Endobronchial Mucus Gland Adenoma: A Case Report

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S45-S45
Author(s):  
A D Sandhu ◽  
Y Liu
Keyword(s):  
Frozen Section ◽  
Case Reports ◽  
Bronchial Epithelium ◽  
Benign Tumors ◽  
Low Grade ◽  
Sleeve Resection ◽  
Diagnostic Challenge ◽  
Epithelial Tumor ◽  
Mucus Gland ◽  
The Right

Abstract Introduction/Objective Mucus Gland Adenoma (MGA) is a rare benign epithelial tumor with few case reports. They arise from submucosal glands and ducts of large proximal airways, but have been reported peripherally and within lung parenchyma. MGAs form an exophytic mass that causes obstructive symptoms, occurring in all ages without gender predilection. MGAs have low to no malignant potential, but may be confused with more aggressive entities. Thus, MGA may present a diagnostic challenge on frozen section. Methods We present the case of a 66-year-old male with recurrent right pneumonia and empyema. Bronchoscopy revealed an obstructing mass in the right bronchus intermedius. Biopsies and cytology were insufficient showing only benign bronchial epithelium. Therefore, the patient underwent surgical sleeve resection of the right bronchus intermedius for diagnosis and treatment. It was received in two pieces measuring 1.0 x 0.6 x 0.5 and 2.0 x 1.5 x 0.9 cm - a well-circumscribed, firm white nodule with a smooth exterior and pushing borders. Cut surfaces were mucoid, homogenous and rubbery, with cysts measuring up to 2 mm. Histology showed crowded mucus-filled acini and tubules lined by bland cuboidal to columnar cells without atypia or mitosis. The stroma showed smooth muscle bundles and lymphocytic infiltrate. Benign bronchial epithelium lined the surface. A preliminary diagnosis of “adenoma” was made, with final classification pending permanent section. Results It showed positivity for s100, CK5/6, and CAM5.2. DOG1 showed a luminal staining pattern. NapsinA was negative and TTF-1 was patchy. P63, P40, CK5/6 and calponin highlighted myoepithelial cells, underlining the benign nature of the process. Conclusion MGA may resemble adenocarcinoma, low-grade mucoepidermoid carcinoma, and other benign adenomas. It presents a diagnostic challenge on frozen section as its malignant differentials are more common. Thus, it is important to recognize and be aware of these rare, benign tumors.

scholarly journals Mucinous cystadenomas of the liver

2013 ◽  
Vol 141 (3-4) ◽  
pp. 173-177
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Miodrag Jovanovic ◽  
Marjan Micev ◽  
Natasa Colovic ◽  
...  
Keyword(s):  
Frozen Section ◽  
Benign Tumors ◽  
Appropriate Treatment ◽  
Head Of The Pancreas ◽  
Malignant Alteration ◽  
Mucinous Cystadenomas ◽  
The Right ◽  
Healthy Liver ◽  
Single Lesion ◽  
Partial Excision

Introduction. Biliary cystadenomas of the liver are rare benign tumors prone to malignant alteration so that a total excision is recommended. Objective. The aim of the paper is to present our experience in treatment and to evaluate whether a simple ablation represents the appropriate treatment. Methods. Over a 10?year period 25 patients (24 women) of the average age of 58 years suffering from cystadenomas of the liver, 18 in the right, 4 in the left and 3 in both lobes of the liver were operated. Twenty?three patients had a single lesion, while two patients had 3 and 6 lesions, respectively. Pain was present in 20, occasional vomiting in 4, discomfort in 2 and a sense of fullness in 2 patients. Three patients were jaundiced, 1 due to cystadenoma of the liver, 2 due to concomitant tumors of the head of the pancreas, while 5 patients had concomitant diseases. Results. A total ablation was performed in 22 patients, left lateral bisegmentectomy in 1 and partial excision in 2 patients. Six additional procedures were performed. Five cystadenomas of the liver had ?ovarian like? stroma, all in women. A focal malignant alteration was found in 2 patients aged 66 and 79 years, respectively. Recurrence was registered in 1 female patient in whom a partial excision had been done. Two patients with concomitant malignancy and 1 patient who developed malignant histiocytosis six months after surgery, died after 1, 2 and 3 years, respectively. Conclusion. Biliary cystadenomas of the liver may be misdiagnosed as simple liver cysts, so that ?frozen section? histology is highly recommended. In most cases the tumor may be successfully treated by ablation up to the healthy liver tissue. Major liver resections are rarely necessary.

