Non-Hodgkin lymphoma, diagnostic, and prognostic particularities in children – a series of case reports and a review of the literature (CARE compliant)

Mărginean, Cristina Oana; Meliţ, Lorena Elena; Horváth, Emőke; Gozar, Horea; Chinceşan, Mihaela

doi:10.1097/md.0000000000009802

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…The imagistic tools are extremely useful in establishing the diagnosis of ovarian tumors and they usually consist in pelvic and abdominal ultrasound. [6] Ultrasound is widely used in the assessment of multiple pediatric pathologies, such as abdominal tumors, [9] inflammatory bowel diseases [10,11] (IBD-urile si SCAD-ul), but also cardiac malformations. [12] In certain cases, abdominal-pelvic MRI may also be required.…”

Section: Discussionmentioning

confidence: 99%

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

Mărginean¹,

Chinceşan²,

Mărginean³

et al. 2019

Medicine

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Rationale: Ovarian or adnexal tumors are very rare in patients below the age of 18 years, most of them being functional cysts, only 10% being malignant. We report 3 cases of ovarian tumors with the aim of revealing the particularities regarding the diagnosis and management of benign and malignant ovarian tumors in pediatric patients. Patient concerns: The 1st case, a 9-year-old girl presented for diffuse abdominal pain, distended abdomen and rapid increase in abdominal volume. The 2nd case describes a 13-year-old female patient admitted for acute abdominal pain and nausea, and the 3rd one was an 18-year-old female teenager who presented for distended abdomen, intermittent diffuse abdominal pain and rapid increase in abdomen volume. Diagnoses: The abdominal ultrasound revealed in all 3 patients suggestive signs for ovarian tumors. Interventions: The 1st patient underwent laparotomy with adnexectomy, and the histopathological exam showed the diagnosis of dysgerminoma . The 2nd patient underwent laparoscopy with adnexectomy, and the histopathological exam revealed a borderline tumor . The 3rd patient benefited by a laparotomy with left ovariectomy, and the histopathological exam pointed out a mature teratoma. Outcomes: The outcome was favorable in all 3 cases, but the patients with dysgerminoma and mature teratoma were further referred to the oncologist for proper assessment. Lessons: Laparoscopy may represent the first choice for uncomplicated ovarian masses. The diagnosis and the therapeutic plan must be based on symptoms, pelvic ultrasound, the time of menarche and the potential serum markers.

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Section: Discussionmentioning

confidence: 99%

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

Mărginean¹,

Chinceşan²,

Mărginean³

et al. 2019

Medicine

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“…In our patient, non-caseating granulomas were identified in all biopsy specimens. Because the transbronchial approach was unsuccessful, we were forced to perform an open surgery for mediastinal and lung biopsies in order to confirm the diagnosis and to exclude the possibility of other pathologies ( 27 ). Thus, other similar granulomatous disorders include Blau syndrome, autoimmune lymphoproliferative syndrome, or Crohn disease.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia, an Important Puzzle Piece in Uncommon Onset Pediatric Sarcoidosis—A Case Report and a Review of the Literature

et al. 2020

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Sarcoidosis (SD) is a systemic granulomatous condition that is especially encountered in young adults and rarely in children, affecting predominantly the lungs and lymph nodes. We report the case of a 14-year-old teenage boy admitted to our clinic for nausea, vomiting, and weight loss. Clinical examination at the time of admission revealed malaise, pallor, and abdominal tenderness in the epigastric area at palpation. Laboratory tests revealed an elevated level of hemoglobin, mild thrombocytosis, increased erythrocyte sedimentation rate, and a mild increase in creatinine and urea levels along with hypercalcemia. An abdominal ultrasound revealed a right ectopic kidney, whereas the upper digestive endoscopy showed intense hyperemia and edema of the gastric mucosa. Thoracic computed tomography scan revealed giant hilar and mediastinal lymphadenopathy, along with multiple micronodules within the lung parenchyma and ground-glass aspect. The level of angiotensin-converting enzyme was high, parathormone was normal, and vitamin D level was low. Pathological examination of the bronchial, mediastinal, and lung biopsies established the diagnosis of SD. We administered oral corticosteroids for 2 months with outstandingly favorable outcome and no signs of recurrence 6 months after the cessation of the therapy.

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“…Extremes of age represents an important risk factor for the development of CAAs associated to KD along with male gender, prolonged fever and a delay in diagnosis or treatment. [7] Thus, most often KD is misdiagnosed as infectious pathology, autoimmune disorders, [9,10] malignancies, [11,12] or even sepsis. [13] Echocardiography is therefore essential in diagnosing different cardiopathies.…”

Section: Discussionmentioning

confidence: 99%

The peculiarities of Kawasaki disease at the extremes of age

Mărginean¹,

Meliţ²,

Mărginean

2019

Medicine

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Rationale:Extremes of age is an important risk factor for the development of coronary arteries aneurysms (CAAs) associated to Kawasaki disease (KD) along with male gender, prolonged fever and a delay in diagnosis or treatment.Patient concerns:We report two cases of KD in the extremes of age, a 5-month-old male infant and a 9-year-old child in order to underline the features of this disorder outside the typical age range of 1 to 4 years. The 5-month-old male was admitted in our clinic for generalized polymorphous exanthema and fever for approximately 7 days. The laboratory test pointed out leukocytosis and increased inflammatory biomarkers. The 9-year-old male child was admitted in our clinic for fever and submandibular adenopathy. The onset was approximately 5 days before the admission with a sudden development of unilateral, painless, submandibular lymphadenopathy for which the ENT specialist recommended antibiotics and nonsteroid anti-inflammatory drugs. In the 2nd day of admission, he presented severe desquamation of hands and soles.Diagnosis:Both cases were diagnosed with KD. The echocardiography showed no cardiac impairment in the infant, while in the older patient it revealed mild dilation of the left coronary artery.Interventions:Both patients received intravenously immunoglobulin and pulsed methylprednisolone.Outcomes:The evolution was favorable in both cases, but in the infant, the C-reactive protein levels persisted mildly elevated for approximately 2 months after the diagnosis.Lessons:The peculiarities of KD in the extremes of age are related to a higher frequency of incomplete features and an increased incidence of coronary artery lesions resulting in a delay of the diagnosis, and subsequent poorer outcomes.

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Non-Hodgkin lymphoma, diagnostic, and prognostic particularities in children – a series of case reports and a review of the literature (CARE compliant)

Cited by 17 publications

References 22 publications

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

Hypercalcemia, an Important Puzzle Piece in Uncommon Onset Pediatric Sarcoidosis—A Case Report and a Review of the Literature

The peculiarities of Kawasaki disease at the extremes of age

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