue pathology of three cases showed increased collagen fiber proliferation in one, scattered bundles of smooth muscle fibers amid diffuse collagen fiber proliferation in another, and abnormal proliferation of striated muscle fibers with varying diameters, increased paired box (PAX)7-positive satellite cells expressing slow muscle myosin in the third case. Conclusions: Pediatric progressive restrictive strabismus presents with restrictive changes, without significant alterations in globe protrusion and eyelid fissure height. Imaging examinations reveal thickening of the extraocular muscle bellies in the affected eye. Although strabismus correction surgery improves eye position, postoperative eye movement remains restricted. Histopathological findings in some cases show abnormal proliferation of skeletal muscle fibers or collagen fibers.

Clinicopathological study of epithelioid and spindle cell rhabdomysarcoma with EWSR1/FUS-TFCP2 fusion

Objective: To investigate the clinicopathological and genetic features of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion. Methods: The clinical, morphological and immunohistochemical features of 14 cases of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion diagnosed from January 2019 to December 2022 in the Department of Pathology, Foshan Traditional Chinese Medicine Hospital, Foshan, China were retrospectively analyzed. The cases were all subject to FISH or next generation sequencing for analysis of molecular genetic features. The literature was reviewed. Results: There were 5 males and 9 females, with the age at presentation ranging from 6 to 36 years (mean, 22 years). Tumors occurred in the head and neck (9 cases), pelvic region (2 cases), bladder (one case), right humerus (one case), and the abdominal wall, humerus and pubic at the same time (one case). Presenting symptoms varied by location but often included pain or discomfort. Most of the patients showed aggressive radiographic features with soft tissue extension. The tumors had a median size of 6.6 cm (range, 2-23 cm). The tumors were poorly defined and irregularly shaped. Microscopic examination showed diffuse proliferation of spindle or epithelioid cells. While morphologically high-grade tumors displayed obvious cytological atypia, a high mitotic count and tumor necrosis, low-grade tumors grew in sheets and fascicles composed of spindle, epithelioid cells with moderate or abundant amounts of eosinophilic cytoplasm, without pronounced cytological atypia. The tumor cells expressed Desmin, MyoD1, and Myogenin, as well as ALK, EMA, and CKpan. EWSR1/FUS-TFCP2 gene fusion was detected in 14 cases with next generation sequencing and confirmed by FISH. Six cases had EWSR1-TFCP2 fusions and 8 cases showed FUS-TFCP2 fusions. Follow-up information was available in 13 patients, ranged from 5 to 37 months. At the end of follow-up period, 7 patients died of the disease. Six patients were alive:two cases had local recurrences and metastases, two cases of recurrences, one case of metastasis and one case without recurrences and metastasis. Conclusions: Epithelioid and spindle cell rhabdomysarcomas with EWSR1-TFCP2 or FUS-TFCP2 fusion show a very aggressive clinical course, and more commonly occur in the head and neck. Their genetic hallmark is the presence of EWSR1/FUS-TFCP2 fusions. Familiarity with its clinicopathological characteristics is helpful in avoiding misdiagnoses.

A case of Candida meningitis in a patient with CARD9 deficiency: an autopsy report

Here we present the case of a 23-year-old female with a history of onychomycosis and oral thrush since childhood. She presented with a gradual onset of headache, and cerebrospinal fluid (CSF) analysis on admission revealed an elevated mononuclear cell count. Hydrocephalus was observed on brain MRI. Candida albicans (C. albicans) was detected in the CSF, and antifungal treatment was initiated to diagnose of Candida meningitis. Due to an insufficient therapeutic response, intraventricular administration of liposomal amphotericin B initiated; however, the lesions persisted. Subsequently, the patient experienced repeated occlusions of the ventriculoperitoneal shunt tube, ultimately dying from a bacterial shunt infection. Autopsy findings revealed diffuse fungal proliferation on the surface of the brainstem and ventricular walls. Genetic testing confirmed a diagnosis of CARD9 deficiency. Although CARD9 deficiency is a rare disease, genetic testing should be considered when primary immunodeficiency is suspected.

Hyperplasia of Brunner's glands as a cause of gastrointestinal bleeding in a young patient: endoscopic approach.

