Challenges in the diagnosis of cutaneous adnexal tumours

2015 ◽  
Vol 68 (12) ◽  
pp. 992-1002 ◽  
Author(s):  
Richard Danialan ◽  
Kudakwashe Mutyambizi ◽  
Phyu P Aung ◽  
Victor G Prieto ◽  
Doina Ivan
Keyword(s):  
Differential Diagnosis ◽  
Sweat Gland ◽  
Systematic Approach ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Cutaneous Metastases ◽  
Histological Features ◽  
Immunohistochemical Studies ◽  
Tumour Differentiation

The diagnosis of cutaneous adnexal neoplasms, a heterogeneous group of entities, is often perceived by practising pathologists as challenging. A systematic approach to diagnosis is necessary for classification of these lesions, which establishes the tumour differentiation (follicular, sebaceous, sweat gland or apocrine) and evaluates histological features differentiating between benign and malignant entities. Consideration of clinical history is a necessary adjunct in evaluation of the adnexal neoplasm, as characteristic anatomical sites are described for many adnexal lesions. In some instances, immunohistochemical studies may also be employed to aid the diagnosis. The differential diagnosis between primary cutaneous adnexal neoplasms and cutaneous metastases from visceral tumours may also be difficult. Clinical, radiological, histological and immunohistochemical characteristics will be further discussed, considering that the correct diagnosis has a significant impact on the patient's management and prognosis.

scholarly journals A New Classification of Endodontic-Periodontal Lesions

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid S. Al-Fouzan
Keyword(s):  
Differential Diagnosis ◽  
Periodontal Disease ◽  
Periodontal Diseases ◽  
Correct Diagnosis ◽  
Clinical Classification ◽  
New Classification ◽  
Appropriate Treatment ◽  
Simultaneous Existence ◽  
Endodontic Disease

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

The Recurrent Nevus Phenomenon: A History of Challenge, Controversy, and Discovery

2011 ◽  
Vol 135 (7) ◽  
pp. 842-846 ◽  
Author(s):  
John C. Fox ◽  
Jon A. Reed ◽  
Christopher R. Shea
Keyword(s):  
Personal Experience ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Melanocytic Nevi ◽  
History Of ◽  
Immunohistochemical Studies ◽  
Recurrent Nevus ◽  
Potential Challenge ◽  
Microscopic Findings ◽  
Histopathologic Features

Abstract Context.—The diagnosis of recurrent nevus poses a potential challenge to practicing pathologists. Although most recurrent nevi show uniform microscopic findings and pose no great diagnostic difficulty, a few cases exhibit some histopathologic features similar to, and in some cases indistinguishable from, melanoma. Historically, the term pseudomelanoma has been used in the literature to describe such recurrent nevi, although this label has the potential for confusion and is no longer the favored term for recurrent pigmented melanocytic nevi. Objective.—To describe historical, histopathologic, and immunohistochemical features of recurrent pigmented melanocytic nevi and to review briefly the literature surrounding the mechanism of recurrence. Data Sources.—Published peer-reviewed literature and the authors' personal experience. Conclusions.—Recognition of the histopathologic pattern of recurrent nevi leads the pathologist to the correct diagnosis in most cases; however, in particularly challenging specimens or in circumstances in which there is insufficient clinical history, immunohistochemical studies have proved helpful in distinguishing recurrent nevi from melanoma.

Clear Cell Hidradenoma: A Mimic of Metastatic Clear Cell Tumors

2005 ◽  
Vol 129 (5) ◽  
pp. e113-e116 ◽  
Author(s):  
Keith E. Volmar ◽  
Thomas J. Cummings ◽  
Wei Hua Wang ◽  
Andrew J. Creager ◽  
Douglas S. Tyler ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Needle Aspiration ◽  
Detailed Clinical History ◽  
Immunohistochemical Studies ◽  
Physical Findings

Abstract Clear cell hidradenoma is a benign skin appendage tumor that may mimic conventional-type renal cell carcinoma. Histologically, clear cell hidradenoma contains small ductular lumens, focal apocrine and squamoid change, and a less prominent vascular pattern than renal cell carcinoma. Furthermore, immunohistochemical studies can aid in distinguishing the 2 tumors. Knowing the cytologic features of primary skin adnexal neoplasms helps distinguish them from cutaneous metastases, which are more commonly referred for fine-needle aspiration biopsy evaluation. Detailed clinical history, physical findings, and ancillary studies are essential for correct diagnosis and categorization of these tumors. We report the rare case of a patient with renal cell carcinoma who underwent excision of an axillary clear cell hidradenoma, which was clinically suggestive of cutaneous metastatic disease.

