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Introduction: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a very rare and aggressive type of gastrointestinal non-Hodgkin's lymphoma (NHL) with a poor prognosis., Case Presentation: A 59-year-old man presented with a three-days history of diffuse abdominal pain associated with distention and obstipation. Abdominal computed tomography (CT) scan showed small bowel obstruction (SBO) due to moderately thickened jejunal loop. The SBO was treated conservatively, and after a workup, the patient underwent a laparoscopic oncological small bowel resection. The final pathology sampling revealed transmural sheets of atypical lymphoid cells that were identified as MEITL, which is a very rare type of small bowel lymphoma, by the histo-immunopathoplogy studies. He responded to three courses of chemotherapy, and the patient went into remission at the end of the third chemotherapy session. Five months post remission patient was rushed to the emergency with acute mesenteric ischemia and died shortly after., Discussion: An extremely uncommon and aggressive type of T-cell lymphoma is called monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). Gastrointestinal involvement was detected in the majority of the patients. 40 % of the published cases had stage IV disease. Based on morphological classification, the tumors were classified into two groups: Typical (58 %) and atypical (i.e., non-monomorphic or exhibiting necrosis, angiotropism, or starry-sky pattern) (42 %). Mostly caused by driver gene changes that de-regulate JAK/STAT signaling and histone methylation, it is resistant to standard therapy and includes morphologic and genetic variants that carry a very high clinical risk., Conclusion: We report a case of MEITL detected after jejunal resection in a patient presented initially with SBO. Our patient has a recurrence-free survival of 5 months after chemotherapy, but passed away 5 months after remission due to acute mesenteric ischemia., Competing Interests: Conflict of interest statement The authors report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We report for the first time a case of atypical unilateral sacroiliitis secondary to mechanical stress injury. Unilateral sacroiliitis can be caused by a variety of etiologies. The first diagnosis to rule out is infection since it requires urgent treatment to avoid its serious consequences. Spondyloarthritis can be manifested by unilateral sacroiliitis in its early stage. Sacral fractures should always be looked for on the imaging modalities performed. In our case, no signs of infection or systemic disease were found. No fracture was seen on the imaging examinations and we had negative cultures on the computed tomography-guided biopsy realized. A history of mechanical stress was the only clue found suggesting the diagnosis of a probable stress related sacroiliitis. A thorough review of the literature will be provided stating the different causes of sacroiliitis described till now, with discussion of this new reported entity., (Copyright Journal of Radiology Case Reports.)

Introduction: Cholecystectomy is one of the most frequently done procedures in general surgery. There are few reports of amputation neuromas following this procedure. This presentation describes a case of obstructive jaundice due to amputation neuroma in a patient with a history of cholecystectomy., Case Presentation: We report about a 53 y o lady who presented with obstructive jaundice, 8 years following open cholecystectomy. Paraclinical investigations were in favor of cholangicarcinoma, however the final pathology revealed an amputation neuroma of the CBD., Discussion: Amputation neuromas are rarely seen in the era of laparoscopic cholecystectomy. They are benign reparative lesions of the CBD following surgery or manipulation of the extra hepatic biliary tree. It is very difficult to diagnose them pre-operatively. Surgical resection is the first choice of treatment., Conclusion: Traumatic neuromas should always be among the differential diagnosis, when assessing a CBD mass in patients with a previous history of open cholecystectomy or surgery to the gastrointestinal tract., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: The relationship between androgens and blood pressure, insulin resistance, lipid profile, adiponectin and hs-CRP in a young Middle-Eastern population has not been examined previously. We studied this relationship in a randomly selected population of Lebanese students., Methods: Three hundred and sixty-eight subjects (201 men and 167 women) aged 18-30 years were included in the study. Anthropometric and biological parameters [waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), triglycerides, total cholesterol, HDL cholesterol, homeostasis model assessment of insulin resistance (HOMA-IR), total testosterone (TT), dehydroepiandrostenedione sulphate (DHEAS), sex hormone-binding globulin (SHBG), adiponectin (ADP) and hs-CRP] were measured., Results: In men, there were inverse associations of both TT and SHBG with body mass index (BMI), WC, HOMA-IR, triglycerides and hs-CRP. After adjustment for major confounders (BMI, WC, age and smoking), associations disappeared except for those between TT and hs-CRP, and for SHBG HOMA-IR, hs-CRP and triglycerides. In women, only SHBG was inversely associated with BMI, WC, HOMA-IR and hs-CRP and positively correlated with adiponectin. Except for the association between SHBG and adiponectin, these correlations disappeared after adjustment for confounders. Although DHEAS appeared to correlate negatively with blood pressure in men, this relationship disappeared after adjustment for confounders, while a relationship between DHEAS and triglycerides in women persisted after such adjustment. In multivariate regression analysis, SHBG was an independent predictor of hs-CRP, triglycerides and HOMA-IR in men and of adiponectin in women., Conclusion: Our results suggest that SHBG is independently associated with HOMA-IR, adiponectin, hs-CRP and triglycerides. A gender difference in these associations is observed. Further studies are needed to elucidate these findings., (© 2011 Blackwell Publishing Ltd.)

We evaluated the efficacy and safety of a monotherapy by piperacillin and sulbactam potentially associated to vancomycin as an empiric antimicrobial therapy in febrile neutropenic patients treated with nephrotoxic chemotherapy for solid tumors. Twenty-three patients were treated during 32 episodes with piperacillin 4 g i.v. every 8 hours and sulbactam 1 g IV every 8 hours. If the patient remained febrile after 48 hours, 1 g of vancomycin i.v. was added every 12 hours as indicated by our study design. The mean duration of neutropenia was 5.5 days (2-13 days). In ten episodes, the granulocyte nadir was < 100/mm3. Infection was microbiologically documented in seven episodes (22%) with six Gram negative bacilli and 3 Gram positive cocci. There were 19 apyrexia with piperacillin and sulbactam (59%) and further seven were resolved by the addition of vancomycin (total success: 81%). Failure was observed in six episodes consecutive to germ resistance (one episode), clinical deterioration (one episode), relapsing fever related to Pseudomonas infection (one episode), persistent fever despite withdrawal of neutropenia and no microbiological documentation (two episodes) and protocol violation (one episode). Neither septic death nor toxicity were observed. We conclude that this empirical treatment is active and safe in short period febrile neutropenic episodes in patients heavily treated with nephrotoxic chemotherapy for solid tumors.