Massive Haemoptysis due to Obscure Aetiology: Perils and Management Dilemmas

Pulmonary actinomycosis is an important differential diagnosis in patients with long-standing pulmonary infiltrates related to poor oral hygiene or compromised immune function. Up to a quarter of cases of thoracic actinomycosis are misdiagnosed as lung malignancy. Here, we report a 56-year-old man with a hypodense lesion in the left lower lobe presenting with recurrent massive haemoptysis for about one year. He underwent left lower lobe lobectomy due to intractable haemoptysis. Histopathological examination demonstrated actinomycosis infiltrating the left lower lobe. Rarity of the case was the presence of actinomycosis in an immunocompetent individual and without underlying preexisting lung disease. Also, intractable massive haemoptysis necessitating surgical excision which proved to be both diagnostic and curative due to actinomycosis is an unusual occurrence.

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Ameloblastic Fibrosarcoma of the Mandible: A Case Report and Brief Review of the Literature

Case Reports in Pathology ◽

10.1155/2015/245026 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Abelardo Loya-Solis ◽

Karla Judith González-Colunga ◽

Cynthia M. Pérez-Rodríguez ◽

Natalie Sofía Ramírez-Ochoa ◽

Luis Ceceñas-Falcón ◽

...

Keyword(s):

Histopathological Examination ◽

Surgical Excision ◽

Second Molar ◽

Odontogenic Epithelium ◽

Left Mandible ◽

Long Term Follow Up ◽

History Of ◽

Ameloblastic Fibrosarcoma ◽

Mitotic Figures ◽

One Year

Ameloblastic fibrosarcoma is an uncommon odontogenic tumor composed of a benign epithelial component and a malignant ectomesenchymal component most frequently seen in the third and fourth decades of life. It mainly presents as a painful maxillary or mandibular swelling. Radiographs show a radiolucent mass with ill-defined borders. Radical surgical excision and long-term follow-up are the suggested treatment. We report the case of a 22-year-old female with a 2-month history of an asymptomatic swelling in her left mandible. Examination revealed an exophytic growth measuring3×3 cm extending from the mandibular left first premolar to the second molar. The patient underwent a left hemimandibular resection. Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

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Multiple endo bronchial lipoma: a rare case report

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01287-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shunjin Zhao ◽

Yuexiang Shui ◽

Zhong Dai

Keyword(s):

Rare Case ◽

Histopathological Examination ◽

Main Bronchus ◽

Tumor Resection ◽

Lower Lobe ◽

Left Main Bronchus ◽

Left Lower Lobe ◽

Heavy Smoker ◽

Left Main ◽

Segmental Bronchus

Abstract Background Endobronchial lipoma is an extremely rare benign tumor, which is generally located in the first three subdivisions of the tracheobronchial tree. According to the existing literature, all endobronchial lipomas are single (one per patient). Here, we report a rare case in which the patient presented with two endobronchial lipomas in the same patient, and underwent a bronchoscopic tumor resection in the left main bronchus and the left lower bronchus. Both tumors were pathologically confirmed as endobronchial lipoma. Case presentation A 52-year-old Chinese man presented at the clinic reporting a mild cough with yellow color sputum and exertional dyspnea for 2 weeks. He was a heavy smoker (45 pack-years). Chest auscultation demonstrated faint wheezing in left lower lobe. Computed tomography (CT) revealed two low-density endobronchial masses located in the middle segment of the left main bronchus and the posterior basilar segmental bronchus of the left lower lobe. The neoplasms measured a CT-attenuation value of -70HU, −98HU in density with air trapping and atelectasis in the segmental bronchus of the left lower lobe. The patient underwent interventional bronchoscopic management to remove the neoplasms by using an electrosurgical snare, cryotherapy, and electrocautery. The locations of the neoplasms were confirmed at the left main bronchus and the superior segment of the left lower lobe during bronchoscopic intervention. Histopathological examination confirmed that both tissues were consistent with lipomas. After 18 months of follow-up, the patient was free of symptoms and CT revealed that bronchiectasia remained in the superior segment of the left lower lobe; however, no mass lesion was present in the left bronchus. Conclusions This case suggests that an endobronchial lipoma can present as multiple lesions, and both proximal and distal types can simultaneously occur in the same patient. Thus, these findings help us further understand the biology of endobronchial lipomas.

