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13
100432
13
The histology showed that tumor cells were arranged in a rare trabecular pattern with a prominent lymphoid stroma.
[]
100432
14
Carcinomatous cells were polygonal with granular amphophilic cytoplasm and a nucleus with fine chromatin.
[]
100432
15
Nucleoli were generally inconspicuous.
[ [ "Up to 8 mitoses per 10 HPF", "counted" ] ]
100432
16
Up to 8 mitoses per 10 HPF were counted.
[]
100432
17
No lympho-vascular component or intraductal component was noted.
[ [ "grade II", "Scarf" ] ]
100432
18
The tumor was grade II of Scarf Bloom Richardson.
[]
100432
19
Surgical margin was clear.
[]
100432
20
The resected axillary lymph nodes contained metastases, including one/19 N level I lymph nodes.
[]
100432
21
The immunohistochemistry study showed an expression of the following antibodies Ck (AE1/AE3) on the carcinomatous component, CD3 and CD20 with homogenous distribution in the stroma.
[]
100432
22
The Ki-67 labeling index was: 40% (estimated on 10HPF), Estrogen receptor status were 90%, progesterone receptor 10% (both using Allred score) and the human epidermal growth factor was negative.
[ [ "40%", "index" ], [ "90%", "receptor" ], [ "10%", "receptor" ], [ "negative", "factor" ] ]
100432
23
Based on the histopathological and immunohistochemical findings the case has been reported as lymphoepithelioma-like carcinoma of the breast and staged as pT1N1M0.
[ [ "pT1N1M0", "staged" ] ]
100432
24
The post-operative pet scan showed no distant metastasis.
[]
100432
25
The laboratory data showed a normal level of carbohydrate antigen 15-3(CA15-3: 39.8 U/ml).
[ [ "a normal level", "antigen" ], [ "39.8 U/ml", "CA15-3" ] ]
100432
26
Following surgery, the patient underwent four cycles of doxorubicin and cyclophosphamide and twelve cycles of paclitaxel chemotherapy.
[]
100432
27
She declined endocrine therapy and was treated with radiotherapy commencing 3 weeks after chemotherapy.
[]
100432
28
The radiation dose was 50Gy in 25 fractions using a 6MV photon tangent pair followed by a boost of 10Gy in 5 fractions using 6MV photon tangent pair.
[]
100432
29
Regular follow up consists of physical examination every three months.
[]
100432
30
At her 1 year follow-up, the patient was doing well with no evidence of recurrent disease.
[]
100453
1
A 3 years old girl born from non-consanguineous parents, without any neonatal suffering; with good psychomotor development, from a popular district in one of our cities, without any obvious contact with dogs; presented with exophthalmia associated with unilateral blindness evolving rapidly within 3 months.
[]
100453
2
Clinical examination showed a non-pulsatile, painless, axial, irreducible exophthalmia with no sign of conjunctivitis or keratitis, and right monocular blindness, right ptosis; and fundal examination had objectified right papillary oedema.
[]
100453
3
The rest of the clinical examination was normal.
[ [ "normal", "examination" ] ]
100453
4
Brain and orbital magnetic resonance imaging (MRI) revealed an extra-connal right orbital lesion near the orbital apex, measuring 28 x 18mm, of oval shape, it appeared hypo-signal in T1 and hyper-signal in T2, limited by a thin wall which took contrast product, this lesion compressed the optic nerve towards the nasal region.
[ [ "28 x 18mm", "measuring" ] ]
100453
5
Chest x-ray and abdominal ultrasound did not reveal any other localization.
[]
100453
6
The patient was operated by performing a right extra-dural frontal approach, a cyst puncture was done in the first intention because the cyst was adherent to the neighbouring structures making its complete removal impossible, then a microscopic extirpation of the cystic membrane, combined with abundant washing by hypertonic serum to sterilize the cystic sit and reduce chances of dissemination.
[]
100453
7
Histological examination was in favour of intra-orbital hydatidosis.
[]
100453
8
Postoperatively, the patient was given an antihelminthic treatment of albendazole at a dose of 10mg per kilogram per day in 3 doses separated by 2 weeks; the evolution was marked by the significant regression of the exophthalmia and the gradual improvement of the visual acuity.
