scholarly journals 571 Case of A Rare Presentation of Solitary Fibrous Tumour of the Pleura (SFTP)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Ishak ◽  
N Kostoulas
Keyword(s):  
Recurrence Risk ◽  
Tumour Mass ◽  
Rare Presentation ◽  
Ki 67 ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Pet Ct ◽  
Chest X Ray ◽  
Double Space ◽  
Mitotic Figures

Abstract Presentation A 69-year-old male presented with rapidly worsening symptoms of breathlessness, productive cough, and weight loss. Examination revealed a deviated trachea, and no breath sounds on auscultation of the left side of the chest. Investigations Chest X-ray revealed a giant mass associated with a large pleural effusion, subtotal lung collapse and mediastinal shift. FEV1 was 39% predicted and DLCO 62% predicted. Management Due to the severity of presentation, urgent pleural inspection, drainage, and biopsy were carried out. Compression of the heart resulting in tamponade with increased heartrate and breathlessness was suspected Further investigations and management Pleural biopsies and pleural fluid cytology were negative for malignancy. PET-CT showed mild avidity. Definitive management was tumour mass resection via left double space open thoracotomy. Macroscopy/Microscopy/Immunohistopathology Intra-operatively, the tumour was giant, occupying three quarters of the chest cavity. It measured 21 × 14×8 cm. The whole lung was attached to the chest wall with adhesions. Microscopy revealed patternless architecture, high vascularity, hypercellularity, necrosis, elongated nuclei, pale cytoplasms and mitotic activity of 2-3 mitotic figures per 10-highpower-fields. Immunohistochemistry stained positive with CD34, BCL2, CD99, Ki-67 and STAT6. Diagnosis of SFT was suspected; malignant potential could not be predicted. Follow-up was with repeat CT scans for five years. Recurrence risk was given as 20%. Learning points

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

scholarly journals Correlation of 18F-FDG PET/CT SUVmax with clinical features, D-dimer and LDH in patients with primary intestinal lymphoma

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110298
Author(s):  
Shuo Zhou ◽  
Wenxin Chen ◽  
Meifu Lin ◽  
Guobao Chen ◽  
Cailong Chen ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Staging ◽  
Imaging Features ◽  
Intestinal Lymphoma ◽  
Ki 67 ◽  
Positive Correlation ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
D Dimer

Objective To investigate the characteristics of fluorine-18-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake value (SUVmax) in primary intestinal lymphoma (PIL) and its correlation with D-dimer and lactate dehydrogenase (LDH). Methods Fifty-two patients diagnosed with PIL from June 2016 to December 2019 were analyzed. All patients underwent 18F-FDG PET/CT. The relationships between SUVmax and different pathological subtypes, clinical stages and risk grades were analyzed. The correlations between SUVmax and Ki-67, LDH and D-dimer were determined. Additionally, PET/CT imaging results were collected from 35 patients with primary intestinal cancer (PIC) and compared with the imaging features of PIL. Results SUVmax was significantly different between PIL and PIC groups and various PIL pathological subgroups. Patients in the high-risk PIL group had markedly higher SUVmax values than the intermediate-risk and low-risk groups. A significant positive correlation was observed between SUVmax and Ki-67 in patients with PIL. SUVmax was significantly different between the elevated and normal D-dimer groups. D-dimer showed a positive correlation with SUVmax. Conclusion 18F-FDG PET/CT SUVmax reflects the aggressiveness of lymphoma to a certain degree, is correlated with Ki-67 and determines the risk grades of PIL. Moreover, it facilitates differential diagnosis, clinical staging and treatment based on D-dimer levels.

Adrenocortical Carcinoma With Concomitant Myelolipoma in a Patient With Hyperaldosteronism

2005 ◽  
Vol 129 (6) ◽  
pp. e144-e147 ◽  
Author(s):  
Xichun Sun ◽  
Alberto Ayala ◽  
Claudia Y. Castro
Keyword(s):  
Adrenocortical Carcinoma ◽  
Severe Hypertension ◽  
Serum Potassium Level ◽  
Venous Invasion ◽  
Ki 67 ◽  
Unilateral Adrenalectomy ◽  
Aldosterone Level ◽  
Serum Aldosterone ◽  
Mitotic Figures ◽  
Atypical Mitosis

