scholarly journals Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

2021 ◽  
pp. 73-76
Author(s):  
Shinjiro Kono ◽  
Patricia Ann L. Lee ◽  
Hirohiko Kakizaki ◽  
Yasuhiro Takahashi
Keyword(s):  
Differential Diagnosis ◽  
Japanese Woman ◽  
Soft Tissue Lesion ◽  
Palpebral Conjunctiva ◽  
Biopsy Specimens ◽  
Body Sensation ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
Conjunctival Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

scholarly journals Long-lasting response to afatinib that persisted after treatment discontinuation in a case ofEGFR-mutated lung adenocarcinoma

2019 ◽  
Vol 12 (1) ◽  
pp. e227383 ◽  
Author(s):  
Yumie Yamanaka ◽  
Yoshitaka Seki ◽  
Takeo Ishikawa ◽  
Kazuyoshi Kuwano
Keyword(s):  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Complete Response ◽  
Middle Lobe ◽  
Japanese Woman ◽  
Old Japanese ◽  
Exon 19 Deletion ◽  
History Of ◽  
Epidermal Growth ◽  
The Right

It is unknown whether tyrosine kinase inhibitors targeting epidermal growth factor receptor (EGFR) can be discontinued in patients in whomEGFR-mutated lung cancer has well stabilised. We present a case of a 73-year-old Japanese woman with no history of smoking. Right pulmonary lower lobectomy, lymph node dissection and segmental resection of the right middle lobe were performed. Additionally, she underwent adjuvant chemotherapy for stage IIIB adenocarcinoma harbouring anEGFRexon 19 deletion. Afatinib was administered for liver metastases after 15 months. A complete response of metastatic disease was achieved for 2 years. However, afatinib was unavoidably discontinued due to splenectomy for the treatment of idiopathic thrombocytopenic purpura. Although afatinib was not resumed, due to the abscess formation as surgery complication, a drug-free complete response was sustained for over 18 months. The present case suggests that exceptional and durable responses to afatinib can be achieved in individual cases.

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

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.

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

2017 ◽  
Vol 78 (04) ◽  
pp. 407-411 ◽  
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.

Cochlear fistula found in a naturally healed tympanic cavity

1991 ◽  
Vol 105 (8) ◽  
pp. 656-658 ◽  
Author(s):  
Mamoru Suzuki ◽  
Isao Nishida ◽  
Katsuhiro Hirakawa ◽  
Masafumi Nikaido ◽  
Yasuo Harada
Keyword(s):  
Semicircular Canal ◽  
Posterior Wall ◽  
Japanese Woman ◽  
Mastoid Cavity ◽  
Tympanic Cavity ◽  
Ear Canal ◽  
Horizontal Semicircular Canal ◽  
Old Japanese ◽  
History Of ◽  
Exploratory Surgery

AbstractA cochlear fistula found in a naturally healed mastoid cavity is reported. The patient is a 53-year-old Japanese woman who was complaining of unsteadiness. She hada long history of otorrhoea in childhood. Her tympanic and mastoid cavities were widely open and were covered by thin epithelium. The posterior wall of the ear canal was missing. She had no hearing in the ear but responded to electrical promontory testing. Exploratory surgery was indicated at which fistulae of the basal turn of the cochlea and the horizontal semicircular canal were found. These fistulae were sealed by pieces of bone andmuscle.

scholarly journals Neuroleptic malignant syndrome as part of an akinetic crisis associated with sepsis in a patient with Lewy body disease

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-227216 ◽  
Author(s):  
Saki Manabe ◽  
Hidetaka Yanagi ◽  
Hideki Ozawa ◽  
Atsushi Takagi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Lewy Body ◽  
Cardiopulmonary Arrest ◽  
Lewy Body Disease ◽  
Kidney Injury ◽  
Spontaneous Circulation ◽  
Japanese Woman ◽  
Old Japanese ◽  
History Of ◽  
Tentative Diagnosis

A 65-year-old Japanese woman with Parkinson’s disease, later diagnosed with Lewy body disease, presented with a 2-day history of systemic tremors. She also had fever without rigidity or creatine kinase (CK) elevation. She was diagnosed with sepsis caused by pyelonephritis with acute kidney injury and parkinsonism exacerbation. Although antibiotic and fluid therapy improved her pyuria and renal function, her fever and tremors persisted. On the fourth day, her symptoms worsened and resulted in cardiopulmonary arrest; however, quick resuscitation allowed the return of spontaneous circulation. Simultaneously, hyperthermia, altered consciousness, extrapyramidal symptoms, dysautonomia and CK elevation were noted. Thus, dantrolene administration was initiated with a tentative diagnosis of neuroleptic malignant syndrome (NMS). This caused her fever to subside, and her symptoms gradually improved. It was difficult to distinguish between parkinsonism exacerbation associated with sepsis and NMS. Physicians should consider NMS early on, even if the patient does not fulfil the diagnostic criteria.

scholarly journals Mesothelioma in two sheep with pericardial effusion and ascites

2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Domestic Animals ◽  
Diagnostic Pathology ◽  
First Case ◽  
Clinical Presentations ◽  
Rare Tumours ◽  
Microscopic Features ◽  
History Of ◽  
The Right

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.