scholarly journals Classification and diagnosis of vitiligo

2020 ◽  
Vol 63 (12) ◽  
pp. 731-740
Author(s):  
Sang Ho Oh
Keyword(s):  
Differential Diagnosis ◽  
Clinical Features ◽  
Clinical Course ◽  
Correct Diagnosis ◽  
Affected Area ◽  
The Right

Vitiligo is a relatively common, acquired hypopigmentary disorder caused by the loss of epidermal melanocytes. It is characterized by asymptomatic, well-circumscribed round to oval-shaped whitish patches that vary in size. Depending on various clinical features, vitiligo is classified into several types, that is, non-segmental, segmental, and undetermined/unclassified vitiligo. The uniform classification of vitiligo is very important in predicting its clinical course and prognosis and communication among researchers. In particular, segmental vitiligo is a highly distinctive subtype of vitiligo considering its clinical features and prognosis. It usually has an onset early in life and spreads rapidly within the affected area limited to one segment of the integument. Signs of vitiligo activity such as Koebnerʼs phenomenon, trichrome vitiligo, inflammatory vitiligo, and confetti-like lesions give useful information to start treatments to block the progression of the disease. Lastly, other hypopigmentary disorders should be distinguished from vitiligo to make the correct diagnosis and prescribe the right treatment. In this report, I review the clinical features of vitiligo, various subtypes according to classification, and the importance for differential diagnosis of hypopigmentary disorders from vitiligo.

Imaging of Tuberculosis

1996 ◽  
Vol 37 (3P2) ◽  
pp. 496-505 ◽  
Author(s):  
J. Brismar ◽  
C. Hugosson ◽  
S. G. Larsson ◽  
C. Lundstedt ◽  
R. Nyman
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumour ◽  
Signal Intensity ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Local Hospital ◽  
Important Differential Diagnosis ◽  
Ct Findings ◽  
Tumour Vasculature ◽  
T2 Weighted Images

Purpose: To show that intracranial tuberculosis (TB) often masquerades as brain tumour. Material and Methods: Forty-six patients with intracranial TB, who after CT at the local hospital were referred for surgery or radiotherapy of brain tumour, are presented. Sometimes the correct diagnosis was first established during surgery for tumour. Results: The differentiation between TB and gliomas, meningiomas, metastases, or lymphomas may be impossible from the clinical history and CT findings. Angiography, done in 25 of our cases, often helped by not showing the expected tumour vasculature. MR, performed in 9 patients, helped by demonstrating a layered capsule on T2-weighted images in 4 of the lesions (hypointense rim outside hyperintense rim); the centres of the lesions were of decreased, usually very mixed T2 signal intensity. Conclusion: Even in patients with findings typical of brain tumour, TB remains an important differential diagnosis.

Psychosis due to traumatic brain injury – controversies and diagnoses difficulties

2016 ◽  
Vol 33 (S1) ◽  
pp. S626-S626
Author(s):  
A. Amorim
Keyword(s):  
Traumatic Brain Injury ◽  
Differential Diagnosis ◽  
Brain Injury ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Medical Condition ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Competing Interest ◽  
Psychiatric Complications

IntroductionA traumatic brain injury (TBI) can cause numerous psychiatric complications. Humor and anxious disorders, personality disorders and psychoses are some of those possible problems. The diagnosis of psychosis due to traumatic brain injury (PDTBI), although controversial, has been subject of crescent debate and the idea that a TBI could cause a psychosis is gaining credibility. Diagnosing a PDTBI can be difficult. DSM-5 criteria are rather vague and there are many potential confounding factors due to similarities with other etiological psychosis.Objectives and aimsAlert clinicians to the diagnosis of PDTBI, clarify this clinical entity and define features that may allow them to do the differential diagnosis with other etiologic psychotic disorders.MethodsThe authors performed a research in PubMed using the keywords psychosis and traumatic brain injury and selected the adequate articles to meet the objectives proposed.ResultsDifferential diagnosis of PDTBI should be done with schizophrenia, schizoaffective psychosis, delusional disorder, substance-induced psychosis, psychosis due to other medical condition and with posttraumatic stress disorder. Differentiating PDTBI and schizophrenia can be particularly difficult. Some features have been proposed in the literature as potentially differentiating, namely the presence of negative symptoms (more common in schizophrenia), findings in MRI/CT and EEG.ConclusionsEstablishing PDTBI diagnosis can be difficult. While awaiting new studies, clinicians should, in cases of TBI related psychosis, achieve a meticulous clinical history and mental exam, in order to ensure a correct diagnosis and, therefore, determine an appropriate intervention.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Clinical and Histopathological Features of Scleroderma-like Disorders: An Update

