Eosinophilic Fasciitis Associated with Myositis

Eosinophilic fasciitis is clinically characterized by symmetrical scleroderma-like indurations of the skin with pain. The histological features are fascial inflammation with lymphocytes and eosinophils as well as thickened and fibrotic fascia. Lymphocytic infiltration and degeneration of the underlying muscle are rarely observed. We report a 69-year-old Japanese woman who presented with multiple areas of glossy induration and painful peau d'orange-like lesions on the chest and four extremities. T2-weighted magnetic resonance imaging showed significant hyperintense thickening of the fascia of the lower extremities. Histopathological examination of a biopsy specimen from the induration showed marked fibrinoid degeneration of the fascia and the neighboring muscle with mixed cellular infiltration of lymphocytes and eosinophils. The predominant CD8+ lymphocytic infiltrates were observed by immunohistological study. A diagnosis of eosinophilic fasciitis with myositis was made. Oral administration of prednisolone and discontinuation of exercise significantly improved the lesions and pain.

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Neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus

Clinics and Practice ◽

10.4081/cp.2012.e16 ◽

2012 ◽

Vol 2 (1) ◽

pp. 16

Author(s):

Takeshi Kusunoki ◽

Katsuhisa Ikeda

Keyword(s):

Maxillary Sinus ◽

Neuroendocrine Carcinoma ◽

Past History ◽

Japanese Woman ◽

Old Japanese ◽

Weighted Magnetic Resonance Imaging ◽

Maxillary Cyst ◽

Left Maxillary Sinus ◽

Eye Movement Disorders ◽

Cheek Swelling

We report a case of a neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus that was difficult to distinguish from a postoperative maxillary cyst. The patient was a 65-year-old Japanese woman who complained of left exophthalmos with cheek swelling and eye movement disorders. In past history, she had, 40 years previously undergone operation on the bilateral maxillary sinus by Caldwell-Luc’s method. In a preoperative computed tomography, a mass occupied the left maxillary sinus showing irregular densities with destruction of the posterior bone walls and invasion into the left orbital. Both TI and T2 weighted magnetic resonance imaging showed low intensities and unevenness in the mass. We performed a biopsy of the maxillary tumor according to Caldwell-Luc’s method. Histological examination diagnosed neuroendocrine carcinoma. Radiation therapy (total 66Gy) resulted in partial response for this tumor. However, sinonasal neuroendocrine carcinoma has been identified as highly aggressive, with a high probability of recurrence and metastasis.

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Successful management of cutaneous lymphangitis carcinomatosa arising from cervical cancer with paclitaxel-cisplatin and bevacizumab combination therapy: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-019-2262-x ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Fumihiro Nakamura ◽

Manabu Seino ◽

Yuriko Suzuki ◽

Hirotsugu Sakaki ◽

Takeshi Sudo ◽

...

Keyword(s):

Cervical Cancer ◽

Combination Therapy ◽

Histopathological Examination ◽

Therapeutic Option ◽

Japanese Woman ◽

Positron Emission ◽

Curative Radiotherapy ◽

Old Japanese ◽

Effective Therapeutic Option ◽

Lymphangitis Carcinomatosa

Abstract Background Globally, cervical cancer is the fourth most common cancer in women. Here, we report a case of cutaneous lymphangitis carcinomatosa arising from cervical cancer, an extremely rare and treatment-resistant condition. Case presentation A 64-year-old Japanese woman presented with genital bleeding. She was diagnosed as having stage IB1 squamous cell cervical cancer and subsequently treated with radiotherapy. Approximately 2 years after the curative radiotherapy, she developed itching, skin rash, and small nodules on her left femoral and pubic area. Slight 18F-fluorodeoxyglucose uptake was detected at her left femoral skin on positron emission tomography with computed tomography. A histopathological examination was performed on a biopsy sample from an erythematous macule on her left femoral skin and vulva. Consequently, she was diagnosed as having cutaneous lymphangitis carcinomatosa arising from cervical cancer. Paclitaxel (135 mg/m2), cisplatin (50 mg/m2), and bevacizumab (15 mg/kg) combination therapy was administered every 21 days. Both itching and rash improved after three treatment cycles. After the completion of six cycles, skin erythema in the femoral and vulval area disappeared completely. Our patient experienced a 25-month symptom-free interval after the last chemotherapy session. Conclusion Our findings suggest that combination chemotherapy plus bevacizumab is an effective therapeutic option in patients with cutaneous lymphangitis carcinomatosa arising from cervical cancer.

