The article presents an example of successful surgical treatment of a 73-year-old patient with symptomatic occlusion of the internal carotid artery, which resulted in transient cerebral hemodynamic disturbance and was accompanied by a speech disorder in the form of dysarthria. An extra-intracranial microanastomosis for revascularization of the left cerebral hemisphere was performed. The peculiarity of this case is the combination of the progressive course of squamous cell lung cancer and occlusion of the left internal carotid artery. To date, such a combination of pathologies has not been described in the medical literature, which makes this case particularly significant for clinical practice.

Background. Lymphadenopathy in pubertal children is a common pathological condition due to both specific and non-specific reasons. Differential diagnosis of lymphadenopathies is essential for the detection of malignant diseases such as lymphomas.

Aim. To evaluate the possibility of using the systemic immune-inflammation index (SII) as an auxiliary method for the differential diagnosis of lymphadenopathies in pubertal children.

Materials and methods. The study included 160 pubertal children (11–17 years old), divided into 3 groups: group 1 (n = 40) – children of both sexes (22 (55 %) boys and 18 (45 %) girls) with Hodgkin lymphoma; group 2 (n = 40) – children in equal sex ratio with acute infectious mononucleosis; group 3 (n = 40) – children (n = 40) in equal sex ratio with reactive lymphadenitis. Before treatment indicators of general blood test were determined, followed by calculation of the SII. As the norm, average values of parameters obtained from the results of general blood test of conditionally healthy pubertal children (n = 40) in equal sex ratio were used. Statistical processing of the results was performed using Statistica 10.

Results. Average leukocyte counts in pubertal children with acute infectious mononucleosis were higher than normal: 2-fold higher in boys and 2.3-fold higher in girls, due to 3–3.6-fold increase in lymphocytes counts. However, there was about 1.5-fold decrease in the average platelet count in comparison with the norm. In pubertal children with Hodgkin lymphoma, the average values of the leukocytes count were 1.5 times higher in boys, and 1.7 times higher in girls compared to the norm, due to 2.1–2.4-fold increase in neutrophil count, at the same time there was about 1.4-fold increase in platelet count. In pubertal children with acute infectious mononucleosis SII values were 4.5 times lower than normal in boys and 4 times lower in girls. In pubertal children with Hodgkin lymphoma SII values exceeded the norm in boys – 6.7 times, and in girls – 6.5 times.

Conclusion. Calculation of the SII based on the results of general blood test can be used as an auxiliary, convenient and easily accessible method which allows identifying patients with lymphadenopathy of unknown origin who need in additional diagnostic methods.

Lymphedema is a chronic, long-lasting and usually sluggish disease, which leads to partial or complete impairment of limb function, limits the patient’s social opportunities. This article presents a review of the medical literature on the modern concept of lymphedema, its classification, etiology, diagnosis and treatment.