scholarly journals Renal Leiomyosarcoma: A Diagnostic Challenge

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Jose R. Valery ◽  
Winston Tan ◽  
Cherise Cortese
Keyword(s):  
Renal Mass ◽  
Early Stage ◽  
Flank Pain ◽  
Bone Lesions ◽  
Brush Cytology ◽  
Diagnostic Challenge ◽  
Male Smoker ◽  
Initial Biopsy ◽  
Pathologic Analysis ◽  
Prompt Diagnosis

Renal leiomyosarcoma is a very rare tumor that clinically and radiographically mimics more common renal malignancies. The infrequency of the condition makes it very difficult to diagnose. A 70-year-old male smoker presented with months of hematuria, right-sided flank pain, and weight loss. Imaging revealed a 3.8-centimeter renal mass that had characteristics similar to renal cell carcinoma. Initial biopsy of the mass was negative for malignancy. Two months later, subsequent imaging revealed what appeared to be metastatic bone lesions. Again, a biopsy of one of the lesions was negative for malignancy. Subsequent ureteral pyeloscopy, ureteroscopic renal pelvis biopsy, and brush cytology were negative for malignancy as well. The decision was made to perform nephrectomy for the removal of the mass. Pathologic analysis revealed renal leiomyosarcoma. This case illustrates the difficulty in diagnosing renal leiomyosarcoma. Repeated pathologic sampling was negative because of the tumor heterogeneity. Prompt diagnosis and treatment are very significant as surgical resection at an early stage offers the best prognosis.

Plasmablastic Myeloma Versus Plasmablastic Lymphoma; Is MYC Rearrangement Helpful Towards A Precise Diagnosis?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S105-S105
Author(s):  
M Khedr ◽  
Y Yusuf ◽  
L Aftab
Keyword(s):  
Reference Range ◽  
Final Diagnosis ◽  
Plasmablastic Lymphoma ◽  
Bone Lesions ◽  
Molecular Testing ◽  
Diagnostic Challenge ◽  
Plasma Cell Neoplasm ◽  
Hiv Antibodies ◽  
Precise Diagnosis ◽  
Diagnostic Work

Abstract Introduction/Objective Plasmablastic myeloma (PBM) is a rare and aggressive plasma cell neoplasm. Differentiating PBM from plasmablastic lymphoma (PBL) represents a diagnostic challenge, as both diseases have overlapping cytomorphologic and immunophenotypic features. Genetic mutations in MYC occur in a majority of PBL cases but rarely in PBM, thus can theoretically be used to differentiate between both neoplasms. Methods We report a case of a 53-year-old female who presented with a rapidly growing mass in her right mandible. Biopsy revealed circumscribed nodules of immunoblastic cells with moderate cytoplasm, large vesicular nuclei and large prominent nucleoli. Apoptotic debris and brisk mitoses were present. Molecular testing revealed a C-MYC rearrangement. The location of the neoplasm and the above described morphological features were suggestive of PBL, especially with a positive C-MYC rearrangement. The neoplastic cells were positive for CD138, MUM1,CD56 and kappa; and negative for CD45, CD20, PAX5, CD3, CD5, CD30, EBER-ISH, HHV8, ALK-1, Lambda, EMA, CD21, CD23, pancytokeratin, CK20, CK7, Cam5.2, chromogranin, synaptophysin, HMB45, S100, P16, P40. MIB-1 showed high positivity, approximately 95%. Results Patient underwent further diagnostic work up, her HIV antibodies result were negative however, she was found to be anemic (Hemoglobin 6.6 g/dl; reference range 12-16 g/dl) and hypercalcemic (Calcium 12.3 mg/dl; reference range 8.5-10.5 mg/dl). PET scan revealed multiple hypermetabolic lytic bone lesions. The bone marrow biopsy showed 80% cellularity with extensive involvement by atypical plasmacytic cells forming large clusters. The patient’s final diagnosis was PBM. Conclusion Differentiating PBM from PBL is essential as treatment is different. Although MYC rearrangement in PBM is not common, it has been demonstrated and therefore should not be used to exclude this diagnosis. Here, we highlight the importance of correlating detailed clinical, radiological, laboratory, histological and genetics data for reaching the final diagnosis.