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Granular cell tumour arising from the Kiesselbach's area of the nasal septum

The Journal of Laryngology & Otology ◽

10.1017/s002221510600394x ◽

2006 ◽

Vol 121 (2) ◽

pp. 170-173 ◽

Cited By ~ 3

Author(s):

T Sasaki ◽

K Yamamoto ◽

T Akashi

Keyword(s):

Nasal Septum ◽

Histopathological Examination ◽

English Literature ◽

Granular Cell ◽

Surgical Excision ◽

Japanese Woman ◽

Cell Tumour ◽

Granular Cell Tumour ◽

Old Japanese ◽

The Right

An extremely rare case of a granular cell tumour arising from the right Kiesselbach's area (Little's area) of the nasal septum is reported. A 69-year-old Japanese woman consulted our clinic and her chief complaints were of continuous serous discharge, stuffiness and occasional slight bleeding from the right nasal cavity. Fibrescopy showed a multilocular mass, which was provisionally considered a nasal polyp. Surgical excision was attempted. During surgery, the tumour shrank markedly following local application of adrenaline, suggestive of hypervascularity. The tumour was successfully excised by careful dissection after cauterisation of the mucosa surrounding the tumour. Histopathological examination revealed morphological features of granular cell tumour immunopositive for S-100 protein. This is the first report of granular cell tumour arising from the Kiesselbach's area in the English literature. The eccentric behaviour of the tumour and the management of a granular cell tumour arising from this area are discussed, together with a literature review.

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Solitary Hepatic Eosinophilic Granuloma Accompanied by Eosinophilia Without Parasitosis: Report of a Case

International Surgery ◽

10.9738/intsurg-d-14-00126.1 ◽

2015 ◽

Vol 100 (6) ◽

pp. 1011-1017 ◽

Cited By ~ 1

Author(s):

Takatsugu Yamamoto ◽

Toru Miyazaki ◽

Yukiko Kurashima ◽

Kazunori Ohata ◽

Masato Okawa ◽

...

Keyword(s):

Intestinal Tract ◽

Immunoglobulin E ◽

Histopathological Examination ◽

Past History ◽

Eosinophilic Granuloma ◽

Japanese Woman ◽

Larva Migrans ◽

Enzyme Linked Immunosorbent Assay ◽

Type I ◽

Old Japanese

A 43-year-old Japanese woman visited for a hepatic tumor incidentally found. We suspected eosinophilic granuloma of the liver (EGL) due to visceral larva migrans (VLM). However, neither past history nor medical interview indicated a risk of parasitosis. Blood testing revealed eosinophilia, serum examination showed normal results for immunoglobulin E, and enzyme-linked immunosorbent assay yielded negative for Toxocara and Anisakis. Gastric and colonic endoscopy revealed normal features. Several imagings showed central necrosis of the tumor. After informed consent, laparoscopic resection was performed. Histopathological examination showed EGL without parasites. No recurrence had occurred postoperatively. Most reports documented that EGL are caused by VLM. However, parasites are not always demonstrable on serum, histopathological, or immunochemical examinations. When acting as allergens to induce type I responses, microscopic agents other than parasites in the intestinal tract could induce eosinophilic inflammation in the liver. Accumulation of more cases should help clarify other pathogeneses for EGL.

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Tonsillar lipoma: a case report

The Journal of Laryngology & Otology ◽

10.1017/s0022215100130968 ◽

1995 ◽

Vol 109 (7) ◽

pp. 662-664 ◽

Cited By ~ 5

Author(s):

Hiroshi Harada ◽

Shoichi Kashiwagi ◽

Minoru Morimatsu ◽

Tadamitsu Kameyama ◽

Masami Takahashi

Keyword(s):

Case Report ◽

Connective Tissue ◽

Histopathological Examination ◽

Fibrous Tissue ◽

Japanese Woman ◽

Fibrous Connective Tissue ◽

Fat Tissue ◽

Mucosal Epithelium ◽

Old Japanese ◽

Benign Tumours

AbstractBenign tumours of the tonsils are rare. Only a few cases of tonsillar lipoma have been previously reported. The case of a pedunculated polypoid lipoma of the palatine tonsil in a 44-year-old Japanese woman is presented. The ‘polyp’ was excised and an histopathological examination was carried out. The ‘polyp’ contained dilated lymphatics in the dense fibrous connective tissue beneath the overlying mucosal epithelium and below the mature fat tissue with intervening strands of fibrous tissue.

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Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

BMC Endocrine Disorders ◽

10.1186/s12902-021-00757-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuki Yamauchi ◽

Hiraku Kameda ◽

Kazuno Omori ◽

Michio Tani ◽

Kyu Yong Cho ◽

...

Keyword(s):

Herpes Zoster ◽

Cushing’S Disease ◽

Cardiopulmonary Arrest ◽

Severe Infection ◽

Japanese Woman ◽

The Body ◽

Cushing's Disease ◽

Old Japanese ◽

Subclinical Cushing’S Disease ◽

Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

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Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320969380 ◽

2020 ◽

Vol 11 ◽

pp. 215145932096938

Author(s):

Yuki Suzuki ◽

Toshihiko Kasashima ◽

Kazutoshi Hontani ◽

Yasuhiro Yamamoto ◽

Kanako Ito ◽

...

