Case report of a granular cell tumour in the nasal septum of a child

A six-year-old child with a nasal septal polyp presents with pain and nasal discharge. The diagnosis of a granular cell tumour was made histologically on excision of the polyp. This interesting case of an uncommon lesion presenting in a relatively rare paediatric age group is, as far as we know, the first report of a granular cell tumour involving the nasal septum.

Focal nodular hyperplasia: an unusual liver mass in a paediatric patient

We report an unusual case of focal nodular hyperplasia (FNH) occurring in a 19-month-old female without a typical central fibrous scar. Ultrasound demonstrated a solid, hypoechoic, highly vascular mass situated in the left lobe of the liver. Computed tomography showed a solid mass with no evidence of a central fibrous scar. A hepatic angiogram demonstrated enlarged right and left hepatic arteries supplying the vascular tumour, with early venous drainage into the inferior vena cava; a feature which has not been previously described. Surgical resection was carried out and a solid, nodular tumour measuring 9 x 4 x 4 cm was removed. The diagnosis of FNH was made histologically. The characteristic imaging findings of FNH will be discussed and a review of the literature of FNH in children will be presented.

Salvia miltiorrhiza reduces experimentally-induced hepatic fibrosis in rats

BACKGROUND/AIMS

Hepatic fibrosis occurs as a result of injury to the liver parenchyma and biliary system. We have studied the effect of the traditional Chinese medicinal herb, Salvia miltiorrhiza, in an experimental model of hepatic fibrosis and evaluated its effect on various paradigms involved in hepatic fibrosis.

METHODS

Liver fibrosis was induced in male Wistar rats by chronic administration of carbon tetrachloride for 10 weeks. The carbon tetrachloride-treated rats were randomly assigned to three groups: no treatment, Salvia for 12 weeks from the onset of carbon tetrachloride treatment, and Salvia for 2 weeks after the completion of the 10-week course. The normal control groups in the study were: neither carbon tetrachloride nor Salvia, and Salvia only for 12 weeks. The livers were graded histologically and analyzed by reverse transcription-polymerase chain reaction for the transcription of genes involved in liver fibrosis, namely, transforming growth factor-beta1 and the extracellular matrix components procollagens I and III, tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-13. The transcripts were normalized against that of glyceraldehyde-3-phosphate dehydrogenase and analyzed statistically.

RESULTS

The histological evaluation showed that Salvia could reverse the fibrosis caused by carbon tetrachloride treatment. Rats treated with the herb had reduced levels of transforming growth factor-beta1, procollagens I and III and tissue inhibitor of metalloproteinase-1 transcripts and an increased level of matrix metalloproteinase-13 transcript, when compared to the disease control.

CONCLUSION

Salvia miltiorrhiza, a cheap and widely available herb, significantly reduces carbon tetrachloride-induced hepatic fibrosis in rats.

Holoprosencephaly and chromosomal anomalies

Holoprosencephaly is a rare cerebral malformation resulting from failure or incomplete cleavage of the forebrain. The sonographic diagnosis consists of monoventricle, fused thalami and absent cavum septum pellucidi. Chromosomal anomalies, diabetes mellitus, alcohol, autosomal recessive inheritance and toxins have been implicated. We describe seven cases of holoprosencephaly diagnosed in the antenatal and postnatal periods. The chromosomal anomalies included trisomy 13, triploidy, trisomy 13 with an unbalanced 13; 14 translocation and isochromosome of the long arm of 18. The clinicopathological findings and chromosomal anomalies are correlated.

Kimura's disease involving the median nerve: a case report

Kimura's disease is an uncommon chronic inflammatory process of obscure origin. It is more common among Orientals and affects particularly the young male. Sites of predilection include the head and neck region, primarily the subcutaneous tissue and dermis. Unusual sites of occurrence that have been reported include the kidney, the orbit, the ear and the spermatic cord. Kimura's disease involving a major nerve bundle has not been described, and we report here the findings of a case of histologically proven Kimura's disease of the median nerve occurring in a 21-year-old Chinese girl. Typical diagnostic histological features of Kimura's disease in contrast to angiolymphoid hyperplasia, and the treatment options for Kimura's disease are also described.

Myxoma of the maxillary antrum in children

Myxomas of the maxillary antrum are rare tumours, particularly in childhood. Although circumscribed, they are often more extensive than apparent and so tend to recur despite their benign nature. Myxomas are gelatinous and are composed of stellate and spindle cells embedded in an abundant alcian blue-positive, mucoid stroma in which blood vessels are often scattered throughout the tumour. Three patients with maxillary myxomas, all presenting in infancy or early childhood, are described.

Adenosquamous carcinoma of the ileum--a case report

Small bowel malignancies are very uncommon and adenosquamous carcinomas of the small intestine are extremely rare. We report the second case of an adenosquamous carcinoma of the ileum in a 77-year-old Chinese male.

Clear cell carcinoma of the lung--a case report

Clear cell carcinoma of the lung is a rare entity. We report the first case seen locally. The patient is symptomatic, presenting with a large pulmonary tumour. Histologically, there were clusters of large tumour cells with ample clear cytoplasm and absence of mucin, glandular and squamous differentiation. Urine analysis, blood carcinoembryonic antigen level and abdominal CT scan were normal.

Dieulafoy's disease: cause of massive upper gastrointestinal haemorrhage in two Asian women

Dieulafoy's disease is a submucous arterial malformation of the stomach, and is a known cause of massive upper gastrointestinal bleeding. To date, 125 cases have been reported in the literature. Fatality is high if the condition remains undiagnosed. Endoscopy is difficult but important in the diagnosis of Dieulafoy's disease. Dieulafoy's disease in two Asian women are reported here. Both required large amount of blood transfusions as the diagnosis was not recognised early. Greater awareness of the condition will enable earlier diagnosis and reduced mortality from this condition.