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Search Results: 1 - 10 of 145849 matches for " Samir B. Kahwash "
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Incidental Finding of Isolated Rosai-Dorfman Disease in the Tonsils of a 4-Year-Old Girl: A Case Report and a Brief Review of Current Practice in Tonsillectomy Specimen Handling  [PDF]
Julianne Qualtieri, Samir B. Kahwash
Open Journal of Pathology (OJPathology) , 2013, DOI: 10.4236/ojpathology.2013.31002

We report herein a case of isolated Rosai-Dorfman disease (Sinus Histiocytosis with Massive Lymphadenopathy) diagnosed upon routine microscopic examination of tonsils in a child. The patient is a 4 year old girl who had a history of sleep apnea, but no other significant medical history or other findings on physical examination. In this report, we discuss the various approaches to handling of tonsillectomy specimens. We also discuss the value of routine microscopic examination, providing a list of case examples of incidental, clinically important, findings that can be missed if a microscopic examination of tonsils was not performed. We finally discuss the clinical significance of finding histologic evidence of Rosai-Dorfman disease in a child.

Jacobsen/Paris-Trousseau Syndrome: Report of a Case with Emphasis on Platelet’s Light Microscopic and Ultrastructure Findings  [PDF]
Michael Losos, Basil M. Kahwash, Miriam Conces, Joel Thompson, Riten Kumar, Samir B. Kahwash
Open Journal of Pathology (OJPathology) , 2016, DOI: 10.4236/ojpathology.2016.61002
Abstract: Jacobsen syndrome (JS) is a rare, inherited disorder, characterized by facial and skull dysmorphism, mental retardation, and platelet abnormalities. Paris-Trousseau syndrome (PTS) is a platelet function disorder that may be encountered in patients affected by JS. PTS is manifested by a mild lifelong bleeding tendency. Morphologically, the presence of large fused platelet alpha granules is characteristic. We present a case of Jacobsen syndrome in a child and highlight the typical morphologic and ultrastructure findings of platelets.
Hemoglobin K-Woolwich (Hb KW): Its Combination with Sickle Cell Trait  [PDF]
Ruchika Sharma, Melissa Rhodes, Elizabeth Varga, Samir B. Kahwash
Open Journal of Pathology (OJPathology) , 2014, DOI: 10.4236/ojpathology.2014.43017

Hemoglobin K-Woolwich (Hb KW) is a rare hemoglobin variant with very few cases reported. It is most prevalent in West African countries, particularly Nigeria, Ghana, and the Ivory Coast. Some reports suggest Hb KW may be a clinically benign trait, whereas others indicate it may behave similarly to a β+ thalassemia. The combination of hemoglobin S and hemoglobin KW (Hb S/KW) is a rare double heterozygous disorder with little known clinical characteristics. We report the hematologic and clinical data on three patients with Hb S/KW to help describe the characteristics of this patient population. The first two cases represent first cousins, ages 3 and 2 years. They are clinically asymptomatic. They have normal hemoglobin and mean corpuscle volume (MCV) levels without reticulocytosis. The third case is of a 14-year-old male who is non-anemic with no microcytosis. He has been clinically well except for abdominal pain upon dehydration. On hemoglobin electrophoresis, these patients have Hb S levels slightly higher than typically observed with sickle cell trait and a delay of hemoglobin F to adult levels. There exists a need for more reports to better delineate the clinical course and management of these patients.

Clinical Pathological Correlation Quiz: A 7-Month-Old Girl with Congenital Neutropenia and Increased Bone Morrow “Blasts”  [PDF]
Ruchika Sharma, Jessica A. Hemminger, Samir B. Kahwash
Open Journal of Pathology (OJPathology) , 2014, DOI: 10.4236/ojpathology.2014.41001

Persistent Neutropenia in a child presents a wide differential diagnosis, spanning the spectrum of benign disorders (such as congenital neutropenia, cyclic neutropenia, etc.) to malignant processes (such as myelodysplasia or acute leukemia). The morphologic findings in the bone marrow of a patient with neutropenia may show considerable overlap with those seen in hematopoietic malignancies. We present herein a case that demonstrates this overlap and discuss features that can help in avoiding diagnostic pitfalls.