Keyword(s):

Intertrochanteric Fracture ◽

Screening Method ◽

Oxygen Demand ◽

Japanese Woman ◽

Trauma Patients ◽

Lung Field ◽

Old Japanese ◽

Femoral Intertrochanteric Fracture ◽

Novel Coronavirus ◽

The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

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Rapid Deterioration of Latent HBV Hepatitis during Cushing Disease and Posttraumatic Stress Disorder after Earthquake

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0037-1598052 ◽

2017 ◽

Vol 78 (04) ◽

pp. 407-411 ◽

Cited By ~ 1

Author(s):

Ryosuke Tashiro ◽

Teiji Tominaga ◽

Yoshikazu Ogawa

Keyword(s):

Hepatic Dysfunction ◽

Residual Tumor ◽

Optic Chiasm ◽

Japanese Woman ◽

Hbv Reactivation ◽

Cushing Disease ◽

Old Japanese ◽

Threatening Condition ◽

The Right ◽

Subtotal Removal

AbstractReactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster. A 47-year-old Japanese woman was an inactive HBV carrier until the Great East Japan Earthquake occurred and follow-up was discontinued. One year after the earthquake she had intractable hypertension, and her visual acuity gradually worsened. Head magnetic resonance imaging showed a sellar tumor compressing the optic chiasm, and hepatic dysfunction with HBV reactivation was identified. Endocrinologic examination established the diagnosis as Cushing disease. After normalization of hepatic dysfunction with antiviral therapy, transsphenoidal tumor removal was performed that resulted in subtotal removal except the right cavernous portion. Steroid hormone supplementation was discontinued after 3 days of administration, and gamma knife therapy was performed for the residual tumor. Eighteen months after the operation, adrenocorticotropic hormone and cortisol values returned to normal. The patient has been free from tumor regrowth and HBV reactivation throughout the postoperative course.Accomplishment of normalization with intrinsic steroid value with minimization of steroid supplementation should be established. Precise operative procedures and careful treatment planning are essential to avoid HBV reactivation in patients with this threatening condition.

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Multiple-System Atrophy in Long-Term Professional Painter: A Case Report

Case Reports in Pathology ◽

10.1155/2012/613180 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5

Author(s):

Yusa Nagai ◽

Riko Kitazawa ◽

Miku Nakagawa ◽

Munenori Komoda ◽

Takeshi Kondo ◽

...

Keyword(s):

Multiple System Atrophy ◽

Medulla Oblongata ◽

Neurodegenerative Disorder ◽

Histopathological Examination ◽

Neuronal Loss ◽

Cytoplasmic Inclusion ◽

Multiple Organ ◽

Old Japanese ◽

History Of

Introduction. Multiple system atrophy (MSA) is a rare and severe adult-onset, sporadic, and progressive neurodegenerative disorder. Here, we describe an autopsy case of MSA in a long-term professional painter. Although typical glial cytoplasmic inclusion (GCI) was not observed in a routine histological examination, strong α-synuclein immunostaining in the nucleus confirmed the diagnosis of MSA.Case Presentation. A 48-year-old Japanese man with a long occupational history of professional painter was sent to the emergency room, where he died of multiple organ failure. The patient had suffered tremors and inarticulateness at age 28, developed diabetes at 42 and was diagnosed with spinocerebellar degeneration at 46. A histopathological examination showed severe neuronal loss, gliosis, and tissue rarefaction in the paleostriatum, striate body of the substantia nigra, the pons, and the olivary nucleus of the upper medulla oblongata, intermediolateral of the spinal gray matter (sacral region). α-synuclein-positive GCI in oligodendroglia was occurred in the cerebral cortex, the midbrain, the medulla oblongata, and the spinal cord. These findings confirmed the presence of multiple-system atrophy (OPCA+SDS).Conclusion. Although the pathogenesis of MSA is still unclear, prolonged, and extensive exposure to organic solvents, together with a hyperglycemic morbidity attributed to diabetes, may have contributed to the onset and clinical course of the present case.

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Identification of Transmissible Viral Proventriculitis (TVP) in broiler chickens in Poland

Polish Journal of Veterinary Sciences ◽

10.1515/pjvs-2017-0050 ◽

2017 ◽

Vol 20 (2) ◽

pp. 417-420 ◽

Cited By ~ 2

Author(s):

M. Śmiałek ◽

M. Gesek ◽

A. Śmiałek ◽

A. Koncicki

Keyword(s):

Body Weight ◽

Eastern Europe ◽

Broiler Chickens ◽

Central And Eastern Europe ◽

Histopathological Examination ◽

Lymphocytic Infiltration ◽

Glandular Epithelium ◽

Vacuolar Degeneration ◽

Ductal Epithelium

Abstract The aim of the study was to investigate the possibility of Transmissible Viral Proventriculitis (TVP) occurrence in broiler chickens in Poland. In march 2016 proventriculi samples were collected from broiler chickens showing poor uniformity and decreased body weight, accompanied by enlarged proventriculi. Histopathological examination of affected proventriculi revealed typical lesions associated with TVP (vacuolar degeneration and necrosis of glandular epithelium, replacement of glandular epithelium by hyperplastic ductal epithelium and moderate to severe lymphocytic infiltration). To our best knowledge, up to date there is no report indicating the presence of TVP in Poland nor in Central and Eastern Europe.

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