A CASE OF BRUNNERS GLAND HAMARTOMA CAUSING OBSTRUCTIVE JAUNDICE

Brunner’s gland hamartoma is a rare benign tumor of duodenum .We present a case of large pedunculated duodenal hamartoma causing obstructive jaundice and significant dilatation of intrahepatic biliary radicles. Duodenal polyp is a rare benign tumor formed from a proliferation of Brunner gland, typically forming polypoid growth in proximal duodenum and can extend up to 3rd part of duodenum. It may be incidental finding but can present in emergency with obstruction and hemorrhage requiring surgical endoscopic resection.

Ocular pathological changes in hamsters experimentally infected withSchistosoma mansoni

Ocular lesions have been reported in patients with schistosomiasis; however, the problem with studying schistosomal infection of the human eye is that biopsies are almost impossible to take, and histopathological examination of suspicious lesions can only be undertaken post-mortem or after enucleation. This work aimed to study the possible effects and pathogenesis of schistosomiasis on the eye. This study involved 55 hamsters; five hamsters remained non-infected and the remaining 50 hamsters were infected withSchistosoma mansonicercariae. Infected hamsters were sacrificed on weeks 8, 12, 16 and 20 post-infection (pi). Eye sections were prepared and stained for histopathological and immunohistochemical studies. Histopathological changes detected in hamsters infected after 16 and 20 weeks included looseness and oedema of the innermost retinal layers together with hyperplastic polypoid growth. Neither eggs nor granulomata were detected in eye sections throughout the experimental period. Deposition ofS. mansoniantigen was revealed in 35% of infected hamsters. Later, on weeks 16 and 20 pi, moderate subepithelial conjuctival deposits and marked subchoroidal and scleral deposition were detected. In conclusion, the deposition of schistosomal antigen and immune complexes may play a pivotal role in the ocular changes that occur in schistosomiasis, even in the absence of detectableSchistosomaeggs. Schistosomiasis should be suspected in cases with unexplained ophthalmological findings, especially in endemic areas.

Giant destructive sinonasal polyposis

Introduction. Authors report their clinical experience in managing a 46-year-old male patient with long lasting nose breathing difficulties caused by nasal obstruction due to a large bilateral tumor masses in both nasal cavities. Case Outline. Physical examination, laboratory and biochemistry analyses, as well as computed tomography showed an inhomogeneous soft-tissue tumor mass completely filling both nasal cavities, maxillary, ethmoidal, sphenoidal, and frontal sinuses on both sides, accompanied by destruction of bony walls of all sinuses. Preoperative histopathology analysis showed a polyp with squamous metaplasia. The gigantic polypoid mass was removed by bicoronal approach to the frontal and ethmoidal sinuses and by direct approach to the maxillary sinuses and nasal cavity. Definite histopathology analysis confirmed the initial diagnosis, but the presence of fungal hyphae in allergic mucus was also observed. Conclusion. Polypoid growth in the nose rarely grow to such gigantic dimensions that it causes destruction of all walls of paranasal sinuses. Considering so far published reports from the literature, the presented case is among the biggest nasal polyps reported until now.