The cytology of intracranial clear cell meningioma with an unusual scalp presentation

Intracranial meningiomas are not often aspirated unless they erode the skull and present as swelling in the head and neck region. We describe the cytologic findings of fine needle aspiration cytology in a clear cell variant of intracranial meningioma presenting with swelling in the left parietal region of the scalp in a 45-year-old woman. The diagnosis was confirmed by histopathology. Clear cell meningioma is characterized by patternless sheets of clear polygonal cells. Clear cell meningioma is a rare distinctive cytological subtype of meningioma with high recurrence rate and increased mortality, which necessitate frequent follow-up after surgical excision. The recognition of clear cell meningiomas is important here and should be distinguished from other clear cell lesions of the scalp. If clear cell epithelial neoplasm is encountered on fine needle aspiration, it is reasonably possible to provide at least a differential diagnosis of meningioma based upon the focal whorls, sparce vascularity on low magnification, along with the presence of pseudoinclusion and inconspicuous nucleoli at high magnification

Packed red cell transfusions alter mesenteric arterial reactivity and nitric oxide pathway in preterm lambs

BACKGROUND: Cases of necrotizing enterocolitis occurring within 48 h of packed red blood cell (PRBC) transfusions are increasingly being described in observational studies. Transfusion-associated gut injury is speculated to result from an abnormal mesenteric vascular response to transfusion. However, the mechanism of disruption of the balance between mesenteric vasoconstriction and relaxation following transfusion is not known. METHODS: Preterm lambs (n = 16, 134 d gestation; term: 145–147 d) were delivered and ventilated for 24 h. All the lambs received orogastric feeds with colostrum. In addition, 10 of these lambs received PRBC transfusions. Vasoreactivity was evaluated in isolated mesenteric arterial rings using norepinephrine and endothelin-1 as vasoconstrictors. Endothelium-dependent (A23187, a calcium ionophore) and endothelium-independent (SNAP) nitric oxide (NO) donors were used as vasorelaxants. Mesenteric arterial endothelial NO synthase (eNOS), soluble guanylyl cyclase (sGC), and phosphodiesterase 5 (PDE5) mRNA analyses and protein assays were performed. RESULTS: Transfusion with PRBC significantly increased mesenteric vasoconstriction to norepinephrine and endothelin-1 and impaired relaxation to A23187 and SNAP. Mesenteric arterial eNOS protein decreased following PRBC transfusion. No significant changes were noted in sGC and PDE5 mRNA or protein assays. CONCLUSION: PRBC transfusion in enterally fed preterm lambs promotes mesenteric vasoconstriction and impairs vasorelaxation by reducing mesenteric arterial eNOS

Summary of: Salivary stones: symptoms, aetiology, biochemical composition and treatment

Salivary stones, also known as sialoliths, are calcified concrements in the salivary glands. Sialoliths are more frequently located in the submandibular gland (84%), than in the parotid gland (13%). The majority of the submandibular stones are located in Wharton's duct (90%), whereas parotid stones are more often located in the gland itself. Salivary stones consist of an amorphous mineralised nucleus, surrounded by concentric laminated layers of organic and inorganic substances. The organic components of salivary stones include collagen, glycoproteins, amino acids and carbohydrates. The major inorganic components are hydroxyapatite, carbonate apatite, whitlockite and brushite. The management of salivary stones is focused on removing the salivary stones and preservation of salivary gland function which depends on the size and location of the stone. Conservative management of salivary stones consists of salivary gland massage and the use of sialogogues. Other therapeutic options include removal of the stone or in some cases surgical removal of the whole salivary gland