Langer's axillary arch (AA), the most common anatomical variant in the axillary area of definite clinical significance. This is an updated review of the reported variations in the structure, ...highlighting its morphological diversity and its potential in complicating axillary lymph node biopsy, lymphadenectomy, or breast reconstruction.
A review of the literature concerning the AA published between 1812 and 2020 was performed using the PubMed, Scopus, Embase, and Cochrane medical databases. The frequency, laterality, morphology, origin, lateral attachment points, vascularization, and neurosis of the AA were the parameters retrieved from the collected data.
The prevalence of AA ranged from 0.8% to 37.5%. It is more often unilateral, muscular in nature, and extending from the latissimus dorsi to the pectoralis major. It is vascularized by the lateral thoracic vessels or the subscapular artery and innervated by the thoracodorsal nerve.
Langer's AA, when present, may complicate surgical procedures in the area; therefore, every surgeon performing breast or axillary surgery should be aware of this entity and its variations to ensure maximal effectiveness and safety in the management of patients.
Reconstructing scalp defects after basal cell carcinoma removal in elderly patients is challenging. This case report emphasizes Matriderm® as a successful alternative, addressing limitations of ...traditional methods. The application of Matriderm® in resource-limited scenarios adds insights to surgical literature, and its' usage addresses challenges in patients, contributing to surgical knowledge.
Immunoglobulin G4-related disease is an immune-mediated condition comprised of a number of various disorders sharing unique pathologic, serologic, and clinical features. Diagnosis of immunoglobulin ...G4-related sclerosing mastitis is challenging as the clinical and imaging findings mimic breast malignancies or other types of inflammatory mastitis. Herein, we describe a case of a female patient with a painless palpable mass in her right breast. An excisional core biopsy led to the rare diagnosis of immunoglobulin G4-related sclerosing mastitis, and the patient received steroid treatment for a month. To date, the patient has remained disease-free without any recurrence. As immunoglobulin G4-related sclerosing mastitis is a very rare disease, further studies are needed to reach conclusions about the pathogenesis, diagnosis, and treatment of this entity.
A case of a 42-year-old female patient with a two-days diffuse colicky abdominal pain, nausea and three episodes of vomiting is presented. Furthermore, patient complained for inability to eat for ...almost a week. In addition, patient had a history of subtotal gastrectomy Billroth II-type, due to gastric ulcer six years ago. There were no other known co-morbidities. Except for a distended, somewhat painful abdomen and sluggish bowel sounds, the rest clinical examination was unremarkable. Plain abdominal X-ray and ultrasound findings agreed with the clinical suspicion of sub-acute small bowel obstruction probably due to post-operative adhesions. A conservative management was decided. However, the patient after an initial clinical improvement, had a relapse of symptoms with the first feeding attempt. A followed computed tomography of the abdomen revealed a well define, oval, mass-like containing mostly air bubbles lesion, occupying for approximately six centimeters long the jejunum lumen. The diagnosis of jejunal phytobezoar was set. In accordance of computed tomography diagnosis were the intra-operative findings and the post-operative histopathology.
Reconstructing scalp defects after basal cell carcinoma removal in elderly patients is challenging. This case report emphasizes Matriderm® as a successful alternative, addressing limitations of ...traditional methods. The application of Matriderm® in resource-limited scenarios adds insights to surgical literature, and its' usage addresses challenges in patients, contributing to surgical knowledge.
Immunoglobulin G4-related disease is an immune-mediated condition comprised of a number of various disorders sharing unique pathologic, serologic, and clinical features. Diagnosis of immunoglobulin ...G4-related sclerosing mastitis is challenging as the clinical and imaging findings mimic breast malignancies or other types of inflammatory mastitis. Herein, we describe a case of a female patient with a painless palpable mass in her right breast. An excisional core biopsy led to the rare diagnosis of immunoglobulin G4-related sclerosing mastitis, and the patient received steroid treatment for a month. To date, the patient has remained disease-free without any recurrence. As immunoglobulin G4-related sclerosing mastitis is a very rare disease, further studies are needed to reach conclusions about the pathogenesis, diagnosis, and treatment of this entity.
is a flowering plant cultivated for its lemon-scented leaves and used in folk medicine for the preparation of tea for the alleviation of symptoms of gastrointestinal disorders, cold, and asthma. The ...oil extracted from the plant leaves was shown to possess antioxidant potential and to exert antiproliferative activity against breast cancer. The aim of this study was to further investigate potential antitumor effects of
oil (LCO) on breast cancer. The in vitro antiproliferative activity of LCO was examined against murine DA3 breast cancer cells by the sulforhodamine B assay. We further explored the LCO's pro-apoptotic potential with the Annexin-PI method. The LCO's anti-migratory effect was assessed by the wound-healing assay. LCO was found to inhibit the growth of DA3 cells in vitro, attenuate their migration, and induce apoptosis. Finally, oral administration of LCO for 14 days in mice inhibited by 55% the size of developing tumors in the DA3 murine tumor model. Noteworthy, in the tumor tissue of LCO-treated mice the apoptotic marker cleaved caspase-3 was elevated, while a reduced protein expression of survivin was observed. These results indicate that LCO, as a source of bioactive compounds, has a very interesting nutraceutical potential.