Brunner's gland hyperplasia or Brunneroma is a rare benign proliferative lesion of the small intestine. It is often incidentally discovered during endoscopy or imaging studies. The endoscopic presentation can be nodular, polypoid, or a diffuse glandular proliferation with thickening of the duodenal wall, which can be mistaken for malignant neoplasia. It rarely causes gastrointestinal bleeding. Is presented a case of a 25-year-old man who presented with melena and anemia secondary to Brunner's gland hyperplasia.

An Assessment of Primary Cardiac Lymphoma: A Rare Case in Indonesia

Introduction: : Primary cardiac lymphoma (PCL) is an uncommon malignancy with a high mortality rate. The disease is commonly found as non-Hodgkin’s lymphoma (NHL), mainly located in the heart or pericardium. PCL is difficult to diagnose due to its unspecific clinical manifestations. Echocardiography, computed tomography (CT) scanning, and magnetic resonance imaging (MRI) can help in diagnosing PCL, but histopathological examination is the gold standard for a definitive diagnosis. Therefore, this study aimed to compare the case of malignant cardiac lymphoma and MRI with earlier related literature. Case Presentation: This study reported a case of PCL in 52 years old male who came to Cipto Mangunkusumo Hospital with intra cardiac tumour and underwent surgery with median sternotomy. CT scan of the chest showed a mass in the left atrial and no significant abnormalities in other organs. Histopathological examination showed the morphologic feature of diffuse monotonous proliferation of atypical large B lymphocytes. The lymphoma diagnosis was supported by immunohistochemistry including CD20, MUM1, and Ki67 positivity. Conclusions: PCL was difficult to diagnose due to nonspecific clinical manifestations. Immunostaining helped to diagnose more specifically and determine the treatment plan. Histologic finding from PCL was mostly Diffuse Large B-cell lymphoma (DLBCL) and the prognosis was poor. Therefore, identifying the subtype of DLBCL was important for prognostic.

PATHOMORPHOLOGICAL CHANGES IN THE ORGANS OF CATS CAUSED BY ALIMENTARY LYMPHOMA. CLINICAL CASES

The article presents the results of clinical, ultrasonographic, pathomorphological and immunohistochemical studies of two random cases of alimentary lymphoma in 9- and 12-year-old domestic cats. Clinical signs of the disease were similar and characterized by anorexia, cachexia, vomiting and diarrhea that appeared in different periods of the disease. The mucous membranes of the oral cavity and eyes were icteric, the abdomen was visually enlarged, palpation revealed nodular thickenings in the abdominal cavity. During the ultrasound diagnostics, diffuse multiple non-encapsulated anechoic formations with uneven edges and growth of tumorous tissue into the intestinal wall were visualized. In another cat, there was an encapsulated formation of a hypoechoic fine-grained structure with well-defined vascularization.&#x0D; From the moment of the preliminary diagnosis until the very death, the cats were kept in the clinic under supervision. After the death, an autopsy was performed with the selection of material for histopathological examination. Organs’ fragments were fixed in 10% aqueous solution of neutral formalin and Carnois fluid. Histological preparations were made according to the generally accepted methods. Immunophenotyping of lymphoma type was performed using CD3 (T-cell) and CD79a (B-cell) markers. During the pathological autopsy, an increase in mesenteric lymph nodes, their compaction, and focal thickening of the small intestine wall were revealed. The histological examination showed that jejunum was the most infiltrated intestinal segment, in which massive, diffusely placed monomorphic lymphoblastic cells were localized in the mucous membrane lamina, submucosa and muscle layers. The submucosal layer vessels were sharply dilated, filled with erythrocytes; the muscles of the inner circular layer were swollen. The outer (longitudinal) muscle layer of the jejunum thickened significantly and was intensively infiltrated by lymphoblastic cells.&#x0D; Typical diffuse lymphoblastic proliferations were also detected in the cortical substance of lymph nodes and lymphoid nodules. Stasis and significant expansion of the marginal sinus vessels were visualized too. In addition, moderate mononuclear lymphoblastic infiltrates were detected in the pancreas parenchyma with their perivascular location. Immunohistochemically, a significant positive expression of CD3 cells was detected both in the jejunum mucous membrane and the marginal sinus area, around the germinal centers of the lymph nodes, which indicated a T-cell type of lymphoma.

