Functional Ulnar Nerve Paraganglioma: First Documented Occurrence in the Extremity With Hitherto Undescribed Associated Extensive Glomus Cell Hyperplasia and Tumorlet Formation

2017 ◽  
Vol 26 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Louis Tsun Cheung Chow ◽  
Michael Ho Ming Chan ◽  
Simon Kwok Chuen Wong

Extra-adrenal paraganglioma has never been described in the extremities. A 34-year-old woman complained of an enlarging mass in the right forearm for 18 months. Imaging showed a circumscribed vascular tumor attached to the ulnar nerve; biopsy revealed features of paraganglioma. The resected tumor consisted of zellballen pattern of chief cells staining positively for chromogranin with surrounding S100-positive sustentacular cells. The chief cells contained many neurosecretory granules and mitochondria, whereas the sustentacular cells contained a large amount of rough endoplasmic reticulum and some microfilaments. There was adjacent extensive glomus cell hyperplasia and tumorlet formation. The intraoperative blood pressure dropped abruptly on tumor removal. The serum normetanephrine level decreased from a preoperative level of 1987 pg/mL (normal < 149 pg/mL) to normal after operation. The patient admitted on questioning to a history of paroxysmal attacks of transient palpitation, hand tremors, and sweating; imaging showed no evidence of tumor in other parts of the body, and there was no family history of similar tumor; she remained well 33 months after the operation. This occurrence of functional ulnar nerve paraganglioma with the hitherto undescribed associated glomus cell hyperplasia and tumorlet formation attests to the probable existence of normal sympathetic paraganglia in the extremity and their intimate functional relationship with glomus bodies.

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.


2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.


1955 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
MJ Mackerras ◽  
DF Sandars

Adult Angiostrongylus cantonensis live in the pulmonary arteries. Unsegmented ova are discharged into the blood stream, and lodge as emboli in the smaller vessels. First-stage larvae break through into the respiratory tract, migrate up the trachea, and eventually pass out of the body in the faeces. Slugs (Agriolimax laevis) act as intermediate hosts. Two moults occur in the slug, and third-stage larvae appear about the 17th day. The larvae remain within the two cast skins until freed in the stomach of the rat by digestion. They then pass quickly along the small intestine as far as the lower ileum, where they leave the gut and become blood-borne. They congregate in the central nervous system, and have been found there 17 hr after ingestion. The anterior portion of the cerebrum is the most favoured site, and here the third moult takes place on the sixth or seventh day and the final one between the 11th and 13th days. Young adults emerge on the surface of the brain from the 12th to 14th day, and spend the next 2 weeks in the subarachnoid space. From the 28th to 31st days they migrate to the lungs via the venous system, passing through the right side of the heart to their definitive site in the pulmonary arteries. The prepatent period in the rat usually lies between 42 and 45 days.


2013 ◽  
Vol 821-822 ◽  
pp. 735-745
Author(s):  
Alttabi Furat Jamal Hassan ◽  
Xiang Yang Bian ◽  
Xiao Yu Xin

There were signs of the first civilization known to humanity for more than 6000 years BC in the north of Iraq have disappeared this civilization to appear after 500 years in southern Iraq, the Sumerian civilization, which was considered as the opinion of scientists or civilizations, exceeds the impact to Asia and the countries that had been in contact (Sumerians) and see them today in other towns and villages. In subsequent periods of time appeared distinct personalities to their nature, religious, social, special clothing with clothes seem especially long. And usually dress is made from raw wool material making them in the Sumerian era. Put the garment on the body and leaves the top of the right shoulder with the survival of an open hand. There are of special clothing used by the clergy in the exercise of religious mourning rituals .There are traditional clothes to the clergy of other faiths. The clothing we see in the beginning of the third millennium BC has gained status in society in general, and was also the head cover. The animals have for centuries symbolized the signs of a divinity that we see hanging on the walls of some temples in northern Iraq. Centuries have been mentioned in the history of the Arabian were animal horns in Sumerian times to symbolize the moon in the Sumerian language .


2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
İhsan Yıldız ◽  
Yavuz Savaş Koca ◽  
Gökhan Avşar ◽  
İbrahim Barut

Introduction. Unintentional foreign body ingestion commonly occurs accidentally in children aged between 3 months and 6 years and at advanced ages or results from psychiatric disorders such as hallucination in patients with mental retardation. Most of the ingested foreign bodies are naturally discharged from the body but some of them may require surgical intervention.Presentation of Case. A 29-year-old mentally retarded female patient was admitted to the emergency service with a two-day history of abdominal pain, nausea, and vomiting. Physical examination revealed abdominal tenderness, defense, and rebound on palpation. Radiological examination revealed diffuse air-fluid levels and a radiopaque impression of a metal object in the right upper quadrant. The metal teaspoon causing ileal perforation was extracted by emergency laparotomy. On postoperative day 7, the patient was uneventfully discharged following a psychiatric consultation.Discussion. Foreign body ingestion can occur intentionally in children at developing ages and old-age patients, or adults and prisoners, whereas it may occur unintentionally in patients with mental retardation due to hallucination. However, repeated foreign body ingestion is very rare in individuals other than mentally retarded patients.Conclusion. Mentally retarded patients should be kept under close surveillance by surgeons and psychiatrists due to their tendency to ingest foreign bodies.