Primary cerebellar histiocytic sarcoma in a 17-month-old girl

2012 ◽  
Vol 10 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Kiyoshi Gomi ◽  
Mio Tanaka ◽  
Mariko Yoshida ◽  
Susumu Ito ◽  
Masaki Sonoda ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Brain Mri ◽  
Histiocytic Sarcoma ◽  
Cerebellar Tumor ◽  
Pediatric Age Group ◽  
Old Japanese ◽  
History Of ◽  
Dural Attachment ◽  
The Right ◽  
Aggressive Clinical Course

The authors report on a case of histiocytic sarcoma (HS) in a pediatric patient presenting with a solitary tumor in the cerebellum, with the aim of providing insight into primary HS in the CNS, which is especially rare. A 17-month-old Japanese girl presented with a 2-week history of progressive gait disturbance. Brain MRI revealed a 4.7 × 4.3 × 4.3–cm well-demarcated solitary mass in the right hemisphere of the cerebellum, initially suggestive of medulloblastoma, ependymoma, or anaplastic astrocytoma. On intraoperative inspection the cerebellar tumor showed intensive dural attachment and was subtotally removed. Histological and immunohistochemical findings were consistent with HS. The patient subsequently received chemotherapy, and her preoperative neurological symptoms improved. Primary HS in the CNS usually demonstrates an aggressive clinical course and is currently considered to have a poor prognosis. The possibility of this rare tumor should be included in the differential diagnosis of localized cerebellar tumors in the pediatric age group.

scholarly journals Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yuko Ono ◽  
Nozomi Ono ◽  
Kazuaki Shinohara
Keyword(s):  
Liver Dysfunction ◽  
Laboratory Data ◽  
Japanese Woman ◽  
Over The Counter ◽  
Tissue Hypoperfusion ◽  
First Case ◽  
Old Japanese ◽  
History Of ◽  
History Of Depression ◽  
Adrenergic Receptor Agonist

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.

scholarly journals Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Takayuki Inoue ◽  
Ken Kobayashi ◽  
Mizuki Sawada ◽  
Sumiko Ishizaki ◽  
Haruo Ito ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Skin Lesions ◽  
Japanese Woman ◽  
Bowen’S Disease ◽  
Seborrheic Keratosis ◽  
Bowen's Disease ◽  
Pathologic Features ◽  
Old Japanese ◽  
History Of ◽  
Pigmented Skin Lesions

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD.

scholarly journals Leptomeningeal carcinomatosis from gallbladder cancer after curative resection: A case report and review of literature

2021 ◽  
Author(s):  
MASASHI OKAWA ◽  
JUN KADONO ◽  
IWAO KITAZONO ◽  
SHUNSUKE MOTOI ◽  
KENTARO GEJIMA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Curative Resection ◽  
Fluid Pressure ◽  
Leptomeningeal Carcinomatosis ◽  
Japanese Woman ◽  
Cancer Case ◽  
Extended Cholecystectomy ◽  
Old Japanese ◽  
Impaired Awareness ◽  
The Right

Introduction Only 12 cases of gallbladder (GB) cancer associated with leptomeningeal carcinomatosis (LMC) have been reported so far. Herein, we report the first known case of LMC originating from GB cancer after curative resection and discuss the risk factors of LMC associated with GB cancer. Case Presentation An 85-year-old Japanese woman presented with vomiting and impaired awareness 2 years after curative extended cholecystectomy for GB cancer . Computed tomography showed hydronephrosis of the right kidney and ureteral thickening. Magnetic resonance imaging revealed areas of hyperintense reflecting lesions along the cerebral sulci, suggesting meningitis. A spinal tap showed an elevated cerebrospinal fluid pressure of > 270 mmH 2 O, and cytological examination of the spinal fluid revealed the presence of adenocarcinoma cells. The patient was diagnosed with retroperitoneal metastasis and LMC originating from GB cancer. The patient was given palliative care and died 4 weeks after the onset of symptoms. Conclusion The findings of this study show that LMC could occur even after curative resection of GB cancer and should be considered when patients present with neurological symptoms. Retroperitoneal metastases and poorly differentiated tumors are possible risk factors of LMC originating from GB cancer.

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