Exogenous Lipoid Pneumonia Presenting as an Enlarging Lung Nodule in a Patient with a Long-standing Usage of Petroleum Jelly

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
C P Onyenekwu ◽  
Y Sheinin
Keyword(s):  
Lung Nodule ◽  
Giant Cells ◽  
Lung Lesion ◽  
Chronic Obstructive ◽  
Petroleum Jelly ◽  
Body Type ◽  
Obstructive Pulmonary Disease ◽  
Lipoid Pneumonia ◽  
Ct Guided ◽  
Type Giant

Abstract Introduction/Objective Lipoid pneumonia is an uncommon inflammatory lung lesion resulting from the aspiration of endogenous or exogenous oily substances. It has no age or sex preponderance, and its mode of presentation is non- specific. Radiologic imaging findings may mimic that of a malignant lung lesion. Methods We report a case of a 69-year-old female with a history of chronic obstructive pulmonary disease, rheumatoid arthritis and a 30-pack year smoking. She was being followed for an enlarging PET positive spiculated left upper lung nodule. She underwent a CT-guided core biopsy of the lung nodule. Results Biopsy showed histiocytes and multinucleated giant cells with lipid vacuoles and associated marked fibrosis. Review of a percutaneous lung biopsy performed two years prior showed a chronic inflammatory process with associated fibrosis in the presence of nonpolarizable vacuoles, many of which were intracytoplasmic within multinucleate foreign body type giant cells. A re-assessment of the patient with further history taking revealed a longstanding practice of nighttime application of petroleum jelly to nostrils and lips. Together, these findings are consistent with an exogenous lipoid pneumonia. Conclusion Lipoid pneumonia although an entity with limited literature description, should be considered in patients presenting with enlarging lung nodules. Early diagnosis of this lesion ensures appropriate treatment and prevents unnecessary invasive procedures.

Immunoglobulin G4-Related Ophthalmic Disease: A Case Report

2020 ◽  
Vol 103 (7) ◽  
Keyword(s):  
Giant Cells ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Body Type ◽  
Immunoglobulin G4 ◽  
Idiopathic Orbital Inflammation ◽  
Systemic Corticosteroids ◽  
Type Giant ◽  
Ophthalmic Disease ◽  
Complete Ophthalmoplegia

The authors reported a rare case with immunoglobulin (Ig) G4-related ophthalmic disease presented with chronic progressive bilateral complete ophthalmoplegia and blindness from orbital apex syndrome. MRI brain and orbit demonstrated ill-defined infiltrative lesions at bilateral orbital apexes, bilateral optic canals, and bilateral Meckel’s caves, causing optic nerve compression and possibly optic neuropathy with generalized leptomeningeal enhancement at dura, cavernous sinus, and parotid gland. Lumbar puncture revealed few small lymphocytes, rare monocytes, very rare neutrophils with degenerative cells in background, and negative for malignancy. Serology titers for IgG subclass 4 (IgG4) had resulted in 5.959 grams per deciliter (g/dL). A dural biopsy revealed aggregate histiocytes with chronic inflammation and focal foreign body type giant cells. Motility improvement was achieved in the patient after systemic corticosteroids treatment. IgG4 serology should be considered for workup when patients present with chronic idiopathic orbital inflammation. Keywords: IgG4-related ophthalmic disease, Ophthalmoplegia, Orbital apex syndrome

Foreign Body Granulomatous Response to Particulate Bony Debris

1996 ◽  
Vol 09 (03) ◽  
pp. 119-25
Author(s):  
Z. Ish-Shalom ◽  
I. Misselevich ◽  
D. G. Mendes ◽  
J. H. Boss
Keyword(s):  
Foreign Body ◽  
Granulation Tissue ◽  
Bone Allograft ◽  
Giant Cells ◽  
Body Type ◽  
Artificial Joints ◽  
Foreign Body Giant Cells ◽  
Type Giant ◽  
Granulomatous Response ◽  
Massive Bone

SummaryArchival material was retrieved in order to histologically assess the body’s response to micron-sized, necrotic bony particles. Specimens were obtained from (1) human bone grafts in a subcutaneous or muscular pouch of athymic nude mice, (2) a massive bone allograft replacing a patient’s humerus, (3) rabbits’ healing tibial cortical bone defects littered with finely dispersed bony particles, (4) periprosthetic tissues of patient’s aseptically loosened artificial joints and (5) interfacial membranes of intramedullary nails used for fixation of patients’ fractured long bones. Necrotic bony debris was found to induce a giant celled granulomatous reaction. In sections of undecalcified samples stained by the von Kossa method, small calcific particles were observed to be present within polykaryonic macrophages (foreign body giant cells) and surrounded by mononuclear macrophages. It is concluded that a foreign body-type giant celled granulation tissue participates in the degradation of micron-sized, necrotic bony detritus, whether the disintegrating bone is of the xeno-, alio- or autogenic provenance.Histological examination of von Kossa-stained sections, of undecalcified specimens, revealed a giant celled granulomatous response to bony debris. Irrespective of whether or not the disintegrating bone was of auto-, alio- or xenogeneic provenance, micron-sized bony particles were found to be phagocytosed by polykaryonic macrophages of the granulation tissue.

scholarly journals Cytology pulmonary in horses (Equus caballus) maintained the field or stabled

2016 ◽  
Vol 9 (5) ◽  
pp. 57
Author(s):  
W. F. Fortes Júnior ◽  
R. C. A. Berber ◽  
T. V. Souza ◽  
A. C. Rosa ◽  
I. Deconto
Keyword(s):  
Pulmonary Hemorrhage ◽  
Giant Cells ◽  
Chronic Obstructive ◽  
Cytological Analysis ◽  
Obstructive Pulmonary Disease ◽  
Analysis Group ◽  
Group I ◽  
Group Ii ◽  
Exercise Induced ◽  
Cytological Alterations

Tracheobronchial secretion was collected by endoscopy (Welch-AllynÒ, 200cm long and 9mm diameter), from equines with different ages, races and sex, for posterior cytological analysis. Thirty-six equines were divided into two groups (Group I = stabled, n = 18; Group II = field regimen, n = 18). Animals of Group I (age = 3.5 years) were lodged in the Tarumã´s Jockey Club in Curitiba, Parana State. The equines of Group II always were maintained at field condition (never were stabled), in the farm located in Jacarezinho, Paraná State. Following endoscopic exams, tracheobronchial secretion smears were stained by Pappenhein´s method and submitted to cytological analysis. Group I had higher frequency of tracheal discharge than Group II. The cytological analysis showed more presence of macrophages (58.8%), foamy cells (2.3%), body giant cells (0.2%), neutrophils (4.57%), eosinophils (0.7%) and Curshmann´s spirals (0.04%) on 3 of the 18 animals. The cytological analysis of Group II showed higher frequency of ciliated epithelial cells than Group I, and no Curshmann´s spirals were observed. In conclusion, data showed that horses stabled had more cytological alterations than the animals maintained at field, therefore more tracheobronchial complications. Thus, the care of place where horse are stabled have influence on development of respiratory diseases, may predispose to affections as Chronic Obstructive Pulmonary Disease and Exercise-Induced Pulmonary Hemorrhage, as well athletic horses may be never reach their full respiratory potential.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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