Traumatic brain injury (TBI) is a devastating and extraordinarily expensive entity. It is becoming increasingly burdensome in the military setting with societal costs of managing the sequelae of TBI running into the billions of dollars (US$) each year. Increasing awareness among non-neurosurgical medical personnel of the pathophysiology of TBI and rapid and appropriate assessment, triage and treatment will increase the likelihood of a better outcome in any given head injured patient. Careful attention to prevention of secondary injury is vital if further decline following the initial insult is to be achieved. Early and repeated neurological assessment, and aggressive management of intracranial hypertension and disorders affecting airway and cardiorespiratory systems are the mainstay of managing moderate to severe TBI. This management may involve medical and surgical options and often requires battlefield assessment prior to aeromedical evacuation. The unique profile and epidemiology of TBI in the military, necessitates ongoing research into primary prevention and appropriate, cost-effective means of assessing and treating these often debilitating injuries. Improvements in the prevention and care of these individuals will lead to enormous individual and societal gains.
Primary central nervous system lymphoma of T-cell lineage (PCNSTL) is an extremely rare entity, with relatively few cases reported in the literature. Presented here is a case of a 44-year-old, HIV negative woman found to have a solitary cerebellar lesion following presentation to the Emergency Department with a fall. The lesion responded to emergent dexamethasone and was followed with serial MRI imaging, which continued to show lesion regression. The lesion was shown to have recurred on MRI 14 months post-presentation and found to be T-cell lymphoma following immunophenotyping and TCR gene rearrangement studies of tissue specimen obtained via excisional biopsy.
We have examined primary tumor
sections from melanoma patients by immunohistochmistry (IHC) for the presence
of the odontogenic ameloblast-associated protein (ODAM). Within these patient
tissues we have observed a correlation of nuclear ODAM staining in the primary
tumors with sentinel lymph node (SLN) metastasis. Surgically, SLN invasion in
melanoma is considered an important indicator of more aggressive, invasive
melanoma and to date there are limited biomarkers which strongly correlate with
metastatic disease. The observation that ODAM staining in melanoma associates
with SLN invasion may have important prognostic implications which could assist
in the management of melanoma. Notably, ODAM expression may correlate with
pathway-signaling we have previously reported to be affected by ectopic ODAM
expression in cultured melanoma and breast cancer cell lines.