Pelvik rabdomyosarkoma tedavisi sonrası geç dönem komplikasyonları: Olgu sunumu

The efficiency of radiation therapy and chemotherapy has had a major impact on the surgical procedures recommended for rhabdomyosarcoma. With multidisciplinary regimens, survival rates have improved significantly compared to those in the past. However, radiation therapy in conjunction with chemotherapy may have deleterious side effects particularly in children. In this report, a case who presented with vaginal occlusion, and a secondary malignant tumor long after successful treatment of a pelvic rhabdomyosarcoma at 3 years of age is described. The importance ofiong term follow-up in soft tissue sarcomas of childhood is emphasized by this postradiation sarcoma which has developed twelve years after initial treat;not;ment.Radyoterapi ve kemoterapinin tedavideki etkinliği rabdomyosarkoma için önerilen cerrahi işlemlerde önemli değişikliklere neden olmuştur. Multidisipliner yaklaşımlar sonucunda yaşam oranları eskiye oranla belirgin artış göstermiştir. Ancak kemoterapi ile birlikte olan radyasyonun özellikle çocuklarda önemli yan etkileri görülebilir. Bu çalışmada, üç yaşında iken pelvik rabdomyosarkom tanısı alarak başarılı bir şekilde tedavi edilen bir hastada, uzun süre sonra ortaya çıkan vajinal oklüzyon ve sekonder maliğn tümör tanımlanmıştır. Hastada tedaviden oniki yıl sonra ortaya çıkan postradyasyon sarkomu, yumuşak doku tümörlerinde uzun süreli izlemin önemini vurgulamaktadır

A case with intravascular large B cell lymphoma who was presented with fever of unknown origin, edema and generalized telangiectesia

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Disseminated Mycobacterium fortuitum- chelonae complex infection in a child with IL-12 receptor deficiency

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Should Core Needle Lymph Node Biopsy be a Relevant Alternative to Surgical Excisional Biopsy in Diagnostic Work Up of Lymphomas?

Objective: Surgical excisional biopsy is accepted as the standard of care approach in the diagnosis of lymphomas. Financial issues related to the increased cost and the invasive nature of the procedure forced physicians to use some alternative diagnostic methods. Percutaneous core needle biopsy, which gained a reputation for the diagnosis of lymphomas with the advent of improved pathological, immunohistochemical, and molecular analysis, made it possible to have an accurate diagnosis with limited tissue samples. In this retrospective study, we aimed to compare the diagnostic yield of surgical excisional biopsy and core needle biopsy. Materials and Methods: This study included 131 patients who were diagnosed with lymphoma with a nodal biopsy which was acquired via surgical excisional biopsy or core needle biopsy between 2014 and 2020 in our center. Around 68 patients underwent surgical excisional biopsy and the remaining 63 underwent core needle biopsy. Samples that allowed to the identification of the exact tumor type and/or subtype were accepted as fully diagnostic. Sufficient amount of tissue that the pathologist could have any suspicious findings considering malignant lymphoma was classified as partial diagnostic group. Inadequate samples were the ones who were not enough to report any final diagnosis.Results: The patients who underwent a core needle biopsy were significantly older than the patients who underwent to surgical excisional biopsy (56.8 vs. 47.6, P = .003). Despite the full diagnostic ability of surgical excisional biopsy outperformed core needle biopsy (95.2 % vs. 83.8 %, P = .035), in 92.6% of the patients whose tissue samples were obtained via core needle biopsy were accepted to have a sufficient diagnosis to initiate the treatment and not required a second biopsy, which was comparable with the ones achieved by surgical excisional biopsy (92.6% vs. 95.2%, P = .720).Conclusion: According to the results obtained in our study, we may conclude that core needle biopsy is a viable and comparable alternative to surgical excisional biopsy, offering a less invasive and less-expansive approach

Tuberculous meningits in adults in Turkey: Epidemiology, diagnosis, clinic and laboratory

A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity

Predictors of outcome in patients with tuberculous meningitis

OBJECTIVE: To assess predictors of mortality and neurological sequelae in patients with tuberculous meningitis (TBM)