1/2. cytomegalovirus mononucleosis as a cause of prolonged fever and prominent weight loss in immunocompetent adults.Four immunocompetent adults presented with protracted fever lasting > 6 weeks and severe weight loss, associated with primary cytomegalovirus (CMV) infection. Each patient had spleen enlargement, lymphocytosis and hypertriglyceridaemia, but recovered spontaneously. A further 20 immunocompetent patients with primary CMV infection were also reviewed, and all presented the usual clinical picture of CMV mononucleosis. It was concluded that CMV mononucleosis should be considered in the differential diagnosis in patients with prolonged fever and weight loss if lymphocytosis is present.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
2/2. Gastric carcinoma in a 13-year-old girl.Gastric cancer is uncommon before the fifth decade of life. The appearance of adenocarcinoma in young adults has motivated molecular studies that aimed to identify inherited mutations. Moreover, carcinoma of the stomach in the young adult is sufficiently rare to generate considerable interest in each occurrence of it, especially when it occurs in the gastroesophageal junction. We report a case of gastric carcinoma in a 13-year-old girl, who was referred to our service with weakness, malaise, weight loss, and slight dysphagia. An upper endoscopy with biopsy revealed a gastric Borrmann III tumor, with invasion of the distal esophagus; histopathological analysis revealed a moderately differentiated adenocarcinoma. During staging, she was diagnosed with several metastases, including the lymph nodes, liver, spleen, and ovary. She was referred for radiochemotherapy and died within 4 months. We should consider and investigate the possibility of malignancy even in young patients with persistent symptoms or anemia, in order to diagnose this malignancy at earlier stages.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |