A SWOLLEN MIDDLE FINGER IN A MIDDLE-AGED FARMER

Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 121-123 ◽  
Author(s):  
Somprakas Basu ◽  
Shilpi Bhadani ◽  
Vijay Kumar Shukla
Keyword(s):  
Proximal Phalanx ◽  
Middle Finger ◽  
Needle Aspiration ◽  
Excision Biopsy ◽  
Middle Aged ◽  
Cytological Examination ◽  
Diagnostic Dilemma ◽  
X Ray ◽  
The Right ◽  
Bony Erosion

Hand tumors are not common and a swollen finger poses considerable diagnostic dilemma. We present a case of a middle-aged farmer who had presented with a painless swelling of the middle finger of the right hand without any neurovascular deficit or evidence of metastasis. An X-ray of the finger showed cortical expansion and bony erosion of the proximal phalanx. A fine needle aspiration cytological examination was inconclusive. He underwent a digit amputation in view of subsequent morbidity and chances of recurrence following local excision. Biopsy proved it to be a giant cell tumor of the proximal phalanx. Following six months of treatment he is doing well. We herein highlight an unusual tumor of the finger and its diagnostic and treatment challenges.

scholarly journals Submandibular lipoma in elderly female in mid western Nepal: A Case Report

2017 ◽  
Vol 4 (2) ◽  
pp. 46-49
Author(s):  
Bishow Tulachan ◽  
Buddha Nath Borgohain
Keyword(s):  
Needle Aspiration ◽  
The Body ◽  
Rare Entity ◽  
Medical Sciences ◽  
Diagnostic Dilemma ◽  
Submandibular Region ◽  
Medical College ◽  
Needle Aspiration Cytology ◽  
The Right ◽  
Rule Out

Background and Objectives: The submandibular lipomas are relatively rare entity. The reported age of the patients were from birth to 84 years old, and average being 55.7 years. These are mainly asymptomatic and mostly cause aesthetic concerns. Deep lipomas, especially in the head and neck, are not commonly reported. To our knowledge there’s not even a single publication regarding the lipoma in the submandibular region in our mid western region as well as in our country.Presentation of case: A 72 years old female presented with complaints of painless progressive neck swelling in the right submandibular region for about 2 years. Clinically, it was thought to be submandibular gland neoplasm/ lymphadenopathy. Ultrasonography (USG) and fine-needle aspiration cytology (FNAC) were done. It was negative for malignancy. She underwent excision of the mass under general anesthesia without postoperative complications. The histopathology confirmed it to be lipoma. Discussion: Lipoma is a common benign mesenchymal tumour that is found almost anywhere in the body. However, a large lipoma is relatively rare in the submandibular region. On clinical doubt, one can rely on USG / MRI (magnetic resonance imaging) and FNAC to rule out diagnostic dilemma. The treatment of choice is simply excision. Conclusion: It’s a rare entity and may be the first report of a lipoma in the submandibular region in an elderly people. One should rule out its possibility while going through the submandibular region diseases.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (2): 46-49

scholarly journals Oral nodular fasciitis – A case report with a diagnostic schema

2019 ◽  
Vol 25 (2) ◽  
pp. 21
Author(s):  
Deepika Rathna ◽  
Mary Mathew ◽  
Adarsh Kudva ◽  
Monica Charlotte Solomon
Keyword(s):  
Smooth Muscle Actin ◽  
Excision Biopsy ◽  
Incisional Biopsy ◽  
Diagnostic Dilemma ◽  
Microscopic Appearance ◽  
Histological Appearance ◽  
Blue Stain ◽  
Malignant Lesions ◽  
Collagenous Stroma ◽  
The Right

