Assessment of post-operative pain management at the American University of Beirut Medical Center.
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Adolescent↗
Biomedical subjects
A Mufarrij
Publications and source records attributed to A Mufarrij.
Concomitant fibrous dysplasia and aneurysmal bone cyst of the skull base. Case report and review of the literature.
The combination of fibrous dysplasia and aneurysmal bone cyst of the skull base is extremely rare yet it should be recognized, lest the rapid growth of the lesion and the radiological picture lead to the wrong diagnosis of a malignant process. We report on a 6(1/2)-year-old patient who suffered from concomitant fibrous dysplasia and aneurysmal bone cyst of the skull base. He is still disease-free 4 years postoperatively. The treatment of choice remains early surgical removal of the maximal amount of involved bone that can safely be achieved. There is no role for radiotherapy in the treatment of these lesions. A review of the literature is included.
Bone Cysts, Aneurysmal↗
Latent Epstein-Barr virus infection is an unlikely event in the pathogenesis of immunoproliferative small intestinal disease.
BACKGROUND: The observed seasonal and geographic variations in the incidence of immunoproliferative small intestinal disease (IPSID) suggest that environmental factors contribute to its pathogenesis. One such environmental factor, the Epstein-Barr virus (EBV), has been associated with other B-cell lymphoproliferative disorders. METHODS: IPSID tissues obtained at the time of initial diagnosis were retrieved from the American University of Beirut pathology archives (1972-1983) and examined for EBV genetic information by colorimetric in situ hybridization (ISH) and polymerase chain reaction (PCR). Eight patients were identified, four of whom also had serologic and immunohistochemical evidence of alpha-heavy chain disease. Thirteen tissue samples from these eight patients were available for study: eight were intestinal and five were nodal. Non-Hodgkin's B-cell lymphoma cases (nine) were randomly selected from the same archive to serve as a control for EBV in that geographic location. The ISH method used a probe to the "W" repetitive region of EBV, with the human placental DNA probe as a control for sample preparation. The PCR method amplified a 110 base pair region in the long internal direct repeat with amplification of beta-actin as control for DNA preservation. Both assays used formalin fixed paraffin embedded Raji cells as a positive control. RESULTS: Neither ISH nor PCR demonstrated EBV in any of the eight patients with IPSID: The results for one of seven control blocks with adequate DNA preservation were positive when PCR was used but were negative when ISH was used. CONCLUSIONS: These findings do not support a role for EBV in the induction of B-cell proliferation in IPSID:
Adolescent↗
Cardiac fibroma with tumor involvement of the mitral valve: diagnosis by cross-sectional echocardiography.
The clinical, cross-sectional echocardiographic, haemodynamic, and angiographic features of a case of cardiac fibroma in a newborn with unexplained pulmonary hypertension, and direct tumor involvement of the posterior leaflet of the mitral valve, are presented. The role of echocardiography in the pre-operative evaluation of cardiac tumors is discussed.
Echocardiography↗
Hypergonadotropic hypogonadism with congestive cardiomyopathy: an autosomal-recessive disorder?
We report on two sisters with ovarian dysgenesis and secondary hypergonadotropic hypogonadism and congestive cardiomyopathy. Their parents are first cousins. It is suggested that these are the main manifestations of a previously unreported autosomal-recessive syndrome.
Adolescent↗
Hemorrhagic cystitis and sicca syndrome secondary to amyloidosis in rheumatoid arthritis.
Vesical bleeding and sicca complex proved to be due to unrecognized amyloidosis in a patient with chronic rheumatoid arthritis. The features of amyloidosis of the lower genitourinary tract are outlined.
Aged↗
Candida tropicalis endocarditis in idiopathic hypertrophic subaortic stenosis.
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Candidiasis↗
Congenital infiltrating lipomatosis of the face: clinicopathologic evaluation and treatment.
Congenital lipomatosis of the face is characterized by collections of nonencapsulated, mature lipocytes which infiltrate local tissues and tend to recur after surgery. These lesions represent a distinct clinicopathologic entity that has not been previously reported in this location in children. Three children with congenital lipomatosis of the face were treated at the Institute of Reconstructive Plastic Surgery over a 2- to 14-year follow-up period. In each instance, pathologic evaluation by light and electron microscopy revealed similar lesions sharing the following morphologic criteria: (1) nonencapsulated tumors containing mature fat cells, (2) infiltration of adjacent muscle and soft tissue, (3) absence of malignant characteristics, (4) absence of lipoblasts, (5) presence of fibrous elements in conjunction with increased numbers of nerve bundles and vessels, and (6) hypertrophy of subjacent bone. All three lesions recurred after numerous excisions, some of which were extensive. All were benign by histologic examination and remained so for as long as 14 years. Surgical treatment improved the aesthetic appearance of each child despite evidence of tumor persistence. Although these tumors are benign, we recommend an early aggressive surgical approach to control the infiltrative nature of their growth and to improve facial appearance.
Child↗
Giant lymph node hyperplasia. An immunopathologic and ultrastructural study of a case of the multicentric plasma cell variant.