Abstract We present a case of aldosterone-secreting adrenocortical carcinoma with concomitant myelolipoma. To the best of our knowledge, this is the first such reported case. The patient was a 43-year-old man with severe hypertension. Clinical workup revealed an increased serum aldosterone level, hypokalemia, and metabolic alkalosis, and a left adrenal mass was found on computed tomography. The patient underwent a unilateral adrenalectomy, which led to improvement in blood pressure, the serum potassium level, and aldosterone concentration. The tumor weighed 70 g and measured 5.0 cm. On microscopic examination, we found necrosis, focal cytologic atypia, diffuse eosinophilic cells comprising more than 75% of the tumor, 5 to 7 mitotic figures per 50 high-power fields, rare atypical mitosis, and venous invasion. At the periphery of the tumor but within the capsule, microscopic areas of myelolipoma were seen. Ki-67 staining was positive in 20% of the tumor cells. Although rare, aldosterone-secreting carcinoma associated with myelolipoma should be included in the differential diagnosis of adrenal gland masses.

scholarly journals Nodular fasciitis on the zygomatic region: a rare presentation

2013 ◽  
Vol 88 (6 suppl 1) ◽  
pp. 89-92 ◽  
Author(s):  
Ilner de Souza e Souza ◽  
Mayra Carriijo Rochael ◽  
Rogério Estevam Farias ◽  
Roberto Bezerra Vieira ◽  
Janaina Silva Tirapelle Vieira ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Histopathological Examination ◽  
Excisional Biopsy ◽  
Nodular Fasciitis ◽  
Rare Presentation ◽  
Ki 67 ◽  
Immunohistochemical Markers ◽  
The Face ◽  
Rare Location ◽  
High Cellularity

Nodular fasciitis is a benign tumor, resulting from reactive proliferation composed of fibroblastic/myofibroblastic cells. Due to its rapid growth and high cellularity it may be mistaken for sarcoma. Despite the possibility of spontaneous regression, excision is the treatment of choice. A 24-year-old female patient presented with a nodule on the zygomatic region with 3 months of evolution. Excisional biopsy was performed. Histopathological examination associated with immunohistochemical markers HHF35, AML and Ki-67 allowed diagnostic confirmation. The main relevance of the case presented is its rare location, suggesting its inclusion among the differential diagnoses of tumor lesions on the face.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

scholarly journals Correlation between Semi-Quantitative 18F-FDG PET/CT Parameters and Ki-67 Expression in Small Cell Lung Cancer

2016 ◽  
Vol 50 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Soyeon Park ◽  
Eunsub Lee ◽  
Seunghong Rhee ◽  
Jaehyuk Cho ◽  
Sunju Choi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Small Cell ◽  
Small Cell Lung ◽  
Ki 67 ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Absolute Improvements in Freedom From Distant Recurrence to Tailor Adjuvant Endocrine Therapies for Premenopausal Women: Results From TEXT and SOFT

2020 ◽  
Vol 38 (12) ◽  
pp. 1293-1303 ◽  
Author(s):  
Olivia Pagani ◽  
Prudence A. Francis ◽  
Gini F. Fleming ◽  
Barbara A. Walley ◽  
Giuseppe Viale ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Function ◽  
Cox Model ◽  
Premenopausal Women ◽  
Recurrence Risk ◽  
Distant Recurrence ◽  
Composite Measure ◽  
Clinicopathologic Characteristics ◽  
Ki 67 ◽  
Ovarian Function Suppression

PURPOSE The Tamoxifen and Exemestane Trial (TEXT)/Suppression of Ovarian Function Trial (SOFT) showed superior outcomes for premenopausal women with hormone receptor (HR)–positive breast cancer treated with adjuvant exemestane plus ovarian function suppression (OFS) or tamoxifen plus OFS versus tamoxifen alone. We previously reported the magnitude of absolute improvements in freedom from any recurrence across a continuous, composite measure of recurrence risk to tailor decision making. With longer follow-up, we now focus on distant recurrence. METHODS The TEXT/SOFT HR-positive/human epidermal growth factor receptor 2 (HER2)–negative analysis population included 4,891 women stratified by predetermined chemotherapy use. Kaplan-Meier estimates of 8-year freedom from distant recurrence were analyzed using subpopulation treatment effect pattern plot (STEPP) methodology across subpopulations defined by the continuous composite measure of recurrence risk. For each patient, the composite risk value was obtained from a Cox model that incorporated age; nodal status; tumor size; grade; and estrogen receptor, progesterone receptor, and Ki-67 labeling index expression levels. RESULTS The overall rate of 8-year freedom from distant recurrence was 91.1% and ranged from approximately 100% to 63% across lowest to highest composite risks. TEXT patients who received chemotherapy had an average absolute improvement with exemestane plus OFS versus tamoxifen plus OFS of 5.1%, and STEPP analysis showed improvements from less than 1% to more than 15% from lowest to highest composite risks. SOFT patients who remained premenopausal after chemotherapy had an average 5.2% absolute improvement with exemestane plus OFS versus tamoxifen and reached 10% across composite risks; for tamoxifen plus OFS versus tamoxifen, the maximum improvement was approximately 3.5%. Women who did not receive chemotherapy had a more than 97% rate of 8-year freedom from distant recurrence, and improvements with exemestane plus OFS ranged from 1% to 4%. CONCLUSION Premenopausal women with HR-positive/HER2-negative breast cancer and high recurrence risk, as defined by clinicopathologic characteristics, may experience a 10% to 15% absolute improvement in 8-year freedom from distant recurrence with exemestane plus OFS versus tamoxifen plus OFS or tamoxifen alone. The potential benefit of escalating endocrine therapy versus tamoxifen alone is minimal for those at low recurrence risk.

