scholarly journals Primary pulmonary glomus tumour: a diagnostic challenge

2020 ◽  
Vol 13 (2) ◽  
pp. e231926
Author(s):  
Vikram Singh ◽  
Vikas Kumar ◽  
Harkant Singh ◽  
Nandita Kakkar
Keyword(s):  
Correct Diagnosis ◽  
Benign Tumour ◽  
Glomus Tumour ◽  
Arteriovenous Anastomosis ◽  
Diagnostic Challenge ◽  
Glomus Cells ◽  
Deep Dermis

Glomus tumour is uncommon benign tumour, which derives from the glomus cells present around arteriovenous anastomosis. These tumours are found most commonly in the deep dermis of the extremities. Primary pulmonary glomus tumour is extremely rare and often misdiagnosed. Knowledge about the existence of glomus tumour in the lung, its classic histomorphology and judicious use of immunohistochemistry can help us in clinching the correct diagnosis.

Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

2021 ◽  
Vol 14 (3) ◽  
pp. e237669
Author(s):  
Susan Addley ◽  
Moiad Alazzam ◽  
Catherine Johnson ◽  
Hooman Soleymani majd
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
High Risk ◽  
Kinase Inhibitor ◽  
Correct Diagnosis ◽  
Rectovaginal Septum ◽  
Gastrointestinal Stromal Tumours ◽  
Diagnostic Challenge ◽  
High Quality ◽  
Primary Surgery

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

Glomus Coccygeum in Surgical Pathology Specimens

1999 ◽  
Vol 123 (10) ◽  
pp. 905-908
Author(s):  
Zoran Gatalica ◽  
Liqiang Wang ◽  
Emmanuel T. Lucio ◽  
Markku Miettinen
Keyword(s):  
Smooth Muscle ◽  
Single Case ◽  
Smooth Muscle Actin ◽  
Neuron Specific Enolase ◽  
Diagnostic Challenge ◽  
Accurate Identification ◽  
Surrounding Soft Tissue ◽  
Glomus Cells ◽  
Pathologic Processes ◽  
Glomus Coccygeum

Abstract Background.—Rarely encountered nonpathologic structures may pose diagnostic problems and cause unnecessary special investigations. More importantly, however, they may be falsely accused as culprits in unrelated pathologic processes. Glomus coccygeum is one such structure. Glomus bodies (including coccygeal glomus) consist of modified smooth muscle cells arranged in layers around small vascular channels. When found in distal extremities, they generally do not represent a diagnostic problem; however, large glomus bodies present in a pericoccygeal location (glomus coccygeum) may cause significant problems for a surgical pathologist unfamiliar with this structure. Design.—We reviewed 37 coccygeal bones removed during rectal resection for carcinoma (rectal and uterine) and for various other reasons, among which was a single case of coccygodynia. Immunohistochemical and ultrastructural examinations were performed in selected cases. Results.—Sharply circumscribed glomus bodies composed of various proportions of glomus cells without atypia or pleomorphism and without expansile growth or infiltration of surrounding soft tissue or bone were identified in 50% of cases. Size varied significantly (maximum 4 mm), but paradoxically the smallest glomus body (less than 1 mm) was found in the case of coccygodynia. Glomus coccygeum posed a significant diagnostic challenge to the pathologists involved in these cases, as the retrospective review found that it was diagnosed correctly in only 3 cases. Conclusions.—Glomus coccygeum is a nonpathologic structure that exhibits significant variation in size and proportion of the constitutive elements. Immunohistochemical demonstration of smooth muscle actin and neuron-specific enolase in glomus cells may be beneficial for accurate identification of this organelle.

Diagnostic challenge of soft tissue extranodal Hodgkin lymphoma in core-needle biopsy: case report

2020 ◽  
pp. 003693302094126
Author(s):  
Nives Jonjić ◽  
Toni Valković ◽  
Danijela Veljković Vujaklija ◽  
Koviljka Matušan Ilijaš
Keyword(s):  
Soft Tissue ◽  
Hodgkin Lymphoma ◽  
Needle Biopsy ◽  
Correct Diagnosis ◽  
Inflammatory Lesion ◽  
Primary Lymphoma ◽  
Low Grade ◽  
Diagnostic Challenge ◽  
Surgical Biopsy ◽  
Major Interest

Hodgkin lymphoma (HL) is an uncommon malignancy usually limited to the lymph nodes and lymphatic system while extranodal involvement is much less common than in non-Hodgkin lymphoma. The current report presents an unusual case of primary classical HL (cHL), nodular sclerosis type with mixed cellularity in buttock soft tissue of 78-year old man. Primary lymphoma of the gluteal muscle is a rare disease and primary cHL is even rarer. In addition, to this unusual extranodal presentation, the present case highlight a diagnostic challenge in fine-needle biopsy masquerading a low grade sarcoma, primarily myxoinflammatory fibrosarcoma or an inflammatory lesion. However, surgical biopsy and immunohistochemistry guided correct diagnosis that was of major interest for further successful treatment.