scholarly journals Investigation of an EHV-1 Outbreak in the United States Caused by a New H752 Genotype

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 747
Author(s):  
Nicola Pusterla ◽  
Samantha Barnum ◽  
Julia Miller ◽  
Sarah Varnell ◽  
Barbara Dallap-Schaer ◽  
...  
Keyword(s):  
Early Stage ◽  
Clinical Signs ◽  
Amino Acid Position ◽  
High Viral Load ◽  
The United States ◽  
Neurological Deficits ◽  
Diagnostic Challenge ◽  
Genotype I ◽  
Flunixin Meglumine ◽  
Nasal Secretions

Here we report on an EHV-1 outbreak investigation caused by a novel genotype H752 (histidine in amino acid position 752 of the ORF 30 gene). The outbreak involved 31 performance horses. Horses were monitored over a period of 35 days for clinical signs, therapeutic outcome and qPCR results of EHV-1 in blood and nasal secretions. The morbidity of the EHV-1 outbreak was 84% with 26 clinically infected horses displaying fever and less frequently anorexia and distal limb edema. Four horses showed mild transient neurological deficits. Clinically diseased horses experienced high viral load of EHV-1 in blood and/or nasal secretions via qPCR, while subclinically infected horses had detectable EHV-1 mainly in nasal secretions. The majority of infected horses showed a rise in antibody titers to EHV-1 during the outbreak. All 31 horses were treated with valacyclovir, while clinically infected horses further received flunixin meglumine and sodium heparin. This investigation highlights various relevant aspects of an EHV-1 outbreak caused by a new H752 genotype: (i) importance of early detection of EHV-1 infection; (ii) diagnostic challenge to assess H752 genotype; (iii) apparent benefit of valacyclovir use in the early stage of the outbreak; and (iv) weekly testing of blood and nasal secretions by qPCR in order to monitor individual infection status and lift quarantine.

Symptomatic kidney stones in an anuric patient on dialysis: A case report

2021 ◽  
pp. 039156032110359
Author(s):  
Hossein Dialameh ◽  
Farshad Namdari ◽  
Mehrdad Mahalleh ◽  
Mohammad Lotfi ◽  
Zoha Ali
Keyword(s):  
Renal Colic ◽  
Chest Ct ◽  
Chief Complaint ◽  
Flank Pain ◽  
The Past ◽  
Extracorporeal Shock Wave ◽  
Stage Renal Disease ◽  
End Stage ◽  
Prompt Diagnosis ◽  
Chest Ct Scan

Introduction: Renal colic is a colicky-type of flank pain that can commonly be presented in patients undergoing dialysis especially if they are anuric considering the fact that there are multiple controversies and little published experience on this topic, we found it very important to report this case. We also aimed to increase awareness and emphasize the importance of renal colic in anuric patients on dialysis. Case description: We herein report a case of a 42-year old man with a chief complaint of bilateral colic flank pain, He had developed end stage renal disease due to ADPKD and was on hemodialysis since the past 5 years. Previously, he went through a series of workup but was left undiagnosed. Abdomen-pelvic and chest CT scan without contrast was performed showing bilateral renal pelvic stones and some nephrocalcinosis in both kidneys. bilateral ureteroscopy was performed and bilateral DJ was installed for a total of 6 weeks and extracorporeal shock wave lithotripsy was done. With prompt diagnosis, the patient was pain free and stone free before discharge. The patient is also reported to be stone free 6 months after the procedure. Conclusion: Patients on dialysis are still capable of forming symptomatic renal tract stones even if they are anuric.

scholarly journals Validity of negative bone biopsy in suspicious bone lesions

2021 ◽  
Vol 10 (7) ◽  
pp. 205846012110306
Author(s):  
Mine B Lange ◽  
Lars J Petersen ◽  
Michael B Nielsen ◽  
Helle D Zacho
Keyword(s):  
Bone Biopsy ◽  
False Negative ◽  
Exclusion Criterion ◽  
Bone Lesions ◽  
False Negatives ◽  
Patient Morbidity ◽  
Bone Biopsies ◽  
Initial Biopsy ◽  
Valid Criterion

