Retroperitoneal Castleman's tumor and paraneoplastic pemphigus: report of a case and review of the literature

BACKGROUND: Castleman's disease is a rare lymphoproliferative syndrome. Its etiology and pathogenesis are unclear. The disease can be occasionally associated with a paraneoplastic pemphigus (PNP), an autoimmune mucocutaneous disorder commonly seen in neoplasms of lymphocytic origin. CASE PRESENTATION: We present a case of a 63-year old male patient who was referred for surgical treatment of a lately diagnosed retroperitoneal pelvic mass. The patient had been already treated for two years due to progressive diffuse cutaneous lesions histologically consistent with lichen ruber verucosus and pemphigus vulgaris. Intraoperatively a highly vascularized solid mass occupying the small pelvis was resected after meticulous vascular ligation and hemostasis. After surgery and following immunosuppressive treatment a clear remission of the skin lesions was observed. CONCLUSION: Castleman's tumor should be always suspected when a retroperitoneal mass is combined with PNP. In a review of the literature we found 37 additional cases. Complete surgical resection of the tumor can be curative in most of the cases

Past Arctic aliens have passed away, current ones may stay

Published version. Source at http://doi.org/10.1007/s10530-015-0937-9.Increased human activity and climate change are expected to increase the numbers and impact of alien species in the Arctic, but knowledge of alien species is poor in most Arctic regions. Through field investigations over the last 10 years, and review of alien vascular plant records for the high Arctic Archipelago Svalbard over the past 130 years, we explored long term trends in persistence and phenology. In total, 448 observations of 105 taxa have been recorded from 28 sites. Recent surveys at 18 of these sites revealed that alien species had disappeared at half of them. Investigations at a further 49 sites characterised by former human activity and/or current tourist landing sites did not reveal any alien species. Patterns of alien species distribution suggest that greater alien species richness is more likely to be aligned with ongoing human inhabitation than sites of transient use. The probability of an alien species being in a more advanced phenological stage increased with higher mean July temperatures. As higher mean July temperatures are positively correlated with more recent year, the latter finding suggests a clear warming effect on the increased reproductive potential of alien plants, and thus an increased potential for spread in Svalbard. Given that both human activity and temperatures are expected to increase in the future, there is need to respond in policy and action to reduce the potential for further alien species introduction and spread in the Arctic

A liver fibrosis cocktail? Psoriasis, methotrexate and genetic hemochromatosis

BACKGROUND: Pathologists are often faced with the dilemma of whether to recommend continuation of methotrexate therapy for psoriasis within the context of an existing pro-fibrogenic risk factor, in this instance, patients with genetic hemochromatosis. CASE PRESENTATIONS: We describe our experience with two male psoriatic patients (A and B) on long term methotrexate therapy (cumulative dose A = 1.56 gms and B = 7.88 gms) with hetero- (A) and homozygous (B) genetic hemochromatosis. These patients liver function were monitored with routine biochemical profiling; apart from mild perivenular fibrosis in one patient (B), significant liver fibrosis was not identified in either patient with multiple interval percutaneous liver biopsies; in the latter instance this patient (B) had an additional risk factor of partiality to alcohol. CONCLUSION: We conclude that methotrexate therapy is relatively safe in patients with genetic hemochromatosis, with no other risk factor, but caution that the risk of fibrosis be monitored, preferably by non-invasive techniques, or by liver biopsy