Brain tumors are the second most common etiology in pediatric patients with focal seizures undergoing surgery for drug-resistant epilepsy. These neoplasms have a number of distinctive features from those found in adult patients, one of which is a wide polymorphism of structural architectonics during neuroradiological examination. Given the tremendous biological stability of these tumors, not in all cases of pre-surgical examination it is possible to verify the presence of a neoplastic process in the structure of the epileptogenic substrate using routine neuroimaging methods. In some complex diagnostic cases, a multimodal imaging approach and in-depth complex examination are required for reliable diagnosis and success of the results of epileptic surgery.

Морозовская детская городская клиническая больница ДЗ Москвы 1 , Российский национальный исследовательский медицинский университет им. Н.И. Пирогова МЗ РФ 2 , Москва, Центральный научно-исследовательский институт эпидемиологии Роспотребнадзора 3 , Федеральный научно-исследовательский центр эпидемиологии и микробиологии им. Н.Ф. Гамалеи МЗ РФ 4 , Москва, Россия В статье представлен случай врожденной пневмоцистной инфекции, убедительно доказанной и подтвержденной различными методами лабораторной диагностики, в т.ч. морфологическими со специальной окраской. Помимо этого, были обследованы родители, которые явились источниками инфицирования. Врожденные пневмонии, особенно у недоношенных новорожденных, представляют собой непосредственную угрозу жизни. В связи с этим своевременное обследование матери и ребенка, а также назначение этиотропных антибактериальных препаратов являются важной задачей по предотвращению фатальных исходов данного заболевания.

Background. Ependymomas are a group of glial tumours, usually occurring in the posterior cranial fossa, less often — in the lateral ventricles and spinal cord. Most often, the recurrence of ependymomas occurs in primary sites, or in the central nervous system (CNS). Ependymoma metastasis beyond the craniospinal system occurs rarely if ever. Description of a Clinical Case. A clinical example of extraneural metastasis to the bones and bone marrow in a 10-year-old patient with supratentorial anaplastic ependymoma after complex therapy has been presented. A review of published cases of the development of extraneural ependymoma metastasis in children has been presented. An attempt was made to consider possible risk factors for their development. Conclusion. Ependymal tumours are capable of extraneural metastasis to the bone and hematopoietic systems. Continued growth and metastasis lead to extremely unfavourable prognosis for the disease.

Pneumocystosis is well known as an opportunistic infection that is presently most frequently registered in patients with HIV infection and in those with other immunodeficiency states. Earlier, after the Second World War, Pneumocystis pneumonia was most commonly detected in debilitated and premature children; nosocomial outbreaks of pneumocystosis were studied in detail in the 1960s and 1970s. The pathogen is transmitted through the air, but a number of references indicate that it can be transmitted through the placenta. Despite the increasing number of publications on pneumocystosis in pediatrics, physicians remain unfamiliar with this disease. The paper provides evidence that Pneumocystis jiroveci can infect the fetus in utero. If unrecognized, the disease can lead to a child's death due to severe respiratory failure. The authors describe their case of generalized pneumocystosis that has developed in a child with evidence of intrauterine infection (detection of the pathogen in the autopsy material and placenta and identification of serological markers in his/her parents). The issues that are associated with intrafamilial infection and a risk for in utero transmission of P. jiroveci are discussed.

Introduction. At present, lymphadenopathy – as a cause of idiopathic intestinal intussusception in little children - comes to the fore. However, intestinal intussusception in case of destructive mesenteric lymphadenitis in combination with lymphoid hyperplasia of the ileocecal angle ( what does not exclude lymphoma intraoperatively) is extremely rare in clinical practice.Purpose. To present a therapeutic and diagnostic algorithm in intestinal intussusception which was caused by the “volumetric“ abdominal lymphadenopathy.Case Report. A 3-year-old boy was admitted by the ambulance with recurrent abdominal pain, single episode of vomiting and no stool for 4 days. The ultrasound examination revealed intermittent ileocecal intussusception. The risk factor which had triggered the disease was an acute respiratory viral infection complicated with purulent mesenteric lymphadenitis and lymphoid hyperplasia with ulcerative lesions of the mucous membrane in the ileocecal junction. Laparoscopic desinvagination with lymph node removal and colonoscopy with ladder biopsy were performed. A differential diagnostics of nonspecific lymphadenopathy, Burkitt’s lymphoma and Crohn’s disease was made. Immunohistological examination intraoperatively was made; examination of the biopsy material excluded tumor and inflammatory bowel disease (IBD). The inflammatory process regressed under conservative therapy (antibacterial, anti-inflammatory and antispasmolytic) ; there were no any recurrent intussusception episodes within one-year follow-up.Conclusion. Successive ultrasound, laparoscopic and colonoscopic examinations followed by the immunohistological analysis of intraoperative and biopsy material allowed to put a correct diagnosis and, thereby, to minimize surgical aggression in ileocecal intussusception which was accompanied by volumetric lymphadenopathy.