scholarly journals Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Robert Rejdak ◽  
Pavel Pogorelov ◽  
Christian Y. Mardin ◽  
Małgorzata Szkaradek ◽  
Anselm G. M. Juenemann
Keyword(s):  
Correct Diagnosis ◽  
Complete Recovery ◽  
Vascular Tumor ◽  
Pulmonary Involvement ◽  
Epithelioid Cell ◽  
Complete Disappearance ◽  
Initial Examination ◽  
Central Necrosis ◽  
Conjunctival Biopsy ◽  
Systemic Examination

Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy.Patient. A 25-year-old man was referred to our department for further management of an “iris tumor with iridocyclitis” in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function.Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.

scholarly journals Sooty bark disease of maples: the risk for hypersensitivity pneumonitis by fungal spores not only for woodman

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Markus Braun ◽  
Doris Klingelhöfer ◽  
David A. Groneberg
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Correct Diagnosis ◽  
Fungal Spores ◽  
Paper Mill ◽  
Complete Recovery ◽  
Interstitial Lung Diseases ◽  
Acer Pseudoplatanus ◽  
Occupational Physicians ◽  
Mould Fungus ◽  
Public Areas

AbstractIn the middle of the twentieth century, the from North America sooty bark disease (SBD) of maples was first discovered in England and has spread in the last decades in Central Europe, in particular. The trigger of SBD is the mould fungus Cryptostroma (C.) corticale. The most common infested maple is the sycamore, Acer pseudoplatanus, a common tree in woods and parks. The disease is characterised by peeling of the outer layer of the bark and brownish-black spores under the peeled off bark. These spores can cause maple bark disease (MBD) in humans, a hypersensitivity pneumonitis (HP) with similar symptoms like COPD, allergic asthma, influenza or flu-like infections and interstitial pneumonia. Persons who have intensive respectively occupational contact with infested trees or wood, e.g., woodman, foresters, sawyers or paper mill workers, are at risk in particular. Since C. corticale favours hot summers and host trees weakened by drought, SBD will increasingly spread in the future due to ongoing climate change. Consequently, the risk of developing MBD will increase, too. As with all HPs, e.g., farmer’s lung and pigeon breeder’s disease, the diagnosis of MBD is intricate because it has no clear distinguishing characteristics compared to other interstitial lung diseases. Therefore, the establishment of consistent diagnosis guidelines is required. For correct diagnosis and successful therapy, multidisciplinary expertise including pulmonologists, radiologists, pathologists and occupational physicians is recommended. If MBD is diagnosed in time, the removal of the triggering fungus or the infested maple wood leads to complete recovery in most cases. Chronic HP can lead to lung fibrosis and a total loss of lung function culminating in death. HP and, thus, MBD, is a disease with a very high occupational amount. To avoid contact with spores of C. corticale, persons working on infested wood or trees have to wear personal protective equipment. To protect the public, areas with infested maples have to be cordoned off, and the trees should be removed. This is also for impeding further spreading of the spores.

scholarly journals Kaposiform Hemangioendothelioma: clinicopathological characteristics of 8 cases of a rare vascular tumor and review of literature

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qurratulain Chundriger ◽  
Muhammad Usman Tariq ◽  
Jamshid Abdul-Ghafar ◽  
Arsalan Ahmed ◽  
Nasir Ud Din
Keyword(s):  
Pediatric Population ◽  
Adult Population ◽  
Correct Diagnosis ◽  
Kaposi Sarcoma ◽  
Minor Component ◽  
Vascular Tumor ◽  
Giant Cells ◽  
Clinicopathological Characteristics ◽  
Multinucleated Giant Cells ◽  
Kaposiform Hemangioendothelioma