[]
100453
9
The patient however still retains a right unilateral nasal hemianopia after two years of follow-up.
[]
100453
10
An MRI done in the same period shows a cure of the patient by a complete disappearance of the cyst.
[]
100490
1
We received a boy 3-year-old boy with autistic disorder on hospital of pediatric ward A at university hospital Mohammed VI of Marrakesh.
[]
100490
2
He has no family history of illness or autistic spectrum disorder.
[]
100490
3
The history revealed that at 2 years of age.
[]
100490
4
The child was diagnosed with a ‘‘severe communication disorder,'' with social interaction difficulties and sensory processing delay.
[]
100490
5
A composite follow-up of all previous assessments and investigations was undertaken.
[]
100490
6
Blood work was normal (thyroid-stimulating hormone (TSH), hemoglobin, mean corpuscular volume (MCV), and ferritin).
[ [ "normal", "work" ] ]
100490
7
Genetic testing was unremarkable (normal karyotype, negative for fragile X) and the magnetic resonance imaging (MRI) in search of a demyelinating attack of the white matter, electroencephalography (EEG), optometry assessment were also normal.
[ [ "normal", "karyotype" ], [ "negative", "X" ], [ "normal", "imaging" ], [ "normal", "MRI" ], [ "normal", "assessment" ], [ "normal", "EEG" ], [ "normal", "electroencephalography" ] ]
100490
8
At the conclusion of this composite assessment, the boy was given a primary diagnosis of autistic spectrum disorder.
[]
100490
9
A plan was instituted including speech-language therapy, intensive individualized educational programming, and contact was encouraged with the Autism Society.
[]
100490
10
For that purpose, the parents moved to morocco to be surrounded by family without any huge improvement.
[]
100490
11
Upon direct questioning at initial presentation, the 3-year-old child was reported by the parents to have unexplained fatigue, Gastrointestinal symptoms included bloating, constipation and diarrhea.
[]
100490
12
Psychiatric symptoms included a frequently depressed mood, disproportionate anger, and emotional lability.
[]
100490
13
On exploring his history, the child was born from yemenite father and Moroccan mother in Germany at-term weighing 3500 g with an Apgar score of 9 at 1 minute and 10 at 5 minutes after an uneventful pregnancy and delivery.
[ [ "3500 g", "weighing" ], [ "9", "Apgar" ], [ "10", "Apgar" ] ]
100490
14
No concerns were present in the neonatal period.
[]
100490
15
Development in the first 24 months of life appeared fine according to the parents-his motor skills seemed to progress normally and he achieved expected milestones.
[]
100490
16
After 2 years of age, however, his language skills slowly began to regress.
[]
100490
17
He also demonstrated a change in temperament as he started to whine repeatedly and to scream without provocation.
[]
100490
18
Physical examination revealed a height and weight normal for age.
[ [ "normal", "weight" ], [ "normal", "height" ] ]
100490
19
He was uncommunicative, restless, and somewhat agitated.
[]
100490
20
General examination was unremarkable other than dark rings around the eyes.
[]
100490
21
There were no dysmorphic features evident.
[]
100490
22
He had difficulty maintaining eye contact, and he appeared disinterested in what was taking place.
[]
100490
23
No abnormality was found on abdominal assessment.
[]
100490
24
Anti-tissue transglutaminase antibodies levels were 76 U (normal < 10).
[ [ "76 U", "levels" ] ]
100490
25
The patient underwent upper endoscopy as duodenal biopsy to confirm a celiac disease diagnosis.
[]
100490
26
It shows a total villous atrophy corresponding to a stage 4 of Marsh classification.
[ [ "stage 4", "classification" ], [ "stage 4", "atrophy" ], [ "positive screen", "disease" ] ]
100490
27
Given the positive screen for celiac disease (positive anti-tissue transglutaminase antibodies and results of duodenal biopsy), dietary intervention was immediately commenced.
[ [ "positive", "results" ], [ "positive", "antibodies" ] ]
100490
28
All gluten was eliminated from the boy's diet.
[]
100490
29
Within 1 month, the boy's gastrointestinal symptoms were relieved and his behavior had changed.
[]
100490
30
The mother reported that her boy became progressively more communicative.
