Massive Mass Research Articles

Massive cystic hygroma of the neck with respiratory distress in newborn

Cystic hygroma is one of the congenital benign tumors of the lymphatic system, which commonly occurs on the neck and axial area. Despite its benign nature, cystic hygroma of the neck is potentially a life-threatening condition. The massive mass on the neck may block the neonatal airway. Here we report a newborn baby presented with cystic hygroma on the neck, which impairs the neonatal airway and breathing. Complete excision was carried out. The patient had an uneventful postoperative recovery. • Cystic hygroma is a benign tumor of the lymphatic system, which commonly occurs on the neck and axial area. • Massive mass on the newborn neck typically causing neonatal respiratory distress. • Complete excision are essential for cystic hygroma.

Grids of stellar models with rotation

Context. Grids of stellar models, computed with the same physical ingredients, allow one to study the impact of a given physics on a broad range of initial conditions and they are a key ingredient for modeling the evolution of galaxies. Aims. We present here a grid of single star models for masses between 0.8 and 120 M⊙, with and without rotation for a mass fraction of heavy element Z = 0.006, representative of the Large Magellanic Cloud (LMC). Methods. We used the GENeva stellar Evolution Code. The evolution was computed until the end of the central carbon-burning phase, the early asymptotic giant branch phase, or the core helium-flash for massive, intermediate, and low mass stars, respectively. Results. The outputs of the present stellar models are well framed by the outputs of the two grids obtained by our group for metallicities above and below the one considered here. The models of the present work provide a good fit to the nitrogen surface enrichments observed during the main sequence for stars in the LMC with initial masses around 15 M⊙. They also reproduce the slope of the luminosity function of red supergiants of the LMC well, which is a feature that is sensitive to the time-averaged mass loss rate over the red supergiant phase. The most massive black hole that can be formed from the present models at Z = 0.006 is around 55 M⊙. No model in the range of mass considered will enter into the pair-instability supernova regime, while the minimal mass to enter the region of pair pulsation instability is around 60 M⊙ for the rotating models and 85 M⊙ for the nonrotating ones. Conclusions. The present models are of particular interest for comparisons with observations in the LMC and also in the outer regions of the Milky Way. We provide public access to numerical tables that can be used for computing interpolated tracks and for population synthesis studies.

The Song #2019GantiPresiden and Political Communication in Simulacra Analysis

This research aims to find out how the hashtag #2019GantiPresiden, which was initially just a common hashtag on Twitter, has triggered a massive mass movement in Indonesia. Moreover, the hashtag incarnated into various souvenirs, even into a song that shouted the need for Indonesia to have a new president. The Hashtag #2019GantiPresiden became a medium of communication to convey political messages from political actors and those interested in the Indonesian presidential elections in 2019. Qualitative method was used in the drafting of this paper by collecting data relating to the topic of discussion and then using the Simulacra logic initiated by Jean Baudrillard in data analysis. The study concluded that in 2019, the #2019GantiPresiden hashtags showed the world that a voice on social media could become a great mass power in the real world.

Disseminated Alveolar Echinococcosis.

Alveolar echinococcosis (AE) is caused by the larval form of the tapeworm Echinococcus multilocularis. In humans, E. alveolaris metacestode cells proliferate in the liver inducing a hepatic disorder that mimics liver cancer and can spread to other organs. From 1960 to 1972 mortality was at 70% and 94% after 5 and 10 years of follow-up, respectively. Since then, studies have shown an increasing trend towards improving survival rates [1]. As AE is also spreading to new areas of Eastern Europe, researchers seek to better understand the clinical presentation of pathology, including asymptomatic forms. Clinical case; One 36-year-old woman from Peshkopia has been admitted to the Gastrohephatology department on 20.07.2011 with fatigue, anorexia, dull pain in right hypochondrium, mild epigastric pain, bloating, and weight loss. The epidemiological anamnesis showed that the patient lived in the village and had pets. On physical examination, the patient appeared severely ill with jaundice, massive hepatomegaly, massive mass in the mesogastric area, and anxiety. Laboratory examinations were as follows: Hb 11.1 g/dl, sediment 25 mm/h; leukocytes 6700/mm3; platelets 127000/mm3; prothrombin level 60%, uremia 12.7 mmol/l; creatinine 0.78 mmol /l; ALP 127 U/I; AST 15 U/I; ALT 37 U/I; GGT 131 U/I; bilirubin 3.7 mg/l, albumin 2.8 gr / l, total protein 8.1 gr / l, HbsAg negative, anti-HCV negative. Regarding serology, the titer of anti-echinococcal antibodies was positive (22, n = 11) Conclusions: Clinical presentation and radiologic imaging findings of disseminated alveolar echinococcosis can mimic metastatic malignancy, and diagnosis can be challenging in atypically advanced cases. As the incidence of human alveolar echinococcosis appears to be increasing and, physicians should be aware of alveolar echinococcosis, its epidemiology, and its clinical features.

