http://dr.limu.edu.ly/handle/123456789/5227 2026-07-23T05:39:10Z 2026-07-23T05:39:10Z http://dr.limu.edu.ly/handle/123456789/5255 2026-07-13T08:28:30Z 2026-05-25T00:00:00Z

Primary Breast Langerhans Cell Histiocytosis in an Adolescent Girl: A Rare Diagnostic Case with Clinicopathologic and Immunohistochemical Insights Background: Langerhans Cell Histiocytosis (LCH) is a rare clonal myeloid neoplasm characterized by the proliferation of CD1a-positive dendritic cells driven by activation of the MAPK pathway. Breast involvement is exceptionally uncommon, particularly in adolescents, where it may mimic more prevalent benign and malignant breast lesions, posing a significant diagnostic challenge. Case Presentation: A 16-year-old female presented with a progressively enlarging left breast mass. Radiologic assessment revealed a large heterogeneous lesion extending from the axilla into the breast, with cystic components, skin thickening, and vascular encasement, categorized as BI-RADS 4C. The patient underwent surgical excision. Histopathologic examination demonstrated sheets of large histiocytic cells with oval to grooved nuclei and abundant eosinophilic cytoplasm, accompanied by a prominent inflammatory infiltrate rich in eosinophils, lymphocytes, plasma cells, and multinucleated giant cells. Immunohistochemical analysis showed diffuse positivity for CD1a, S100, and CD68, confirming the diagnosis of LCH. Comprehensive staging revealed no evidence of multisystem involvement, consistent with single-system disease. The patient was treated with complete surgical excision without systemic therapy and remains clinically stable, 3 months postoperatively. Conclusion: This case highlights an exceedingly rare presentation of LCH as a primary breast mass in an adolescent. It underscores the importance of considering LCH in the differential diagnosis of atypical breast lesions in young patients. Definitive diagnosis relies on histopathologic and immunophenotypic evaluation, which is critical for appropriate management and avoidance of misdiagnosis.

2026-05-25T00:00:00Z http://dr.limu.edu.ly/handle/123456789/5253 2026-07-13T08:28:30Z 2026-05-25T00:00:00Z

The First Reported Case Worldwide of Chronic Gossypiboma Complicated by Secondary Tuberculous Psoas Abscess from Pott’s Disease: A Case Report Highlighting Diagnostic Anchoring Tuberculous psoas abscess secondary to spinal tuberculosis (Pott’s disease) is a significant clinical challenge across the world. While gossypiboma (retained surgical gauze) is a known surgical complication, its coexistence with an active mycobacterial infection presents a unique presentation. Here we reported the first documented worldwide case of a secondary tuberculous psoas abscess arising from Pott’s disease coexisting with a chronic gossypiboma in a 42-year-old woman. The diagnosis was missed for three years, during which her symptoms were mistakenly treated as recurrent urinary tract infections. Radiological imaging showed a large psoas abscess alongside a pelvic mass. A laparoscopic procedure revealed a large abscess and an encapsulated retained surgical gauze with dense adhesions (pseudocyst) that was removed. Mycobacterium culture confirmed the diagnosis; anti-tuberculous therapy was promptly initiated. We hypothesized that the gossypiboma may have provided a sequestered environment, potentially “hiding” or exacerbating the tuberculous process. This case shows the significant dangers of diagnostic anchoring and the importance of reconsidering diagnoses when treatment fails in patients with non-resolving symptoms. Managing such complex presentations of surgical and infectious pathologies requires a high index of suspicion and a multidisciplinary approach.

2026-05-25T00:00:00Z http://dr.limu.edu.ly/handle/123456789/5251 2026-07-13T08:28:30Z 2026-05-25T00:00:00Z

Perception and Attitude of Medical Students Towards Online Learning Background: On the 11th of March 2020, the World Health Organization categorized COVID-19 as severe enough to warrant the act of social distancing. In response, the Libyan International University (LIU) implemented online learning platforms to reduce the rate of transmission among students and staff, allowing them to study and instruct from anywhere, at any time, and with more convenience. This study aimed to explore students’ attitudes and perceptions towards online learning in medical education. Methodology: A cross-sectional study involving 250 medical students was conducted. The completed questionnaire comprised questions related to demographic characteristics and their online learning experience. Statistical significance and inferential statistics were determined through SPSS software analysis. Results: About 178 (71.2%) reported health issues during online learning, and 156 (62.4%) did not feel that online learning adequately prepares them for mastering clinical skills. Additionally, 117 (46.8%) struggled with motivation, though 142 (56.8%) valued the flexibility of online classes. Conclusion: Overall, the study concluded that the students’ perception was positive towards online learning. However, more is required to instill confidence in the ability to practice medicine under these circumstances.

2026-05-25T00:00:00Z http://dr.limu.edu.ly/handle/123456789/5254 2026-07-13T08:28:30Z 2026-05-25T00:00:00Z

Mediastinal Lymph Node Calcification in a Patient with Pulmonary Hypertension: A Novel Clue to Accurate Diagnosis Mediastinal lymph node calcification is an important but often overlooked radiological clue in patients with pulmonary hypertension, particularly in tuberculosis-endemic settings. We report a 27-year-old man with progressive dyspnea and ankle oedema, previously treated successfully for pulmonary tuberculosis, whose echocardiography suggested pulmonary hypertension. Non-contrast chest computed tomography demonstrated extensive, dense, coarse calcification of subcarinal and paratracheal mediastinal lymph nodes, with chronic post-infectious parenchymal lung changes but no evidence of active tuberculosis—consistent with pulmonary hypertension secondary to chronic lung and thoracic sequelae. This case highlights the diagnostic value of careful CT assessment of calcified mediastinal nodes in young patients with pulmonary hypertension.

2026-05-25T00:00:00Z