Abstract Background Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumor of intermediate malignant potential which shows locally aggressive growth but only rarely metastasizes. It is mostly considered to be a tumor of pediatric population but its occurrence in the adults is not uncommon as once considered. Histologically, KHE can mimic other soft tissue neoplasms of different behaviors (e.g. Kaposi Sarcoma, hemangioma) and establishing the correct diagnosis is important for appropriate treatment. Herein, we describe the clinicopathological features of 8 cases of KHE which will be helpful in making their diagnosis. Methods We reviewed pathology reports, microscopy glass slides and obtained follow up information about 8 cases of KHE which were diagnosed at our institution from January 2008 till June 2020. Immunohistochemical stain for HHV8 was also performed. Results Age ranged from 7 months to 25 years. Seven patients were less than 20 years of age and one patient was 25 years old. Equal gender distribution was observed. Extremities were the most common sites of involvement, followed by head and neck, pancreas and ischiorectal region. 2 cases were resection specimen and all others were incisional biopsies. The largest tumor size was 5.5 cm in one of the resections. The incisional/fragmented tissues were all less than 5 cm in aggregate. Most cases showed predominance of nodular growth and a minor component of spindle cell population along with lymphangiomatosis like vascular channels, with evidence of microthrombi in 2 cases. Few multinucleated giant cells were observed in 2 cases. None of the cases exhibited significant nuclear atypia or mitotic activity. One of the cases arising in dermis showed underlying bone involvement. HHV8 was negative in 7/7 cases. Conclusions KHE can also involve adult population and it should always be considered in the differential diagnoses of a vascular lesion. Presence of multinucleated giant cells is a rare finding. Knowledge about histological features and potential mimics is helpful in avoiding misdiagnosis.

scholarly journals Penile Mondor’s disease: a case report

2013 ◽  
pp. 37-39
Author(s):  
M. Bolognesi
Keyword(s):  
Case Report ◽  
Clinical Diagnosis ◽  
General Practitioners ◽  
Correct Diagnosis ◽  
Complete Recovery ◽  
Benign Condition ◽  
Dorsal Vein ◽  
Mondor’S Disease ◽  
Mondor's Disease ◽  
Appropriate Therapy

CASE REPORT This article describes a case report with a review of the symptomatology diagnosis, and treatment of thrombophlebitis in the superficial dorsal vein of the penis. Penile Mondor’s disease is a benign condition, and after appropriate therapy, near complete recovery takes place within three weeks. DISCUSSION Thrombophlebitis of the superficial dorsal vein of the penis (Penile Mondor’s disease) is a rare, but important clinical diagnosis that any physician, and in particular general practitioners, should be able to recognize. Indeed, correct diagnosis and consequent reassurance can help to control the anxiety typically experienced by patients suffering from the disease.

scholarly journals Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

2020 ◽  
Author(s):  
Ellahe Azizlou ◽  
Mohsen AminSobhani ◽  
Sholeh Ghabraei ◽  
Mehrfam Khoshkhounejad ◽  
Abdollah Ghorbanzadeh ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Cutaneous Lesions ◽  
Odontogenic Origin ◽  
The Face ◽  
History Of ◽  
Relationship Of ◽  
Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

Pulmonary Langerhans Cell Histiocytosis and Other Pulmonary Histiocytic Diseases: A Review

2008 ◽  
Vol 132 (7) ◽  
pp. 1171-1181 ◽  
Author(s):  
Timothy Craig Allen
Keyword(s):  
Literature Review ◽  
Langerhans Cell Histiocytosis ◽  
Correct Diagnosis ◽  
Pulmonary Involvement ◽  
Langerhans Cell ◽  
Data Sources ◽  
Primary Material ◽  
Pulmonary Langerhans Cell Histiocytosis

Abstract Context.—Pulmonary Langerhans cell histiocytosis is the most common and best known pulmonary histocytic lesion; however, the realm of pulmonary histiocytic lesions also includes an assortment of uncommon diseases that may exhibit pulmonary involvement. Objective.—To review pulmonary Langerhans cell histiocytosis and other pulmonary histiocytoses to better ensure correct diagnosis and optimal assessment of prognosis and treatment. Data Sources.—Literature review and primary material from the author's institution. Conclusions.—This review discusses the most common pulmonary histocytosis, pulmonary Langerhans cell histiocytosis, and also reviews the uncommon pulmonary histiocytic lesions, which are distinct from pulmonary Langerhans cell histiocytosis.