New measurement for the stellar mass black hole in Cygnus X-1

<p indent=0mm>The study on stellar mass black holes is an important issue in astrophysics. Over the past decades, astronomers have confirmed some stellar mass black holes and determined their physical properties via the observations of the X-ray binaries and the gravitational waves emitted from the mergers of binary black holes. Recently, a research team re-measured the precise distance of Cygnus X-1 (an X-ray binary) and subsequently derived the values of the mass, spin, and other properties of the black hole V1357 Cyg in Cygnus X-1. The results show that the mass of Cygnus X-1 is (21.2 ± 2.2) <italic>M</italic>_⊙, indicating that V1357 is the most massive stellar mass black hole in X-ray binaries, thus challenging the existing models of massive stellar binary evolution. The future precise measurements of similar black holes in X-ray binaries would further deepen our understanding of the stellar evolution models as well as the physical properties of stellar mass black holes.

Commodification Practices in the Begawe Sasak’s Lombok Tradition

The begawe tradition, which has become the popular culture of Sasaknese, has begun shifted by the consumption of mass cultures, such as catering services, the use of tools or begawe needs, starting to be replaced by industrial products for rent or sale. The forms of commodification in the begawe tradition, especially in begibung (eating together) and betulung (helping each other), two things that become the ‘aura’ of begawe. This difference can be seen from the shifting values, from the principle of kinship to individualism; of various equipment that is transformed and then commercialized. The new ethnography in this case study becomes the basis for examining the commodification practice in the begawe tradition, which switches to catering services and traditional equipment and replaces by modern equipment. The author, who is part of the Sasak community, also takes a participatory approach in begawe events held by the community. This shows that the alienation of popular culture in society cannot be contained by massive mass culture, so that people, which were initially established with high social values, began to form individualist societies that competed to show their social status. The consumption of signs/symbols has formed a society trapped in a pseudo-need that is unwittingly oppressive. Awareness to be critical and filter the mass culture needs a sphere for negotiation to return the spirit of the social community based on kinship interaction.

Pinpointing the jet apex of 3C 84

Nearby radio galaxies that contain jets are extensively studied with very long baseline interferometry (VLBI), addressing jet launching and the physical mechanisms at play around massive black holes. 3C 84 is unique in this regard because the combination of its proximity and large super massive black hole mass provides a high spatial resolution to resolve the complex structure at the jet base. For 3C 84, an angular scale of 50 μas corresponds to 200−250 Schwarzschild radii (Rs). Recent RadioAstron VLBI imaging at 22 GHz has revealed an east-west elongated feature at the northern end of the VLBI jet, which challenges past interpretations. Here we propose instead that the jet apex is not located within the 22 GHz VLBI core region but more upstream in the jet. We base our arguments on a 2D cross-correlation analysis of quasi-simultaneously obtained VLBI images at 15, 43, and 86 GHz, which measures the opacity shift of the VLBI core in 3C 84. With the assumption of the power-law index (kr) of the core shift being set to 1, we find the jet apex to be located 83 ± 7 μas north (upstream) of the 86 GHz VLBI core. Depending on the assumptions forkrand the particle number density power-law index,n, we find a mixed toroidal-poloidal magnetic field configuration, consistent with a region that is offset from the central engine by about 400–1500Rs. The measured core shift is then used to estimate the magnetic field strength, which amounts toB= 1.80−4.0 G near the 86 GHz VLBI core. We discuss some physical implications of these findings.