Introduction: The spectrum of myofibroblastic lesions of the oral cavity ranges from reactive to benign to malignant lesions with overlapping histopathologic and immunohistologic characteristics posing a diagnostic dilemma. Observation: A 30-year-old male presented with a spontaneous swelling over the right lower buccal gingiva giving a clinical suspicion of a benign mesenchymal tumor. The lesion presented with a varied biphasic microscopic appearance that posed as a challenge for diagnosis. Commentaries: The incisional biopsy of the lesion showed a highly collagenous stroma with spindle-shaped cells, while the excision biopsy revealed myxoid and hyalinized stroma. A panel of markers comprising of SMA (smooth muscle actin). CD-34, β-Catenin, and Alcian blue stain was employed to arrive at a diagnosis. Conclusion: Most myofibroblastic lesions present with diverse histological appearance which warrants a thorough assessment of the cellular and stromal components for an accurate diagnosis.

scholarly journals A case of primary adenocarcinoma of Meckel’s diverticulum presenting as ovarian mass and literature review

2021 ◽  
pp. 380-382
Author(s):  
Arnab Gupta ◽  
Singh Inderdeep ◽  
Haldar Sudip ◽  
Chakraborty Biman
Keyword(s):  
Adnexal Mass ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Needle Aspiration ◽  
Meckel's Diverticulum ◽  
Primary Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Mesenteric Border ◽  
Needle Aspiration Cytology ◽  
The Right

Meckel’s diverticulum (MD) is the most common congenital anomaly affecting the gastrointestinal tract. It is located on the anti-mesenteric border of the small intestine and occurs due to incomplete obliteration of the omphalomesenteric duct during embryogenesis. Tumors, particularly cancers, are rare complications of MD. Carcinoids are the most common malignancies in this site. Adenocarcinomas are extremely rare and carry a poor prognosis. Here, we present the case of adenocarcinoma of MD presenting as Krukenberg tumor in a 42-year-old lady and causing a diagnostic dilemma. Pelviabdominal examination revealed large bilateral adnexal masses along with ascites and computed tomography-guided fine-needle aspiration cytology from the right adnexal mass was suggestive of adenocarcinoma. At exploratory laparotomy, a MD was found with hard intramural growth palpable at the tip of MD adnexal deposits and omental caking. Immunohistochemistry revealed CK 7- and CK 20+ve and also CDX2 positive. The rarity of presentation of bilateral adnexal mass due to primary adenocarcinoma of MD urges us to report this case.

scholarly journals An unusual case in endocrinology practice: Suture granuloma

2016 ◽  
Vol 50 (3) ◽  
pp. 145-147 ◽  
Author(s):  
Guven Baris Cansu ◽  
B. Taskiran ◽  
T. Bakar ◽  
B.P. Cengiz
Keyword(s):  
Unusual Case ◽  
Fine Needle Aspiration Biopsy ◽  
Rare Complication ◽  
Neck Region ◽  
Needle Aspiration ◽  
Ultrasound Images ◽  
Suture Materials ◽  
Anterior Neck ◽  
Cytological Examination ◽  
The Right

Abstract Objective. Suture granuloma, the rare complication of thyroidectomy, results from the use of nonabsorbable suture materials. Despite its typical ultrasound images and benign course, it carries utmost importance in the diff erential diagnosis of lymph nodes, recurrent nodules, and recurrence in the case of thyroid cancers. Subject and Results. Fifty four years old female patient, who underwent bilateral thyroidectomy in July 2010, was diagnosed with multinodular goiter and incidentally discovered micropapillary carcinoma (2 mm). Four years later, she was readmitted to hospital due to painless swelling in the right and left anterior neck region. Ultrasonography revealed nodules with irregular boundaries, containing micro- and macro-calcifications and hyperechoic lines in both sides of the thyroid bed and isthmus. Fine needle aspiration biopsy was performed in the right and left sided mass and the cytological examination was compatible with the diagnosis of the suture granuloma. Conclusions. Suture granuloma should be considered in the differential diagnosis of the local recurrence

Histologic Findings and Cytological Alterations in Thyroid Nodules After Radioactive Iodine Treatment for Graves’ Disease: A Diagnostic Dilemma

