Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review

We present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticulonodular shadows. Hematological, immunological, and microbiological tests for hepatitis, lymphoma, AIDS, and immunoglobulin deficiencies were negative. Laboratory tests demonstrated elevated erythrocyte sedimentation rate, elevated plasma and urinary ß2-microglobulin (ß2-MG) levels, and elevated C-reactive protein and fibrinogen. Both blood routine and bone marrow aspiration showed elevated eosinophil granulocytes. The diagnosis of cryptococcal lymphadenitis was obtained by excisional biopsy of the cervical lymph nodes. The patient was treated with intravenous amphotericin B and oral flucytosine for five weeks, then with subsequent oral fluconazole for three months. The patient is now doing well. Our case suggests that the diagnosis of cryptococcal lymphadenitis is very difficult without etiology and pathology, especially for a patient with a normal immune system; lymph node biopsy is necessary to diagnose it, and immediate antifungal treatment is necessary to treat it.

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Relapsing Kikuchi-Fujimoto Disease Requiring Prolonged Steroid Therapy

Case Reports in Emergency Medicine ◽

10.1155/2019/6405687 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Ulrich Gerwig ◽

Rolf Guenter Weidmann ◽

Gregor Lindner

Keyword(s):

Lymph Nodes ◽

Steroid Therapy ◽

Lymph Node Biopsy ◽

Therapeutic Trial ◽

Cervical Lymph Nodes ◽

Recurrent Headache ◽

Node Biopsy ◽

History Of ◽

Necrotizing Lymphadenitis ◽

Inflammatory Drugs

We report the case of a 26-year-old woman with an eight-week history of painfully enlarged cervical lymph nodes, recurrent headache, and malaise. Her medical history was unremarkable. The physical examination showed multiple enlarged cervical lymph nodes. Laboratory examination was unremarkable, and magnetic resonance tomographic imaging showed multiple enlarged cervical lymph nodes with aspect of a lymphoma. Lymph node biopsy revealed Kikuchi-Fujimoto disease, histologically characterized by histiocytic necrotizing lymphadenitis. A therapeutic trial with nonsteroidal anti-inflammatory drugs (NSAID) showed no effect, so steroid therapy was started. Due to relapse of symptoms after steroid withdrawal the tapering regimen was prolonged for a total of seven months.

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Ocular non-teratoid medulloepithelioma with teratoid metastases in ipsilateral intraparotid lymph nodes

European Journal of Ophthalmology ◽

10.1177/1120672119870079 ◽

2019 ◽

pp. 112067211987007

Author(s):

Jayati Sarangi ◽

Aanchal Kakkar ◽

Diya Roy ◽

Rishikesh Thakur ◽

Chirom Amit Singh ◽

...

Keyword(s):

Lymph Nodes ◽

Histopathological Examination ◽

Previous History ◽

Rare Presentation ◽

Cervical Lymph Nodes ◽

Extranodal Extension ◽

Positron Emission ◽

Parotid Neoplasm ◽

History Of ◽

The Right

Purpose: To describe a rare presentation of a case of intraocular non-teratoid medulloepithelioma with teratoid metastases in ipsilateral intraparotid lymph nodes. Case description: A 9-year-old male child with previous history of ciliary body non-teratoid medulloepithelioma presented with a swelling in the right pre-auricular region for 1 month. Magnetic resonance imaging and positron emission tomography–computed tomography showed a right intraparotid mass with enlarged ipsilateral cervical lymph nodes. A core biopsy was taken from the lesion, which on microscopy showed a tumor composed of small round cells arranged in cords, tubules lined by multilayered cells, and in cribriform pattern. These cells were embedded in a hypocellular, loose myxoid matrix. Based on the histopathological characteristics and previous history, a diagnosis of medulloepithelioma metastastic to ipsilateral parotid gland was made. The patient underwent right total conservative parotidectomy and bilateral neck dissection. Histopathological examination revealed metastatic medulloepithelioma in five out of eight intraparotid lymph nodes, with extranodal extension into the adjacent parotid parenchyma. Foci of hyaline cartilage were identified within the tumor, leading to a diagnosis of metastatic teratoid medulloepithelioma. Conclusion: Intraparotid lymph node metastases from intraocular medulloepithelioma is a rare possibility and we recommend that the parotid should be evaluated in cases of intraocular medulloepithelioma at initial presentation as well as during the follow-up period. Also, metastasis should be considered in all pediatric patients with solitary mass lesions showing unconventional histology for a primary parotid neoplasm.