Background The presence of malignant cells in bone biopsies is considered gold standard to verify occurrence of cancer, whereas a negative bone biopsy can represent a false negative, with a risk of increasing patient morbidity and mortality and creating misleading conclusions in cancer research. However, a paucity of literature documents the validity of negative bone biopsy as an exclusion criterion for the presence of skeletal malignancies. Purpose To investigate the validity of a negative bone biopsy in bone lesions suspicious of malignancy. Material and Method A retrospective cohort of 215 consecutive targeted non-malignant skeletal biopsies from 207 patients (43% women, 57% men, median age 64, and range 94) representing suspicious focal bone lesions, collected from January 1, 2011, to July 31, 2013, was followed over a 2-year period to examine any additional biopsy, imaging, and clinical follow-up information to categorize the original biopsy as truly benign, malignant, or equivocal. Standard deviations and 95% confidence intervals were calculated. Results 210 of 215 biopsies (98%; 95% CI 0.94–0.99) showed to be truly benign 2 years after initial biopsy. Two biopsies were false negatives (1%; 95% CI 0.001–0.03), and three were equivocal (lack of imaging description). Conclusion Our study documents negative bone biopsy as a valid criterion for the absence of bone metastasis. Since only 28% had a confirmed diagnosis of prior cancer and not all patients received adequately sensitive imaging, our results might not be applicable to all cancer patients with suspicious bone lesions.

scholarly journals Belated Diagnosis of a Primary Bone Lymphoma of the Elbow: A Rare Case and Review of the Literature

2020 ◽  
pp. 100-107
Author(s):  
Michele Boffano ◽  
Nicola Ratto ◽  
Martina Rezzoagli ◽  
Andrea Conti ◽  
Pietro Pellegrino ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Rare Disease ◽  
Rare Case ◽  
Early Stage ◽  
Bone Lesions ◽  
Review Of The Literature ◽  
Primary Bone Lymphoma ◽  
Lytic Bone Lesions ◽  
Primary Bone ◽  
Bone Lymphoma

Primary non-Hodgkin bone lymphoma (PBL) is a rare disease that accounts for <2% of all lymphomas in adults. PBL can be monostotic or polyostotic, mainly causing destructive and lytic bone lesions frequently located in the femur, humerus, and pelvis. PBL is rarely considered a differential diagnosis of the osteolytic tumor. In addition, PBL is not uncommonly diagnosed with delay because patients do not experience symptoms nor show objective abnormalities in the early stage of disease. Here, we reported a 60-year-old woman with a PBL of the elbow.

scholarly journals Short-Term High Fat Intake Does Not Significantly Alter Markers of Renal Function or Inflammation in Young Male Sprague-Dawley Rats

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Catherine Crinigan ◽  
Matthew Calhoun ◽  
Karen L. Sweazea
Keyword(s):  
Kidney Disease ◽  
Renal Mass ◽  
Early Stage ◽  
Young Male ◽  
Protective Effects ◽  
Sprague Dawley ◽  
High Fat ◽  
Short Term ◽  
Sprague Dawley Rats ◽  
The Impact

Chronic high fat feeding is correlated with diabetes and kidney disease. However, the impact of short-term high fat diets (HFD) is not well-understood. Six weeks of HFD result in indices of metabolic syndrome (increased adiposity, hyperglycemia, hyperinsulinemia, hyperlipidemia, hyperleptinemia, and impaired endothelium-dependent vasodilation) compared to rats fed on standard chow. The hypothesis was that short-term HFD would induce early signs of renal disease. Young male Sprague-Dawley rats were fed either HFD (60% fat) or standard chow (5% fat) for six weeks. Morphology was determined by measuring changes in renal mass and microstructure. Kidney function was measured by analyzing urinary protein, creatinine, and hydrogen peroxide (H2O2) concentrations, as well as plasma cystatin C concentrations. Renal damage was measured through assessment of urinary oxDNA/RNA concentrations as well as renal lipid peroxidation, tumor necrosis factor alpha (TNFα), and interleukin 6 (IL-6). Despite HFD significantly increasing adiposity and renal mass, there was no evidence of early stage kidney disease as measured by changes in urinary and plasma biomarkers as well as histology. These findings suggest that moderate hyperglycemia and inflammation produced by short-term HFD are not sufficient to damage kidneys or that the ketogenic HFD may have protective effects within the kidneys.