scholarly journals Keratoacanthoma of the Nasal Septum Secondary to Ranibizumab Use

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jason E. Cohn ◽  
Hilary M. Caruso Sales ◽  
Giang Huong Nguyen ◽  
Harvey Spector ◽  
Kenneth Briskin
Keyword(s):  
Nasal Septum ◽  
Skin Lesions ◽  
Low Grade ◽  
Cutaneous Lesions ◽  
Epithelial Tumor ◽  
Vegf Inhibitor ◽  
Central Crater ◽  
Well Differentiated ◽  
The Right ◽  
Endothelial Growth Factor

Keratoacanthoma (KA) is a benign epithelial tumor that typically presents as a firm, cone-shaped, flesh-colored nodule with a central horn-filled crater. KA is considered to be a low-grade variant of squamous cell carcinoma (SCC). We report a rare case of a 72-year-old male who presented with a KA involving the nasal septum, possibly related to ranibizumab use. A flesh-colored lesion on the right anterior nasal septum lesion was visualized on examination. Histologic examination revealed a well-circumscribed, dome-shaped central crater filled with keratin, well-differentiated squamous epithelium with ground-glass cytoplasm with pushing margins, and intraepithelial microabscesses establishing the diagnosis of KA. KA of the nasal septum has only been reported once in the literature. This case is unusual because it normally presents on sun-exposed areas. Additionally, this patient was taking ranibizumab, a vascular endothelial growth factor (VEGF) inhibitor for macular degeneration. Despite ranibizumab not being directly linked to precancerous and cancerous skin lesions, agents in this medication class have been. Although it is difficult to prove associations in this isolated case, the role of ranibizumab causing cutaneous lesions should be further investigated.

Tracheo-oesophageal groove Hodgkin’s lymphoma presenting as stridor: a diagnostic challenge

2021 ◽  
Vol 14 (1) ◽  
pp. e238271
Author(s):  
Joshua Agilinko ◽  
Anas Gomati ◽  
Ghada Bashat ◽  
Muhammad Shakeel
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Case Reports ◽  
Rare Condition ◽  
Needle Aspiration ◽  
Hodgkin's Lymphoma ◽  
Diagnostic Challenge ◽  
Thyroid Papillary ◽  
Diagnostic Work ◽  
The Right ◽  
Team Setting

A 38-year-old male patient presented to the ear, nose and throat department with shortness of breath over last 2 months. The CT scan of the neck and chest revealed a 3.3×3 cm tumour behind the right thyroid lobe extending into the tracheo-oesophageal (TO) groove with tracheal compression. The ultrasound scan of the neck and targeted fine needle aspiration followed by core biopsy raised a suspicion of Hodgkin’s lymphoma. The patient underwent a right hemithyroidectomy and incisional biopsy of the right TO groove tumour. The histology confirmed a Hasenclever’s three nodular sclerosing Hodgkin’s lymphoma for which he received adjuvant chemotherapy. An incidental pT1a pN0 thyroid papillary microcarcinoma in the adjacent thyroid parenchyma was completely excised. This represents a case of TO Hodgkin’s lymphoma, of which there are no current published case reports. We aim to raise awareness about this rare condition by sharing the diagnostic work up and successful management in a multidisciplinary team setting.

