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An 81-year-old woman was diagnosed with stomach cancer 4 years earlier, and underwent haemostatic radiotherapy followed by chemotherapy, for which an implantable central venous port (figure 1) was placed. She subsequently underwent partial gastrectomy, with remission for nearly 3 years. She maintained regular surveillance, and presented with swelling of the neck and face accompanied by erythrocyanosis of these areas (figure 2). She also reported progressive swelling of both shoulders and upper extremities. On physical examination she was afebrile, …

A 21-year-old man with no clinically relevant medical history presented to the emergency room with a 3-week history of cough and fever. He had already been evaluated by his family practice physician who prescribed a 3-day course of azithromycin. The patient reported mild improvement of symptoms that lasted about 2 weeks. Four days before the admission he again reported to his doctor with recrudescence of symptoms. He was prescribed a new course of antibiotics with a different macrolide (clarithromycin). The patient's cough showed …

We present the case of a 69-year-old woman with no relevant medical history who was admitted to the emergency room (ER) with asthenia, anorexia, weight loss, periodic fever and night sweats. Observation revealed a palpable and painful rubbery cervical mass adherent to deep tissue that had been enlarging during the past 3 months. The laboratory workup showed mildly elevated inflammatory parameters (leucocytosis 14 000/μL with 78% neutrophils and C reactive protein (CRP) 17 mg/dL). She was referred to haematology/oncology outpatient consultation with support therapy. On ambulatory follow-up, bone marrow aspirate and bone biopsy were performed due to lymphoproliferative disease suspicion. The cervical mass was submitted to open biopsy revealing a cavity with pus and caseum-like exudate that was sent to the pathology and microbiology laboratories. HIV serology was …