A 22-year-old male patient had proptosis and lower-lid mass extending to the orbit. Histopathology following surgical excision showed a characteristic picture of non-caseating granuloma. Acid-fast bacilli were seen in tissue sections. The patient responded to antituberculous therapy.

A 22-year-old male patient had proptosis and lower-lid mass extending to the orbit. Histopathology following surgical excision showed a characteristic picture of non-caseating granuloma. Acid-fast bacilli were seen in tissue sections. The patient responded to antituberculous therapy.

A 22-year-old male patient had proptosis and lower-lid mass extending to the orbit. Histopathology following surgical excision showed a characteristic picture of non-caseating granuloma. Acid-fast bacilli were seen in tissue sections. The patient responded to antituberculous therapy.

PURPOSE . To evaluate the long-term efficacy of surgical excision alone in the treatment of non-Hodgkin¹s lymphoma localized to the lacrimal gland. MATERIALS AND METHODS . Thirteen patients with primary lacrimal gland lymphoma were included. The presumptive diagnosis was based on: (1) The painless and relatively slow onset of unilateral lacrimal gland swelling, mostly in elderly adults; (2) The CT pattern of a soft tissue mass in the lacrimal gland region with defined margins and molds to the globe; (3) The negative results of systemic work-up. The involved lacrimal gland was excised via an anterior trans-septal approach in 12 cases and by lateral canthotomy, upper cantholysis, and a trans-periosteal approach in one case. Following histopathologic confirmation of the diagnosis, no supplemental therapy was given. The patients were followed for a minimum of 5 years (5–8 years). RESULTS . In all patients, the excised lacrimal gland lymphoma was firm, nodular and appeared encapsulated. The histologic subtypes of the excised masses were: low-grade lymphomas in 11 cases (7 small lymphocytic, 3 plasmacytoid lymphocytic, 1 follicular small cleaved) and intermediate grade in 2 cases (1 follicular large cell and 1 diffuse small cleaved). No evidence of local recurrence or systemic dissemination was reported during the follow-up period in any of the patients. CONCLUSIONS . Surgical excision of the tumor is a new curative technique for lymphoma localized to the lacrimal gland without any other orbital or systemic involvement. By this technique, orbital radiotherapy and its potential ocular complications can be avoided. However, more study is recommended.

PURPOSE . To evaluate the long-term efficacy of surgical excision alone in the treatment of non-Hodgkin¹s lymphoma localized to the lacrimal gland. MATERIALS AND METHODS . Thirteen patients with primary lacrimal gland lymphoma were included. The presumptive diagnosis was based on: (1) The painless and relatively slow onset of unilateral lacrimal gland swelling, mostly in elderly adults; (2) The CT pattern of a soft tissue mass in the lacrimal gland region with defined margins and molds to the globe; (3) The negative results of systemic work-up. The involved lacrimal gland was excised via an anterior trans-septal approach in 12 cases and by lateral canthotomy, upper cantholysis, and a trans-periosteal approach in one case. Following histopathologic confirmation of the diagnosis, no supplemental therapy was given. The patients were followed for a minimum of 5 years (5–8 years). RESULTS . In all patients, the excised lacrimal gland lymphoma was firm, nodular and appeared encapsulated. The histologic subtypes of the excised masses were: low-grade lymphomas in 11 cases (7 small lymphocytic, 3 plasmacytoid lymphocytic, 1 follicular small cleaved) and intermediate grade in 2 cases (1 follicular large cell and 1 diffuse small cleaved). No evidence of local recurrence or systemic dissemination was reported during the follow-up period in any of the patients. CONCLUSIONS . Surgical excision of the tumor is a new curative technique for lymphoma localized to the lacrimal gland without any other orbital or systemic involvement. By this technique, orbital radiotherapy and its potential ocular complications can be avoided. However, more study is recommended.

A 25-day-old boy presented with a left corneal mass and left nasal obstruction.The mass involved the entire cornea with a skinlike surface and protruded outside the palpebral fissure. CT of the orbits disclosed a large cyst coating the entire left cornea, in an eye with a well-formed anterior chamber and a clearly evident lens. CT also revealed left nasal meningo-encephalocele. The eye with the mass was excised. The histopathologic report confirmed the diagnosis of corneal dermoid in an otherwise normally developed eye.This report of a huge dermoid involving the entire corneal diameter and extending into the sclera without ocular alteration posterior to Descemet's membrane is the first such report in the literature.The literature on corneal dermoids is also reviewed.

A 25-day-old boy presented with a left corneal mass and left nasal obstruction.The mass involved the entire cornea with a skinlike surface and protruded outside the palpebral fissure. CT of the orbits disclosed a large cyst coating the entire left cornea, in an eye with a well-formed anterior chamber and a clearly evident lens. CT also revealed left nasal meningo-encephalocele. The eye with the mass was excised. The histopathologic report confirmed the diagnosis of corneal dermoid in an otherwise normally developed eye.This report of a huge dermoid involving the entire corneal diameter and extending into the sclera without ocular alteration posterior to Descemet's membrane is the first such report in the literature.The literature on corneal dermoids is also reviewed.

