Hypercalcaemia associated with disseminated cryptococcosis

2021 ◽  
Vol 14 (12) ◽  
pp. e245025
Author(s):  
Hazwani Aziz ◽  
Noor Lita Adam ◽  
Nor Afidah Karim
Keyword(s):  
Incidental Findings ◽  
Kidney Injury ◽  
Final Diagnosis ◽  
Lymph Node Biopsy ◽  
Normal Serum ◽  
Serum Phosphate ◽  
Adrenal Lesion ◽  
Node Biopsy ◽  
Rim Enhancement ◽  
Cervical Lymph Node Biopsy

We report an elderly man who presented with giddiness and right-sided weakness, constipation and constitutional symptoms for 6 months duration. Blood investigations indicated hypercalcaemia with normal serum phosphate and acute kidney injury. Serum intact parathyroid hormone was suppressed. CT revealed bilateral tiny lung nodules with right upper lobe tree in bud appearance and incidental findings of bilateral adrenal lesion. Tuberculosis was ruled out. CT adrenal showed multiseptated hypodense rim enhancement adrenal lesion bilaterally. Adrenal function tests were normal except for low dehydroepiandrosterone (DHEA). Right-sided cervical lymph node biopsy confirmed fungal infection with the presence of intracellular and extracellular fungal yeast. Serum cryptococcus antigen titre was positive. Our final diagnosis was disseminated cryptococcosis with lungs, bilateral adrenal gland and lymph nodes involvement. The patient was then treated with antifungal treatment. Serum calcium was normalised after 1 month with marked clinical improvement.

Five biopsies, one diagnosis: challenges in idiopathic multicentric Castleman disease

2020 ◽  
Vol 13 (11) ◽  
pp. e236654
Author(s):  
Julie Semenchuk ◽  
Asad Merchant ◽  
Ali Sakhdari ◽  
Vishal Kukreti
Keyword(s):  
Lymph Node ◽  
Kidney Injury ◽  
Lymph Node Biopsy ◽  
Castleman Disease ◽  
Pleuritic Chest Pain ◽  
Multicentric Castleman Disease ◽  
Node Biopsy ◽  
Significant Clinical Improvement ◽  
Night Sweats ◽  
Inflammatory Changes

A previously healthy 29-year-old man initially presented to the hospital with pleuritic chest pain and shortness of breath. Over the next 2 months he developed ongoing fevers and night sweats with recurrent exudative pleural effusions and ascites. He had an extensive infectious and autoimmune workup that was unremarkable. He had an initial lymph node biopsy that showed reactive changes only. He had an acute kidney injury and his renal biopsy revealed thrombotic microangiopathy. His liver biopsy showed non-specific inflammatory changes. His bone marrow biopsy showed megakaryocyte hyperplasia and fibrosis, which raised suspicion for the thrombocytopenia, ascites, reticulin fibrosis, renal dysfunction and organomegaly syndrome subtype of multicentric Castleman disease. This prompted a repeat lymph node biopsy, showing changes consistent with mixed type Castleman disease that fit with his clinical picture. He was initiated on steroids and siltuximab with significant clinical improvement.

scholarly journals Clinical Study on the Case of Patient with Iatrogenic Brachial Plexus Injury after Cervical Lymph Node Biopsy: A Case Report

2013 ◽  
Vol 30 (5) ◽  
pp. 219-226 ◽  
Author(s):  
Yu Ri Kim ◽  
Seung Hee Noh ◽  
Kun Hyung Kim ◽  
Gi Young Yang ◽  
Byung Ryul Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Clinical Study ◽  
Brachial Plexus ◽  
Cervical Lymph Node ◽  
Brachial Plexus Injury ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Cervical Lymph Node Biopsy

scholarly journals Tuberculosis in patients with chronic renal failure

1987 ◽  
Vol 29 (3) ◽  
pp. 127-130 ◽  
Author(s):  
Flávio Jota de Paula ◽  
Luiz Sérgio Fonseca de Azevedo ◽  
Luiz Estevam Ianhez ◽  
João Egidio Romão Júnior ◽  
Pedro Renato Chocair ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pulmonary Involvement ◽  
Lymph Node Involvement ◽  
Immunosuppressive Drugs ◽  
Lymph Node Biopsy ◽  
The Other ◽  
Pleural Biopsy ◽  
Node Biopsy ◽  
Node Involvement ◽  
Cervical Lymph Node Biopsy