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1275
Author(s):  
Rosario Foti ◽  
Rocco De Pasquale ◽  
Ylenia Dal Bosco ◽  
Elisa Visalli ◽  
Giorgio Amato ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Antinuclear Antibodies ◽  
Correct Diagnosis ◽  
Main Body ◽  
Muscular Tissue ◽  
Histological Features ◽  
Histopathological Features ◽  
Clinical Evolution ◽  
Pathological Conditions

Scleroderma-like disorders include a set of entities involving cutis, subcutis and, sometimes, even muscular tissue, caused by several pathogenetic mechanisms responsible for different clinical–pathological pictures. The absence of antinuclear antibodies (ANA), Raynaud’s phenomenon and capillaroscopic anomalies constitutes an important element of differential diagnosis with systemic sclerosis. When scleroderma can be excluded, on the basis of the main body sites, clinical evolution, any associated pathological conditions and specific histological features, it is possible to make a correct diagnosis.

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

Classification of papillary thyroid carcinoma histological images based on deep learning

2021 ◽  
pp. 1-11
Author(s):  
Yaning Liu ◽  
Lin Han ◽  
Hexiang Wang ◽  
Bo Yin
Keyword(s):  
Neural Network ◽  
Differential Diagnosis ◽  
Deep Learning ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Image Features ◽  
Papillary Thyroid ◽  
Histological Image ◽  
Histological Images

Papillary thyroid carcinoma (PTC) is a common carcinoma in thyroid. As many benign thyroid nodules have the papillary structure which could easily be confused with PTC in morphology. Thus, pathologists have to take a lot of time on differential diagnosis of PTC besides personal diagnostic experience and there is no doubt that it is subjective and difficult to obtain consistency among observers. To address this issue, we applied deep learning to the differential diagnosis of PTC and proposed a histological image classification method for PTC based on the Inception Residual convolutional neural network (IRCNN) and support vector machine (SVM). First, in order to expand the dataset and solve the problem of histological image color inconsistency, a pre-processing module was constructed that included color transfer and mirror transform. Then, to alleviate overfitting of the deep learning model, we optimized the convolution neural network by combining Inception Network and Residual Network to extract image features. Finally, the SVM was trained via image features extracted by IRCNN to perform the classification task. Experimental results show effectiveness of the proposed method in the classification of PTC histological images.

scholarly journals Bladder perivascular epithelioid cell neoplasm: The importance of immunohistochemistry in the diagnosis of an unusual neoplasm

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110008
Author(s):  
Solange De Noon ◽  
Benjamin Ayres ◽  
Uday Patel ◽  
Rami Issa ◽  
Colan Maxwell Ho-Yen
Keyword(s):  
Differential Diagnosis ◽  
Epithelioid Cell ◽  
Review Of The Literature ◽  
Histological Features ◽  
Perivascular Epithelioid Cell Neoplasms ◽  
Perivascular Epithelioid Cell ◽  
Organ Systems ◽  
Cell Neoplasm ◽  
Key Features ◽  
Mesenchymal Tumours

Perivascular epithelioid cell neoplasms represent a group of uncommon mesenchymal tumours with as yet undiscovered benign counterpart. Although perivascular epithelioid cell neoplasms have been described arising in most organ systems as well as in soft tissue and bone, only a small number of perivascular epithelioid cell neoplasms have been reported in the bladder. To date, there is no agreed system for predicting the behaviour of these tumours. We describe a case of a perivascular epithelioid cell neoplasm of the bladder arising in a 57-year-old male and initially diagnosed on biopsy and present a review of the literature focussing on the pathological differential diagnosis and the importance of key histological features in conjunction with a broad immunohistochemical panel. This case report highlights the key features of bladder perivascular epithelioid cell neoplasms that distinguishes these rare neoplasms from other bladder lesions.

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