Abstract Background: Natriuretic Peptide (NP) system has emerged as one of the most important hormonal systems in control of cardiovascular homeostasis. Liver cirrhosis may affect NP levels that were well described in heart failure. NP prognostic evaluation was well established in many diseases. Objectives: to measure serum and ascitic NT-proBNP levels in cirrhotic and cardiac Egyptian patients to diagnose a cut-off value for exclusion of heart failure, to assess if cirrhosis per se may contribute in NT-proBNP elevation and to assess the contribution of these levels as predictors of mortality in liver cirrhosis. Patients and methods: A prospective cohort study was conducted in 80 patients (50 cirrhotics and 30 had heart failure). Serum and ascitic (if available) NT-proBNP were measured. Cirrhotic patients were followed for 1-year. Kaplan-Meier survival analysis was used to evaluate 1-year survival rates. Logistic regression analyses were performed with 1-year mortality as the dependent variable. Results: Median serum and ascitic NT-proBNP levels in cirrhotics were 239.4 and 267pg/ml versus 10596.6 and 9771 pg/ml in heart failure patients (P0.001). Serum and ascitic NT-proBNP cut-off values >1000 pg/ml resulted in sensitivity of 100% and 93.3% and specificity of 97.8% and 92.5% for exclusion of cardiac disease in cirrhotics. NT-proBNP was elevated in cirrhotics compared with age matched controls (P0.001) and significantly correlated with severity of liver cirrhosis based on Child-Pugh and MELD (P=0.05, P0.001 respectively). Higher NT-proBNP associated with increased 1-year mortality. NT-proBNP was an independent predictor for mortality in cirrhotics in addition to other conventional factors. Conclusion: NT-pro BNP could be a powerful initial non-invasive diagnostic tool for exclusion of heart disease in cirrhotic patients. End stage cirrhosis per se may contribute to NT-proBNP elevation. NT-proBNP provided incremental information in 1-year mortality prediction in decompensated cirrhotics.

Abstract Background: Natriuretic Peptide (NP) system has emerged as one of the most important hormonal systems in control of cardiovascular homeostasis. Liver cirrhosis may affect NP levels that were well described in heart failure. NP prognostic evaluation was well established in many diseases. Objectives: to measure serum and ascitic NT-proBNP levels in cirrhotic and cardiac Egyptian patients to diagnose a cut-off value for exclusion of heart failure, to assess if cirrhosis per se may contribute in NT-proBNP elevation and to assess the contribution of these levels as predictors of mortality in liver cirrhosis. Patients and methods: A prospective cohort study was conducted in 80 patients (50 cirrhotics and 30 had heart failure). Serum and ascitic (if available) NT-proBNP were measured. Cirrhotic patients were followed for 1-year. Kaplan-Meier survival analysis was used to evaluate 1-year survival rates. Logistic regression analyses were performed with 1-year mortality as the dependent variable. Results: Median serum and ascitic NT-proBNP levels in cirrhotics were 239.4 and 267pg/ml versus 10596.6 and 9771 pg/ml in heart failure patients (P0.001). Serum and ascitic NT-proBNP cut-off values >1000 pg/ml resulted in sensitivity of 100% and 93.3% and specificity of 97.8% and 92.5% for exclusion of cardiac disease in cirrhotics. NT-proBNP was elevated in cirrhotics compared with age matched controls (P0.001) and significantly correlated with severity of liver cirrhosis based on Child-Pugh and MELD (P=0.05, P0.001 respectively). Higher NT-proBNP associated with increased 1-year mortality. NT-proBNP was an independent predictor for mortality in cirrhotics in addition to other conventional factors. Conclusion: NT-pro BNP could be a powerful initial non-invasive diagnostic tool for exclusion of heart disease in cirrhotic patients. End stage cirrhosis per se may contribute to NT-proBNP elevation. NT-proBNP provided incremental information in 1-year mortality prediction in decompensated cirrhotics.

Abstract Background: Natriuretic Peptide (NP) system has emerged as one of the most important hormonal systems in control of cardiovascular homeostasis. Liver cirrhosis may affect NP levels that were well described in heart failure. NP prognostic evaluation was well established in many diseases. Objectives: to measure serum and ascitic NT-proBNP levels in cirrhotic and cardiac Egyptian patients to diagnose a cut-off value for exclusion of heart failure, to assess if cirrhosis per se may contribute in NT-proBNP elevation and to assess the contribution of these levels as predictors of mortality in liver cirrhosis. Patients and methods: A prospective cohort study was conducted in 80 patients (50 cirrhotics and 30 had heart failure). Serum and ascitic (if available) NT-proBNP were measured. Cirrhotic patients were followed for 1-year. Kaplan-Meier survival analysis was used to evaluate 1-year survival rates. Logistic regression analyses were performed with 1-year mortality as the dependent variable. Results: Median serum and ascitic NT-proBNP levels in cirrhotics were 239.4 and 267pg/ml versus 10596.6 and 9771 pg/ml in heart failure patients (P0.001). Serum and ascitic NT-proBNP cut-off values >1000 pg/ml resulted in sensitivity of 100% and 93.3% and specificity of 97.8% and 92.5% for exclusion of cardiac disease in cirrhotics. NT-proBNP was elevated in cirrhotics compared with age matched controls (P0.001) and significantly correlated with severity of liver cirrhosis based on Child-Pugh and MELD (P=0.05, P0.001 respectively). Higher NT-proBNP associated with increased 1-year mortality. NT-proBNP was an independent predictor for mortality in cirrhotics in addition to other conventional factors. Conclusion: NT-pro BNP could be a powerful initial non-invasive diagnostic tool for exclusion of heart disease in cirrhotic patients. End stage cirrhosis per se may contribute to NT-proBNP elevation. NT-proBNP provided incremental information in 1-year mortality prediction in decompensated cirrhotics.