This manuscript discusses a rare case of acute appendicitis caused by metastasis from invasive breast carcinoma of no special type in a 70-year-old female previously diagnosed with breast cancer. It delves into the diagnostic challenges and management complexities of such unusual clinical presentations. The paper includes an analysis of 19 documented cases, enriching the understanding of metastatic patterns and treatment strategies in breast cancer. It underlines the importance of considering a history of malignancy when diagnosing acute abdominal conditions and emphasizes a comprehensive approach in interpreting diagnostic imaging in patients with past oncological issues to effectively manage metastatic breast cancer exhibiting atypical manifestations.

Rupture of the thyrocervical trunk aneurysm into the thoracic cavity does not occur very often. It is an urgent condition due to hemorrhagic shock by massive hemothorax with potentially fatal consequences. Pregnancy and puerperium are additional risk factors for a rupture of the thyrocervical trunk aneurysm in patients with neurofibromatosis and aneurysms. This is the first case of thyrocervical trunk aneurysm rupture after a Cesarean section in a patient with neurofibromatosis type I noted down in the literature. The patient, a 33-year-old woman with neurofibromatosis type I, three days after an already performed Cesarean section had acute pain in the left area of the neck, swelling, and a hematoma that progressed rapidly to respiratory distress, hemothorax, and hemorrhagic shock. Emergency endotracheal intubation was performed for airway control. Urgent computer tomography angiography procedure showed extracranial artery, thyrocervical trunk aneurysm rupture, and vertebral aneurysm without rupture. The patient was urgently and successfully treated by endovascular coil embolization of a ruptured thyrocervical trunk aneurysm and subsequently thoracic drainage for massive hemothorax. Postoperatively, her left neck pain decreased, after which she had no further neurologic deficits. The patient was discharged 10 days later. Thyrocervical trunk aneurysm rupture is a rare condition with a potential outcome of death which requires urgent intervention. Endovascular coil embolization is a minimally invasive, safe, and efficient treatment for patients with rupture of thyrocervical trunk aneurysm and following comorbidities.

BACKGROUND: According to the 2016 World Health Organization classification of lymphoid neoplasms, high- grade B-cell lymphoma (HGBL) is defined as a new category for aggressive diffuse large B-cell lymphomas (DLBCL), including DLBCL NOS as well. CASE REPORT: An 80-year-old patient was admitted because of an enlargement of the lymph node located in the right neck region. The patient underwent 6 cycles of R-CHOP, which is considered to be the standard treatment for non-Hodgkin lymphomas (NHL) DLBCL (NOS) CSII B “Bulky,” and he subsequently achieved complete remission (CR). A lymph node biopsy was performed, PH No. 12742/21, which revealed the following: LCA+, CD79 α CD20+, and CD5+, in approximately 50% of the cells, NHL DLBCL (NOS) was of GCB origin, etc. The international prognostic index risk score was 2, the cumulative illness rating scale score was 4. In addition, no bone marrow infiltration was reported. A COP-based chemotherapy protocol was administered, after which the evaluation showed disease relapse. Multi-slice spiral computed tomography (MSCT) follow-up showed an enlarged conglomerate of lymph nodes in all the neck levels. Dg: NHL DLBCL (NOS) CS IVB “Bulky” E (the hypopharynx). The echocardiography results were the following: (EF 50%, aortic insufficiency with MR1+, TR1+ of the aortic valve 3+). The patient was presented to the Consilium, who decided to apply the following therapy (Polatuzumab vedotin + Rituximab + Bendamustine). After III cycle of treatment, MSCT follow-up was performed. The patient gained weight, oral food intake was enabled, whereas the quality of life was significantly improved. CONCLUSION: The administration of ta treatment may be provided to elderly patients with relapsed HGBL.

Introduction/Objective: Hodgkin lymphoma (HL) is a rare neoplasm of the lymphatic system and is one of the most common cancers in the young adult population. Histopathologically, 95% of Hodgkin lymphoma is classic Hodgkin lymphoma (cHL). Eosinophilia, both peripherally and in tissues, is relatively common in patients with HL, especially in the nodular sclerosis and mixed cellularity subtypes. Its presence indicates a complex interaction between tumor cells and the immune system. In addition to eosinophilia present in the tissue sample, eosinophilia is also detected in the peripheral blood. The study aimed to analyze HL patients by sex, age, clinical stage, the International Prognostic Score (IPS), and B symptoms, as well as to determine the association between tumor mass size and the complete blood count, erythrocyte sedimentation rate (ESR), the C reactive protein (CRP) level, the clinical stage, and the IPS, with special reference to the significance of eosinophilia in peripheral blood as a predictor of tumor mass size and therapeutic response. Materials and methods: A retrospective analysis of 58 new cases of HL, diagnosed and treated at the Clinic for Hematology of the University Clinical Center Kragujevac, was performed between December 31, 2018, and December 31, 2023. Data was obtained from written medical records. The initial blood laboratory parameters at diagnosis were analyzed, and the therapeutic response was assessed after the first-line therapy was administered. IBM SPSS Statistics, Version 23, software was used for statistical data processing. Statistical significance was defined at p < 0.05. Results: At presentation, the observed population had advanced disease - CS III (27.6%) and CS IV (39.7%); B symptoms were present in 76% of the patients, and a high IPS was registered in 48.3% of the subjects. Bulky mediastinal mass was present in 48.3% of patients, while 34.3% of patients presented with nonmediastinal localization. No correlation was found between the leukocyte count, the eosinophil count, the hemoglobin level, the erythrocyte sedimentation rate, CRP values, the clinical stage, IPS, and the maximum diameter of the measured lymph nodes (p > 0.05). However, the analysis showed a statistically significant association between eosinophilia and therapeutic response (p = 0.024), indicating its potential prognostic significance. Conclusion: Peripheral blood eosinophilia was shown to be a potential predictor of therapeutic response, but not a predictor of tumor mass size. Clinical and radiological diagnostics remain the standard for assessing tumor burden.

Introduction. Aggressive B-cell lymphomas are a heterogeneous group of diseases with various clinical, patohistological, genetic characteristics and a variety of treatment outcomes. Diffuse large B-cell lymphoma is the most common lymphoma in European countries, some lymphomas are recognized as specifically aggressive, providing non-adequate response to the standard treatment (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). High-grade B-lymphomas. One group consists of those which are carriers of the c-myc, bcl-2 or bcl-6 rearrangement established by Fluorescence in situ hybridization, and are called high grade B lymphomas, which can be double hit or triple hit. The other group consists of those with blastoid morphology, which are not carriers of the c-myc, bcl-2 and bcl- 6 rearrangement and are called Not Otherwise Specified. This heterogeneous group is a carrier of a single myc mutation in 45% of cases, in 15% of patients, an additional analysis of gene expression profiling indicates the presence of high grade B lymphomas double hit sig+. Extranodal localization with Central Nervous System involvement is frequently reported. Clinical staging and disease progression along with risk assessment by means of IPI scores and aaIPI scores in patients with high-grade B-lymphomas. Diagnostic procedures during the clinical interview, physical examination, laboratory analyses and various additional diagnostic procedures. High-grade Blymphomas treatment. Studies indicate more intensive induction chemotherapy including central nervous system prophylaxis for these patients. Conclusion. The question of how to choose the most effective therapeutic strategy in high grade B lymphomas is still open at this moment, and examinations are focused on the research of molecular mechanisms of lymphomagenesis.