Intravascular large B-cell lymphoma presenting with fever and refractory acidosis.

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse large B-cell lymphoma, characterized by malignant B-cells primarily localized to the lumina of small- and medium-sized blood vessels without lymphadenopathy. Two patients initially presented with fever of unknown origin and persistent lactic acidosis without evidence of tissue hypoxia. Neither patient had an identifiable source of infection and both underwent peripheral blood smear demonstrating leukocytosis with a neutrophilic predominance and thrombocytopenia without evidence of hematologic malignancy.

Educational Case: Hypersensitivity Vasculitis.

http://journals.sagepub.com/doi/10.

Right Ventricle Rupture After Open Heart Surgery.

The potential complications of cardiac surgery with sternotomy include mediastinitis and major bleeding, events that are infrequent but carry high mortality.We report a unique complication of median sternotomy. A 71-year-old man underwent coronary artery bypass grafting complicated by sternal dehiscence on postoperative day 7.

Forensic Autopsy Experience and Core Entrustable Professional Activities: A Structured Introduction to Autopsy Pathology for Preclinical Student.

The forensic and autopsy pathology service within the Department of Pathology at University of North Dakota School of Medicine provides an optional, structured autopsy experience for medical students during the second year of the curriculum. This experience reinforces forensic autopsy pathology as the practice of medicine and highlights the American Association of Medical Colleges Core Entrustable Professional Activities. Students self-select for this optional, noncredit autopsy observership.

Addison Disease: The First Presentation of the Condition May be at Autopsy.

Addison disease is chronic primary adrenal insufficiency, which, in developed countries, is most commonly due to autoimmune destruction of the cortex (termed autoimmune or idiopathic Addison disease). Although the disease process has some classic features, such as increased pigmentation, salt craving, and signs and symptoms related to decreased blood pressure, the initial clinical presentation may be vague and/or insidious. Following an acute stressor such as a gastrointestinal (GI) infection, the patient may experience an adrenal crisis, which can cause sudden death.

Application of a classification system focusing on potential asphyxia for cases of sudden unexpected infant death.

Current classification schemes for sudden unexpected infant death (SUID) may not be optimal for capturing scene events that potentially predispose to asphyxia. (1) To compare causes of death in a group of SUID cases assigned by multiple reviewers using our recently published classification scheme for SUID that is based on asphyxial risk at the death scene, and (2) To compare these newly assigned causes of death to that originally assigned by the medical examiners of record who performed the autopsies. Five reviewers independently assigned causes of death for 117 cases of SUID, including 83 originally diagnosed as sudden infant death syndrome (SIDS), accessioned into the San Diego SIDS/SUDC Research Project from the San Diego County Medical Examiner's Office.