Hodgkin Lymphoma in a Thymic Cyst: Report of a Case with Multiple Secondary Neoplasms
Saeeda Almarzooqi,Sue Hammond,Samir B. Kahwash
Case Reports in Medicine , 2010, DOI: 10.1155/2010/795037
Abstract: The presentation of Hodgkin Lymphoma in a thymic cyst is rare. We describe a case in a 9 year-old boy, with a long follow-up course, complicated by two secondary neoplasms and a post bone marrow transplant lymphoproliferative disorder. We also review the literature on such presentations and second malignant neoplasms in childhood.
Phagocytized Neutrophil Fragments in the Bone Marrow: A Phenomenon Most Commonly Associated with Hodgkin Lymphoma
Michael A. Arnold,Samir B. Kahwash
ISRN Hematology , 2014, DOI: 10.1155/2014/363854
Abstract: Bone marrow macrophages containing other cells, or large pieces of other cells, represent a distinctive feature of diseases such as Hemophagocytic Lymphohistiocytosis (HLH) and Rosai-Dorfman disease. We describe a distinct variation of phagocytic histiocyte morphology, featuring histiocytes containing predominantly fragments of neutrophil nuclei. We retrospectively reviewed initial bone marrow samples for Hodgkin lymphoma, Burkitt lymphoma, Ewing sarcoma, or evaluation for nonneoplastic conditions, scoring the presence or absence of the above-described histiocytes. We find that these histiocytes, which we term “fragmentophages,” are associated with staging marrow sampling for malignancy, especially Hodgkin lymphoma (Hodgkin lymphoma: 28/34 or 82.4%, Ewing sarcoma: 11/26 or 42.3%, Burkitt lymphoma: 4/13 or 30.8%). These cells are significantly less common in marrow samples for nonneoplastic conditions (4/21 or 19.0%). Fragmentophages are significantly associated with malignancy, especially Hodgkin lymphoma, and their recognition has the potential to provide a clue to an underlying malignancy. 1. Introduction The histologic patterns of Hemophagocytic Lymphohistiocytosis (HLH) and Rosai-Dorfman disease are distinctive, each characterized by macrophages containing large parts of other cells. HLH is characterized by increased macrophage uptake and destruction of red blood cells, red blood cell precursors, and platelets, resulting in potentially lethal peripheral cytopenias. Rosai-Dorfman disease features the proliferation of distinctive, large histiocytic cells which accumulate usually in the sinuses of lymph nodes and contain predominantly intact lymphocytes. Both of these diseases can involve the bone marrow. Thus, the identification of bone marrow macrophages containing other cells in their cytoplasm evokes consideration of these diagnoses [1, 2]. We have observed a morphologically distinct pattern of macrophages containing mainly neutrophil nuclear fragments in bone marrow samples of children in association with malignancy. This pattern is important to distinguish from HLH and Rosai-Dorfman disease and has the potential to be a first clue to an associated malignancy. 2. Methods and Materials A retrospective review of initial bone marrow samples and patient chart material over a 5-year period was performed in accordance with an Institutional Review Board approved protocol. Staging marrow samples represented patients treated at our pediatric center for Hodgkin lymphoma, Ewing Sarcoma, and Burkitt lymphoma or were initial bone marrow biopsies for
Secondary Acute Myeloid Leukemia in a One-Year-Old Girl Diagnosed with JAK2-V617F Mutation Positive Myeloproliferative Neoplasm
Gary M. Woods,Rajinder P. S. Bajwa,Samir B. Kahwash,Terri Guinipero
Case Reports in Medicine , 2014, DOI: 10.1155/2014/473297
Abstract: Myeloproliferative neoplasms (MPNs) are a group of clonal disorders characterized by hyperproliferation of hematologic cell lines and have been associated with tyrosine kinase JAK2-V617F mutations. Secondary acute myeloid leukemia (sAML) is a known complication of JAK2-V617F+ MPNs and bears a poor prognosis. Although the evolution of a JAK2-V617F+ MPN to a mixed-lineage leukemia has been reported in the pediatric population, no evolutions into sAML have been described. We present a case of a one-year-old girl diagnosed with JAK2-V617F+ MPN with evolution into sAML. Despite initial morphologic remission, she eventually relapsed and succumbed to her disease. 