Massimo Poppi

Primary non-Hodgkin's lymphoma of the sciatic nerve followed by localization in the central nervous system: case report and review of the literature.

OBJECTIVE AND IMPORTANCE A unique case of primary non-Hodgkins lymphoma of the sciatic nerve followed by multiple loci in the central nervous system is described. CLINICAL PRESENTATION The lesion occurred in a 44-year-old immunocompetent man with a palpable mass in the left popliteal fossa and a 10-month history of progressive weakness and numbness of the left foot. The tumor was a diffuse large lymphoma of B-cell origin of an intermediate grade of malignancy according to the criteria of the International Working Formulation. INTERVENTION Because diagnosis of the malignant lymphoma was performed on frozen section, resection of the nerve trunk was avoided. The patient was treated with radiotherapy and chemotherapy. At 6 months after the discovery, biopsy, and treatment of the sciatic nerve lymphoma, other lesions demonstrating the same histological features were observed in the central nervous system. The patient died 4 years and 2 months after presentation as a result of the central nervous system lesions and without clinical evidence of systemic extraneural localization. CONCLUSION A review of the literature indicates that primary peripheral nerve lymphomas occur in the sciatic nerve. These cases, and the case described in our study, share common clinicopathological findings that justify discussing them separately as distinct entities.

CT scan and surgical treatment of traumatic iliacus hematoma with femoral neuropathy: case report.

Iliacus hematoma should be suspected as the cause of femoral neuropathy in cases of minor trauma in teenagers, especially when the onset of paralysis is delayed and therefore an acute traction injury of the nerve is unlikely. In our 14-year-old female patient the condition followed minor trauma. In such cases CT scan should be performed. When this reveals a hematoma and the nerve lesion is rapidly progressing or complete, the hematoma should be promptly evacuated.

Ganglionic cysts of the peroneal nerve at the knee: CT and surgical correlation.

The CT appearance of two cases of ganglionic cysts of the common peroneal nerve at the knee is reported. In both cases the ganglion appeared as a cystic unenhanced lesion of mucoid density. The radiological findings were confirmed by surgery. The differences in the appearance of intraneural and extraneural ganglia are discussed.

Amyloidoma of the brachial plexus

BACKGROUND Amyloidomas of the peripheral nervous system are rare lesions. Most commonly, they involve the gasserian ganglion and the branches of the fifth cranial nerve. No association with systemic amyloidosis has been reported. CASE DESCRIPTION We describe an amyloidoma of the lower trunk of the right brachial plexus. At the age of 34 years, this 71-year-old female had undergone radical right mastectomy for breast cancer with axillary lymph node dissection followed by radiotherapy. On admission, she presented with burning pain to the right hand and mild motor deficit to the ulnar-innervated intrinsic hand muscles. A palpable lesion was found in the supraclavicular region. On surgical inspection, the lesion appeared to originate from the lower trunk of the right brachial plexus. The middle and upper trunks were dislocated. Histologically, fibrous connective tissue embedded small nerve bundles featuring perineurial and endoneurial fibrosis as well as amyloid. Amyloid featured immunoreactivity for both lambda and kappa chains. DISCUSSION Localized amyloidoma of brachial plexus has never been reported. Because of compressive rather than infiltrative growth of the present lesion, a conservative surgery was achieved. Our immunohistochemical findings indicated that peripheral nerve amyloidomas are not, by definition, monoclonal in nature.

Intraneural ganglion of the peroneal nerve: An unusual presentation: Case report

The authors report an intraneural ganglion of the peroneal nerve at the fibular head, in which the external appearance of the nerve was normal at operation. Only the incision of the epineurium permitted discovery of the lesion.

Acute bilateral extradural hematomas in a case of osteogenesis imperfecta congenita

Acute bilateral extradural hematomas occurred after apparently trivial trauma in a patient suffering from osteogenesis imperfecta congenita. Factors influencing the development of this dramatic complication are peculiar to this rare disorder of bone and connective tissue development and include bony weakness, increased vascular fragility, and possible coagulopathies.

Ulnar neuropathy due to a carpal ganglion The diagnostic contribution of CT

Clinical features and electrophysiologic studies indicated a lesion of the ulnar nerve in the wrist of a 50-year-old man. CT of this region revealed a ganglion inside Guyons canal. Surgical exploration disclosed a carpal ganglion compressing the ulnar nerve just proximal to its division.

Distal Ulnar Neuropathy from Carpal Ganglia: A Clinical and Electrophysiological Study

&NA; The clinical and electrophysiological observations in two cases of distal ulnar neuropathy from carpal ganglia are reported. In the first case, the ganglion was compressing the ulnar nerve just proximal to its division; in the second case, the ganglion was compressing the deep branch of the ulnar nerve just at its origin. In both cases, both axonal degeneration and segmental demyelination were present. A clinical classification of the compression syndromes of the deep ulnar branch is proposed.

Did Goethe Describe Attention Deficit Hyperactivity Disorder

As early as 1846, the typical symptoms of attention deficit hyperactivity disorder (ADHD) were described by Heinrich Hoffmann (1809–1894). However, in Goethe’s masterpiece Faust (1832), the character of Euphorion strongly suggests ADHD diagnosis.

Neuropathy caused by spontaneous intraneural hemorrhage: case report.

A case of ulnar neuropathy at the elbow produced by spontaneous intraneural hemorrhage in a patient with acquired immunodeficiency syndrome and thrombocytopenia is reported. Intraneural hemorrhage in patients with bleeding disorders occurs infrequently. It consists of acute intrafascicular bleeding, presumably producing very high elevations of endoneurial fluid pressure. The clinical features and treatment of this condition are considered, the pertinent literature is reviewed, and the involved pathophysiological mechanisms are discussed.