scholarly journals A case of poorly differentiated adenocarcinoma with lymphoid stroma originated in the ascending colon diagnosed as lymphoepithelioma-like carcinoma

2019 ◽  
Vol 13 (4) ◽  
pp. 538-544
Author(s):  
Kengo Kai ◽  
Hideki Hidaka ◽  
Takeshi Nakamura ◽  
Yuji Ueda ◽  
Kosuke Marutsuka ◽  
...  
Keyword(s):  
Large Intestine ◽  
Elective Surgery ◽  
Histopathological Examination ◽  
Case Reports ◽  
Medullary Carcinoma ◽  
Hepatic Flexure ◽  
Wall Thickening ◽  
Ascending Colon ◽  
Lymphoid Stroma ◽  
Poorly Differentiated

AbstractAn 86-year-old woman’s stool sample was positive for blood. Computed tomography (CT) showed wall thickening of the ascending colon at the hepatic flexure. Colonoscopy showed near-complete obturation by colon cancer. Since she was asymptomatic, elective surgery was planned. Laparoscopic right hemicolectomy was performed. Histopathological examination showed poorly differentiated carcinoma cells proliferating in a solid pattern with marked lymphocyte infiltration. The diagnosis was lymphoepithelioma-like carcinoma (LELC) associated with Epstein-Barr virus (EBV) infection; however, EBV-encoded small RNA–in situ hybridization was negative. Microsatellite instability was not assessed. The postoperative course was uneventful and she was discharged on the 15th postoperative day. She remains recurrence-free at 2 years after surgery. Past reports note that colorectal carcinomas with dense lymphoid stroma may be related to LELC or medullary carcinoma (MC). Gastrointestinal LELC is rare, with some reports on LELC of the esophagus and stomach. Reports on LELC of the large intestine are very rare. MC of the large intestine is relatively new concept, firstly described in the WHO Classification of Tumours of the Digestive System 3rd Edition in 2000. We herein present a case of lymphoepithelioma-like carcinoma of the ascending colon and relevant case reports about LELC and MC of the large intestine.

scholarly journals Mesenteric Phlebosclerosis Associated with Herbal Medicine

2020 ◽  
Vol 14 (3) ◽  
pp. 516-521
Author(s):  
Kimitoshi Kubo ◽  
Noriko Kimura ◽  
Norishige Maiya ◽  
Soichiro Matsuda ◽  
Momoko Tsuda ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Rare Case ◽  
Lower Abdominal Pain ◽  
Hepatic Flexure ◽  
Wall Thickening ◽  
Ascending Colon ◽  
High Grade Fever ◽  
Radiological Features ◽  
Intravenous Antibiotics ◽  
Fat Stranding

Mesenteric phlebosclerosis (MP) associated with herbal medicine is rarely reported and its endoscopic and radiological features remain poorly described. An 81-year-old woman was admitted to our hospital for right lower abdominal pain and high-grade fever. Computed tomography (CT) revealed wall thickening, pericolic fat stranding, and linear calcifications extending from the cecum to the hepatic flexure of the colon. Ultrasonography (US) revealed wall thickening of the cecum and ascending colon. Colonoscopy (CS) revealed dark-purple edematous mucosa with erosion and ulcers from the cecum to the hepatic flexure of the colon. The patient was histopathologically diagnosed with MP, discontinued orengedokuto, and was treated with intravenous antibiotics for 1 week. Six months after treatment, US and CT revealed no significant changes, but CS showed improvement in dark-purple edematous mucosa with erosion and ulcers. To our knowledge, this report represents a valuable addition to the MP literature describing a rare case of MP associated with herbal medicine.

scholarly journals Nonneoplastic Tongue Swellings of Lymphatic and Lymphocytic Origin: Three Case Reports

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Manar A. Abdul Aziz ◽  
Nermin M. Yussif
Keyword(s):  
Lymphatic Vessel ◽  
Oral Surgery ◽  
Histopathological Examination ◽  
Case Reports ◽  
Surgical Excision ◽  
Surface Epithelium ◽  
Lymphoepithelial Lesion ◽  
Lymphoid Stroma ◽  
Surgery Department ◽  
And Behavior

Tongue is formed of a mass of muscles and salivary gland embedded in anterior highly vascular and posterior lymphoid stroma and covered by specialized surface epithelium. Growths from all of these heterogonous components may occur resulting in a wide variation in clinical features and behavior, ranging from self-limiting to aggressive lesions. Therefore, surgical excision is the treatment of choice. The aim of the current study is to report three different lesions that came to the Oral Surgery Department in the Faculty of Oral and Dental Medicine, Cairo University. Following clinical and histopathological examination, the diagnosis of reactive lymphoproliferative lesion, cystic lymphoepithelial lesion, and developmental lymphatic vessel malformation was reached.