scholarly journals Giant Lipomas of the Hand. Our Experience

2020 ◽  
Vol 48 (02) ◽  
pp. 72-78
Author(s):  
Patricia Balvís-Balvís ◽  
Javier Yañez-Calvo ◽  
Manuel Castro-Menéndez ◽  
María José Ferreirós-Conde
Keyword(s):  
Slow Growth ◽  
Case Reports ◽  
Case Series ◽  
Surgical Excision ◽  
Functional Results ◽  
Clinical Feature ◽  
Benign Tumors ◽  
Low Grade ◽  
Complete Excision ◽  
Large Size

Abstract Objective Giant lipomas are benign tumors larger than 5 cm in size that are very uncommun in the hand, with the extant literature limited to case reports and small case series. The aim of the present study is to describe our experience with giant lipomas at the level of the hand, reviewing the most important aspects in relation to their diagnosis and treatment. Material and Methods We present 6 patients treated in our service with giant lipomas of the hand between 2007 and 2015. Four cases only presented difficulty in grasping and mobilizing the hand due to the large size of the lipoma. Two cases were accompanied by a clinical feature of compression of the median nerve in relation to its location within the carpal tunnel. Results All patients underwent surgery, and a complete excision of the lipoma was performed. The functional results have been satisfactory in all cases. Conclusions Giant lipomas of the hand are infrequent tumors of slow growth, generally asymptomatic, although they can cause a compressive pathology due to the great size that they reach. Magnetic resonance imaging is an especially useful test to locate and accurately determine the size of the lesion in view of its surgical excision. After surgery, it is important to make a differential diagnosis with low-grade liposarcomas through an anatomopathological study, since both, macroscopically, have similar characteristics.

Solitary Cardiac Low-Grade Neuroendocrine Tumor: A Case Report and Review of the Literature

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
M Kavesh ◽  
P Drew ◽  
B Stewart
Keyword(s):  
Neuroendocrine Tumor ◽  
Frozen Section ◽  
Mitotic Rate ◽  
Complete Resection ◽  
Low Grade ◽  
Primary Tumors ◽  
Radiotracer Uptake ◽  
Pet Ct ◽  
The Right

Abstract Introduction/Objective Primary tumors of the heart are uncommon; even rarer are primary cardiac neuroendocrine tumors. To our knowledge, only two cases have been described to date, both being high-grade tumors. We report a solitary low-grade neuroendocrine tumor of the heart, unexpectedly discovered on the wall of the right ventricle in a 44-year-old man during aortic valve repair for infectious bacterial endocarditis. Results Frozen section was sent intraoperatively and showed a plasmacytoid neoplasm. Final pathology of the biopsies showed a tumor composed of both cohesive and discohesive plasmacytoid cells separated by a vascular network and strands of fibrosis. Neither necrosis nor a mitotic rate greater than 2 mitoses per 2 mm2 were seen. The tumor showed strong reactivity for AE1/3, synaptophysin and CDX2 with focal reactivity for chromogranin-A and CD56, confirming the diagnosis of a low-grade neuroendocrine tumor. Both an esophagogastroduodenoscopy and colonoscopy were performed and showed no evidence of a primary gastrointestinal tumor. PET-CT DOTATATE performed after complete resection of the tumor showed no abnormal radiotracer uptake. The possibility of an intestinal neuroendocrine tumor undetected by DOTATATE PET-CT with a single known metastasis to the heart was considered. This too, on the basis of the literature, was considered exceedingly rare. Complete resection of this patient’s tumor was considered sufficient treatment; the patient was advised to follow up annually with medical oncology. Conclusion The presentation and management of a solitary cardiac low-grade neuroendocrine tumor has not previously been described in the literature.

scholarly journals Lymphadenitis “As Rosary beads” - a diagnostic challenge

2019 ◽  
Vol 44 (3) ◽  
pp. 20-23
Author(s):  
Vitorino Modesto Dos Santos ◽  
Micheline Silva Abreu De Azevedo ◽  
Katia Rejane Marques Brito ◽  
Larissa Almondes Da Luz ◽  
Kayursula Dantas Ribeiro
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Definitive Diagnosis ◽  
Medical Attention ◽  
Diagnostic Challenge ◽  
Regional Lymph Nodes ◽  
Primary Health ◽  
Primary Focus ◽  
The Right ◽  
High Index Of Suspicion