Ectopic kidney injury due to blunt abdominal trauma Karapepera, Vaia; Kofina, Konstantinia; Papatheodorou, Nikolaos ...
Journal of surgical case reports,
02/2023, Letnik:
2023, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Ectopic kidney is a relatively uncommon anatomic variation that is usually detected incidentally in patients undergoing imaging for an unrelated reason. Most cases are asymptomatic and are often ...revealed by a complication; however, ectopic kidney is generally associated with higher risk of traumatic injury, urinary tract infection, renal calculi and other urologic conditions. We report the case of a 65-year-old male patient with a post-traumatic renal laceration on a previously undiagnosed ectopic pelvic kidney, with successful conservative treatment.
Abstract
Merkel cell carcinoma is a rare neuroendocrine malignancy that arises from the dermis, in cases of immunocompromised, middle-aged patients or on skin exposed to sunlight. It only rarely ...presents in extra-cutaneous locations. We present the case of a 63-year-old female with a mass in the adipose tissue of the upper arm, without skin involvement and concurrent axillary lymph node enlargement. She was treated with wide excision and lymph node dissection; pathology led to the diagnosis of Merkel cell carcinoma, and she was subsequently submitted to adjuvant radiotherapy. No signs of recurrence are present 8 years postoperatively. Primary Merkel cell carcinoma can rarely be located in the adipose tissue without skin involvement. In cases of high suspicion, preoperative MRI scan can show the extent of the lesion, as well as lymph metastases.
Abstract 3011
CD81 is a tetraspanin cell surface protein that regulates CD19 expression in B lymphocytes and enables hepatitis C virus infection of human cells. Immunohistochemistry and FC have ...showed that CD81 expression is downregulated in multiple myeloma and PC lines (Luo, 2010). It appears also that normal PCs are CD81+ at a high percentage (Rawstron, 2008). However, information about CD81 utility in phenotypic diagnosis of PC disorders is scanty. We assessed the frequency and the diagnostic value of the FC detection of CD81 surface expression in multiple myeloma (MM), monoclonal gammopathy of undetermined significance (MGUS) and non-hematological malignancy subjects.
A total of 84 bone marrow aspirates were analyzed in this study. These included 52 diagnosis/disease progression MM samples, 8 samples from MGUS patients and 24 samples from reactive plasmacytosis and ITP patients. A 4-color FC technique was used for PC analysis. Based on the European Myeloma Network guidelines (Rawstron, 2008), we evaluated expression of CD19, CD27, CD56 and CD81 on PCs identified by the CD38/CD45/CD138 combination. At least 100,000 events/tube were acquired, leading to a sensitivity limit of 0.1%. FC positivity threshold for studied antigens was set at 20%. Any deviation from the normal PC phenotype (CD19+CD27+CD56-) was considered as abnormal. Diagnostic tests also included FBC, biochemistry, beta-2 microglobulin, IgA, IgG, IgM, kappa and lambda light chain serum levels, serum protein electrophoresis and immunofixation, bone marrow aspirate and skeletal survey where required.
Median PC percentage was significantly higher in the bone marrow aspirate when compared to FC as expected 15.5(3-96)% vs. 2(0.11-53)%, p<0.001. CD81 positivity was identified in 19% (10/52) of MM samples and 50% of MGUS (4/8) and normal PC samples (12/24). CD81 plasma cell expression was significantly different between normal and MM samples (median: 16.8(1.9-52.4)% vs. 2.5(0-90.4)%, p<0.001) and between MGUS and MM patients (median: 14.4(1.5-53)% vs. 2.5(0-90.4)%, p=0.001). Mean fluorescence intensity of CD81 was similar in the 3 groups. A positive correlation was found between CD81 and CD19 expression (rho=+0.596, p<0.0001) and between CD81 and CD27 (rho=+0.358, p=0.001) while CD56 expression was negatively correlated with CD81 (rho=-0.291, p=0.007). Flow cytometry provided correct diagnosis in 87% (73/84) of cases; 8 samples were identified as false positive and 3 as false negative. Subsequently, a Receiver Operating Characteristic (ROC) curve analysis was performed in order to assess CD19, CD27, CD56 and CD81 antigens' sensitivity and specificity in discriminating normal from malignant PCs (Figure); although CD81 shared similar sensitivity and specificity with CD27, CD19 was shown to have the highest sensitivity and specificity in detecting correctly PC identity.
This study provides laboratory evidence that CD81 expression in PCs is strongly correlated with CD19, CD27 and CD56 expression. CD81 surface detection seems to characterize normal PCs in reactive plasmacytosis, ITP and MGUS. However, it has an inferior sensitivity and specificity, in discriminating normal from malignant PCs, when compared to CD19.
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No relevant conflicts of interest to declare.
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