scholarly journals EVOLUTIVE PECULIARITIES OF AN ILEO-CECAL VALVE TUMOR: CASE REPORT

2019 ◽  
Vol 6 (3) ◽  
pp. 85-89
Author(s):  
Elena Neștian ◽  
M A Șoitu ◽  
Rodica Birla ◽  
Daniela Dinu ◽  
Cristina Iosif ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
Tumor Formation ◽  
Intestinal Transit ◽  
Thick Wall ◽  
Ascending Colon ◽  
Left Flank ◽  
Left Hypochondrium ◽  
The Right

Introduction: Tumors of ileo-caecal valve are most clinically manifested either through transit disorders or anemic syndrome. The 88-year-old patient is admitted for abdominal pain in the left flank, vomiting, asthenia and lack of intestinal transit for faeces, with a progressive onset of one week. Clinical examination: generalized affected state, wide abdomen, painful left flank and hypochondrium, lack of intestinal transit and pallor. Paraclinic: severe hypochromic microchrome anemia (hemoglobin: 5.8 g / dl). Plain radiography: hydro-aeric levels in the left hypochondrium. Abdominal CT: ileo-colic intussusception that completely occupies the ascending colon to the hepatic flexure, with no visible tumoral lesions. After hydroelectrolytic and hemodynamic balancing with restoration of intestinal transit, colonoscopy is performed: 5 cm ulcer-vegetative tumor formation at the ileo-caecal valve level - biopsy with histopathological examination: moderately differentiated adenocarcinoma. Patient refuses surgery. After 3 weeks, the patient returns to the clinic for the recurrence of digestive symptoms and emergency surgery is performed: laparotomy by median suprasubombilical incision, finding: ileo-ceco-appendico-colic invagination up to the middle third of the transverse colon, defective attachment of ascending colon, ileum dilated with thick wall. The invagination is reduced, the tumor formation is discovered. Right hemicolectomy with ileotransversoanastomosis is performed. Postoperatively, the patient shows a simple evolution with discharge of the 9th postoperative day. Conclusions: The ileocolic invagination in adults is most often the appearance of a tumor located on mobile segments of the intestine. The right colon invagination is possible when there is a defect of acolation, anatomical peculiarity encountered in the presented case.

scholarly journals Fetus in fetu: two case reports from North African country

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Moutaz Ragab ◽  
Omar Nagy Abdelhakeem ◽  
Omar Mansour ◽  
Mai Gad ◽  
Hesham Anwar Hussein
Keyword(s):  
Histopathological Examination ◽  
Case Reports ◽  
Abdominal Mass ◽  
Mature Teratoma ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Mass Effect ◽  
Fetus In Fetu ◽  
Vascular Connection ◽  
First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

Micronodular Thymoma With Lymphoid Stroma: A Trio of Cases, With Diverse-associated Histological Features

2021 ◽  
pp. 106689692110011
Author(s):  
Neha Bakshi ◽  
Shashi Dhawan ◽  
Seema Rao ◽  
Kishan Singh Rawat
Keyword(s):  
Mediastinal Mass ◽  
Single Case ◽  
Case Reports ◽  
Good Prognosis ◽  
Anterior Mediastinal Mass ◽  
Histological Features ◽  
Lymphoid Stroma ◽  
Thymic Cysts ◽  
Robotic Thymectomy ◽  
Conventional Type

Introduction. Micronodular thymoma with lymphoid stroma (MNTLS) is a rare thymoma subtype characterized by distinctive histological appearance, unique clinical profile, and indolent course with good prognosis. In addition to its distinctive morphology, MNTLS may be associated with diverse histological features, such as thymic cysts and conventional thymoma, complicating the diagnostic picture further. Materials and methods. We report herein an account of 3 elderly patients (male—02; female—01), who presented with anterior mediastinal mass, and underwent robotic thymectomy. Microscopic examination revealed MNTLS in all 3 cases. In addition, 2 cases showed associated histological features in the form of a multilocular thymic cyst and conventional (type B2) thymoma, respectively. All 3 patients are doing well without recurrence or metastasis at 34, 28, and 19 months postsurgery. Conclusions. Awareness of this rare thymoma subtype is vital among pathologists to avoid misdiagnosis and ensure appropriate patient management. To date, only a few cases of this rare thymoma subtype have been reported in the literature, mostly as single case reports.

scholarly journals Diagnosis of Fibrotic Distal Ileum Stenosis after Ischemic Enteritis Using Transabdominal Ultrasonography