Introduction: nodular lymphangitis (NL) may be a manifestation of various infectious and non-infectious conditions, characterised by subcutaneous inflammatory nodules that extend from the site of the primary focus to the regional lymph nodes. NL usually constitutes a challenge in primary health care, and histopathological and microbiological evaluations are necessary to establish the definitive diagnosis. Methods: We report a classic case of NL that developed in the upper limb of a middle-aged man after trauma on the right thumb. The objective:  was to emphasise some aspects of the differential diagnosis in a patient with NL and to reduce the rate of misdiagnosis in the scenery of initial medical attention. Results: the clinical manifestations were non-specific, but the microbiological study revealed typical characteristics of sporotrichosis. The treatment with itraconazole (200 mg daily) for six months was successful. Conclusion: NL constitutes a challenging condition and the early diagnosis depends on a high index of suspicion. Case reports may reduce late diagnoses with unfavourable results.

Challenges in the Intraoperative Consultation of Low-Grade Epilepsy-Associated Neuroepithelial Tumors by Cytomorphology in Squash Preparations

2022 ◽  
pp. 1-7
Author(s):  
Olcay Kurtulan ◽  
Burçak Bilginer ◽  
Figen Soylemezoglu
Keyword(s):  
Ganglion Cells ◽  
Case Reports ◽  
Daily Practice ◽  
Individual Case ◽  
Glioneuronal Tumor ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Low Grade ◽  
Diagnostic Challenge ◽  
Neuroepithelial Tumors ◽  
Tumor Types

<b><i>Introduction:</i></b> Low-grade epilepsy-associated neuroepithelial tumors (LEATs) create a diagnostic challenge in daily practice and intraoperative pathological consultation (IC) in particular. Squash smears are extremely useful in IC for accurate diagnosis; however, the knowledge on cytopathologic features of LEATs is based on individual case reports. Here, we discuss the 3 most common and well-established entities of LEATs: ganglioglioma (GG), dysembryoplastic neuroepithelial tumor (DNT), and papillary glioneuronal tumor (PGNT). <b><i>Methods:</i></b> Thirty patients who underwent surgery for GG, DNT, and PGNT between 2001 and 2021 were collected. Squash smears prepared during intraoperative consultation were reviewed by 1 cytopathologist and an experienced neuropathologist. <b><i>Results:</i></b> Among the 30 tumors, 16 (53.3%) were GG, 11 (36.6%) DNT, and 3 (10%) PGNT. Cytomorphologically, all of the 3 tumor types share 2 common features such as dual cell population and vasculocentric pattern. GG smears were characteristically composed of dysplastic ganglion cells and piloid-like astrocytes on a complex architectural background of thin- to thick-walled vessels. DNT, on the other hand, showed oligodendroglial-like cells in a myxoid thin fibrillary background associated with a delicate capillary network. Common cytological features of PGNT were hyperchromatic cells with narrow cytoplasm surrounding hyalinized vessels forming a pseudopapillary pattern and bland cells with neuroendocrine nuclei dispersed in a neuropil background. <b><i>Conclusion:</i></b> A higher diagnostic accuracy can be obtained when squash smears are applied with frozen sections. However, it is important to integrate clinical and radiologic features of the patient as well as to know the cytopathologic features of the LEAT spectrum in the context of differential diagnosis to prevent misinterpretation in the IC.