Carbon and Nitrogen Sourcing in High Elevation Landscapes of Mustang in Central Nepal

Mustang valley in the central Himalaya of Nepal is a unique landscape formed by massive soil mass during a glacial period, which is attributed to a mix of vegetations and long agricultural history. Soil nutrients and their sourcing is highly important to understand the vegetation assemblage and land productivity in this arid zone. Twenty soil samples (from 0 to 20 cm depth) were collected from three landscape positions in Mustang district: valley, ridge, and midslope. We explored nutrient sourcing using natural abundance carbon (δ13C) and nitrogen isotope (δ15N) employing isotope ratio mass spectrophotometry. The results showed that the total soil carbon (TC) and total nitrogen (TN) ranged from 0.3 to 10.5% and 0.3 to 0.7%, respectively. Similarly, the CN ratio ranged from 0.75 to 15.6, whereas soil pH ranged from 6.5 to 7.5. Valley soil showed higher values of TN, CN, and soil pH than the ridge and midslope soils. The valleys had more positive δ15N signatures than ridge and midslope, which indicates higher inorganic and organic N fertilizer inputs in the valley bottom than in the midslope and ridge. This suggests that a higher nutrient content in the valley bottom likely results from agro-inputs management and the transport of nutrients from the ridge and midslope. Soil pH and CN ratio were a non-limiting factor of nutrient availability in the study regions. These findings are crucial in understanding the nutrient dynamics and management in relation to vegetation and agricultural farming in this unique topography of the Trans-Himalayan zone of Mustang in central Nepal.

Prenatal diagnosis of megaduodenum using ultrasound: a case report

BackgroundCongenital megaduodenum is a rare disorder; however, its prenatal diagnosis has not been reported previously. We report the case of an abdominal cystic mass in a fetus that was later diagnosed as megaduodenum.Case presentationAn abdominal cystic mass was found during ultrasonography of a fetus at 11 weeks of gestation. The mass progressively enlarged with gestation. The amniotic fluid volume decreased and then returned to normal. During the last prenatal ultrasound examination, the mass was observed communicating with the stomach; therefore, duodenal dilation was suspected. Finally, the patient was diagnosed with megaduodenum caused by a developmental defect in the nerve plexus.ConclusionsCongenital megaduodenum is a differential diagnosis of massive fetal abdominal cystic masses. Ultrasound examinations of such masses communicating with the stomach may help determine the diagnosis.

A Mass in Disguise: A Rare Case of High-Attenuation Adrenal Myelolipoma

Abstract Background: Adrenal incidentalomas are common, and imaging studies play a large role in reaching the diagnosis in many cases. Adrenal myelolipomas are classically diagnosed by CT as a hypodense well circumscribed heterogenous mass with low attenuation. Clinical Case: A 51-year-old man with history of resistant hypertension presented with neck pain after a motor vehicle crash. After a cervical X-ray revealed an odontoid fracture, a whole body CT was obtained. The CT incidentally identified a massive heterogeneous left adrenal mass measuring 22.3 × 15.5 × 20.6 cm, with multiple attenuation measurements ranging from 20 to 53 Hounsfield units (HU). The patient’s physical examination and hormonal assessment were both unrevealing, with normal catecholamine, androgen, and an unremarkable renin aldosterone ratio. Inpatient urinary cortisol levels were elevated, however a repeat urinary cortisol as an outpatient weeks after repair of the odontoid fracture showed normal levels, suggesting physiologic stress response. Positron emission tomography showed a metabolically inactive adrenal mass without metastatic diseases. The patient eventually underwent a left adrenalectomy, and pathology revealed a myelolipoma measuring 24.2 × 20.5 × 8.3 cm. Imaging characteristics for adrenal incidentalomas are considered useful diagnostic information according to most clinical guidelines. Lesions with high HU are typically pheochromocytomas, adrenocortical carcinoma, metastatic disease, or lipid poor adenomas. Myelolipomas are identified on CT by their characteristically low HU (often -30). In this case of a massive myelolipoma with high HU, the unique imaging characteristics posed a diagnostic challenge. The patient’s history of resistant hypertension combined with the high HU led to the patient undergoing extensive testing for a functional mass or cancer. Conclusion: This is a rare case of a massive myelolipoma with low attenuation. The role of imaging studies in the diagnosis of adrenal incidentalomas is not definitive, and detailed exam along with hormonal assessment may be warranted in atypical cases. Providers should consider myelolipoma in the differential diagnosis of a large adrenal mass with a negative hormonal evaluation even in the setting of high HU.

