Case of leprosy mimicking preseptal cellulitis: a diagnostic dilemma

2022 ◽  
Vol 15 (1) ◽  
pp. e245641
Author(s):  
Deepayan Sarkar ◽  
Himani Chawla ◽  
Priti Singh ◽  
Vidhya Verma
Keyword(s):  
Giant Cells ◽  
Multidrug Therapy ◽  
Diagnostic Dilemma ◽  
Preseptal Cellulitis ◽  
Soft Tissue Swelling ◽  
Oral Steroids ◽  
Lymphocytic Infiltrates ◽  
Systemic Antibiotics ◽  
Superficial Soft Tissue ◽  
Multinucleate Giant Cells

A 36-year-old Asian man presented with swelling over the left frontal region involving the upper eyelids, with associated erythema and tenderness for 1 month duration. Clinically he was diagnosed as a case of preseptal cellulitis, however, the lesion did not improve on broad-spectrum systemic antibiotics. CT showed superficial soft tissue swelling in the forehead extending till the superior part of orbit. Histopathological assessment of the lesion revealed clusters of epithelioid cells with multinucleate giant cells in the dermis along with perivascular and periadnexal lymphocytic infiltrates, suggestive of leprosy. The patient was started on oral steroids with multidrug therapy, following which the patient showed early resolution of the lesion within 10 days of treatment. Leprosy is endemic in India, leprosy with reactional episodes mimics other inflammatory and infective etiologies making diagnosis difficult. Leprosy should be present in an ophthalmologist’s diagnostic repertoire while dealing with periorbital swellings for early clinical diagnosis and favourable outcomes.

Cerebrotendinous xanthomatosis with radiological abnormalities of the chest

2021 ◽  
Vol 14 (9) ◽  
pp. e243715
Author(s):  
Yoshiaki Zaizen ◽  
Masaki Tominaga ◽  
Shuji Nagata ◽  
Tomoaki Hoshino
Keyword(s):  
Genetic Disease ◽  
Blood Cells ◽  
Lung Biopsy ◽  
Giant Cells ◽  
Cerebrotendinous Xanthomatosis ◽  
Histological Findings ◽  
Calcaneal Tendon ◽  
Pulmonary Lesions ◽  
Foamy Macrophages ◽  
Multinucleate Giant Cells

A 55-year-old man with mental retardation and calcaneal tendon thickening was referred for a suspected genetic disease. His serum cholestanol was elevated and genetic analysis of his blood cells for CYP27A1 revealed a homozygous missense mutation. We diagnosed him with cerebrotendinous xanthomatosis (CTX). Chest radiography revealed diffuse micronodular and reticular opacities. Histological findings obtained from the transbronchial lung biopsy revealed foamy macrophages and multinucleate giant cells with marked lipid crystal clefts. Although there are few reports of pulmonary lesions in CTX, we concluded from the radiological and histopathological findings that the pulmonary lesions were indeed caused by the CTX. The patient was treated with chenodeoxycholic acid. His neurological findings and calcaneal tendon thickening were unchanged; however, his serum cholestanol and radiological abnormalities of the chest decreased.

Lesions of the Enamel Organ of Developing Dog Teeth following Experimental Inoculation of Gnotobiotic Puppies with Canine Distemper Virus

1981 ◽  
Vol 18 (5) ◽  
pp. 684-689 ◽  
Author(s):  
R. R. Dubielzig ◽  
R. J. Higgins ◽  
S. Krakowka
Keyword(s):  
Canine Distemper Virus ◽  
Giant Cells ◽  
Enamel Organ ◽  
Post Inoculation ◽  
Canine Distemper ◽  
Experimental Inoculation ◽  
Enamel Epithelium ◽  
Viral Inclusions ◽  
Reduced Enamel Epithelium ◽  
Multinucleate Giant Cells

Ten 7-day-old gnotobiotic Beagle puppies were inoculated intraperitoneally with virulent canine distemper virus (R252-CDV). The dogs were killed and perfused with paraformaldehyde/glutaraldehyde from eight to 36 days after inoculation. The developing teeth of the mandibles were examined by light microscopy, and the teeth from three dogs were examined by electron microscopy. Necrosis of individual cells in the stratum intermedium of the developing tooth was the first change, detectable at day 9 post-inoculation. At day 16 post-inoculation, there was disorganization of the ameloblasts. In the stratum intermedium, multinucleate giant cells and large eosinophilic cytoplasmic viral inclusions were prominent. Ultrastructurally, these inclusions consisted of clusters of tubular aggregates typical of canine distemper virus nucleocapsids. At 28 to 36 days post-inoculation, the changes were seen in the reduced enamel epithelium. Multinucleate cells were seen, but no inclusions. Some necrotic cells were seen. In these teeth, ameloblastic cells of the root were morphologically normal. Our results suggest that distemper virus affects developing teeth by direct infection of the enamel organ.

scholarly journals Giant Cell Tumor of Soft Parts: A Report of an Equine and a Feline Case

1975 ◽  
Vol 12 (5-6) ◽  
pp. 428-433 ◽  
Author(s):  
G. H. Ford ◽  
R. N. Empson ◽  
C. G. Plopper ◽  
P. H. Brown
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Giant Cells ◽  
Cell Tumor ◽  
Superficial Fascia ◽  
Femoral Canal ◽  
Malignant Giant Cell Tumor ◽  
Ultrastructural Characteristics ◽  
Characteristic Features ◽  
Multinucleate Giant Cells

Masses removed from the superficial fascia of the jugular groove of a 12-year-old Arabian mare and from the femoral canal of a 7 1/2-year-old female cat appeared to be counterparts of the human malignant giant cell tumor of soft parts, even recapitulating the clinical behavior of the respective subgroups. Histologically, both neoplasms contained the characteristic features of the malignant giant cell tumor of soft parts: large multinucleate giant cells, pleomorphic mononuclear giant cells, histiocytes, fibroblasts and fibrocytes that were sometimes sarcomatous, and foci of hemorrhage and necrosis. Ultrastructural characteristics of the giant cells suggest mesenchymal origin with osteoblastic or chondroblastic differentiation.

Multinucleate giant cells

1978 ◽  
Vol 126 (3) ◽  
pp. 125-148 ◽  
Author(s):  
T. J. Chambers
Keyword(s):  
Giant Cells ◽  
Multinucleate Giant Cells
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