Bladder cancer: staging with CT and MR imaging

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in 30 patients with histologically proved bladder cancer. MR imaging was accurate in depicting the presence or absence of extravesical spread in 22 patients (accuracy, 73%; sensitivity, 82%; specificity, 62%), and CT was accurate in 24 patients (accuracy, 80%; sensitivity, 94%; specificity, 62%). The MR examinations of two patients were of undiagnostic quality and therefore considered to be technical failures. Each technique resulted in five false-positive and one false-negative examination for the diagnosis of extravesical tumor spread. In 28 patients the integrity of the bladder wall was assessed with MR imaging. In 22 patients the bladder wall was disrupted, and 18 of these patients had deep muscle invasion. In six patients the bladder wall was intact, and none of these patients had evidence of deep muscle invasion at pathologic examination. In this study MR imaging was slightly inferior to CT in the delineation of invasive tumors beyond the bladder wall. However, if one excludes from analysis the two patients with undiagnostic studies, there is no significant difference in accuracy between the two techniques.     

The incidence,aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital

Background  

Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya.     

Polymorphous hemangioendothelioma in a child with acquired immunodeficiency syndrome (AIDS)

Polymorphous hemangioendotheliomas (PH) are rare and borderline malignant tumors that are among the wide range of vascular tumors. We report here a 13-year-old male presenting with a history of weight loss, opportunistic infections, and lymphadenopathy. He was determined to be HIV positive and to have acquired immunodeficiency syndrome (AIDS). A biopsy of a femoral node was diagnostic of PH. His systemic lymphadenopathy appeared to resolve with anti-retroviral therapy. This tumor should be considered within the differential diagnoses of pediatric and immunocompromised patients.     

Evaluation of skin biopsies for fungal infections: role of routine fungal staining

Background: The diagnosis of cutaneous fungal infection is usually made on clinical examination of the lesion and direct microscopic examination of skin scrapings with potassium hydroxide. Histopathological examination is rarely required to confirm dermatophytic infections. There is often a discord between the clinical and histopathological findings and many times clinical appearance can have a poor histopathological correlation. Methods: This retrospective study was carried out on all skin biopsies received in a period of 1 year. The clinical details of all cases were retrieved and slides were reviewed. Routine fungal staining periodic acid‐Schiff (PAS) stain was performed in all cases. Results: Of 403 skin biopsies received in 1 year, material for further staining was available in 338. On re‐examining the slides stained with PAS stain, fungi were identified in 34 cases (10%), of which fungal infection had been suspected clinically in five cases. Conclusions: Use of routine stains like PAS can help to reach a correct diagnosis and initiate appropriate treatment. Fungal staining should be done in skin biopsies with non‐specific clinical details and microscopic findings for best patient management.