http://www.casesjournal.com The latest research articles published by Cases Journal 2010-03-09T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Although the advanced stages of neoplasms have a risk of superior mesenteric venous thrombosis (MVT), an initial clinical diagnosis of MVT is sometimes difficult and it can be treated as a cancer-related pain using NSAIDs and/or opioids.We herein present a case of palliative stage of cancer with acute MVT, which was successfully treated with immediate anticoagulant therapy. We believe this case provides an important clinical lesson, which is that we should remember that MVT is one of the potential causes of abdominal pain with cancer patients and the thrombosis can be easily identified by US and CT. http://www.casesjournal.com/content/3/1/76 Fuminori Goda Hiroyuki Okuyama Ayumu Yamagami Hiromi Nakata Michio Inukai Eiji Ohashi Takeaki Takashima Takashi Himoto Hisashi Masugata Shoichi Senda Cases Journal 2010, 3:76 2010-03-09T00:00:00Z doi:10.1186/1757-1626-3-76 Cases Journal 1757-1626 3 76 2010-03-09T00:00:00Z PDF Hematogones are the normal bone marrow constituents of bone marrow in children and their number decreases with age. As hematogones can resemble malignant lymphoblasts by their morphologic features and by expression of an immature B-cell phenotype, an accurate distinction of hematogone-rich lymphoid regeneration from leukemic lymphoblasts is critical for patient care. The increased number of hematogones had been reported in the bone marrow of children recovering from chemotherapy, aplastic conditions, other forms of bone marrow injury, infections like Cytomegalovirus, HIV and immune thrombocytopenia disorders. We describe here a case of one and half month old male infant with bicytopenia and leucocytosis associated with increased hematogones in the bone marrow due to an unknown probable viral infection. http://www.casesjournal.com/content/3/1/75 Kiran Agarwal Meenu Aggarwal Vikas Kumar Aggarwal Meenu Pujani Manupriya Nain Cases Journal 2010, 3:75 2010-03-04T00:00:00Z doi:10.1186/1757-1626-3-75 Cases Journal 1757-1626 3 75 2010-03-04T00:00:00Z PDF Background: Castleman's disease or angiofollicular lymphoid hyperplasia is a rare benign lymph node hyperplasia usually presenting as an asymptomatic mediastinal mass in children. The disease can present at any extra thoracic site with lymphoid tissue such as retroperitoneal, mesentery, axilla, and pelvis. Hepatic localization castleman disease is very rare in children. Herein, we reported a case of Castleman's disease arising from the lymph node in hilum of liver.Case presentationA 5 -year-old girl with chief complaint of abdominal pain for two months which exaggerated in last three days was referred to the hospital. On routine physical examination, only a generalized abdominal pain was noticed. Routine laboratory investigations and Chest X-Ray were normal. Abdominal Sonography revealed a 3.7x3.1cm solid mass in the hilum of the liver. On the MRI images, a lobulated mass in the portal hepatic associated with mass effect on the portal vein was visible. Histological examination revealed expansion of mantle zone in lymphatic nodules accompanied by burnt out germinal centers. This pattern was matched with the diagnosis of the hyaline-vascular type of Castleman disease. The patient underwent a laparotomy. The patient had an uneventful postoperative course. Conclusion: This pattern was matched with the diagnosis of the hyaline-vascular type of Castleman disease. http://www.casesjournal.com/content/3/1/74 Hossein Karami Alireza Alam Sahebpour Maryam Ghasemi Hasan Karami Mojdeh Dabirian Kurosh Vahidshahi Farzad Masiha Soheila Shahmohammadi Cases Journal 2010, 3:74 2010-03-01T00:00:00Z doi:10.1186/1757-1626-3-74 Cases Journal 1757-1626 3 74 2010-03-01T00:00:00Z PDF Pseudohyperkalemia can appear in a variety of settings and should be recognized early. Treatment of pseudohyperkalemia can lead to an inappropriate decrease of actual serum potassium levels which may lead to life threatening conditions. In the case presented, an 81-year-old male presented with massive leucocytosis and an extremely elevated potassium level. . This case report emphasizes the importance of recognizing pseudohyperkalemia in a patient with a severely increased potassium and WBC level; such patients may be clinically asymptomatic or may have a normal ECG. http://www.casesjournal.com/content/3/1/73 Alice Kim Benjamin Biteman Umer Malik Shahzad Siddique Mersadies Martin Syed Ali Nadeem Maboud Sabiya Raja Alison Zachry Ahmed Mahmoud Cases Journal 2010, 3:73 2010-02-25T00:00:00Z doi:10.1186/1757-1626-3-73 Cases Journal 1757-1626 3 73 2010-02-25T00:00:00Z PDF We report a rare case of late knee locking after an open knee injury in a polytrauma patient with a pelvic fracture and a contralateral femoral artery injury. Once the life and limb threatening injuries were addressed, debridement and washout of the knee wound was performed. X-rays and subsequent CT revealed only an undisplaced patella fracture. The patient presented 6 months later to a knee surgeon with recurrent locking. An arthroscopy was performed and a 10mm plastic soft drink bottle cap was retrieved leading to the immediate resolution of symptoms without complications.Open knee injuries require thorough debridement washout and joint assessment. Late locking should raise the suspicion of an intra-articular loose or foreign body. Arthroscopy is an excellent first line tool in the diagnosis and late management of this unusual problem. http://www.casesjournal.com/content/3/1/72 Simon Boyle Joseph Talbot Quamar Bismil Ernest Schilders