Comparative database search engine analysis on massive tandem mass spectra of pork-based food products for halal proteomics

Mass spectrometry-based proteomics relies on dedicated software for peptide and protein identification. These software include open-source or commercial-based search engines; wherein, they employ different algorithms to establish their scoring and identified proteins. Although previous comparative studies have differentiated the proteomics results from different software, there are still yet studies specifically been conducted to compare and evaluate the search engine in the field of halal analysis. This is important because the halal analysis is often using commercial meat samples that have been subjected to various processing, further complicating its analysis. Thus, this study aimed to assess three open-source search engines (Comet, X! Tandem, and ProteinProspector) and a commercial-based search engine (ProteinPilot™) against 135 raw tandem mass spectrometry data files from 15 types of pork-based food products for halal analysis. Each database search engine contained high false-discovery rate (FDR); however, a post-searching algorithm called PeptideProphet managed to reduce the FDR, except for ProteinProspector and ProteinPilot™. From this study, the combined database search engine (executed by iProphet) reveals a thorough protein list for pork-based food products; wherein the most abundant proteins are myofibrillar proteins. Thus, this proteomics study will aid the identification of potential peptide and protein biomarkers for future precision halal analysis. SignificanceA critical challenge of halal proteomics is the availability of a database to confirm the inferential peptides as well as proteins. Currently, the established database such as UniProtKB is related to animal proteome; however, the halal proteomics is related to the highly processed meat-based food products. This study highlights the use of different database search engines (Comet, X! Tandem, ProteinProspector, and ProteinPilot™) and their respective algorithms to analyse 135 raw tandem mass spectrometry data files from 15 types of pork-based food products. This is the first attempt that has compared different database search engines in the context of halal proteomics to ensure the effectiveness of controlling the FDR. Previous studies were just focused on the advantages of a certain algorithm over another. Moreover, other previous studies also have mainly reported the use of mass spectrometry-based shotgun proteomics for meat authentication (the most similar field to halal analysis), but none of the studies were reported on halal aspects that used samples originated from highly processed food products. Hence, a systematic comparative study is duly needed for a more comprehensive and thorough proteomics analysis for such samples. In this study, our combinatorial approach for halal proteomics results from the different search engines used (Comet, X! Tandem, and ProteinProspector) has successfully generated a comprehensive spectral library for the pork-based meat products. This combined spectral library is freely available at https://data.mendeley.com/datasets/6dmm8659rm/3. Thus far, this is the first and new attempt at establishing a spectral library for halal proteomics. We also believe this study is a pioneer for halal proteomics that aimed at non-conventional and non-model organism proteomics, protein analytics, protein bioinformatics, and potential biomarker discovery.

Unusual cause of heart failure in the young, the intracardiac mass: Diagnostic dilemmas solved by echocardiography

Primary cardiac tumor remains exceedingly rare, accounting for 0.5 cases per million of the population annually. We report a case of cardiac tumor, which was initially misdiagnosed as heart failure secondary to acute coronary syndrome. The diagnosis was revised later after routine echocardiography in the ward. A 39-year-old gentleman who presented to the emergency department with cardiac failure and ischemic changes on the electrocardiogram was initially worked-up for acute coronary syndrome. However, echocardiography was performed later in the ward to evaluate the cardiac ejection fraction, revealing a massive left atrial mass measuring 6 cm × 4 cm. Severe mitral regurgitation was noted through the echocardiogram owing to the mass prolapse into the mitral annulus. The initial presentation of cardiac tumors can be ambiguous. Studies have shown that echocardiography as the noninvasive cardiac imaging approach remains the gold standard of diagnostic tool. Hence, echocardiography should be performed as a routine assessment of cardiac failure. Meanwhile, the incorporation of point of care ultrasound in the available center may assist the physician to diagnose accurately in the emergency department setting by excluding other potential differential diagnoses. Delay in diagnosis and initiation of treatment may result in progression to chronic heart failure and dangerous complication, i.e. hemodynamic sequelae and systemic embolism of the clot. In our experience, we managed to reach an accurate diagnosis, timely referral and appropriate intervention despite the lack of point of care ultrasound.

Co/CoOx heterojunctions encapsulated N-doped carbon sheets via a dual-template-guided strategy as efficient electrocatalysts for rechargeable Zn-air battery

Developing highly efficient oxygen electrocatalysts is of vital importance for rechargeable Zn-air batteries (ZABs). Herein, Co/CoOx nano-heterojunctions encapsulated into nitrogen-doped carbon sheets (NCS@Co/CoOx) are fabricated via a dual-template-guided approach by using zeolitic imidazolate frameworks (ZIFs) as templates. The synergistic integration of structural and compositional advantages endows such catalyst with superior catalytic properties to benchmark noble-metal catalysts. To be specific, the hierarchical micro/mesopores affords massive mass transport channels and maximizes the exposure of accessible active sites, whereas the NCS matrix accelerates electron transfer and prevents the self-aggregation of active species during the electrocatalytic reaction. Moreover, abundant and synergistic Co-based active sites (CoO, Co3O4, Co-Nx) greatly promote the catalytic activity. As the cathode of both liquid and flexible solid-state ZABs, excellent device properties are achieved, outperforming those assembled with commercial Pt/C+RuO2 catalyst. This work presents a feasible and cost-effective strategy for developing oxygen electrocatalysts derived from ZIFs templates.