Unveiling the Unexpected: A Metastatic AFP-Producing Carcinoma of Gastric Origin Masquerading as Hepatocellular Carcinoma on Liver Biopsy

Abstract Introduction/Objective Alpha-fetoprotein (AFP)-producing gastric carcinoma (AFPGC) is a rare and aggressive subtype of gastric cancer characterized by the production of AFP. It is well known for its morphological heterogeneity, displaying a wide spectrum of histological patterns that can mimic other tumor types including hepatocellular carcinoma (HCC), which is similarly associated with AFP elevation, complicating its identification. We report a case of an AFPGC encountered in a liver biopsy. Methods/Case Report A 60-year-old male presented with chronic abdominal pain and unintentional weight loss over the past few months with associated mild constipation and nausea. The patient denied melena or hematochezia. An abdominal CT scan revealed multiple round lesions within the liver, the largest measuring 4.9 cm, without evident primary site. AFP and CEA were elevated at 2883.0 ng/ml and 36.7 ng/ml, respectively. A liver biopsy demonstrated a proliferation of polygonal cells with eosinophilic to clear cytoplasm in a predominantly trabecular and focally acinar/pseudoglandular growth pattern. The tumor cells were positive for Glypican-3, SALL4, CDX-2 and AE1/AE3 while negative for HepPar-1 and Arginase-1. While the tumor's immunoprofile and histomorphology along with elevated serum AFP suggested poorly differentiated HCC, the multifocality of lesions raised a possibility of a metastatic AFPGC. Subsequent upper endoscopic ultrasound prompted by pathology report revealed a large gastric mass and the biopsy showed conventional adenocarcinoma with similar immunoprofile. Colonoscopy showed a cecal polyp consisting of a diffuse proliferation of signet ring cells without a precursor, consistent with metastatic AFPGC. Results (if a Case Study enter NA) NA Conclusion AFPGC is known for its morphologic heterogeneity and mimicry of other entities. This case highlights the importance of considering metastatic AFPGC when tumors with unusual presentation show SALL4 positivity in the setting of elevated AFP. Hepatoid morphology of AFPGC in the liver can be a diagnostic pitfall especially when the primary site is unknown.

Clear Cell Sarcoma masquerading as Malignant Melanoma: A Case Report

Abstract Introduction/Objective Clear cell sarcoma (CCS) is a rare and diagnostically challenging soft tissue tumor that can mimic other malignancies with melanocytic differentiation. Histologically it shows diffuse sheets of clear cells with scattered melanin pigment in a subset of cases. Other morphologies have been described but contain atleast a portion of clear cell features. We report a case of CCS with unusual histomorphology, highlighting the importance of incorporating cytogenetic and immunohistochemical studies to accurately diagnose this tumor. Methods/Case Report We present a case of a 49-year-old male with a left lateral knee mass associated with pain and swelling for one year. A core biopsy revealed a diffuse proliferation of pleomorphic spindle and atypical epithelioid cells. These atypical cells exhibited intranuclear vacuoles, variable prominent nucleoli, abundant dusky cytoplasm, and increased mitotic activity. Immunohistochemical studies were positive for S100, SOX10, and Melan-A (patchy), suggesting a melanocytic differentiation. However, no expression of Preferentially Expressed Antigen in Melanoma (PRAME) or BRAF V600E mutation was noted. Given the clinical history and lack of cutaneous melanocytic lesion, clear cell sarcoma was considered in the differential diagnosis. Fluorescence in situ hybridization (FISH) studies revealed Ewing sarcoma region 1 (EWSR1) gene rearrangement in neoplastic cells, confirming the diagnosis of CCS. Results (if a Case Study enter NA) NA Conclusion The tumor lacked definitive histologic features including clear cell features, demonstrating the variability in histomorphology that can be encountered with CCS. Distinction of CCS from melanoma is of clinical significance as treatment significantly differs. Accurate diagnosis requires the incorporation of cytogenetic and immunohistochemical studies to differentiate it from melanocytic neoplasms. Variability in histomorphology of CCS can pose, as is evident in our case, as a diagnostic pitfall, and CCS should be considered in the differential diagnosis of unusual non-cutaneous melanocytic proliferations that lack clear cell features and show compelete spindle and epithelioid morphology.

Isolated bronchial hemangioma causing recurrent hemoptysis: A case report.