2017 ◽  
Vol 25 (4) ◽  
pp. 314-318 ◽  
Author(s):  
Siba El Hussein ◽  
Yumna Omarzai
Keyword(s):  
Thyroid Nodules ◽  
Radioactive Iodine ◽  
Clinical History ◽  
Needle Aspiration ◽  
Graves Disease ◽  
Cytological Examination ◽  
Diagnostic Dilemma ◽  
History Of ◽  
Iodine Treatment ◽  
Cytological Alterations

Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves’ disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves’ disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging. Thus, pathologists should be aware of the existence of these changes in the setting of radiation therapy for Graves’ disease. Providing pathologists with appropriate clinical history of Graves’ disease treated with radioactive iodine is of paramount importance in order to prevent an overdiagnosis of malignancy.

scholarly journals Primary hydatid disease of the breast clinically masquerading as a galactocele: A case report

2015 ◽  
Vol 3 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Bushra Siddiqui ◽  
Shahbaz Habib Faridi ◽  
Sayeedul Hasan Arif ◽  
Mohammad Aslam
Keyword(s):  
Hydatid Cyst ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Left Breast ◽  
Cytological Examination ◽  
Aspiration Cytology ◽  
Breast Examination ◽  
Needle Aspiration Cytology ◽  
The Right ◽  
Foamy Macrophages

Abstract We report a rare case of a 30-year-old breastfeeding woman who presented to our surgical outpatient department with complaints of a gradually enlarging lump in her left breast for the last 2 months. She also complained of difficulty in breastfeeding for 1 week. On examination, the right breast was normal but there was a 4 cm × 4 cm retroareolar soft lump in her left breast. Examination of the bilateral axilla was normal. A provisional diagnosis of galactocele was made and the patient was subjected to ultrasonic mammography and fine needle aspiration cytology (FNAC). Ultrasonic mammography of the left breast showed a heterogeneous, hypoechoic lesion with thick septations and internal echoes suggestive of a complex cystic lesion, leading to a differential diagnosis of either hydatid cyst or breast abscess. On FNAC, the aspirate was not milky and cytological examination was performed, which revealed hydatid scolices, hooklets, foamy macrophages and granular debris, leading to the final diagnosis of hydatid cyst of the breast. The patient was investigated further but there were no cysts at any other site. Chemotherapy with albendazole was started and surgery was performed after 1 month. Histopathology further confirmed the diagnosis. Owing to the rarity of presentation, this case is being reported here.

scholarly journals Supraclavicular nerve schwannoma: a rare differential diagnosis for a neck lump

2019 ◽  
Vol 6 (3) ◽  
pp. 1010
Author(s):  
Adarsh P. Shah ◽  
Raj Bhutiani
Keyword(s):  
Middle Eastern ◽  
Systemic Disease ◽  
Needle Aspiration ◽  
Excision Biopsy ◽  
Benign Schwannoma ◽  
Supraclavicular Fossa ◽  
Rare Differential Diagnosis ◽  
Needle Aspiration Cytology ◽  
Benign Tumours ◽  
The Right

Supraclavicular schwannomas are very rare benign tumours. We present the case of a 30-year-old middle-eastern man who complained of a gradually enlarging, asymptomatic 2cm non-tender swelling in the right supraclavicular fossa. There were no other symptoms suggestive of systemic disease. Ultrasound imaging was suggestive of an abnormal lymph node, but fine needle aspiration cytology of the lump was inconclusive. Subsequent urgent excision biopsy of the lump on histology revealed it to be a benign schwannoma. On post-operative follow-up, the patient did not have any neurological deficit.