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Contiguous Metastasis of Pulmonary Adenocarcinoma to Meningioma

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1669471 ◽

2018 ◽

Vol 80 (02) ◽

pp. 127-130 ◽

Cited By ~ 3

Author(s):

Masato Nakaya ◽

Yutaka Kurebayashi ◽

Youichi Mochizuki ◽

Raita Fukaya ◽

Masahito Fukuchi ◽

...

Keyword(s):

Tumor Metastasis ◽

Cancer Metastasis ◽

Lower Lobe ◽

Sudden Onset ◽

Magnetic Resonance Images ◽

Left Lower Lobe ◽

Perifocal Edema ◽

Tumor To Tumor Metastasis ◽

One Year ◽

E Cadherin

Background Metastasis from one tumor into another is known as tumor-to-tumor metastasis. We report a case of a contiguous occurrence of meningioma and brain cancer metastasis. Patient A 91-year-old woman presented with a sudden onset of weakness in her right limbs and gait disturbance. Fourteen years previously, she had a tumor that was suspected to be a meningioma in the left frontal convexity with no change for several years. One year earlier to presentation she was diagnosed with lung carcinoma in the left lower lobe. Results Magnetic resonance images revealed enlargement of the tumor with perifocal edema. Histologic examination showed a meningioma with contiguous metastatic poorly differentiated adenocarcinoma, as well as a clearly defined border between the two components. The clinical origin of the metastasis was presumed to be from the left lower lobe of the lung. Conclusion Although our case does not strictly fulfill the definition of tumor-to-tumor metastasis, we suggest a contiguous occurrence develops by the same mechanism and may be a subtype of this process. Although previous reports suggested the loss of epithelial cadherin (E-cadherin) expression in the recipient tumor as the cause of contiguous metastasis, E-cadherin expression was positive in our case and did not seem to be involved in the localization of the metastasis.

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Malignant Lung Carcinoid Tumour with Liver and Bone Metastasis: A Case Report

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v5i1.243 ◽

2020 ◽

Vol 5 (1) ◽

pp. 108

Author(s):

Ummu Afeera Zainulabid ◽

Megat Razeem Abdul Razak ◽

Nurhidayah Hassan ◽

Norra Harun ◽

Fatimatulzahra Abdul Ghani

Keyword(s):

Bone Metastasis ◽

Histopathological Examination ◽

Carcinoid Tumour ◽

Lower Lobe ◽

Chronic Diarrhoea ◽

Surgical Team ◽

Rare Presentation ◽

Lung Malignancy ◽

Medial Segment ◽

Lung Carcinoid

Atypical lung carcinoid tumour, which is highly malignant has not been described widely in the literature. We report a middle-age woman who initially referred for possible lung malignancy. She presented with chronic diarrhoea to surgical team initially, who incidentally found to have a minimally enhancing irregular hypodense lesion at medial segment right lower lobe based on CT thorax finding. This patient later was diagnosed to have malignant lung carcinoid tumour based on histopathological examination with liver and bone metastasis. This case highlights the rare presentation of carcinoid tumour. A thorough history, supplemented by imaging and bronchoscopic examinations may lead to the diagnosis.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 108-111

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Myoepithelioma originating from the floor of the mouth

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh161010119m ◽

2017 ◽

Vol 145 (11-12) ◽

pp. 639-642

Author(s):

Vinícius Muniz ◽

Pauline Cardoso ◽

de Fernandes ◽

Leonardo Melo ◽

Bráulio Carneiro ◽

...

Keyword(s):

Salivary Gland ◽

Histopathological Examination ◽

Surgical Excision ◽

Incisional Biopsy ◽

Proper Treatment ◽

Floor Of The Mouth ◽

Complete Surgical Excision ◽

One Year ◽

Slow Growing

Introduction. Myoepithelioma primarily affects the parotid gland and usually presents as a slow-growing painless lump. The aim of this paper is to report a case of myoepithelioma in the mouth floor. Case outline. A young man noticed a painless increased volume in the left side of the mouth floor region, which after one year of evolution presented as a sessile tumor with normal colored mucosa and the absence of secretion output. Computed tomography with contrast showed an image with slightly heterogeneous density, with well-defined limits. Incisional biopsy was performed under local anesthesia, and pathology examination of the sample revealed a myoepithelial neoplasm. Total excision of the lesion was performed under general anesthesia, and histopathological examination confirmed the diagnosis of the salivary gland myoepithelioma. The patient did not present signs of relapse after a year of follow up. Conclusion. Despite the fact that myoepithelioma originating in the salivary gland are considered rare, especially in the mouth floor, this tumor should be considered in the differential diagnosis of similar lesions. Proper treatment appears to be complete surgical excision and post-operative follow-ups shows should be carried out as long as possible, despite the fact that relapses are extremely rare.

