This case describes the radiological-surgical correlation of a rare case of osteosarcoma of the rib in a 15-year-old boy. Successful repair of his chest wall defect using a wire mesh following extensive surgical resection of the tumour is highlighted,such a procedure being the first instituted at our centre.

Haemophagocytic lymphohistiocytosis (HLH) is a clinico-pathologic entity caused by increased proliferation and activation of benign macrophages with haemophagocytosis throughout the reticulo-endothelial system. Virus-associated HLH is a well-recognised entity. Although majority of parvovirus B19 associated HLH does not require any specific treatment and carries good prognosis, outcome of children is worse than adults. We report here a case of HLH associated with acute parvovirus B19 infection in a young healthy patient with underlying hereditary spherocytosis, with bone marrow findings typical of parvovirus infection. Although this patient had spontaneous recovery of cell counts, he succumbed due to complication from prolonged ventilation. Unexpectedly, his immunoglobulin levels were inappropriately normal despite on-going ventilator associated pneumonia, which reflects inadequate humoral immune response towards infection.
Parvovirus

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.
Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/ethnology ; Gastrointestinal Hemorrhage/*etiology ; Gastrointestinal Hemorrhage/therapy ; Malaysia ; Retrospective Studies ; Risk Factors ; Sex Factors

Jessner’s lymphocytic infiltration of skin is an uncommon disorder characterised by benign accumulations of lymph cells in the skin. It is of unknown aetiology and presents as erythematous papules and plaques on the face, neck and/or back, with possible itching of the skin surrounding the lesions. The lesions may remain unchanged for many years and then spontaneously disappear, without residual scarring. Current literature on this topic are limited and numerous treatments have been tried with limited success. We report a recent case of Jessner’s lymphocytic infiltration seen in our practice and discuss the histology and our approach to management.