Neue Charakteristika klinisch manifester Latexallergiker

2019 ◽  
Vol 7 (1) ◽  
pp. 29-31
Author(s):  
Vera Mahler
Keyword(s):  
Medical History ◽  
Skin Test ◽  
Correct Diagnosis ◽  
Natural Rubber Latex ◽  
Specific Ige ◽  
Latex Allergy ◽  
Skin Tests ◽  
Diagnostic Challenge ◽  
Positive Skin ◽  
Significant Difference

Background: Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. Methods: Sera of skin test-positive patients from a historic cohort (1995-2001, n = 149 patients) and currently (2014-2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥ 0.35 kU/l), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. Results: In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. Conclusion: Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy.

Use of the implantable loop recorder in children and adolescents

2006 ◽  
Vol 16 (6) ◽  
pp. 572-578 ◽  
Author(s):  
Matthias Gass ◽  
Christian Apitz ◽  
Schahriar Salehi-Gilani ◽  
Gerhard Ziemer ◽  
Michael Hofbeck
Keyword(s):  
Correct Diagnosis ◽  
Diagnostic Challenge ◽  
Tertiary Referral Centre ◽  
Loop Recorder ◽  
Additional Tool ◽  
Electrocardiographic Monitoring ◽  
Increased Risk ◽  
Malignant Arrhythmia ◽  
The Mean ◽  
Structural Disease

Introduction: Recurrent but infrequent syncopes represent a diagnostic challenge, since they frequently remain unexplained despite extensive investigations. This applies specifically for patients who carry an increased risk of potentially lifethreatening arrhythmias, either due to congenital cardiac disease or primary electrical disorders. Implantable loop recorders permit long-term electrocardiographic monitoring. Experience with these devices is still limited in children. Patients and methods: Between January 1999 and August 2005, 12 patients underwent implantation of a loop recorder in our tertiary referral centre. The mean age was 10.9 years, with a range from 2 to 17 years. Of the patients, 6 had structural disease, 3 had primary electrical abnormalities, and 3 had no cardiovascular disease. Results: Resyncope occured in 9 of the 12 patients. Arrhythmic origin of the syncope was diagnosed in 4 of these patients. The events recorded were ventricular fibrillation in 2, intermittent asystole in 1, and pacemaker-syndrome in the other patient. Malignant arrhythmia was ruled out in the remaining 5 patients. There were no complications related to implantation of the loop recorder, and the mean duration until explantation was 8.3 months. Conclusions: Based on our experience, we suggest that implantation of a loop recorder represents an additional tool for a selected group of children. Due to its invasive nature, it should be restricted to patients at high risk, or those in which there is substantial clinical suspicion of the likelihood of serious arrhythmias when conventional testing has been inconclusive. In this cohort, implantation of the loop recorder either helps to establish the correct diagnosis, or to exclude an arrhythmic event, thus avoiding unnecessary escalation of therapy and providing reassurance for the family.

Clinical Differential Diagnosis of Multifocal Motor Neuropathy

2012 ◽  
Vol 7 (2) ◽  
pp. 124 ◽  
Author(s):  
Jean-Marc Léger ◽  
Eugen Gavriliuc ◽  
◽  
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Rare Condition ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy ◽  
Diagnostic Challenge ◽  
Limb Weakness ◽  
Progressive Muscle Weakness ◽  
Immune Mediated ◽  
Clinical Differential Diagnosis

Multifocal motor neuropathy (MMN) is a rare, clinically well-defined condition within the spectrum of chronic, immune-mediated neuropathies. A typical patient history involves slowly or stepwise progressive, predominantly distal, asymmetrical limb weakness and muscle wasting, most frequently in the arm, that may have developed over a period of years. As a rare condition, MMN may present a diagnostic challenge for non-specialists and some patients may wait years for a correct diagnosis. Timely and accurate diagnosis is essential for patients with MMN. Unlike some motor neuropathies, MMN is treatable with intravenous immunoglobulin and untreated patients are likely to experience progressive muscle weakness that may result in serious functional impairment and impaired quality of life. The aim of this article is therefore to provide a guide for non-specialist neurologists to the clinical recognition and differential diagnosis of MMN.

scholarly journals Spine Myeloid Sarcoma: A Case Series with Review of Literature

2021 ◽  
Vol 10 (04) ◽  
pp. 251-254
Author(s):  
Kajal Shah ◽  
Harsha Panchal ◽  
Apurva Patel
Keyword(s):  
Myeloid Leukemia ◽  
De Novo ◽  
Correct Diagnosis ◽  
Relevant Literature ◽  
Bone Marrow Involvement ◽  
Case Series ◽  
Diagnostic Algorithm ◽  
Myeloid Sarcoma ◽  
Diagnostic Challenge ◽  
Extramedullary Tumor