scholarly journals A case report of cardiac amyloidosis presenting with chronic pericardial effusion and conduction block

2019 ◽  
Vol 3 (4) ◽  
pp. 1-7
Author(s):  
Kevin John John ◽  
Ajay Kumar Mishra ◽  
Ramya Iyyadurai
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Amyloidosis ◽  
Conduction Block ◽  
Vital Signs ◽  
Permanent Pacemaker ◽  
Rare Presentation ◽  
Amyloid Deposits ◽  
Clinical Presentations ◽  
Chest X Ray ◽  
Pacemaker Insertion

Abstract Background Amyloidosis is caused by the deposition of abnormal proteins in the extracellular space of various organs. The clinical features of amyloidosis depend on the type of amyloid protein and the organ system involved. Case summary A 51-year-old woman developed complete heart block which warranted a permanent pacemaker insertion. She was referred for evaluation of chronic pericardial effusion. The patient had stable vital signs and muffled heart sounds on examination of the cardiovascular system. Her chest X-ray film showed a permanent pacemaker in situ, and echocardiogram showed a chronic pericardial effusion without features of tamponade. On further evaluation, she was found to have an M band on serum electrophoresis, elevated free light chain ratio and amyloid deposits in bone marrow biopsy. Technetium pyrophosphate (Tc-PYP) scintigraphy was consistent with cardiac amyloidosis. Discussion Cardiac amyloidosis can have diverse clinical presentations. Chronic pericardial effusion and conduction block can be a rare presentation of cardiac amyloidosis and needs to be considered while evaluating the same. Cardiac magnetic resonance imaging and Tc-PYP imaging can be used in establishing the diagnosis of cardiac amyloidosis, if endomyocardial biopsy is not feasible.

scholarly journals Prevalence of Newly Diagnosed Malignancies in Patients with Polymyalgia Rheumatica and Giant Cell Arteritis, Comparison of 18F-FDG PET/CT Scan with Chest X-ray and Abdominal Ultrasound: Data from a 40 Week Prospective, Exploratory, Single Centre Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3940
Author(s):  
Amir Emamifar ◽  
Søren Hess ◽  
Torkell Ellingsen ◽  
Susan Due Kay ◽  
Jacob Christian Bang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Fdg Pet ◽  
Abdominal Ultrasound ◽  
Newly Diagnosed ◽  
X Ray ◽  
Pet Ct ◽  
Chest X Ray ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

The aim of the study was to identify the prevalence of newly diagnosed malignancies in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), with the aid of 18F-FDG PET/CT scan compared to conventional imaging techniques: Chest X-ray (CXR) and abdominal ultrasound (US). Secondarily, to examine the relative diagnostic accuracy of these two imaging modalities for the detection of cancer. Eighty consecutive patients with newly diagnosed PMR, GCA, or concomitant PMR and GCA, were included and followed up for 40 weeks. All patients underwent an 18F-FDG PET/CT scan, CXR, and abdominal US at diagnosis. Imaging findings were dichotomously categorized into malignant or benign. Among 80 patients, three patients were diagnosed with seronegative rheumatoid arthritis and were excluded from the analysis. Of the remaining 77, 64 (83.1%) patients were diagnosed with pure PMR, 3 (3.9%) with pure GCA, and 10 (13.0%) with concomitant PMR and GCA. Five types of cancer that were more prevalent than the one-year prevalence of 1.2% among the background population were found in four (5.2%; 95%CI: 1.4–12.8%) patients. CXR/abdominal US could detect the solid cancer in one patient, whereas 18F-FDG PET/CT could identify all four solid cancers. Furthermore, four (5.2%; 95%CI: 1.4–12.8%) cases of monoclonal gammopathy of undetermined significance (MGUS) were found. An increase in C reactive protein (CRP) implicated an increased risk for cancer of 2.4% (OR: 1.024, 95%CI: 1.001–1.047; p = 0.041). 18F-FDG PET/CT can reveal occult cancers at an early stage with a high negative predictive value, and it is specifically beneficial in PMR/GCA patients with nonspecific symptoms.

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