The development of bronchial hemangioma in adults is rare, and massive hemoptysis due to diffuse vascular proliferation of bronchial hemangioma is fatal. A case of a 29-year-old woman kept massive hemoptysis even after being underwent repeated interventional embolization for recurrent massive hemoptysis. Eventually, the patient was performed the operation of right upper lung lobectomy and bronchial hemangioma with extracorporeal membrane oxygenation support and was followed up for 4 years without recurrent hemoptysis. Bronchial hemangioma. For patients with bronchial angiomas bonded with bronchial artery-pulmonary arteriovenous fistulae, the early surgical resection is recommended if bronchial artery embolization (BAE) is considered ineffective.

Thoracic SMARCA4-Deficient Undifferentiated Tumors With Unusual Presentations: A Case Series.

Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a recently described aggressive neoplasm of young smokers defined by SMARCA4 inactivating mutations and characterized by cells with rhabdoid morphology, high mitotic activity, and abundant necrosis. Describe and compare 3 unusual presentations of SMARCA4-UT in older adults, including one presenting as a metastatic lesion mimicking a primary bone sarcoma. Discuss the molecular characteristics of SMARCA4-UT and their relationship to nonsmall-cell lung carcinomas with SMARCA4. Three patients with SMARCA4-UTs were identified utilizing a natural language search in CoPath. hematoxylin and eosin sections from all patients as well as Papanicolaou-stained slides and Diff-Quik-stained slides for the first patient were examined. A broad range of immunostains, including BRG1/SMARCA4, were evaluated. Molecular testing was performed via next-generation sequencing. The 3 patients were aged 58, 70, and 70 years. All had a significant smoking history. The first patient presented with an iliac bone mass and mediastinal lymphadenopathy, the second with mediastinal adenopathy, and the third with a paratracheal mass. All 3 tumors showed a diffuse proliferation of pleomorphic, rhabdoid cells with high mitotic activity and tumor necrosis. SMARCA4 was lost in all 3 tumors by immunohistochemistry. Molecular testing revealed SMARCA4 alterations in the first 2. Thoracic SMARCA4-UT should be considered in the differential diagnosis of pleomorphic rhabdoid tumors in older adults with a smoking history. Although most present as lung and/or mediastinal masses, they may occasionally present as a metastasis and mimic an undifferentiated sarcoma, representing a potential diagnostic pitfall.

Rac GTPase activating protein 1 promotes the glioma growth by regulating the expression of MCM3

Glioma is the most common tumor of the nervous system. The diffuse growth and proliferation of glioma poses great challenges for its treatment. Here, Transcriptomic analysis revealed that Rac GTPase activating protein 1 (RACGAP1) is highly expressed in glioma. RACGAP1 has been shown to play an important role in the malignant biological progression of a variety of tumors. However, the underlying role and mechanism in glioma remain poorly understood. By using quantitative real-time polymerase chain reaction (qRT-PCR), western blot, immunohistochemistry and Orthotopic mouse xenografts, we confirmed that knockdown of RACGAP1 impeded cell proliferation in glioma and prolonged the survival of orthotopic mice. Interestingly, we also found that inhibiting the expression of RACGAP1 reduced the expression of minichromosome maintenance 3 (MCM3) through RNA-seq and rescue assay, while Yin Yang 1 (YY1) transcriptionally regulated RACGAP1 expression. Furthermore, T7 peptide-decorated exosome (T7-exo) is regard as a promising delivery modality for targeted therapy of glioma, and the T7-siRACGAP1-exo significantly improved the survival time of glioma bearing mice. These results suggested that targeting RACGAP1 may be a potential strategy for glioma therapy.

