Cerebellar presence of immune cells in patients with neuro-coeliac disease.

Although various neurodegenerative disorders have been associated with coeliac disease (CD), the underlying neuropathological link between these brain and gut diseases remains unclear. We postulated that the neuronal damage sporadically observed in CD patients is immune-mediated. Our aim was to determine if the loss of neurons, especially Purkinje cells, coincides with microglia activation and T- and B-cell infiltration in the cerebellum of patients with CD and a concomitant idiopathic neurological disease affecting the cerebellum (NeuroCD).

Subacromial impingement by a lipoma arborescens.

Subacromial impingement syndrome (SIS) is the leading cause of shoulder pain. A systemic approach for abnormal causes of SIS is recommended to avoid misdiagnosing rare or sinister pathologies. To our knowledge, only nine cases of subacromial lipoma arborescens associated with impingement syndrome have been reported in the literature.

Challenges in diagnosing aortic leiomyosarcoma post endovascular repair of abdominal aortic aneurysm.

Primary aortic tumors after endovascular aortic repair are rarely reported in the literature. Here, we report an elderly male with abdominal aortic leiomyosarcomas (LMS) after an endovascular aneurysm repair in 2012 for a 5-cm symptomatic abdominal aortic aneurysm using an Endurant II aortic stent graft (Medtronic, Minneapolis, Minn). The autopsy confirmed the aortic LMS after the patient rapidly deteriorated and succumbed to death.

The adequacy of lymph node clearance in colon cancer surgery performed in a non-specialist centre; implications for practice.

Background: Despite recent medical advances, surgery remains the mainstay treatment in colon cancer. It is well established that better patient outcomes are achieved when complex surgery including pancreatic, oesophageal and rectal surgeries are carried out in high-volume centres. However, it is unclear as to whether or not colon cancer patients receive the same benefit.

What is the cause of this synchronous palpable abdominal mass in a woman recently diagnosed with lung cancer as demonstrated in Figure 1?

Colonic metastases from lung cancer are rare [1, 2]. Presentation of an abdominal mass in the setting of a new lung cancer diagnosis should prompt complete evaluation including endoscopic and CT imaging. This case also highlights the need for immunohistochemical analysis of unusual tumor deposits facilitating appropriate treatment.

Predictive factors for colonic resection in patients less than 49 years with symptomatic diverticular disease.

Background: Diverticular disease is a condition strongly associated with low-fiber intake and obesity. There have been reports of an increasing incidence in younger individuals ranging from 12% to 21% of all cases. The aim of this study was to evaluate the management of complicated diverticular disease in patients less than 49 years and attempt to identify factors predictive of a more virulent course.

Malignant neuroendocrine tumour of the appendix in childhood with loco-regional lymph node invasion.

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature.

Unlabelled: A 54 year old lady presented for routine excision of a scalp lesion thought clinically to represent a sebaceous cyst of the right occiput. 4 years earlier she underwent total abdominal hysterectomy and right salpingo-oophorectomy for 3 large uterine fibroids. Histo-pathological examination of the hysterectomy specimen revealed an incidental low-grade leiomyosarcoma.

Is overexpression of HER-2 a predictor of prognosis in colorectal cancer?

Background: The development of novel chemotherapeutic agents in colorectal cancer has improved survival. Following initial response to chemotherapeutic strategies many patients develop refractory disease. This poses a significant challenge common to many cancer subtypes.

Enteropathy associated T cell lymphoma: common in coeliac disease.

A 56-year-old male admitted with haematemesis and epigastric pain and severe weight loss on a background of coeliac disease. Computed tomography (CT) abdomen revealed a thickening of the mucosal folds of a short segment of jejunum. He deteriorated and had an exploratory laparotomy and bowel resection with side-side jejojejunal stapled anastomosis and extended right hemicolectomy and ileocolic anastomosis.