Epithelioid Cell Clusters With an Extensive Lymphoid Background

2007 ◽  
Vol 131 (3) ◽  
pp. 424-433
Author(s):  
Matthew A. Zarka
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Correct Diagnosis ◽  
Diagnostic Category ◽  
Needle Aspiration ◽  
Epithelioid Cell ◽  
Common Pattern ◽  
Fine Needle ◽  
Cell Clusters ◽  
Architectural Pattern

Abstract Context.—Fine-needle aspiration of salivary gland lesions can be particularly challenging for pathologists. There are numerous neoplasms that occur in this area and several cytologic variations of each specific lesion. Objective.—To present and discuss a practical pattern recognition approach to fine-needle aspiration diagnosis, which includes categorizing lesions that share a certain overall cytologic architectural pattern, followed by identifying unique cellular characteristics that are specific to a certain lesion. An extensive discussion of one cytologic common pattern of salivary gland lesions, “epithelioid cell clusters with an extensive lymphoid background,” is presented. The pathologic entities that fall under this architectural pattern group are discussed, with an emphasis on neoplasms. Data Sources.—Published literature and personal experience. Conclusions.—A practical cytologic architectural pattern method can aid the pathologist in rendering a correct diagnosis when evaluating salivary gland lesions. One common pattern in salivary gland cytopathology is epithelioid cell clusters with an extensive lymphoid background. This pattern is often associated with Warthin tumor; however, other benign and malignant entities fall under this diagnostic group. Unique cytologic features separate these lesions into their respective diagnostic category.

Epithelioid Angiomyolipoma: A Morphologically Distinct Variant That Mimics a Variety of Intra-abdominal Neoplasms

2011 ◽  
Vol 135 (5) ◽  
pp. 665-670
Author(s):  
Ozgur Mete ◽  
Theodorus H. van der Kwast
Keyword(s):  
Correct Diagnosis ◽  
Smooth Muscle Tumor ◽  
Epithelioid Cell ◽  
Cell Phenotype ◽  
Renal Oncocytoma ◽  
Nerve Sheath Tumor ◽  
Epithelioid Angiomyolipoma ◽  
Perivascular Epithelioid Cell ◽  
Show Evidence ◽  
Clear Cytoplasm

Abstract This review examines the histopathologic, immunohistochemical, ultrastructural, and molecular biologic features of epithelioid angiomyolipoma (EAML), with an emphasis on the differential diagnosis of intra-abdominal EAML. Epithelioid angiomyolipoma is an uncommon mesenchymal tumor with malignant potential, frequently associated with tuberous sclerosis complex. Histologically, EAML is characterized by sheets or nests of large polygonal epithelioid cells with abundant eosinophilic or occasionally clear cytoplasm, often with prominent nucleoli, and EAML may include multinucleated and markedly pleomorphic forms. As these tumors share a distinctive perivascular epithelioid cell phenotype, they belong to the PEComa tumor family. Nearly all EAMLs show immunoreactivity for both melanocytic and myoid markers. Ultrastructurally, EAMLs show evidence of melanogenesis by the presence of premelanosomes. Epithelioid angiomyolipoma can pose significant diagnostic challenges as it mimics morphologically a variety of neoplasms including renal cell carcinoma, renal oncocytoma, adrenal cortical neoplasm, epithelioid smooth muscle tumor, epithelioid peripheral nerve sheath tumor, epithelioid gastrointestinal stromal tumor, epithelioid melanoma, hepatoblastoma, and hepatocellular carcinoma. The variation in immunophenotype in these tumors requires a prudent use of immunohistochemistry, which may occasionally need complementation by electron microscopy to establish the correct diagnosis.

scholarly journals Angiosarcoma of the lung

2016 ◽  
Vol 42 (1) ◽  
pp. 68-70 ◽  
Author(s):  
Mónica Grafino ◽  
Paula Alves ◽  
Margarida Mendes de Almeida ◽  
Patrícia Garrido ◽  
Direndra Hasmucrai ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Vascular Tumor ◽  
Pulmonary Involvement ◽  
Hematogenous Metastasis ◽  
Rare Neoplasm ◽  
Local Invasion