PA21 A rare case of diffuse infantile fibromatosis

Abstract Fibromatoses are a heterogeneous collection of tumours of the skin and soft tissue with a large variability in presentation. We present a case of diffuse infantile fibromatosis in a 17-day-old infant boy. He was born at 40 + 7 weeks gestation with a vacuum-assisted delivery following an uncomplicated pregnancy. On physical examination, there were two well-circumscribed circular plaques that coalesced centrally on his left elbow. The plaque measured 2 × 1 cm and was firm, nontethered and nontender. Full skin examination was otherwise normal. Histopathological examination showed hyperkeratotic skin with an attenuated epidermis overlying a dermally based bland-appearing spindle cell proliferation. The lesion was infiltrative throughout the dermis and was arranged in short fascicles and interdigitated with subcutaneous fat, which was extensively trapped by spindle cells. There was no significant atypia and mitotic activity was identifiable but not brisk. Immunohistochemical stains showed strong and diffuse reactivity for smooth muscle actin. Infantile fibromatosis is the childhood counterpart of musculoaponeurotic fibromatosis. It is a benign mesenchymal tumour of infancy and early childhood with diffuse proliferations of oval-to-spindled fibroblasts that infiltrate regional structures. There is a male predominance and in most cases is noted within the first 8 years of life. Clinically, it presents as an asymptomatic, white-yellowish mass that is nontethered to the overlying skin. Although any site may be involved, the majority of cases affect the upper limbs, head and neck region. Histological findings include a wide morphological spectrum. In infants, small oval cells appearing between primitive mesenchymal cells and fibroblasts are in a myxoid background. The cells are loosely arranged and infiltrate skeletal muscle and other regional structures. Peripheral lymphocytic inflammation blends with more cellular proliferation composed of spindle-shaped fibroblasts arranged in bundles and fascicles. There is no well-documented immunohistochemical profile. An important differential diagnosis to exclude is congenital/infantile fibrosarcoma, which, characteristically, has high cellularity, uniform herringbone pattern, high mitotic rate, and zones of haemorrhage and necrosis. In terms of management, as there is a high likelihood of local recurrence in 65% of cases, evidence supports complete excision with documented margins. Where the lesion is diffusely infiltrative, a partial resection to maintain the best postoperative function is recommended.

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Metastasis from follicular lymphoma to an ovarian mature teratoma: a case report of tumor-to-tumor metastasis

BackgroundTumor-to-tumor metastasis (TTM) is a rare but well-established phenomenon where histologically distinct tumors metastasize within each other. Here we report the first “known” case of follicular lymphoma that metastasized and extended to a mature ovarian teratoma.CasepresentationA59-year-old Japanese postmenopausal woman visited our hospital for a detailedexamination of an ovarian tumor. Clinical imaging suggested it to be eitherteratoma-associated ovarian cancer with multiple lymph node metastases, ortumor-to-tumor metastasis from malignant lymphoma to ovarian teratoma. Abilateral adnexectomy and retroperitoneal lymph node biopsy were performed.Lined with squamous epithelium, the cyst constituted a mature ovarian teratoma,and the solid part showed diffuse proliferation of abnormal lymphoid cells.Immunohistochemically, the abnormallymphoid cells were negative for CD5, MUM1, and CyclinD1, and positivefor CD10, CD20, CD21, BCL2, and BCL6. Genetic analysis using G-banding andfluorescence in situ hybridization identified a translocation of t(14;18)(q32;q21), and we diagnosed tumor-to-tumor metastasis from nodal follicular lymphomato mature ovarian teratoma. Twelve months after surgery, the patient showed noprogression without adjuvant therapy.ConclusionsThe present case suggests thatmolecular approaches are useful in the diagnosis of TTM in mature ovarianteratomas when morphologic and immunohistochemical findings alone are insufficientfor diagnoses.

Diffuse Thyroid Lipomatosis: 2 Cases Report

Thyroid lipomatosis is a rare disease, characterized by diffuse infiltration of the stroma by mature adipose tissue, leading to increased size of thyroid gland. The pathophysiology of diffuse proliferation of adipose tissue in the thyroid gland is unclear. Our study involves 2 cases with thyroid lipomatosis treated in surgical department B, Ibn Sina University Hospital. In the 2 cases studied, the average age was 50 years and the 2 patients were female. The 2 patients had consulted for a cervical swelling and the physical examination had found a goiter in both patients. They were treated with total thyroidectomy, and the postoperative follow-up was simple, with no deplorable complications. Pathological examination of the surgical specimen showed infiltration of the entire thyroid parenchyma by mature adipocytes, without any sign of hyperplasia, malignancy or amyloid deposition. Diffuse thyroid lipomatosis is considered a rare condition with about 20 cases described in the literature. This entity has no malignant evolutionary potential and the complications are of a mechanical nature.

