Sudden death in an adolescent due to primary angiosarcoma of the right atrium

A 16 year old male adolescent of African ethnicity presented to a health care facility with a long standing history of chronic coughing. The treating medical practitioner requested a chest X-ray which revealed a large left sided pleural effusion. The patient was subsequently transferred to a referral hospital (one Military Hospital) in Pretoria, South Africa. Shortly after the patient arrived in the casualty department, he was in severe respiratory distress and active resuscitation had to be initiated. Despite full resuscitation efforts, the patient demised.http://link.springer.com/journal/120242017-09-30hb2016Forensic Medicin

Lymph node biopsy : some aspects revisited

Lymph node biopsy, if performed correctly, is likely to yield an optimal diagnostic result. However, in view of the invasive nature of the procedure, biopsy should only be undertaken in patients with a definitive clinical indication. Less invasive investigations, such as full blood count and serology, and fine needle aspiration (FNA), may indeed provide a conclusive diagnosis especially if a careful medical history / examination reveals the most likely clinical cause for the lymphadenopathy, which is subsequently confirmed.http://www.cmej.org.za/index.php/cme

Pagetoid reticulosis with CD30 positivity and cytotoxic/suppressor cells

Pagetoid reticulosis (PR), also named Woringer-Kolopp disease, is a low-grade primary cutaneous T-cell lymphoma that usually presents as a solitary, slowly enlarging erythematous or hyperkeratotic plaque on the distal areas of the extremities. Histopathologically, it is characterized by a dense, band-like infiltrate of atypical lymphocytes with prominent epidermotropism within a hyperplastic epidermis, and immunophenotypic studies show in most cases, a CD4-positive T-helper phenotype for the neoplastic lymphocytes. We describe an African man with a more than 20-year history of an acral lesion of PR, which was histopathologically characterized by lymphocyte immunophenotype consisting of CD8- and CD30-positive cells. We discuss the differential diagnosis with other primary cutaneous lymphoproliferative disorders showing similar immunophenotype. This case shows that CD30-positive PR should be included as a rare variant within the spectrum of CD30-positive primary cutaneous lymphoproliferative disorders. As in other primary cutaneous CD30-positive lymphoproliferative processes, lesions of CD30-positive PR show an indolent course and a benign biological behavior. Histopathologically, it shows a prominent infiltrate of atypical lymphocytes within a hyperplastic epidermis. Immunophenotypic studies in lesions of PR have led to the recognition of different phenotypes for the large atypical epidermotropic lymphocytes. The CD4-positive T-helper phenotype appears the most common

Spermatic cord liposarcoma and prostate adenocarcinoma : a synchronous association

Spermatic cord liposarcoma is rare, with fewer than a 100 reported cases in the world literature. We report on its presence in an elderly man who presented with a painless scrotal mass. The serum prostate specific antigen (PSA) level was also found to be elevated. Transrectal ultrasound biopsy of the prostate confirmed the presence of adenocarcinoma. This is the first report of prostatic adenocarcinoma in association with spermatic cord liposarcoma in the English literature. The treatment options for spermatic cord liposarcoma are discussed further