Angiosarcoma is a rare malignant vascular tumor. Pulmonary involvement is usually attributable to metastasis from other primary sites, primary pulmonary angiosarcoma therefore being quite uncommon. We report a case of angiosarcoma with pulmonary involvement, probably primary to the lung, which had gone untreated for more than two years. We describe this rare neoplasm and its growth, as well as the extensive local invasion and hematogenous metastasis at presentation. We also discuss its poor prognosis.

scholarly journals Nasal Glial Heterotopia: Unsuspected Brain Tissue in the Nasopharynx

2013 ◽  
Vol 28 (2) ◽  
pp. 18-21
Author(s):  
Dan Valeriano F. Daffon ◽  
Alberto F. Calderon ◽  
Francisco A. Victoria
Keyword(s):  
Brain Tissue ◽  
Pediatric Patient ◽  
Treatment Plan ◽  
Preoperative Evaluation ◽  
Correct Diagnosis ◽  
Vascular Tumor ◽  
Tissue Mass ◽  
Nasal Mass ◽  
Diagnostic Difficulties ◽  
Glial Heterotopia

Objective: To report a case of ectopic brain tissue in the nasopharynx; discuss the differential diagnoses for and management of, this unilateral nasal mass in a pediatric patient, and describe the diagnostic difficulties and eventual treatment. Methods: Study Design:      Case Report Setting:                 Tertiary Government Hospital Participant:                      One   Results:  A 13-year-old boy consulted with an obstructing mass in the nasopharynx and severe muscle wasting, weight below his age and concurrent anemia.  CT-scan revealed a soft-tissue mass occupying a maxillary sinus and nasopharynx consistent with an antrochoanal polyp.  Initial biopsy revealed a papilloma, but the clinical picture warranted preoperative preparations for a possible vascular tumor such as juvenile angiofibroma.  Transpalatal excision and final histopathology yielded nasal glial heterotopia.  Conclusion: When confronted with a unilateral nasal mass in a pediatric patient, aside from the usual considerations, embryologic anomalies particularly those of the intracranial protrusion variety should be strongly considered. Scrupulous preoperative evaluation and sufficient diagnostic modalities must be pursued in order to arrive a correct diagnosis, treatment plan and prevent possible complications especially those related to intracranial communication. Keywords: Nasal glioma, glial heterotopia, congenital nasal masses

scholarly journals Spontaneous remission of the mandibular nerve paresthesia: a case report

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Ronald Jefferson Martins ◽  
Naiana de Melo Belila ◽  
Mayumi Domingues Kato ◽  
Cléa Adas Saliba Garbin
Keyword(s):  
Case Report ◽  
Correct Diagnosis ◽  
White Male ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Spontaneous Remission ◽  
Complete Recovery ◽  
Nerve Fibers ◽  
Mandibular Nerve ◽  
Transient Loss

Introduction: Paresthesia is usually characterized by a transient loss of sensitivity in the area covered by the affected nerve. Different causes may lead to this occurrence; among them, the injury of nerve structures during the extraction of third molars. The sensitivity recovery depends on the regeneration of the nerve fibers, and in most cases it occurs spontaneously. In some situations, there is a need for a more invasive and expensive treatments to the patient. Objective: The aim of this study was to evaluate the spontaneous remission of the inferior alveolar nerve paresthesia. Case report: We studied a 34 year-old patient, white, male, which presented paresthesia of the inferior alveolar nerve after extraction of the lower right third molar. We chose to wait for the spontaneous return of the sensitivity, which occurred between the first and second postoperative month. Conclusion: The complete recovery of the sensitivity does not occur in all cases, even with the recommended treatments. So the best way to deal with paresthesia is prevention, where the dentist must perform the correct diagnosis with the aid of the necessary additional tests; besides having skill and dexterity in handling the instruments, so that the surgery would be performed safely and without any complications for the patient.Descriptors: Paresthesia; Remission, Spontaneous; Mandibular Nerve.

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