Case Report: Glomus Tumor of the Thigh

2021 ◽  
pp. 154431672199913
Author(s):  
Jessica Kralec
Keyword(s):  
Case Report ◽  
Glomus Tumor ◽  
Benign Tumors ◽  
Diagnostic Challenge ◽  
Glomus Tumors ◽  
Superficial Thrombophlebitis ◽  
History Of ◽  
The Right ◽  
Cold Hypersensitivity ◽  
Extradigital Glomus

Glomus tumors are small, painful benign tumors that occur primarily in the subungual region of the hand. The presentation of glomus tumors in areas other than the hand is rare, but have been reported. Patients with glomus tumors have a prolonged history of focal pain, tenderness, and cold hypersensitivity. However, as all 3 symptoms may not present simultaneously, it can present a diagnostic challenge to clinicians and imagers, often remaining undiagnosed or misdiagnosed for many years. We report a case of an extradigital glomus tumor of the right thigh that was initially diagnosed as focal superficial thrombophlebitis. The diagnosis of glomus tumor was pathologically proven.

scholarly journals P040 An unusual case of giant cell arteritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Jessica Ellis ◽  
Keziah Austin ◽  
Sarah Emerson
Keyword(s):  
Inflammatory Markers ◽  
Illicit Drugs ◽  
Unusual Case ◽  
Temporal Arteritis ◽  
White Cell Count ◽  
Healthcare Providers ◽  
Temporal Artery ◽  
Low Grade ◽  
Temporal Artery Biopsy ◽  
The Right

Abstract Background/Aims  A 49-year-old female of Nepalese heritage was referred with right-sided headache, scalp tenderness, and a painful swelling overlying the right temple. She denied any visual or claudicant symptoms but felt systemically unwell with a fever. There were no symptoms suggestive of an inflammatory arthritis, underlying connective tissue disease or vasculitis. She was normally fit and well with no past medical history. She did not take any regular medications and denied using over the counter or illicit drugs or recent travel. On review she had a low grade fever. There was a large tender, erythematous swelling overlying the right temple. Bilaterally the temporal arteries were palpable and pulsatile. Peripheral pulses were normal with no bruits. There was no evidence of shingles (HSV) or local infection. Full systemic examination revealed no other abnormalities. Laboratory tests showed: PV 2.56, CRP 101, total white cell count 14.38 (eosinophils 0.4), albumin 33, Hb 115. Urine dip was normal. Renal function, liver function and immunoglobulins were normal. ANCA was negative. Hypoechogenicity surrounding the right frontal branch of the right temporal artery was seen on ultrasound. There were no discrete masses suggestive of cysts, abscess or tumours. Temporal artery biopsy confirmed the presence of vasculitis; histology demonstrated transmural lymphohistiocytic inflammation, disruption of the elastic lamina and intimal proliferation. Prednisolone was started at 40mg daily. Four weeks after initially presenting she was asymptomatic and her inflammatory markers had normalised. Methods  The case is discussed below. Results  Temporal arteritis, or GCA, is primarily a disease of older adults; with age 50 often used as an inclusion criteria, and is more common in Caucasian populations. Limited reports exist of GCA in younger cohorts, but these are rare. An important differential in younger patients, such as ours, is juvenile temporal arteritis. This rare localised vasculitis affects almost exclusively the temporal artery. It is typically a disease of young males, who present with non-tender temporal swelling. Systemic symptoms are unusual and inflammatory markers are normal. Clinical or laboratory evidence of organ involvement, peripheral eosinophilia or fibrinoid necrosis on histology should prompt consideration of an AAV or PAN. Incidence of GCA increases in correlation with Northern latitude, with highest rates reported in Scandinavian and North American populations. GCA is rare in Asian populations. Higher diagnostic rates in countries where physicians have increased awareness of GCA proposed as an explanation for this difference; however differences in incidence are still observed between Asian and Caucasian populations presenting to the same healthcare providers. Conclusion  GCA is an uncommon diagnosis in younger and non-Caucasian patients. Thorough investigation through ultrasound and biopsy helped increase our diagnostic confidence in this unusual case. Rheumatologists must be alert to atypical presentations in order to deliver prompt and potentially sight-saving treatment. Disclosure  J. Ellis: None. K. Austin: None. S. Emerson: None.

scholarly journals Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Case Reports ◽  
Mitral Valve Regurgitation ◽  
Catheter Insertion ◽  
Routine Practice ◽  
Hickman Catheter ◽  
Risk Patients ◽  
The Right

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

Sign in / Sign up

Export Citation Format

Share Document