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Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

Journal of Surgical Sciences ◽

10.3329/jss.v23i1.44238 ◽

2020 ◽

Vol 23 (1) ◽

pp. 10-12

Author(s):

Nelema Jahan ◽

Md. Mamunur Rahman ◽

Mohammad Shahidul Alam ◽

Md Saiful Islam

Keyword(s):

Histopathological Examination ◽

Breast Diseases ◽

Histopathological Study ◽

Common Symptom ◽

Breast Lump ◽

Histopathological Findings ◽

Malignant Breast ◽

Breast Lumps ◽

One Year ◽

A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

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Treatment Methods Conditioned by the Gravity of Drug-Induced Gingival Hyperplasias

Revista de Chimie ◽

10.37358/rc.17.11.5941 ◽

2017 ◽

Vol 68 (11) ◽

pp. 2618-2622

Author(s):

Alina Mihaela Calin ◽

Mihaela Debita ◽

Raluca Dragomir ◽

Ovidiu Mihail Stefanescu ◽

Cristian Budacu ◽

...

Keyword(s):

Dental Treatment ◽

Histopathological Examination ◽

Transplant Rejection ◽

Surgical Excision ◽

Channel Blockers ◽

Gingival Hyperplasia ◽

Drug Induced ◽

Treatment Methods ◽

Systemic Medication ◽

Bacterial Plaque

The first drug discovered to be involved in the development of gingival hyperplasia is phenytoin, which is indicated in the treatment of epileptic patients. The other drugs are calcium channel blockers with vasodilating effect. The most important one is Nifedipine, while Ciclosporin A, which is used as an immunosuppressant in the prevention of transplant rejection, causes gingival hyperplasia as a secondary effect. Gingival hyperplasia can reach an impressive volume, completely covering the dental crown and affecting the masticatory and physiognomic functions. The elucidation of the mechanism, by which drug-induced gingival hyperplasia occurs, favoring factors and the choice of conservative or surgical treatment methods, emphasizing the prophylactic treatment. The study batch was subject to intraoral and extraoral clinical examinations and the data were included in the dental treatment sheet of each patient, 11 patients aged over 60 years, who came to the Clinic ... in the period 2014-2016. The diagnosis was based on the anamnesis, the clinical aspect of the lesions and the histopathological examination. After the surgical excision of the hyperplasia affected area, recurrence was prevented by dispensarizing the patients and controlling the bacterial plaque through rigorous oral hygiene. Treatment depends on the severity of the lesions, as well as on the physionomic and masticatory functions. Conservative etiological therapy is attempted, by removing the bacterial plaque and local irritant factors, by reducing the dose of drugs, or by changing the systemic medication.

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Pneumonectomy is necessary following delayed detection of pulmonary artery compromise

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz225 ◽

2019 ◽

Vol 30 (1) ◽

pp. 154-155

Author(s):

Ambria S Moten ◽

Abbas E Abbas

Keyword(s):

Pulmonary Artery ◽

Blood Supply ◽

Lung Tissue ◽

Collateral Circulation ◽

Lower Lobe ◽

Left Lower Lobe ◽

Completion Pneumonectomy

Abstract It has been previously suggested that lung tissue remains viable without blood supply from the pulmonary artery (PA). However, our experience demonstrates otherwise. We present 2 cases of accidental left lower lobe PA occlusion during upper lobectomy causing ischaemic changes to the remaining lung tissue. Both patients became septic secondary to necrosis of infarcted lung and required completion pneumonectomy. Development of collateral circulation to bypass the occluded PA may occur but is often insufficient to support the affected lung tissue. Unless the patient is medically unfit, resection of the ischaemic lung should be undertaken.

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