A case of the multicentric plasma cell variant of giant lymph node hyperplasia (Castleman's disease) was studied. The left supraclavicular and axillary lymph nodes were affected. The parafollicular region of the lymph nodes was greatly expanded by sheets of mature plasma cells and by regionally concentrated as well as singly occurring immunoblasts. Both plasma cells and immunoblasts were polyclonal, as judged by the heterogeneity of immunoglobulin light-and heavy-chain components documented by immunofluorescence microscopy and immunohistochemistry. Ultrastructurally, free ribosomes and polyribosomes were the predominant cytoplasm organelles seen in immunoblasts. In plasma cells, rough endoplasmic reticulum was typically abundant and often contained electron-dense secretory product.
Female↗
A method for the dissection of lymph node specimens (anatomic method).
A method called the "anatomic method" of dissecting lymph nodes in a variety of cancer specimens, is presented. It is found to be comparable to the clearing method in terms of detecting lymph nodes and is unencumbered by the slow turnaround time and economic inconvenience. The anatomic method is described in four steps, illustrated by a schematization of the technique. Its advantages over the clearing method include: 1) it is time saving; 2) it is conducted on the fresh state specimen; 3) it is economical; 4) it reduces the monotony often associated with such dissections; 5) it serves as a teaching exercise. Adoption of the method by pathologists is recommended.
Dissection↗
Diagnosis of congenital mitral and aortic stenosis from the fetal electrocardiogram.
A case of congenital mitral and aortic stenosis diagnosed from the fetal electrocardiogram (FECG) during labor is presented. Cardiologic work-up and autopsy findings in the neonate confirmed the diagnosis. This is the first case in which prenatal diagnosis of a specific anatomical lesion of the heart was made from the FECG and confirmed clinically as well as at autopsy.
Adult↗
Mammary carcinoma with osteoclastlike giant cells cytologically mimicking benign breast disease. A case report.
BACKGROUND: Mammary carcinoma with osteoclastlike giant cells (OCLGCs) is a rare tumor. Few reports on the fine needle aspiration (FNA) findings are available. This case had cytologic findings overlapping with benign breast disease. CASE: A 50-year-old woman presented with multiple masses in her right breast and a 2-cm right axillary lymph node. Cytologic scrapings and FNA of the same breast mass showed large cohesive, two-dimensional epithelial cells with a uniform distribution of small, bland nuclei. Discohesion, single cells with features of malignancy, cytologic atypia and mitosis were lacking. Many OCLGCs were present. CONCLUSION: The cytologic features of this rare type of breast carcinoma need to become familiar to pathologists to avoid a false negative diagnosis.
Biopsy, Needle↗
Gastric leiomyosarcoma: a clinicopathologic study.
Seven patients with gastric leiomyosarcoma (LMS) and leiomyoblastoma (LMB) were seen at the American University of Beirut Medical Center in the period 1970-1983. The natural history, clinical presentation, radiologic findings, histopathologic features and treatment modalities of these patients are discussed. The anatomic location of the tumor had no relation to the occurrence and number of mucosal ulcers. Ulcerations were more frequent with endogastric than exogastric tumors. Histologic pattern, cell shape and number of mitotic figures were the basic morphological criteria for differentiating between LMS and LMB. Maintenance of a reasonable gastric reservoir and avoidance of total or near total gastrectomy are important factors affecting long term morbidity following surgical resection.
Adult↗
Cancer in Lebanon: analysis of 10,220 cases from the American University of Beirut Medical Center.
Cancers seen and recorded between 1983 and 1995 in the Hospital Tumor Registry at the American University of Beirut Medical Center (AUBMC), one of the largest primary and tertiary care hospitals in Lebanon, were retrospectively reviewed and analyzed. There was a total of 10,220 cases, excluding 916 skin cancers other than skin melanoma, averaging 786 cases per year. There were 5086 cancer cases in males with the five most common cancers being: lung cancer (915 cases: 17.9%) followed by bladder cancer (503 cases: 9.8%), larynx (438 cases: 8.6%), lymphoma (393 cases: 7.7%) and leukemia (336 cases: 6.6%). As for female cancer cases, a total of 5134 cases were observed with the five most common cancers being: breast cancer (1821 cases), followed by cervical cancer (535 cases), colo-rectal cancer (256 cases: 4.9%), lymphoma (232 cases: 4.5%), and brain cancer (213 cases: 4.1%). The average age for all cancer cases was 50.5 years with a standard deviation (SD) of 18.8 years. The average age of females (48.8 yrs; SD 17.4) was relatively lower than that of males (52.2 yrs; SD 19.9) and the difference was statistically significant. 40.6% of the patients were under the age of 50 years. 49% of breast cancer patients were below 50 years of age. In children less than 15 years of age, there were 555 cases, with leukemia being the commonest (185 cases: 33.3% of childhood cases) followed by brain cancer (112 cases: 20.1%), lymphoma (63 cases: 11.3%), bone cancer (41 cases: 7.3%), soft tissue sarcoma (35 cases: 6.3%) and kidney cancer (28 cases: 5.0%). Lung cancer in males and breast cancer in females are the most common cancers in Lebanon. These cancers are amenable to prevention (cigarette cessation and anti-smoking campaigns for lung cancer) and early detection (screening, regular breast examination and mammography for breast cancer). Our paper emphasizes the importance of addressing those and other issues including bladder cancer and age at diagnosis of breast cancer. It also presents important epidemiological and historical reference data on cancer in Lebanon during the civil war and immediately after it.
Adolescent↗