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Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the abnormal proliferation of Langerhans cells, a type of immune cell that is normally present in the skin and various other tissues. LCH can affect people of any age but is most commonly diagnosed in children. We report a case of a patient with LCH who developed ipsilateral axillary lymphadenopathology post-COVID-19 vaccination. Lymph node biopsy showed diffuse Langerhans cell hyperplasia which mimicked LCH. Clinically and radiologically, it looked to be a reactive lymph node. The patient was kept on follow up only and after 1 year of follow up the size of lymph nodes regressed confirming to be reactive in nature rather than neoplastic. To the best of our knowledge, this is the second case of Langerhans cell hyperplasia post-COVID-19 vaccination being reported in the literature. [ABSTRACT FROM AUTHOR]

Objective: To assess the pulpal calcification that was presented on radiographs after the completion of orthodontic treatment. Study Design: Retrospective Observational study. Setting: Department of Orthodontic, Ayub Medical College Abbottabad. Period: October 2023 to November 2023. Methods: Following the inclusion and exclusion criteria, the current study was carried out on patients who had reported and registered for orthodontic intervention within the previous five years and had case records from the orthodontics department available. A total of 670 case records were assessed for selecting 191 cases as per sample size. Results: Among 191 patients, 30.4% were male and 69.6% were female. The highest percentage belonged to the 14-16 age group (32%), followed by 20-22 (28.3%), 17-19 (26.2%), and 23-25 (12.6%) age groups. Pre-treatment calcification was 17.8% (n=34), rising to 28.3% (n=54) post-treatment. Pulp calcification significantly increased after orthodontic treatment (p<0.05). No significant differences were found between gender and age groups regarding pulp calcification (p>0.05). However, a significant association existed between pulp calcification and treatment duration (p<0.05). The 25-30 months treatment duration had the highest occurrence (n=27), followed by 31-36 months (n=19). Mandibular teeth had a higher prevalence of pulp calcification (53.7%) than maxillary teeth (46.3%), with tooth number 36 having the highest prevalence (25.9%). A significant relationship was observed between the left and right sides of the dental arches, with the left side exhibiting greater tooth calcification (68.5%) than the right side (31.5%). Conclusions: The present study concluded that there was an increase in the frequency of pulpal calcifications in the observed posterior teeth after orthodontic treatment. Pulpal calcifications were significantly more prevalent in the posterior teeth of the mandibular arch compared to the maxillary arch. Moreover, the likelihood of pulpal calcification increased over the duration of orthodontic treatment. [ABSTRACT FROM AUTHOR]

Malignant gastrointestinal neuroectodermal tumor (GNET), also referred to as clear cell sarcoma-like tumor of the GI tract is a rare mesenchymal tumor of the gastrointestinal tract. It has to be distinguished from various mimickers including gastrointestinal stromal tumor (GIST) due to its aggressive course and different natural history and therapeutic approach. Here we report a case of GNET arising in the small intestine with aberrant DOG1 expression posing a diagnostic challenge. In this context, the combination of clinical, histomorphological, immunohistochemical, and molecular features helped to establish a proper diagnosis. [ABSTRACT FROM AUTHOR]

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown aetiology. It is recently recognised to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase pathway. We report a 49-year-old female patient who initially presented in 2012 to a tertiary care centre in Muscat, Oman, with bilateral facial masses. These were removed but later recurred over a period of 10 years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus and Hashimoto's hypothyroidism. The facial masses were biopsied and they showed classic morphological features in the form of diffuse infiltration by foamy histiocytes with scattered Touton type of giant cells, patchy lymphocytic infiltrates and dense fibrosis. The patient is stable and is being followed-up. The presented ECD case is particularly interesting due to the recurrent bilateral facial masses. To the best of the authors' knowledge, this is the first documented case in Oman. [ABSTRACT FROM AUTHOR]