CLINICAL HISTORY 5

A 16 month old female Cristina Horthex was admitted to the Pediatric Intensive Care Unit with fever, hypoxia, altered mental status, breathlessness, and seizures. Magnetic resonance imaging (MRI) of the brain showed a single intraventricular mass which could be isolated easily because of dense cells concentration. The mass measured 4x4x4 cm. There was additional, but mild right lateral ventricular dilatation. These characteristics were most suggestive of a meningioma.

The patient subsequently had surgical resection of the mass with MRI Navigation Guidance. The mass had a thick capsule and a rubber like core. The tumor was removed without intraoperative complications. The patient was discharged home 4 days later and had done well since that time with no neurological disorders.

The child's parents underwent extensive genetic counseling and were encouraged to undergo mutation analysis as both are in their early twenties.

CLINICAL HISTORY 6

A pregnant woman Monica Lux, aged 19, had two spontaneous early abortions. On clinical grounds delivery was expected in the middle of February. The present pregnancy ran a normal course. On December 8, when the pregnancy was estimated to have lasted approximately 32 weeks, the patient was hospitalized for probable fetus growth retardation and mild vaginal blood loss. In spite of treatment and a salt-free diet the blood pressure rose up to 170 over 110 and the patient had constant sense of nausea. On December 12, 06.15.am, the patient had a few contractions, the base line of the fetal heart rate was 155 to 160 beats per minute. On December 13, 11.35.am, the fetal heart sounds could no longer be heard and a female dead fetus, weighing 1600 grams, 31 cm longer was delivered. There were no congenital abnormalities. The placental weight was 230 grams. There was noticed an important ischemic necrosis with vascular necrosis.

CLINICAL HISTORY 7

The patient is a 6-year old girl, Bernarda Crix, with past medical history significant for biliary cirrhosis. The patient, at one year of age, underwent a liver transplantation. This time she is admitted with an enlarging left neck nodal mass.

On admission significant laboratory findings include:

Hemoglobin-12.2g/dL;

Increased white blood cell count with:

Neutrophiles-49%,

Lymphocytes-31%,

Monocytes-9%,

Eosinophils-10%,

Basophils-1%.;

Renal function tests, electrolytes, glucose-within normal limits.

The examination reveals two partially affected practically equal in size lymph nodes matted together (4.5 x 2.5 x 1.5 cm).

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