Nine cases of tuberculosis (TB) were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7%) had lymph node involvement (4 cervical and 2 mediastinal). Three patients (33.3%) had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary). Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients had previously received immunosuppressive drugs for unsuccessful renal transplantation. Daily fever was present in all but one patient; he was asymptomatic and TB was suspected after routine chest radiography. Biopsy was the diagnostic procedure in 7 patients (77.8%), four by direct cervical lymph node biopsy, 2 by mediastinal, performed by mediastinoscopy and 1 by pleural biopsy. In 2 other patients TB was confirmed by the presence of tubercle bacilli; in sputum (1 patient) and in a bronchial flushing specimen (the other patient). Triple therapy was used in all patients (isoniazid and ethambutol in all), plus rifampicin in 8 and streptomycin in 1. One patient had jaundice and another had optical neuritis. Five patients were cured. The other four died during treatment of causes unrelated to TB or its treatment.

scholarly journals Usefulness of Clinicobiological Data Obtained Prior to Cervical Lymph Node Biopsy

2015 ◽  
Vol 118 (3) ◽  
pp. 206-212 ◽  
Author(s):  
Taiji Kawasaki ◽  
Koichiro Wasano ◽  
Noriomi Suzuki ◽  
Sayuri Yamamoto ◽  
Kaoru Ogawa
Keyword(s):  
Lymph Node ◽  
Cervical Lymph Node ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Cervical Lymph Node Biopsy

scholarly journals Kikuchi's Disease: A Rare Cause of Fever and Lymphadenopathy

2012 ◽  
Vol 5 ◽  
pp. CPath.S8685 ◽  
Author(s):  
A Vivekanandarajah ◽  
B Krishnarasa ◽  
M Hurford ◽  
S Gupta
Keyword(s):  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Imaging Studies ◽  
Benign Condition ◽  
Kikuchi’S Disease ◽  
Node Biopsy ◽  
Cervical Lymph Node Biopsy ◽  
Necrotizing Lymphadenitis ◽  
Work Up ◽  
Kikuchi's Disease

Kikuchi's disease is a benign condition that occurs in women. A young woman presented to the hospital with fevers and cervical lymphadenopathy. Infectious work-up was negative except for streptococcus pharyngitis. Imaging studies revealed the presence of diffuse cervical and axillary lymphadenopathy. The fevers persisted and she underwent excisional cervical lymph node biopsy that revealed histiocytic necrotizing lymphadenitis corresponding to a benign diagnosis of Kikuchi's disease. Three months later, the patient was afebrile and there was complete resolution of the cervical lymphadenopathy.

Metastatic Malignant Peritoneal Mesothelioma Mimicking an Autoinflammatory Syndrome in a 12-Year-Old Boy

2021 ◽  
pp. 109352662110084
Author(s):  
Gabriel Olmedilla ◽  
Clara Undaondo ◽  
Wenceslao Vasquez ◽  
Nuria Rodriguez
Keyword(s):  
Final Diagnosis ◽  
Lymph Node Biopsy ◽  
Peritoneal Mesothelioma ◽  
Autoinflammatory Syndrome ◽  
Malignant Peritoneal Mesothelioma ◽  
Node Biopsy ◽  
Tert Gene ◽  
Unknown Significance ◽  
Peritoneal Biopsy ◽  
Test Result

A case of a malignant peritoneal mesothelioma mimicking an autoinflammatory syndrome in a 12-year-old boy is reported. The patient initially presented with lymphadenopathy and weight loss but without abdominal pain. Three things confounded the initial diagnosis: a positive test result for a gene related to cryopyrin-associated periodic syndrome, a positive response to the autoinflammatory syndrome treatment, and a lymph node biopsy which showed “hyperplastic mesothelial cells in the lymph sinuses.” His symptoms relapsed several years later, and a peritoneal biopsy confirmed the final diagnosis. Complete morphological, immunohistochemical, and molecular diagnoses are described. A translocation in the TERT gene involving the truncation of the promoter was found in the mesothelioma. The translocation has never been described in mesotheliomas and is of an unknown significance.

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