AbstractMyeloid sarcoma (MS) is a malignant extramedullary tumor consisting of immature cells of myeloid origin. It may precede, present concurrently or follow acute myeloid leukemia (AML) in de novo case or may also be present and might be the only manifestation of recurrent AML, myelodysplastic syndrome, or chronic myeloid leukemia. It frequently involves skin, orbit, bone, periosteum, lymph nodes, and gastrointestinal tract, soft tissue, central nervous system, and testis. Because of its different localization and symptoms, and the lack of diagnostic algorithm, MS is a real diagnostic challenge particularly in patients without initial bone marrow involvement. The correct diagnosis of MS is important for optimum therapy, which is often delayed because of a high misdiagnosis rate. We reported three cases of MS derived from spine presented with back pain, paraplegia, paraparesis, respectively, and reviewed the relevant literature.

scholarly journals High Grade Serous Carcinoma Presenting as a Huge Pelvic Mass with Normal Looking Ovaries: A Diagnostic Challenge for Pathologist

2020 ◽  
Author(s):  
Vaishali Walke ◽  
Amrapali Gaikwad ◽  
Madiha Shaikh ◽  
Balwant Kowe
Keyword(s):  
Correct Diagnosis ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
Pelvic Mass ◽  
Clinical Findings ◽  
Serous Carcinoma ◽  
High Grade ◽  
Diagnostic Challenge ◽  
Immunohistochemical Markers ◽  
Specific Symptoms

High-grade serous carcinoma represents 50-60% of all ovarian cancers and is the most common type of malignant surface epithelial tumour. Serous carcinoma is often diagnosed in the sixth and seventh decade, while the mean age for high-grade tumours is 63 year. It’s not only the non-specific symptoms like vague abdominal pain, nausea, gastrointestinal disturbances, but also the unusual presentation which is responsible for delayed diagnosis. This diagnostic delay can become the reason for increased mortality, despite advances in surgical management and chemotherapy. Here, authors discuss a case of 60-year-old postmenopausal women who presented with a huge pelvi-peritoneal mass and with grossly normal ovaries. Considering clinical findings and histomorphology, the possibility of malignant mesothelioma was considered as the first differential diagnosis; however extensive sampling of ovaries and supportive immunohistochemical markers helped us to arrive at a definitive diagnosis. The present case emphasises the importance of extensive tissue sampling and ancillary techniques in arriving at a correct diagnosis.

scholarly journals Urinary disorders and bladder-bowel dysfunction in children: approaches to diagnosis, treatment and prevention

2018 ◽  
pp. 53-59
Author(s):  
AB Moiseev ◽  
AA Mironov ◽  
OB Kolbe ◽  
EE Vartapetova ◽  
VV Polunina ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Correct Diagnosis ◽  
Diagnostic Algorithm ◽  
Bowel Dysfunction ◽  
Diagnostic Challenge ◽  
Urinary Disorders ◽  
Healthcare Facilities ◽  
Treatment And Prevention ◽  
Bladder Bowel Dysfunction ◽  
Urinary Disorder

Pediatric urinary disorders manifested as urinary incontinence, compelling urges to urinate, etc. remain an important problem of contemporary healthcare. In spite of being extensively covered in the literature, urinary disorders, including enuresis, still present a diagnostic challenge to the physicians of primary healthcare facilities. Based on the findings of our retrospective study that revealed discrepancies between referral and final diagnoses of pediatric urinary disorders, we give recommendations to both physicians of primary healthcare facilities and their inpatient care colleagues that will help them to arrive at the correct diagnosis of a urinary disorder or concomitant bladder-bowel dysfunction using the proposed diagnostic algorithm.

scholarly journals Significance of Correct Diagnosis of Odontogenic Extraoral Sinus: A Report Of Two Cases

2018 ◽  
Vol 1 (11) ◽  
pp. 334-338
Author(s):  
Shweta Bansal ◽  
Ruchi Juneja ◽  
Gyanendra Mishra ◽  
Akshay Nambiar
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Correct Diagnosis ◽  
Sinus Tract ◽  
Short Term ◽  
Diagnostic Challenge ◽  
Odontogenic Origin

Cutaneous draining sinus tracts of odontogenic origin often are a diagnostic challenge. A delay in correctly diagnosing these types of lesions can result in unnecessary antibiotic therapy and surgical treatment. This case report presents the clinical course of two cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. These facial lesions were initially misdiagnosed as lesions of non-odontogenic origin. Later on an odontogenic cause was identified and endodontic intervention resulted in resolution of the problem, confirming the initial misdiagnosis.

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