Pulmonary Hypertension in Sickle Cell Disease: A Case Series.

Pulmonary hypertension (PH) is a serious and increasingly recognized complication in sickle cell disease (SCD), particularly in individuals with the homozygous genotype. Elevated tricuspid regurgitant velocity (TRV) increases the potential for future development of PH, yet no standardized management approach currently exists, likely because of the varied pathophysiology of PH in these patients. Transthoracic echocardiogram-derived elevated TRV of more than 2.

Latent JAK2 V617F-Positive Myeloproliferative Neoplasm With Normal Blood Counts and Recurrent Splanchnic Vein Thrombosis in a Young Woman.

Latent myeloproliferative neoplasms are diagnostically challenging clonal hematopoietic disorders characterized by the JAK2 V617F mutation without overt hematologic abnormalities. This case report describes a 33-year-old woman presenting with recurrent splanchnic vein thrombosis, splenomegaly, and a history of unprovoked pulmonary embolism, found to have a JAK2 V617F-positive latent myeloproliferative neoplasm. Despite normal blood counts and unremarkable bone marrow findings, molecular testing confirmed the JAK2 V617F mutation (17% allele frequency), highlighting its critical role in diagnosing occult myeloproliferative neoplasms in patients with unexplained thrombosis.

A Rare Presentation of Prostate Cancer: Psoas Muscle Metastasis Without Bone Involvement.

Prostate cancer is one of the most common cancers worldwide. We present a unique case of metastatic prostate cancer manifesting initially with a psoas muscle mass causing abdominal and hip pain. Computed tomography (CT) imaging revealed a large mass within the left psoas muscle with prominent pelvic and retroperitoneal lymphadenopathy, initially concerning for rhabdomyosarcoma.

Rare Case of Primary Bone Lymphoma.

Primary bone lymphoma (PBL) is a rare entity defined as a lymphoid neoplasm of bone that occurs in the bone without involvement of lymph nodes or other extranodal sites. In this report, we present a case of an elderly female with PBL who presented with regional lymphadenopathy and cutaneous lesions mimicking the primary cutaneous diffuse B-cell lymphoma (PCDBCL), leg type. This review describes the case of a 73-year-old female with primary bone lymphoma who presented with cutaneous lesions and regional lymphadenopathy.

A Review of the Early Detection of Colon Cancer and the Role of Circulating Tumor DNA.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths when both males and females are considered. Screening plays a crucial role in reducing the incidence and mortality of CRC. Traditionally, CRC screening methods are classified into stool-based and visual-based approaches.

When Neisseria meningitidis Strikes an Immunocompetent Host and Purpura Fulminans Results.

Purpura fulminans (PF) is a rapidly progressive, life-threatening condition marked by ecchymotic, tender, and symmetric skin lesions, often resulting from disseminated intravascular coagulation (DIC) secondary to infectious or non-infectious etiologies. PF usually occurs in immunocompromised hosts and is associated with a high mortality rate. Here, we highlight a case of an elderly immunocompetent woman with DIC and subsequent PF.

Ulcerative Colitis Gone Rogue: A Case of Complement-Mediated Thrombotic Microangiopathy in Inflammatory Bowel Disease.

We present an unusual case of complement-mediated thrombotic microangiopathy (formerly known as atypical hemolytic uremic syndrome) associated with inflammatory disease in a young patient. A 26-year-old male patient with no significant past medical history presented to our emergency department with a four-week history of diffuse, moderate, cramping, non-radiating abdominal pain with no known aggravating or relieving factors. Abdominal pain was associated with nausea, vomiting, and bloody stools.

Spectrum of Upper Gastrointestinal Diseases in Patients Presenting with Dyspepsia-A First Report from Myanmar.

Background: Dyspepsia is associated with a variety of benign and malignant gastrointestinal diseases. The aim of the study was to evaluate the spectrum of upper gastrointestinal endoscopic findings in patients presenting with dyspepsia.

Methods: This is a retrospective study on consecutive patients with dyspepsia undergoing upper gastrointestinal endoscopy at the gastroenterology department of Thingangyun General Hospital, University of Medicine 2, Yangon, from January 1, 2017, to December 31, 2019.

Breast Mass Revealing Hidden Lung Cancer.