Rescue extracorporeal membrane oxygenation for massive anterior mediastinal masses.

The management of massive anterior mediastinal masses (AMM) is challenging. With the burgeoning role of extracorporeal membrane oxygenation support (ECMO) beyond the confines of salvage therapy, more trained clinicians are adopting it as a bridge for high-risk procedures or situations where temporary respiratory or cardiac support is required. We report our experience with using ECMO in the management of massive AMM in this case series of three patients sharing their clinical details and the lessons learned from them.

Optimum Design of Half Tunnels for Transportation in the Himalayas

Numerical modeling is a fine tool for the assessment of inaccessible zones or unforeseen conditions in geotechnical engineering. When modeling structures in rocks, the laboratory-determined properties must be factored as per rock mass classification. The joints present in rock mass can be utilized for assessment of wedges forming around the tunnels. Half tunnels or overhanging tunnels are constructed in steep rock slopes through slot cutting. This develops overhanging cliff in hard rocks that looked like a half tunnel. Half tunnels have advantage over conventional tunnels or open excavations as they require less excavation. The current construction practice of half tunnels is solely based on experience of construction in hard rock. This study discusses the stability of half tunnels and analyzes its design in the Himalayas. A road extension case study for existing 7-m span tunnel is modeled and studied. Finite element code is used to assess the stability of half tunnels by analyzing different possible scenarios. In addition, rock mass classification is performed along with wedge analysis, and analytical designs. It was found that massive rock mass is quite suitable for the construction of half tunnels. Also, most economical and stable half tunnel designs were recommended.

Research on Key Construction Technology of Building Engineering Under the Background of Big Data

In the era of the construction engineering industry informatization, the collection, storage, and reuse of big construction data is the only way to apply and inform big data in the construction industry. Relying on the reverse logistics management system, modern construction technology can simulate the timeliness of materials, funds, and time limits of the actual construction site according to the logistics reverse engineering principle. Then, reverse the active management status of the internal logistics model of the actual project. It is one of the critical problems for construction engineering informatization to study applying big data and cloud computing technology to solve problems from massive and complicated data or mass data. Since the research on big data and cloud computing technology started late in construction engineering, it is worth studying which aspects of these technologies can be used in the whole life cycle of this field. This paper proposes a structural construction optimization identification method based on IPEM rapid reanalysis. USES the co-solubility of reverse logistics structure construction technology and applied the data mining method to solve many problems such as refined construction management leftover material surplus in the later construction stage. Finally, a construction optimization model of reverse logistics building system based on improved data mining is proposed according to the actual engineering requirements.

Massive heartbeat stars from TESS

Context. Heartbeat stars are eccentric binaries that exhibit a characteristic shape of brightness changes close to the periastron passage, primarily caused by a variable tidal distortion of the components. Variable tidal potential can drive tidally excited oscillations (TEOs), which are usually gravity modes. Studies of heartbeat stars and TEOs open up new possibilities for probing the interiors of massive stars. There are only a few massive (masses of components ≳2 M⊙) systems of this type that are known thus far. Aims. Using TESS data from the first 16 sectors, we searched for new massive heartbeat stars and TEOs using a sample of over 300 eccentric spectroscopic binaries. Methods. We analysed 2 min and 30 min cadence TESS data. Then we fitted Kumar’s analytical model to the light curves of stars showing heartbeats and performed a times-series analysis of the residuals searching for TEOs and periodic intrinsic variability. Results. We found 20 massive heartbeat systems, of which 7 exhibit TEOs. The TEOs occur at harmonics of orbital frequencies in the range between 3 and 36, with the median value equal to 9, which is lower than those in known Kepler systems with TEOs. The most massive system in this sample is the quadruple star HD 5980, a member of the Small Magellanic Cloud. With a total mass of ∼150 M⊙ it is the most massive system showing a heartbeat. Six stars in the sample of the new heartbeat stars are eclipsing. A comparison of the parameters derived from fitting Kumar’s model and from light-curve modelling shows that Kumar’s model does not provide reliable parameters. In other words, the orbital parameters can be reliably derived from fitting heartbeat light curves only if the model includes all proximity effects. Finally, intrinsic pulsations of β Cep, SPB, δ Sct, and γ Dor-type were found in nine heartbeat systems. This opens an interesting possibility for studies of pulsation-binarity interaction and the co-existence of forced and self-excited oscillations.