scholarly journals Intraocular Tuberculosis

2013 ◽  
Vol 47 (4) ◽  
pp. 193-201 ◽  
Author(s):  
Swapnil Parchand ◽  
Vishali Gupta
Keyword(s):  
Diagnostic Tests ◽  
Early Stage ◽  
Specific Treatment ◽  
Good Prognosis ◽  
Molecular Diagnostic ◽  
Interferon Gamma Release Assay ◽  
Diagnostic Challenge ◽  
Global Epidemiology ◽  
Tuberculosis Therapy ◽  
Intraocular Tuberculosis

ABSTRACT Intraocular tuberculosis remains a major diagnostic challenge and it is extremely important to establish the diagnosis as the specific treatment helps in reducing the recurrences, thus reducing ocular morbidity. The present review aims to describe the global epidemiology and pathogenesis of intraocular tuberculosis with clinical spectrum and different presentations. The challenges in establishing the diagnosis with role of conventional tests like PPD skin test as well as current diagnostic tests including interferon gamma release assay and molecular diagnostic tests are discussed. The treatment requires anti-tuberculosis therapy with the use of concomitant corticosteroids and carries good prognosis provided the treatment is started in the early stage. How to cite this article Parchand S, Gupta V, Gupta A, Sharma A. Intraocular Tuberculosis. J Postgrad Med Edu Res 2013;47(4):193-201.

Prediction of Neurological Disorders Using Visual Saliency

2021 ◽  
pp. 1-11
Author(s):  
Sreelakshmi S. ◽  
Anoop V. S.
Keyword(s):  
Neurological Disorders ◽  
Early Stage ◽  
Brain Magnetic Resonance Imaging ◽  
Visual Saliency ◽  
Machine Learning Techniques ◽  
Learning Techniques ◽  
Magnetic Resonance Imaging Mri ◽  
Processing Techniques ◽  
The Brain ◽  
Prompt Diagnosis

Neurological disorders are diseases of the central and peripheral nervous system and most commonly affect middle- or old-age people. Accurate classification and early-stage prediction of such disorders are very crucial for prompt diagnosis and treatment. This chapter discusses a new framework that uses image processing techniques for detecting neurological disorders so that clinicians prevent irreversible changes that may occur in the brain. The newly proposed framework ensures reliable and accurate machine learning techniques using visual saliency algorithms to process brain magnetic resonance imaging (MRI). The authors also provide ample hints and dimensions for the researchers interested in using visual saliency features for disease prediction and detection.

Obstructive Uropathies

2019 ◽  
pp. 175-182
Author(s):  
Priya Deshpande ◽  
Shuchita Sharma
Keyword(s):  
Urinary Tract ◽  
Imaging Modality ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Flank Pain ◽  
Permanent Damage ◽  
Extrinsic Compression ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Obstructive Uropathy remains an important cause of acute kidney injury. The etiology of obstructive uropathy can be very variable ranging from extrinsic compression of the urinary tract by tumors or surrounding structures to intraluminal obstruction by crystals and stones. Patients with obstructive uropathy manifest symptoms based on the area of obstruction within the urinary tract. Flank pain, hematuria, and suprapubic discomfort are some of the associated symptoms. The diagnosis of obstructive uropathy requires a high index of suspicion and, depending on its nature, can be confirmed clinically and/or with an imaging modality. Prompt diagnosis and treatment with effective relief of obstruction is important in preventing long-term and permanent damage to the kidneys.

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