2019 ◽  
Vol 12 (1) ◽  
pp. e228090 ◽  
Author(s):  
Omer Jamall ◽  
Korina Theodoraki ◽  
Sepideh Amin ◽  
David Verity ◽  
Adam Bates

We present the first reported case of histologically proven colorectal adenocarcinoma with metastatic spread to the optic nerve. A 49-year-old man, with a known history of rectal adenocarcinoma, presented with progressive loss of vision in his left eye. On presentation, he had no perception to light in his left eye and Snellen acuity of 6/36 in the right eye. Fundus examination showed a left globally swollen optic nerve with a few flame-shaped haemorrhages. A gadolinium-enhanced MRI scan demonstrated abnormal thickening of the anterior and mid-section of the optic nerve with high signal on STIR and postgadolinium enhancement. Optic nerve biopsy confirmed the presence of epithelial adenocarcinoma compatible with metastasis of gut origin. The patient died within 4 months of presentation.


2006 ◽  
Vol 19 (1) ◽  
pp. 111-136 ◽  
Author(s):  
Alison Winter

ArgumentThis paper explores the relationship between the medium of motion-picture film and the representation of autobiographical memory during the middle decades of the twentieth century. The paper argues that a reciprocal relationship developed between film and memory, in which film was understood as an externalized form of memory, and memory an internalized record of personal experience similar in many respects to film. Memory was often represented as an object-like entity, preserved in stable form within the body, and able to be extracted by the right stimulus or trigger. A particularly important community in which this representation was developed was psychotherapeutic practitioners with psychoanalytic orientations, particularly during and shortly after the Second World War. In special circumstances, therapists and others claimed, records of past life events could be projected, film-like, onto the screen of an individual's conscious, replaying previous experiences in real time. The paper develops a social historical account of this relationship, and reflects on its significance for the history of selfhood in the twentieth century.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S32-S32
Author(s):  
C P Onyenekwu ◽  
K A Iczkowski ◽  
Y Sheinin

Abstract Introduction/Objective Paragangliomas are tumors originating from the neural crest. Most tumors are benign and arise from various locations in the body. Extra-adrenal paragangliomas arise as sporadic cases in most settings or as part of heredofamilial syndromes in about one-quarter of cases. Succinate dehydrogenase subunit B (SDHB) gene mutations are associated with an aggressive clinical disease course of pheochromocytoma/paraganglioma. Methods We present a 41-year-old male former smoker with a history of a growing right upper lung nodule on chest imaging. He had no cough or respiratory symptoms. Twenty-seven months prior the patient underwent a cystoprostatectomy due to paraganglioma of the bladder. Genetic testing identified a pathogenic mutation in SDHB gene, c.166_170delCCTCA (p.Pro56Tyrfs*5). He underwent a wedge resection of the lung nodule. Results Sectioning of the lung wedge revealed a well circumscribed, firm tan nodule. Microscopically there were nests of large neoplastic cells with round nuclei and eosinophilic granular cytoplasm. Tumor cells were positive for synaptophysin and chromogranin and negative for pan-cytokeratin. S100 highlighted sustentacular cells. The pulmonary neoplasm was morphologically similar to the prior tumor of the bladder. These features are consistent with a metastatic urothelial paraganglioma to the lung, in a background of a hereditary paraganglioma syndrome. Conclusion Extra-adrenal paraganglioma occurring in a setting of hereditary paraganglioma syndrome has a higher risk of metastasis. Lifelong surveillance even after prompt resection of primary tumor with negative margins is required to ensure early detection of metastasis and prevention of complications associated with it.


Author(s):  
Shakib H. Sheikh ◽  
Arti Raut ◽  
Savita Pohekar ◽  
Dipali Ghungrud ◽  
Swapna Morey

Background: A rarity of form of vasculitis, also known as TAK, induces inflammation in the walls of the major arteries in the body: the aorta and its main branches. The disease results from a body attack and inflammation of the walls of the arteries caused by the body's own immune system. Case Presentation: A 37-years-old women had complaints of fever, giddiness, weakness of right upper limb and lower limb since1 day. After undergoing whole blood count, liver function examination, renal and MRI function checks, CT scan, angiography, etc. was studied. She was diagnosed with takayasu arteritis.  She had past medical history of neck pain and numbness since January 2020. For these complaints her family members referred her in private hospital. There is no significant history of surgery in present, lower segment caesarean section and piles operation was done previously. Physical findings were normal except the Glasgow Coma Scale score was 11 that is, patient  was semi-conscious, In General appearance patient activity was dull and weak due disease condition, Patient’s all routine investigations were normal except few like Total WBC count was increased (21,500cell /cm) due to increased infection, Granulocytes were increased  that is 75 % due to infection and autoimmune disease, ESR was increased  that is52mm/h. Angiography showed block in the right common carotid artery, MRI- showed Acute infract in left fronto  temporo parietal region involving insular par ventricular white matter,  absent flow in distal M1 segment of MCA. Conclusion: The most frequently involved arteries and the angiographic trends in this Takayasu Arteritis study were subclavian arteries and carotid arteries. The difference between angiographic characteristics may lead to clinical differences. Operations and surgery should be carried out at various points in the course of the disease.


2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Sushan Homagain ◽  
Suraj Shrestha ◽  
Sushil Sah ◽  
Gopal Sedain

Primary Calvarial Tuberculosis, a rare entity of skull is even rarer after second decade of life in a healthy person without evidence of tuberculosis elsewhere in the body. Most of the cases are often misdiagnosed as osteomyelitis/syphilis/bony metastasis. We report a case of primary skull tuberculosis in 26-year-old male with complains of headache and swelling in the right frontal region with no history of previous tuberculosis. The patient was operated and the histopathological examination of excised tissue was suggestive of tubercular pathology. The patient is doing well after anti-tubercular therapy. Being a rare disease, tubercular osteomyelitis of skull bones is often missed and misdiagnosed due to lack of clinical suspicion and slow growth of mycobacterium cultures. Histopathological examination of biopsy material and demonstration of acid-fast bacilli in the pus are helpful for diagnosis and early management of the disease.


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