Theoretical and Experimental Results from Laboratory Tests by ILCM

The intermediate linear cutting machine (ILCM) is a machine designed to work on an intermediate scale between the full- and the small-scale. The reduced scale involves several advantages compared to full-scale tests, especially in terms of sample supplying and transportation. On the other hand, it has an impact on the testing conditions, resulting in a limitation of the cutting penetration and spacing during the test, as well as in a smaller disc cutter. This affects most of the results, which cannot be directly used for the on-site machine performance prediction. However, some experimental results provided in the literature show that the optimal spacing/penetration ratio is not significantly affected by the changes involved. On this basis, the results obtained from ILCM tests should provide reliable information about the optimal cutting conditions of a tunnel boring machine in massive rock mass. The work performed included the development of some improvements of the testing rig, as well as a modified ILCM testing procedure, according to the one typically used in standard LCM tests. The results provide information about the attitude of the tested lithotypes to mechanical excavation by means of disc tools, including the optimal cutting conditions. Additional work was developed in terms of detailed characterisation of the rock samples involved and assessment of the size distribution of the debris produced during the ILCM tests. Nevertheless, further tests are necessary, in order to assess the consistency of the experimental procedure employed and to investigate the scale effect.

Morphometry of plunge pools and retreat mechanism of waterfall

The paper aimed to explore the morphometry of the plunge pool and retreat mechanism of the waterfalls with the help of an empirical study of Turga Waterfall of Ajodhya Hill, Purulia, West Bengal, India. To explore the morphology of waterfall and its plunge pool, width (w), average depth (d), the maximum depth ( $$d_{{{\text{max}}}} )$$ , bathymetric study of plunge pool, and fall height or drop height $${ }(D_{{\text{h}}} ),$$ the distance of jet impingement from the present headwall $${ }(X_{{\text{n}}} )$$ was recorded from Turga Waterfalls. The magnitude of $$d_{{{\text{max}}}}$$ and $$X_{{\text{n}}}$$ is proportional to $$D_{{\text{h}}}$$ . The presence of a series of successive plunge pools at different elevations intermittent by step-like headwalls suggests gradual continuous vertical drilling of successive plunge pools as a more efficient waterfall retreat mechanism in the homogenous massive rock mass.

Xanthoma disseminatum in dark-skinned people: diagnostic delay and difficulties in treatment in a patient who had a fatal outcome in sub-Saharan Africa

Medical image Xanthoma disseminatum is a proliferative non-Langerhans histiocytosis first described by Montgomery in 1938. We here report the case of a 8-year-old Senegalese boy having skin type VI who died. In 2015 this boy presented with slowly progressive dermatosis, which had occurred at the age of 7 years. Dermatological examination showed diffuse xanthomatous orange papules and nodules on the trunk, axillary and inguinal folds, scrotum, neck and face. Extradermatological examination was normal. Histopathological examination of a skin biopsy showed dermal infiltrate composed of histiocytes and multinucleated giant Touton cells. The diagnosis of non-Langerhans histiocytosis was retained, subject to immunohistochemical analyses which were not availabe. Immunohistochemical analyses were too expensive in the absence of health insurance (our patient was from a low socio-economic background). Tests measuring the amount of lipids were normal. At the age of 11 years, diabetes insipidus and systemic involvement of mediastino-pulmonary and abdominal and pelvic organs supported the diagnosis of xanthoma disseminatum. Mediastino-pulmonary disease was complicated by pneumonitis with dyspnoea which didn´t regress on prednisone treatment (1mg/kg/day). The patient underwent surgical resection of a massive mediastinal mass that compressed the organs. Five months later (in 2019), the patient died due to respiratory distress. The difficulty of diagnosing non-Langerhans histiocytosis in our context is largely related to the inaccessibility of immunohistochemistry. Indeed, if CD68 positive and CD1a negative labeling cells had been early detected, fairly early diagnosis would be made. Thus, we could have offered treatments to improve the quality of child´s life.