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Serendipitous Detection of Cervical Nodal Metastasis in Glomus Jugulare

Indian Journal of Neurosurgery ◽

10.1055/s-0038-1639383 ◽

2018 ◽

Vol 07 (03) ◽

pp. 256-259

Author(s):

Shruti Venkitachalam ◽

Rayappa Chinnusamy ◽

Narendranath Ashok ◽

Swatee Halbe

Keyword(s):

Radiation Therapy ◽

Lymph Nodes ◽

Neck Dissection ◽

Similar Pattern ◽

Adjuvant Radiotherapy ◽

Nodal Metastasis ◽

Cervical Lymph Nodes ◽

Glomus Jugulare ◽

History Of

AbstractWe present the case of a 50-year-old man who presented to us with a history of having received radiation therapy for a glomus jugulare tumor. He had been on regular follow-up with serial imaging scans. The MRI done after 4 years of treatment revealed an interval increase in size. Carotid angiogram revealed, in addition to the glomus, multiple lymph nodes of similar pattern of vascularity, well lateral to the carotid sheath, in the ipsilateral neck. He underwent resection of the tumor and a neck dissection. Histopathology confirmed metastatic glomus jugulare in the cervical lymph nodes. He received adjuvant radiotherapy and is doing well.

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Causes and Presentation Of Cervical Lymphadenopathy

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.4-2.21 ◽

2018 ◽

Vol 4 (2) ◽

pp. 31-35

Author(s):

Arifullah Bangash ◽

Syed Zafar Hassan ◽

Ghulam Muhammad

Keyword(s):

Lymph Nodes ◽

Teaching Hospital ◽

Acute Inflammation ◽

Cervical Lymphadenopathy ◽

Excisional Biopsy ◽

Descriptive Study ◽

Lymph Node Involvement ◽

Cervical Lymph Nodes ◽

Node Involvement ◽

Reactive Hyperplasia

OBJECTIVETo determine the proportion of cervical lymphadenopathy in systemic diseases, their presentation and investigative tools.METHODOLOGYThis descriptive study was carried out from 1st July 2014 to 30 June 2017 in ENT and head and neck department Naseer Teaching Hospital and Town Teaching Hospital, Peshawar. Total of 270 patients with enlarged cervical lymph nodes, of either sex and of any age were approached for inclusion into the study. Patients with suspected acute inflammation were given a trial of antibiotic and followed for two weeks were excluded from the study. Excisional biopsy of the lymph nodes was performed in all these patients with six weeks or more duration.RESULTSIn our study out of 270 patients, 158 (58.5%) were males and the majority of patients (63.3%) had ages from 11-40 years. Tuberculous cervical lymphadenopathy was diagnosed in 145 (53.7%) patients, reactive hyperplasia in 53 (19.6%), lymphoma in 32 (11.8 %,) metastasis to cervical lymph nodes in 30 (11.1%), sarcoidosis in 7 (2.6%) and other very rare conditions as Kawasaki, Kikuchie and Rosi Dorfman were found in only one of each (0.4%). About 136 (50.4%) of the patients had involvement of multiple lymph nodes while 134 (49.6%) had single swelling. The matted lymph nodes were found in 162 (60%) whereas discrete lymph nodes were found in only 108 (40%) cases. Cold abscess was found in 19 (7%) of patients.CONCLUSIONTuberculosis is the commonest cause of cervical lymphadenopathy, with the majority of these patients having multiple lymph node involvement. In children, usually cervical lymphadenopathy is reactive or infective while in older age mostly metastatic.

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Thyroid metastases from breast carcinoma: case report and review of literature

10.21203/rs.3.rs-45880/v1 ◽

2020 ◽

Author(s):

Yichao Wang ◽

Shengliang Zhou ◽

Boyang Yu ◽

Ping Zhou ◽

Zhihui Li ◽

...