[]
100490
31
The child has continued on the gluten-free diet and has progressed well and remained healthy over the following 6 months.
[]
100600
1
A 12-year-old girl was referred to Department of Oral Surgery, with a complaint of pain and swelling in the left of maxilla that appeared 3 months ago.
[]
100600
2
The swelling was slowly progressive, associated with pain.
[]
100600
3
However, the patient did not refer any motor or sensory deficit.
[]
100600
4
There was no family history of similar swelling.
[]
100600
5
Physical examination revealed a left maxillary swelling.
[]
100600
6
There was no facial palsy.
[]
100600
7
No cervical lymph node enlargement was seen.
[]
100600
8
The oral examination showed a 4 cm x 5 cm, tender, compressible mass in the left maxilla, from the lateral incisor to the second premolar teeth.
[]
100600
9
The tumor surface was smooth and red-purple.
[]
100600
10
Several teeth were involved and displaced in the tumor mass.
[]
100600
11
We noted the absence of canine.
[]
100600
12
Vitality tests proved negative on the central and lateral incisor.
[ [ "negative", "tests" ] ]
100600
13
Hight mobility of lateral incisor was noted.
[]
100600
14
Orthopantomography and occlusal radiography showed a wide osteolytic area of the anterior left maxilla, extending from the first permanent molar to the central incisor.
[]
100600
15
The canine was impacted.
[]
100600
16
No root resorption was observed.
[]
100600
17
The radiolucency was closely related to maxillary sinus and involving the nasal cavity.
[]
100600
18
Haematological investigations showed normal serum calcium, phosphorus and parathormone (PTH) levels.
[ [ "normal", "levels" ] ]
100600
19
The provisional diagnosis of benign tumor of the maxilla was made.
[]
100600
20
The patient underwent excision and curettage of the mass with extraction of the canine and lateral incisor tooth.
[]
100600
21
The wound was closed with interrupted sutures.
[]
100600
22
The post-operative histopathological report revealed multinuclear giant cells scattered randomly throughout the cellular and fibrous vascular-rich tissue.
[]
100600
23
New bone formation and granulation tissue rich in mononuclear inflammatory cells was revealed.
[]
100600
24
The giant cells were multinucleated with bland-appearing nuclei, and the background stromal cells displayed no evidence of atypical mitoses.
[]
100600
25
A diagnosis of giant cell tumor was established.
[]
100600
26
During a 1-year serial clinical and radiological follow-up, there was no evidence of recurrence.
[]
100600
27
The facial contour and masticatory function were well-preserved.
[]
100606
1
A 43-year-old non-diabetic Indian male reported to our outpatient department with chief complaints of cough with expectoration, chest pain, reduced appetite, fever with chills, and night sweats for two weeks.
[]
100606
2
He also complained of breathlessness on exertion and had two episodes of blood in his sputum.
[]
100606
3
The patient explained that the cough was continuous and was relieved after taking cough syrup.
[]
100606
4
He also mentioned that the episodes of fever were initially intermittent and then daily for the last two weeks and were relieved after taking Paracetamol.
[]
100606
5
The chest pain was localized to the middle of the chest and was aggravated on exertion.
[]
100606
6
He was a businessman by profession with no history of smoking, alcoholism, or any other substance abuse.
[]
100606
7
Also, there was no history of any contact of TB or COVID-19 in the family or close contacts.
[]
100606
8
And there was no history of foreign travel in the recent past.
[]
100606
9
But he had reported having traveled by a domestic airline about twenty days back.
[]
100606
10
There was no history of weight loss or any other major illness in the past.
[]
100606
11
On examination his vitals were-pulse-108/minute, arterial BP-130/80 mm of Hg, respiratory rate of 30 breaths/minute, Sp02-899% on room air, temperature- 101-degree centigrade.
[ [ "108/minute", "were-pulse" ], [ "130/80 mm of Hg", "BP" ], [ "30 breaths/minute", "rate" ], [ "899%", "Sp02" ], [ "101-degree centigrade", "temperature" ] ]
100606
12
His Sp02 fell by 70% on room air after waking.
[]
100606
13
On auscultation, there was crepitation on the bilateral middle lobes of the lungs.
[]
100606
14
Also, dyspnea on exertion was noted.
[]