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Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is one of the aggressive rare hematopoietic malignancies with predilection to the skin, primarily found in adults. The precise incidence of BPDCN is difficult to estimate due to constantly changing nomenclature and lack of precise defining criteria prior to the 2008 WHO classification system. There are not many cases described in the literature, what makes the diagnostic process challenging. Skin lesions such as erythematous infiltrates and nodules are usually the first manifestation of the disease. Therefore, in doubtful diagnostic cases, dermatologists should perform histopathological and immunohistochemistry examinations along with hematological and oncological cooperation, as early diagnosis and appropriate treatment is essential for improvement of the disease course. This analysis, despite the small number of patients may provide useful information on the clinical and histopathological features of this rare malignancy. [ABSTRACT FROM AUTHOR]

Introduction. Fungi are organisms that are widespread in our environment. The majority of invasive fungal infections are caused by Aspergillus genus, which belongs to mould fungi. An invasive form of aspergillosis, most commonly - invasive pulmonary aspergillosis, in the majority of cases is caused by Aspergillusfumigatus. Aim. The object of this paper is a histoclinical analysis of invasive aspergillosis on the basis of generalized aspergillosis in a patient after a surgical treatment for glioblastoma, WHO grade IV, followed by radiochemotherapy. Materials and methods. A 45-years old female after right-side craniotomy, diagnosed with glioblastoma multiforme, was treated with radiochemotherapy with temozolomide. Leucopenia, thrombocytopenia of WHO grade IV, discrete hemorrhagic condition of the skin and mucous membranes and a single episode of body temperature elevation to 37.4°C were observed during the treatment. On the 45th day the clinical condition of the patient exacerbated. Within several hours the patient manifested severe, rapidly growing respiratory insufficiency and died. Autopsy and histopathologic examination of the tissue specimen confirmed an invasive form of aspergillosis. Discussion. The most advanced pathologic changes were found in the lung specimen, where the presence of Aspergillus fumigatus, necrotic and hemorrhagic changes and an inflammatory reaction of a varied severity were revealed. Conclusions. Because there are many diseases and clinical situations, which pre- dispose to infection, especially in the case of immunosuppresed patients, invasive aspergillosis is still a major diagnostic and therapeutic problem. All patients with prolonged neutropenia, chronically treated with steroids, should be rated as a high risk group. On account of an often untypical or asymptomatic course of the disease in the initial period, any discrete respiratory manifestation should be treated as a prodrome of the fungal infection, even when infection is not confirmed by laboratory tests and radiologic images, or the symptoms are incomplete in CT images. [ABSTRACT FROM AUTHOR]

Introduction. Lymphomas account for about 12% of malignant tumors in children, and anaplastic lymphoma for 10-20% of Hodgkin's and non-Hodgkin's lymphomas. Clinical symptoms associated with malignant tumors of the lymphatic system are not specific. Diagnosis of these tumors is particularly difficult in the absence of a visible tumor or enlarged peripheral lymph nodes, especially when the symptoms may suggest other, far more common diseases such as infections. Extensive clinical diagnostic procedures, including the exploratory laparotomy, intensive symptomatic treatment and antibiotic therapy do not explain the nature of the disease, do not improve the condition of a patient and lead to the death of sick children. In these cases only an autopsy and histopathological examinations demonstrate the presence of anaplastic large T-cell lymphoma's infiltrates of internal organs, bone marrow and lymph nodes. Aim. The aim of this study was to demonstrate that in the diseases of children in which it is difficult to establish a definite clinical diagnosis and an intensive antibiotic therapy does not cause any improvement, a neoplastic disease should be always taken into consideration. Materials and methods. Analysis of the histo-clinical picture of a disease of a child who died due to ALK+ anaplastic large T-cell lymphoma. Diagnostic difficulties resulted in not establishing a clinical diagnosis. Despite conservative treatment, surgical procedure and an intensive antibiotic therapy, the death occurred. The diagnosis was established post-mortem on the basis of immunohistochemical tests: LCA, CD30, CD43, Granzyme B, ALK, CD20, CD3, MPO and Ki67. Case study and results. A 14-year-old boy went to the doctor because of abdominal pain and fever. After week-long treatment with antibiotic (Duomox, Astellas Pharma) acute symptoms subsided, but then relapsed after a month and the boy was admitted to the surgery department. Biochemical studies showed increased levels of inflammatory process markers and aminotransferases. Physical examination revealed positive peritoneal signs. With the suspicion of acute Meckel's diverticulitis, laparotomy and appendectomy were performed. During the surgery, a significantly enlarged right lobe of liver was found. Antibiotic treatment was administered and after a few days following the surgery the symptoms subsided. On the 5th day after the surgery the patient's condition deteriorated and on the 8th day he died. The diagnosis was established on the basis of autopsy: ALK+ anaplastic large T-cell lymphoma (LCA+, CD30+, CD43+, ALK+, Granzyme B+, Ki67+ in 85% of cells). Discussion and Conclusions. Cooperation and efficient communication between the clinician and pathologist are important and necessary in all cases when it is difficult to establish a correct and rapid diagnosis. If in an inflammatory disease the patient's condition is deteriorating despite an intensive antibiotic therapy, the neoplastic disease should be always taken into consideration and the diagnostics should focus on searching for a tumor. [ABSTRACT FROM AUTHOR]