2021 ◽  
pp. 568-577
Author(s):  
Ryo Katsumata ◽  
Noriaki Manabe ◽  
Masaki Matsubara ◽  
Jun Nakamura ◽  
Kazuma Kawahito ◽  
...  
Keyword(s):  
Blood Flow ◽  
Case Reports ◽  
Blood Perfusion ◽  
Distal Ileum ◽  
Wall Thickening ◽  
Current Case ◽  
Abdominal Ultrasonography ◽  
Transabdominal Ultrasonography ◽  
Stenotic Lesion ◽  
Ischemic Enteritis

Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ileum. Contrast-enhanced abdominal ultrasonography revealed a 7-cm stenotic site with increased intestinal wall thickening, which preserved mucosal blood perfusion. Elastography revealed a highly elastic alteration of the stenotic lesion, indicating benign fibrotic changes resulting from chronic insufficient blood flow. Based on a clinical diagnosis of IE with fibrous stenosis, a partial ileostomy was performed. After surgical treatment, oral intake was initiated without recurrence of intestinal obstruction. Pathological findings revealed deep ulceration with inflammatory cell infiltration at the stenotic site. Occlusion and hyalinization of the venules in the submucosal layer indicated IE. In addition to current case, we reviewed past case reports of IE. Through this case presentation and literature review, we summarize the usefulness and safety of transabdominal ultrasonography for diagnosing IE.

scholarly journals Polypoidal lesions of the gastrointestinal tract

2020 ◽  
Vol 10 (1) ◽  
pp. 1625-1629
Author(s):  
Palzum Sherpa ◽  
Abhimanyu Jha ◽  
Sudhamshu Koirala ◽  
Rojan Ghimire
Keyword(s):  
Gastrointestinal Tract ◽  
Large Intestine ◽  
Hyperplastic Polyp ◽  
Histopathological Examination ◽  
Biological Behavior ◽  
Research Centre ◽  
Chi Square ◽  
Neoplastic Lesions ◽  
Chi Square Test ◽  
Conventional Adenoma

Background: With increasing usage of endoscopic procedures, gastrointestinal polypoidal lesions are commonly encountered specimens. Histopathological examination is crucial as biological behavior is dependent on its pathological nature. Materials and Methods: A retrospective descriptive study performed in Pathology department, Om Hospital and Research Centre from January 2017 to June 2019. The study included lesions received as polyp or polypoidal lesions of gastrointestinal tract for histopathological examination. Data was analysed using SPSS version 17.0. Gender, number and site were analysed using Chi square test to evaluate its association with neoplastic nature. Correlation with age and size was tested with Pearson’s correlation coefficient. Results: Among 150 cases of gastrointestinal tract polypoidal lesions, 58% were seen in male and 42% in female. Hyperplastic polyp and conventional adenoma were the commonest non-neoplastic and neoplastic lesions respectively. The age of patients ranged from 7 to 84 years with a mean age of 50 years. Rectosigmoid region was the commonest site. 134 patients had single and 16 had multiple polypoidal lesions. Most polypoidal lesion had size <1 cm. Gender, age, number and size showed no correlation with neoplastic nature. A significant association was found with site with notably higher number of neoplastic lesions in large intestine. Conclusion: A spectrum of histological types of polypoidal lesions were found in Gastrointestinal tract, most frequently in colorectal region. Hyperplastic polyp and adenomatous polyp were the commonest non-neoplastic and neoplastic lesions respectively. A notably higher number of polypoidal lesions in the large intestine were found to be neoplastic in nature.

Imaging Findings in a Case of Carcinoma Oesophagus Presenting with an Intra-Atrial Mass on Echocardiography

2021 ◽  
Vol 8 (25) ◽  
pp. 2238-2241
Author(s):  
Dhruba Borpatra Gohain ◽  
Sujan Dibragede ◽  
Amrita Das ◽  
Tanaya Sarma
Keyword(s):  
Pericardial Effusion ◽  
Left Atrium ◽  
Histopathological Examination ◽  
Normal Sinus Rhythm ◽  
Tertiary Care ◽  
Chest Roentgenogram ◽  
Wall Thickening ◽  
Imaging Findings ◽  
Pulmonary Vessels ◽  
Atrial Mass