Keyword(s):

Breast Carcinoma ◽

Lymph Nodes ◽

Distant Metastases ◽

Needle Aspiration ◽

Thyroid Lesion ◽

Cervical Lymph Nodes ◽

Left Chest ◽

History Of ◽

Thyroid Metastases ◽

The Right

Abstract Rationale: The thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2%.Patient concerns: We report a case of 54-year-old woman with a history of breast carcinoma presented with diffuse scattered microcalcifications in thyroid and enlarged bilateral cervical lymph nodes detected on ultrasound (US). Physical examination of the patient revealed stiff and enlarged thyroid lobes.Diagnoses: FNAB and immunohistochemistry （IHC）of the thyroid lesion confirmed the thyroid metastases from breast cancer.Interventions and outcomes: Due to the comorbidities of breast carcinoma metastases to the right axillary, cervical lymph nodes and left chest wall, the patient received chemotherapy. After a follow-up of 10 months, the patient was alive without any new distant metastases.Lessons: Our case highlights that thyroid metastases should be considered in a patient combined with thyroid lesions and a history of breast carcinoma. IHC played an important role in differentiating thyroid metastases from primary thyroid cancer.

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The Use of Neck Sonography in Identifying Cervical Lymph Node: A Single Center Study from 2019 to 2020

Jundishapur Journal of Chronic Disease Care ◽

10.5812/jjcdc.112926 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Azim Motamedfar ◽

Mohammad Momen Gharibvand ◽

Mojgan Sametzade ◽

Mahsa Akhavan Sabagh

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Cervical Lymphadenopathy ◽

Primary Source ◽

Needle Aspiration ◽

Tnm Staging ◽

Lymph Node Biopsy ◽

Cervical Lymph Nodes ◽

Primary Tumors ◽

Neck Lymph Node

Background: Tumor metastasis, as one of the most important prognostic factors in solid tumors, affects survival remarkably. Cervical lymphadenopathy (LAP) reflects an advanced-stage disease and changes the tumor-node-metastasis (TNM) staging of tumor, resulting in a multidisciplinary approach to the management of cancer. Objectives: This study aimed to assess the importance of neck sonography in monitoring primary tumors. Methods: Records of 166 patients with distant primary cancers who underwent neck sonography from February 2019 to February 2020 were studied. Abnormal lymph nodes were reported, and then the patients underwent neck sonography and fine needle aspiration (FNA) or core needle biopsy (CNB) under direct US guidance. Thirty-two patients who were confirmed for malignant cervical LAP underwent neck lymph node biopsy as an easy and safe way to provide tissue diagnosis instead of providing biopsy from the primary source of tumor. Results: Malignant cervical LAP was confirmed in 32 patients (19.2%) by neck sonography. Seventy-seven patients (46.4%) were male and 89 patients (53.6%) were female. The patients were 22 to 88 years old (mean age = 57.7 years; standard deviation = 12.7). Thirty-two patients (19.2%) had pathological cervical lymph nodes and 134 patients (80.8%) did not have. Conclusions: Metastatic cervical LAP found by neck ultrasound will change pretreatment TNM staging of disease to provide optimal treatment on a case-by-case basis. According to the result of this study, routine neck sonography in patients with distant primary tumors is recommended.

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Aseptic Meningitis in the Decennium of Borrelia burgdorferi Infection (Lyme Disease)

PEDIATRICS ◽

10.1542/peds.87.2.268a ◽

1991 ◽

Vol 87 (2) ◽

pp. 268-269

Author(s):

CHRISTOPH AUFRICHT ◽

WILLI TENNER ◽

GEROLD STANEK

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Physical Examination ◽

Lymph Nodes ◽

Sore Throat ◽

Aseptic Meningitis ◽

Cervical Lymph Nodes ◽

Nuchal Rigidity ◽

History Of ◽

The Right

To the Editor.— A 7-year-old boy with a 2-week history of fatigue, sore throat, and swelling of the right cheek was admitted to our hospital in May 1989. He had no history of intoxication, trauma, fever, or bite. He lived in Vienna and did not travel outside Austria.1 His mother was concerned about his irritability and emotional liability. Physical examination revealed mild hyperemia of his pharynx and ear drums. There were enlarged cervical lymph nodes and mild nuchal rigidity.

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Silicone granuloma: a cause of cervical lymphadenopathy following breast implantation

BMJ Case Reports ◽

10.1136/bcr-2020-239395 ◽

2021 ◽

Vol 14 (3) ◽

pp. e239395

Author(s):

Amarkumar Dhirajlal Rajgor ◽

Youssef Mentias ◽

Francis Stafford

Keyword(s):

Lymph Nodes ◽

Core Biopsy ◽

Cervical Lymphadenopathy ◽

Breast Implants ◽

Cervical Lymph Nodes ◽

History Of ◽

Neck Lump ◽

Breast Implantation ◽

Silicone Granuloma ◽

Nose And Throat

We report a case of a 54-year-old woman with saline-based breast implants who presented to the ear, nose and throat neck lump clinic with a 2-week history of bilateral neck lumps. She was found to have multiple palpable cervical lymph nodes bilaterally in levels IV and Vb. The ultrasonography demonstrated multiple lymph nodes with the snowstorm sign and a core biopsy confirmed a silicone granuloma (siliconoma). This granuloma was likely caused by bleeding gel from the silicone shell of her saline-based implants. This case demonstrates the importance of bleeding gel from saline-based implants, in the absence of implant rupture. Thus, head and neck specialists should consider siliconomas as a cause for cervical lymphadenopathy in patients with saline-based breast implants.