Cases Journal 2010, 3:72 2010-02-24T00:00:00Z doi:10.1186/1757-1626-3-72 Cases Journal 1757-1626 3 72 2010-02-24T00:00:00Z PDF A 68-year-old white female presented with two years of progressively worsening dyspnea. Echocardiography revealed a large right atrial mass and partial obstruction of the inferior vena cava. Further imaging revealed a cystic dense mass in the inferior vena cava and right atrium. Immunohistochemical stains were consistent with leiomyosarcoma. Intraoperatively, the tumor was noted to originate from the posterior aspect of the inferior vena cava. The patient underwent successful resection of the mass. Adjuvant radiation therapy was completed. The patient's dyspnea gradually improved and she continues to remain disease free five years post-resection. http://www.casesjournal.com/content/3/1/71 Venkataprasanth P Reddy Peter J VanVeldhuizen Gregory F Muehlebach Reginald W Dusing James P Birkbeck Stephen K Williamson Leela Krishnan David Meyers Cases Journal 2010, 3:71 2010-02-23T00:00:00Z doi:10.1186/1757-1626-3-71 Cases Journal 1757-1626 3 71 2010-02-23T00:00:00Z PDF Introduction Coronary artery fistulas are abnormal communications between a coronary artery and a cardiac chamber or a major vessel (vena cava, pulmonary vein, pulmonary artery). They are usually diagnosed by coronary arteriography. Clinical presentations are variable depending on the type of fistula, shunt volume, site of the shunt, and presence of other cardiac conditions.Case presentation This report describes a 46-year-old Greek female patient who was admitted to the hospital because of an acute coronary syndrome. She underwent coronary angiogram which showed a coronary artery fistula from the left anterior descending artery to the main pulmonary artery and severe coronary disease. The patient was referred for coronary artery bypass surgery and fistula closure operation.Conclusions Coronary artery fistulas between left anterior descending artery and main pulmonary artery are very rare anomalies. This case report describes a patient with this anomaly combined with severe coronary disease, reviews the current literature and discusses the available options for treating this rare condition. http://www.casesjournal.com/content/3/1/70 Dimitris Papadopoulos Christos Bourantas Chrisostomos Ekonomou Vasilios Votteas Cases Journal 2010, 3:70 2010-02-23T00:00:00Z doi:10.1186/1757-1626-3-70 Cases Journal 1757-1626 3 70 2010-02-23T00:00:00Z PDF Background: This case report documents the effectiveness of inositol treatment on a chronic patient with bipolar disorder I and severe psoriasis. Her lithium treatment was discontinued due to psoriasis exacerbation and inositol was administered. The remarked positive effect of inositol was noted on her stable mood during the last 4 years, the absence of psoriatic lesions, which lead to an improved quality of life of the patient.Case presentationA 62-year-old female Caucasian patient suffering from bipolar disorder, since the age of 32, presenting manic episodes when without lithium treatment. Lithium treatment caused severe exacerbation of psoriasis and was discontinued while anti-psoriatic treatment had no effect. The last 4 years the patient receives 3 gr per day of inositol alone and her mood has been stabilized while there is also a remarkable improvement on her psoriatic lesions. Conclusion: Taking into consideration the course of her bipolar disorder when lithium was discontinued previously we consider that the 4 years of follow up assessments of this patient as a satisfactory time period for concluding that inositol has been a very effective treatment, replacing lithium, for mood stabilization and psoriasis. http://www.casesjournal.com/content/3/1/69 Konstantinos Kontoangelos Nikolaos Vaidakis Ioannis Zervas Olga Thomadaki Smaragda Christaki Nikolaos Stavrianeas George Papadimitriou Cases Journal 2010, 3:69 2010-02-23T00:00:00Z doi:10.1186/1757-1626-3-69 Cases Journal 1757-1626 3 69 2010-02-23T00:00:00Z XML Lately, there has been an increased incidence of late stent thrombosis; especially following Drug eluting stent (DES) implantation.3 Several factors are associated with an increased risk of stent thrombosis, including the procedure itself, patient and lesion characteristics, stent design, and premature cessation of anti-platelet drugs.11 We present a case of late stent thrombosis (LST) following DES implantation after a period of 68 months, making it the longest reported case of LST reported in the literature, despite the use of dual anti-platelet therapy. http://www.casesjournal.com/content/3/1/68 Tarun Nagrani Medhat Zaher Sainath Gaddam George Jabbour Duccio Baldari Roberto Baglini Srinivas Duvvuri Cases Journal 2010, 3:68 2010-02-23T00:00:00Z doi:10.1186/1757-1626-3-68 Cases Journal 1757-1626 3 68 2010-02-23T00:00:00Z PDF The incidence of tuberculosis is increasing in the United States. Extra- pulmonary involvement is more common in patients with HIV/AIDS. The diagnosis of Tuberculosis osteomyelitis requires a high degree of suspicion for accurate and timely diagnosis.We present a case of a 49 year old Caucasian male with HIV/AIDS who presented with a four -month history of soft tissue swelling in the left proximal thigh unresponsive to various broad spectrum antibiotics who was eventually diagnosed with Mycobacterium tuberculosis osteomyelitis of the left proximal femur. http://www.casesjournal.com/content/3/1/67 Supriya Mannepalli Levonne Mitchell-Samon Nilmarie Guzman Manish Relan Yvette McCarter Cases Journal 2010, 3:67 2010-02-23T00:00:00Z doi:10.1186/1757-1626-3-67 Cases Journal 1757-1626 3 67 2010-02-23T00:00:00Z PDF