Acute hemorrhagic cholecystitis related to diffuse neurofibroma of gallbladder in a patient with neurofibromatosis type 1

BackgroundWe report the first case of acute hemorrhagic cholecystitis with large hemoperitoneum related to gallbladder wall fragility caused by neurofibroma cell infiltration.Case presentationA 46-year-old man with neurofibromatosis type 1 (NF1), who had been hospitalized for retroperitoneal hematoma and treated by transarterial embolization 9 days earlier, complained of right upper quadrant pain, bloating, nausea, and emesis. Computed tomography revealed fluid collection and a distended gallbladder with high-density contents. The patient was taken to the operating room for laparoscopic cholecystectomy, with consideration of the hemodynamic tolerance, for acute hemorrhagic cholecystitis. An initial laparoscopy revealed a significant amount of blood in the abdominal cavity exuding from the gallbladder. Due to its fragility, the gallbladder was easily ruptured by surgical manipulation. After conversion to open surgery, subtotal cholecystectomy was performed. Seventeen days after surgery, the patient was transferred to another hospital for rehabilitation. Histological examination revealed diffuse and nodular proliferation of spindle cells that had replaced the muscularis propria of the gallbladder wall.ConclusionThis clinical case highlights how NF1 can cause various symptoms in the blood vessels and gastrointestinal tract, including the gallbladder.

A case of isolated bronchial hemangioma causing recurrent hemoptysis

The development of bronchial hemangioma in adults is rare, and massive hemoptysis due to diffuse vascular proliferation of bronchial hemangioma is fatal.

Effects of Mosquito Coil Smoke Inhalation on the Haematological, Biochemical, and Histopathological Parameters of Wistar Rats (Rattus norvegicus)

Malaria remains the most important mosquito-borne parasitic disease in sub – Saharan Africa and one of the ways of reducing the risk of the disease is by preventing mosquito–human contact. Mosquito coil (MC) is a coiled substance having one or more insecticides that slowly burns to emit smoke that repels mosquitoes. Some emissions from mosquito coil smoke (MCS) have however been reported to have various health implications. In this study, we investigated the effect of MCS inhalation on the haematological, biochemical, and histopathological parameters of Wistar rats. Twenty adults male Wistar rats weighing between 160 and 180g were divided into four groups of five rats each. Group I (G1) served as unexposed control while groups 2 – 4 (G2, G3, G4) were exposed to MCS for 2, 4, and 6 hours respectively each day for eight weeks. At the end of the exposure period, the rats were weighed and sacrificed. Blood samples were collected for haematological and biochemical parameters while kidney, liver and lung samples were harvested for histopathology. There was a significant increase (P&lt;0.5) in the Packed Cell Volume (PCV) and electrolyte level of exposed rats compared to the control. Histopathological evaluation of the kidney showed severe congestion of the renal cortex and moderate diffused degeneration of the renal tubules. Sections of the exposed liver showed mild to moderate periportal cellular infiltration, mild congestion of interstitial capillaries, and mild diffuse hydropic degeneration of hepatocytes. Similarly, sections of exposed lungs revealed severe congestion and oedema of the lungs, moderate diffuse proliferation of alveoli pneumocyte, multiple foci of congestion, and oedema with haemorrhage into the alveoli. These findings suggest that exposure to MCS may have toxic effects on the haematological, biochemical, and histopathological parameters of Wistar rats. Friendlier mosquito control alternatives like Long Lasting Insecticidal–treated Nets should therefore be encouraged.

Ovarian fibrosarcoma : A Case Report

This case report aims to report and discuss cases of ovarian fibrosarcoma. Ovarian fibrosarcoma is a rare casethat generally occurs in women who have menopause. In the case of ovarian fibrosarcoma, the patient was 43years old, had two children, and had no complaints during menstruation. The patient has lost weight in the lastsix months. The patient has performed debulking surgery optimally. On the PA results, it looks macroscopic, apiece of brownish-white tissue, densely rubbery, with a size of 15x12x5 cm, a solid white part is visible, and thereis a yellowish-white part and anger, there is a 0.5-1.5 cm cavity filled with a yellowish liquid. On microscopicexamination of the tumor, the tissue section appears to consist of a diffuse proliferation of tumor cells withhypercellular and hypocellular areas. Based on the results of macroscopic and microscopic examination of thetumor tissue, a skewed sarcoma is established in fibrosarcoma. The patient underwent chemotherapy after tumorsurgery. Although there is no clear consensus on the administration of fibrosarcoma chemotherapy, severalpublished case reports have demonstrated a lower probability of recurrence and a better prognosis in patientsundergoing chemotherapy.