scholarly journals Inflammatory Pseudotumour of the Lung: A Case Report and Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
R. Morar ◽  
A. Bhayat ◽  
G. Hammond ◽  
H. Bruinette ◽  
C. Feldman
Keyword(s):  
Young Adults ◽  
Case Report ◽  
Literature Review ◽  
Computerized Tomography ◽  
Excision Biopsy ◽  
Inflammatory Pseudotumour ◽  
X Ray ◽  
Chest X Ray ◽  
Children And Young Adults ◽  
The Right

We describe a patient with inflammatory pseudotumour of the lung. He was a young man who presented with haemotysis and the chest X-ray and computerized tomography were indicative of a nonbenign lesion in the right upper lobe. Excision biopsy confirmed the diagnosis of inflammatory myofibroblastic pseudotumour of the lung. This is a rare inflammatory nonneoplastic condition commonly affecting children and young adults.

scholarly journals Osteochondroma Presenting Clinically with Carpal Tunnel Syndrome in a 12-Year-old Boy

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Sachin Yashwant Kale ◽  
Aditya Rajendra Gunjotikar ◽  
Rohit Mahesh Sane ◽  
Sushmit Singh ◽  
Sanjay B Dhar ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Middle Finger ◽  
Blood Parameters ◽  
Excision Biopsy ◽  
Shoulder Region ◽  
Tunnel Syndrome ◽  
The Right ◽  
Slow Growing

Introduction: An exostosis is a benign growth of bone, which when capped with cartilage is called osteochondroma, which can appear as solitary or multiple, mostly affecting the long bones, pelvis, and shoulder region. The prevalence of known solitary exostosis is 1–2% in the general population. They are slow growing lesions with rare malignant transformation. In patients with a solitary exostosis, the chance of developing a chondrosarcoma out of an exostosis is around 1%. Case Report: A 12-year-old boy presented to our outpatient department with complaints of pain, and swelling at the right wrist since 1 year and tingling numbness on and around palmar aspect of index and middle finger since 6 months. The swelling was of size 3 cm × 2 cm, Tinel’s sign was positive. His blood parameters were normal. X-ray showed exostoses. Magnetic resonance imaging was suggestive of osteochondroma. Nerve conduction study was normal. Excision biopsy confirmed the diagnosis and also relieved all symptoms. Conclusion: Our case report is unique in its own way as it reminds us that when presented with a case of osteochondroma of the distal radius in children, carpal tunnel syndrome can also occur. Keywords: Osteochondroma, carpal tunnel syndrome, exostosis.

scholarly journals Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature

2011 ◽  
Vol 11 ◽  
pp. 760-765 ◽  
Author(s):  
Farshid Niknam ◽  
Jiezhong Chen ◽  
Sabar Napaki ◽  
Morteza Aghmesheh
Keyword(s):  
Pulmonary Nodules ◽  
Large Cell Carcinoma ◽  
Large Cell ◽  
Needle Aspiration ◽  
Cytokeratin 20 ◽  
Macrophage Response ◽  
X Ray ◽  
Multiple Pulmonary Nodules ◽  
Diagnosis And Management ◽  
The Right

Chest X-ray and CT examinations often find pulmonary nodules that could be malignant or benign. A case is presented and discussed here in order to improve diagnosis and management of pulmonary nodules. A 62-year-old lady was found to have multiple pulmonary nodules by X-ray when she complained of a cough and fever. This was confirmed by a CT scan. Fine needle aspiration (FNA) of one of the lung lesions reported scant atypical epithelial cells that stained positive for TTF-1 and cytokeratin 7, but negative for cytokeratin 20. Thus, it was suspicious for large cell carcinoma. A videothoracoscopic lung biopsy and histopathology were applied and showed a necrotic nodule with surrounding chronic inflammation and macrophage response, with no evidence of malignant cells. Atypical reactive pneumocytes at the periphery of the lesion (an old infarct) were probably equivalent to the atypical cells seen on cytology. This result changed the diagnosis of our patient from a malignant condition to a benign process. Thus, CT and FNA may give a false positive. A second pathological opinion is very useful for the right diagnosis and management, as shown in our case.

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