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths in the United States, frequently metastasizing to the brain, bones, liver, and adrenal glands. However, it is uncommon for lung malignancies to metastasize to the breast, and is generally assumed to carry a poor prognosis.  We present the case of a 62-year-old female who presented for an annual physical exam and complained of persistent neck pain without neurological deficit.

Managing Non-islet Cell Tumor Hypoglycemia in Hepatocellular Carcinoma With Radiation Therapy.

Non-islet cell tumor hypoglycemia (NICTH) is a paraneoplastic syndrome associated with non-mesenchymal-derived and epithelial tumors. A 37-year-old male with stage IVB hepatocellular carcinoma (HCC) and pulmonary metastases presented with recurrent hypoglycemia despite glucose supplementation. Laboratory findings revealed low insulin growth factor 1 (IGF-1) (15 ng/mL), elevated insulin growth factor 2 (IGF-2) (395 ng/ml), and an IGF-2:IGF-1 ratio of 26:1, consistent with NICTH.

Classic Kaposi Sarcoma in an Immunocompetent Male From Haiti: An Unusual Epidemiological Presentation.

Kaposi sarcoma (KS) is an angioproliferative disorder caused by human herpesvirus-8 (HHV-8) infection. KS manifests as vascular and mucosal nodules and is classified into four subtypes based on epidemiology, clinical presentation, histopathology, and HHV-8/human immunodeficiency virus serology. Here, we present a unique case of classic KS in an 84-year-old immunocompetent Haitian male patient, highlighting the rarity of this variant in this population.

Gastroesophageal Junction Adenocarcinoma With Skeletal Muscle Metastases: A Case Report and Literature Review.

Esophageal and gastroesophageal junction (GEJ) malignancies are aggressive, and survival is poor once metastasis occurs. The most common sites of metastatic involvement include the liver, lymph nodes, lung, peritoneum, adrenal glands, bone, and brain, while skeletal muscle (SM) involvement is rare. We report a case of a 68-year-old female who presented with intractable emesis for one month and was found to have a primary GEJ adenocarcinoma measuring up to 6.

Endobronchial Foreign Bodies Presenting as Intermittent Chest Pain and Productive Cough.

A 51-year-old male presented with intermittent chest pain for one month and productive cough with yellow sputum for seven days. He had a history of chronic kidney disease stage G3, depression, and polysubstance abuse. His chest X-ray revealed mild hazy opacity in the right lower lobe, followed by a chest computed tomography without contrast that indicated multiple nodular opacities in the left mainstem bronchus with clear lungs.

A Patient With Hemoglobin SC Disease and Acute Ischemic Stroke Presenting With Altered Mental Status.

A 57-year-old woman with a history of hypertension, diabetes mellitus, obesity, asthma, and hemoglobin SC disease presented to the emergency department by her home health aide after she was found having altered mental status. According to her home health aide, the patient was responding with "Ok" to her questions for more than a day. The hemoglobin on admission was 8.

Incidental Finding of Bilateral Acute Pulmonary Emboli in a Patient With Asymptomatic COVID-19 Infection.

A 58-year-old male with a history of hypertension, dyslipidemia, osteoarthritis of both knees, and morbid obesity presented to the emergency department for opioid detoxification. He complained of generalized soreness, anxiety, and difficulty sleeping but denied signs and symptoms suggestive of coronavirus disease 2019 (COVID-19) infection. His COVID-19 polymerase chain reaction (PCR) result came back positive, and his D-dimer level was 5373 ng/mL.

Gastroduodenal Ulcerative Colitis in Association with Ulcerative Pancolitis.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease, traditionally regarded as being limited to the colorectum. Although several gastroduodenal lesions have been reported in cases of UC, in general, duodenal lesions in UC are believed to be uncommon and gastric lesions in UC are a rare presentation. In this report, we presented a 66-year-old lady with upper GI presentation with gastroduodenal ulcerative colitis accompanying pancolonic UC.

Multiple splenic infarcts: unusual presentation of hereditary spherocytosis associated with acute Epstein-Barr virus infection.

A 19-year-old African American woman presented to the emergency department with a history of left upper quadrant pain for a week, associated with nausea, malaise, loss of appetite, subjective fevers and chills. Her family history is significant for thalassemia in her maternal aunt, and hereditary spherocytosis in her brother, sister and cousin. A contrast-enhanced CT scan of the abdomen and pelvis revealed massive splenomegaly and multiple splenic infarcts.