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Plexiform Vasculopathy in Feline Cervical Lymph Nodes

Veterinary Pathology ◽

10.1177/0300985817747949 ◽

2018 ◽

Vol 55 (3) ◽

pp. 453-456 ◽

Cited By ~ 2

Author(s):

Nicole Jungwirth ◽

Johannes Junginger ◽

Christoph Andrijczuk ◽

Wolfgang Baumgärtner ◽

Peter Wohlsein

Keyword(s):

Endothelial Cells ◽

Lymph Node ◽

Thyroid Gland ◽

Lymph Nodes ◽

Lymphoid Tissue ◽

Vascular Endothelial ◽

Cervical Lymph Nodes ◽

Vascular Neoplasms ◽

History Of ◽

Well Differentiated

Plexiform vasculopathy refers to an endothelial proliferative disorder affecting cervical or inguinal lymph nodes of cats. The cause of this disorder and the origin of the proliferating endothelial cells are still unknown. In 4 cats with a history of a slowly growing, well-demarcated, nonpainful mass adjacent to the thyroid gland, an enlarged dark brown to red lymph node was removed. Histologically, the lymph nodes showed severe loss of lymphoid tissue with accumulations of erythrocytes. In addition, networks of capillary structures with well-differentiated endothelial cells on a collagen-rich stroma were observed, consistent with benign plexiform vasculopathy. Immunohistochemistry revealed the expression of the vascular endothelial markers CD31 and factor VIII–related antigen. In addition, immunolabeling with a Prox-1 antibody indicated a lymphendothelial origin. With respect to our findings, a lymphendothelial origin has to be considered in cases of intranodal vascular neoplasms.

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The Diagnostic Yield of Excisional Biopsy in Cervical Lymphadenopathy: A Retrospective Analysis of 158 Biopsies in Adults

Ear Nose & Throat Journal ◽

10.1177/01455613211023009 ◽

2021 ◽

pp. 014556132110230

Author(s):

Mohamed Bassiouni ◽

Gyeongphill Kang ◽

Heidi Olze ◽

Steffen Dommerich ◽

Philipp Arens

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Retrospective Analysis ◽

Malignant Disease ◽

Diagnostic Yield ◽

Cervical Lymphadenopathy ◽

Excisional Biopsy ◽

Lymph Node Biopsy ◽

Adult Patients ◽

Node Biopsy

Objectives: Cervical lymph nodes are the most common site of peripheral lymphadenopathy. The underlying etiologies are usually benign and self-limiting but may include malignancies or other severe life-threatening diseases. The aim of the current study was to investigate the various underlying pathologies of cervical lymphadenopathy as assessed by the diagnostic yield of excisional lymph node biopsies of the neck in a tertiary adult practice. The evaluation was performed in light of previous literature and regional epidemiological patterns. Methods: Retrospective analysis of hospital charts of 158 adult patients who underwent an excisional biopsy for suspected cervical lymphadenopathy at a tertiary referral head and neck service between January 2017 and December 2019. Results: The most common underlying pathology was unspecific and/or reactive lymphadenitis in 44.5% of specimens, followed by malignant disease in 38.6% of cases. An age above 40 years was significantly correlated with an increased likelihood of malignant disease. Lower jugular and posterior triangle lymph nodes showed higher malignancy rates than other groups (100% and 66.7%, respectively). The overall surgical complication rate was 2.5%. Conclusions: The results of the current study serve as an indicator of the variety of etiologies causing cervical lymphadenopathy. In particular, given the increasing incidence of malignant diseases in recent decades, the findings should alert physicians to the importance of lymph node biopsy for excluding malignancy in persistent cervical lymphadenopathy especially in older adults. The findings emphasize the value of excisional lymph node biopsy of the neck as a useful diagnostic tool in adult patients with peripheral lymphadenopathy.

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