1. Introduction Myeloproliferative neoplasms (MPNs) are a heterogeneous group of disorders manifested by increased hematopoiesis and proliferation of one or more of the hematologic cell lines. A mutation in the tyrosine kinase JAK 2 (JAK2-V617F) is frequently encountered in patients with MPNs [1]. Adults with JAK2-V617F+ MPNs can evolve into acute myeloid leukemia (AML). Evolution into AML from a known MPN is included in the category of secondary AML (sAML). Conversely, the JAK2-V617F mutation is more common in sAML than de novo AML [2–6]. Secondary AMLs evolving from JAK2-V617F+ MPNs bear a poor prognosis since first complete remission (CR) is difficult to obtain; even matched sibling donor hematopoietic stem cell transplant (HSCT) recipients have poor outcomes [4, 7–9]. JAK2-V617F mutations have been described in pediatric patients with MPNs, but the evolution into sAML has not [10]. We describe a case of a one-year-old girl with a JAK2-V617F+ MPN that evolved into sAML. 2. Case Report An 1-year old female presented with a two-month history of fever, fussiness, and refusal to bear weight. Significant physical findings included a one centimeter, freely mobile, nodular mass under her right eyebrow, diffuse lymphadenopathy, and absence of organomegaly. Initial hematologic evaluation revealed a white blood cell count (WBC) of /L, hemoglobin of 9.6?g/dL, and a platelet count of /L. The WBC differential demonstrated a left shift with 2% peripheral blasts. Bone marrow evaluation on hospital day (HD) three was morphologically concerning for myelodysplastic syndrome revealing hypercellularity (Figure 1(a)) with blasts constituting 4% of marrow cells (Figure 1(b)). Cytogenetics revealed 46,XX,dup(8)(q21.3q23), add (11)(p13),del (13)(q12q14),add (18)(p11.2) /46,sl,add(X)(q26),add(3)(p25),add(9)(q32),-del (13), inv (15)(q15sq26.1),+18,-add (18),+mar .ish add (11)(MLL+), which, although complex, identified no
An “acquired” hemoglobin J variant in a sickle cell disease patient
Nawwar Swedan,Kathleen Nicol,Phylis Moder,Samir Kahwash
Therapeutics and Clinical Risk Management , 2008,
Abstract: Nawwar Swedan1, Kathleen Nicol2, Phylis Moder2, Samir Kahwash21Fellow in Transfusion Medicine, Ohio State University, Columbus, Ohio; 2Department of Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OhioAbstract: We report the case of a rare hemoglobin variant, “Hemoglobin J”, discovered while performing hemoglobin electrophoresis following exchange transfusion of a sickle cell disease patient. It is usual practice in our institution to confirm the hemoglobin S level in sickle cell disease patients after red cell exchange. The patient had received 5 red cell units and the source of this variant was traced back to two of those units. Due to the uncertain clinical impact of this variant, and the lack of specific guidelines, the two donors were deferred from future donations to our institution.Keywords: hemoglobin J, sickle cell disease, transfusion
Bilateral Burkitt Lymphoma of the Ovaries: A Report of a Case in a Child with Williams Syndrome
Grace Ifeyinwa Onimoe,Samir Kahwash,Amanda Termuhlen,Thomas G. Gross,Elizabeth Varga,Melissa J. Rose
Case Reports in Medicine , 2011, DOI: 10.1155/2011/327263
Abstract: A 10-year-old female with Williams Syndrome (WS) presented with a two-month history of fatigue, weight loss, and bilateral ovarian masses. Histologic, immunophenotypic, and cytogenetic studies confirmed the diagnosis of Burkitt lymphoma (BL). While there is no established association between the two disorders, this is the third case in the literature of Burkitt lymphoma in a patient with Williams Syndrome.
Transradial Approach Superior to Transfemoral Approach for Guide Catheter Engagement of Right Coronary Artery
Samir B. Pancholy
Clinical Medicine : Case Reports , 2008,
Abstract: We describe one of several cases where right coronary intervention was contemplated. Transfemoral access was selected by the operator. Despite using 12 different guide catheter shapes, attempts at engaging the right coronary artery from transfemoral approach were unsuccesful. The patient was brought for reattempt at percutaneous coronary intervention using transradial approach. Right radial approach allowed immediate JR4 guide catheter seating without difficulty, in the right coronary ostium, with succesful completion of placement of right coronary ostial stent.
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