A 53-year-old male presented to our tertiary care center with complaints of palpitation and difficulty in breathing on exertion which was insidious in onset and gradually progressive. He had a history of back ache and significant weight loss. His physical examination and initial laboratory work up revealed no obvious abnormality. His initial radiological investigation involved chest roentgenogram which revealed cardiomegaly with mediastinal widening and haziness in left lower lung zone (Figure 1). His (electrocardiogram) ECG revealed normal sinus rhythm. Later, patient underwent echocardiography which revealed normal systolic flow with a mass extending up to pericardium (measuring 6.9 x 4.1 cm) in left atrium obstructing mitral flow and minimal pericardial effusion. He was sent to our department for contrast enhanced computerised tomography (CT) thorax scan to evaluate the extension of the left intra atrial mass which revealed a heterogeneously enhancing circumferential wall thickening in mid oesophagus extending from T7 - T11 for an approximate length of 8.3 cm with a single wall thickness of 2.3 cm in left lateral wall. There was also a heterogeneously enhancing lobulated soft tissue density mass with hypodense area within measuring 6.4 (CC) x 7.3 (AP) x 7.9 (TR) cm in left paraesophageal region infiltrating into adjacent pulmonary vessels and left atrium forming a large intracavitary mass with collapse of adjacent lung parenchyma and pericardial effusion with a maximum depth of 1.7 cm (Figure 2 & 3). Multiple enlarged lymph nodes were noted in paratracheal, pretracheal precranial and perivascular regions, largest measuring 1.2 cm in SAD in paratracheal regions (Figure 2B). Based on the imaging findings we made the diagnosis of malignant oesophageal growth with metastatic paraesophageal nodal mass infiltrating into adjacent pulmonary vessels and left atrium forming a large intra-cavitary mass. On following up, endoscopic workup revealed a nodular growth in oesophagus extending from 33 to 38 cms with intact overlying mucosa (Figure 4). On histopathological examination of the specimen taken from the oesophageal growth revealed to be squamous cell carcinoma infiltrating to muscle coat.

Abstract WMP34: Multimodal Evaluation of Unruptured Intracranial Aneurysm Wall

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yukishige Hashimoto ◽  
Kazuhiro Furukawa ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Chiaki Ono ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Three Dimensional ◽  
Fast Spin Echo ◽  
Maximum Diameter ◽  
Patient Specific ◽  
Wall Thickening ◽  
Hemodynamic Parameters ◽  
Aneurysm Wall ◽  
Unruptured Intracranial Aneurysms ◽  
Morphological Variables

Background and Purpose: Recent studies have suggested that MR-vessel wall imaging (VWI) or computational fluid dynamics (CFD) could evaluate aneurysm wall features in unruptured intracranial aneurysms (UIAs). The combination of these modalities might be comprehensive and help better understanding of the pathophysiology of aneurysm wall. This study was performed to disclose the relationship between VWI and hemodynamic characteristics evaluated by CFD. Methods: From April 2017 through May 2019, a total of 36 microsurgically-treated UIAs preoperatively underwent VWI and CFD were reviewed. Three-dimensional T1-weighted fast spin-echo sequences were obtained before and after injection of contrast medium, and aneurysm wall enhancement (AWE) was evaluated. CFD was carried out using patient specific geometry models from three-dimensional CT angiography. Morphological variables, intraoperative inspection and hemodynamic parameters were statistically analyzed between enhanced and nonenhanced wall of UIAs. Fourteen UIAs were available for histopathological examination. Results: In morphological variables, maximum diameter and irregularity were associated with AWE (p=0.02, respectively). AWE lesions corresponded to intraoperatively inspected atherosclerotic lesions of UIAs (sensitivity, 0.90; specificity, 0.79). Among hemodynamic parameters, oscillatory velocity index that suggests the directional changes of the flow velocity was significantly higher in UIAs with AWE (p=0.02). Histopathologic studies revealed that wall thickening accompanied by atherosclerosis, neovascularization, and macrophage infiltration corresponded to AWE lesions, while UIAs without AWE demonstrated various histopathological findings such as myointimal hyperplasia or thinning wall with loss of mural cells and wall degeneration. Conclusions: Pathophysiology of AWE could be explained as atherosclerotic changes with inflammation presumably associated with aberrant flow conditions in irregular UIAs. VWI and CFD are complementarily valuable imaging techniques to understand an aneurysm wall pathophysiology.

scholarly journals Autoinfarction of Giant Parathyroid Adenoma after Preoperative Withdrawal of Anticoagulants

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raoul Verzijl ◽  
Pim J. Bongers ◽  
Geetha Mukerji ◽  
Ozgur Mete ◽  
Karen M. Devon ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Elective Surgery ◽  
Histopathological Examination ◽  
Neck Mass ◽  
Bone Lesions ◽  
Imaging Studies ◽  
Cystic Change ◽  
Parathyroid Adenomas ◽  
History Of ◽  
Brown Tumors

A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia. The surgery was postponed and rescheduled after calcium correction. Intraoperative findings and detailed histopathological examination revealed an infarcted 4.0 cm parathyroid adenoma with cystic change. His bony changes were related to brown tumors associated with long-standing hyperparathyroidism. Autoinfarction of a large parathyroid adenoma causing severe hypocalcemia is a rare phenomenon and may be considered in patients with large parathyroid adenomas after withdrawal of anticoagulants.

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