A case of nodular episcleritis mimicking a solitary giant episcleral mass

2021 ◽  
pp. 112067212110528
Author(s):  
Lan Zhou ◽  
Juanjuan Wang ◽  
Guihua Xu ◽  
Dingding Wang ◽  
Xiaoyi Wang ◽  
...  
Keyword(s):  
Topical Steroid ◽  
Inflammatory Cells ◽  
Systemic Hypertension ◽  
Eye Drops ◽  
Definite Diagnosis ◽  
Imaging Studies ◽  
Immunohistochemical Examination ◽  
History Of ◽  
Inflammatory Drugs

Purpose To describe an atypical nodular episcleritis mimicking a solitary giant episcleral mass, which is not attributed to any systemic diseases and identified only after immunohistochemical examination. Case report A sixty-year-old Chinese woman with systemic hypertension presented with 6-month history of giant, solitary and redness epibulbar mass arising from the superior aspect of her left eye. The lesion gradually enlarged, even with 6-month history of irregular topical steroid eye drops treatment. Imaging studies and laboratory test revealed a 10 mm × 8 mm episcleral mass absence of any infection indicator and autoimmune antibody changes. The mass was completely removed before its extension through the deep scleral, histopathologic examination revealed a nodular episcleritis composed of various chronic inflammatory cells infiltration. Topical steroid eye drops treatment combined with oral steroidal anti-inflammatory drugs was then administrated regularly for 1 month, and no recurrence occurred after 1-year follow-up. Conclusion Nodular anterior episcleritis is characterized by underlying chronic inflammation of the anterior episclera and can be presented as asymptomatic episcleral mass. Besides a thorough investigation systemically, tissue biopsy is required for definite diagnosis.

scholarly journals Radiotherapy for Recurrent Keloid: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 89-91
Author(s):  
Christina Hari Nawangsih Prihharsanti ◽  
Muhamad Rizqi Setyarto ◽  
Dion Firli Bramantyo
Keyword(s):  
Connective Tissue ◽  
Recurrence Rate ◽  
Corticosteroid Injection ◽  
Inflammatory Cells ◽  
Early Postoperative Period ◽  
High Recurrence Rate ◽  
Surrounding Soft Tissue ◽  
History Of

Background: Keloid is a benign growth of connective tissue. There are several risk factors that play a role in keloid growth. Excision surgery is one of the modalities in the treatment of keloids. However, excision surgery alone has a recurrence rate of 45-100%.Case: Male, 37 years old, with complaints arising from a keloid lesions in the left earlobe since three years ago with a history of previous injuries. The lesions is then operated on but always grows back postoperatively. The number of surgeries that have been carried out three times with further treatment in the form of corticosteroid injection. However, keloid still recurrence. Finally it was decided to undergo treatment with surgery followed by radiotherapy within a period of no more than 24 hours postoperatively. Follow-up after six months gave good results without recurrence.Discussion: Keloid has a high recurrence rate after excision surgery. Surgery followed by radiotherapy has a low recurrence rate compared to surgery or surgery followed by administration of corticosteroid injections. Radiotherapy as adjuvant therapy for postoperative keloid excision has the role of sterilizing the connective tissue stem cell active fibroblasts and acute inflammatory cells that grow in the early postoperative period. A study states that administration of postoperative radiation with electrons in keloids in the earlobe at a dose of 15 Gy in three fractions gives a low recurrence rate and a low risk of side effects in the surrounding soft tissue. 

scholarly journals A Case of Spondyloarthritis in Patient Affected by Unicentric Castleman’s Disease Effectively Managed with Surgery Resection and Tocilizumab Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
M. Filippini ◽  
S. Cartella ◽  
O. Bonzanini ◽  
E. Morello ◽  
A. Tincani
Keyword(s):  
Marked Improvement ◽  
Late Onset ◽  
Castleman’S Disease ◽  
Castleman's Disease ◽  
Hla B27 ◽  
History Of ◽  
Inflammatory Drugs ◽  
Rheumatologic Manifestations ◽  
Surgery Resection

A 38-year-old woman was referred to our hospital for rheumatologic manifestations (migrant arthritis and tenosynovitis), without psoriasis or family history of psoriasis, gastroenteric manifestations, or recent genitourinary infections. The instrumental and laboratory tests have suggested a diagnosis of undifferentiated seronegative HLA-B27-positive spondyloarthritis with predominantly peripheral involvement. The symptoms were very severe and resistant to anti-inflammatory drugs and steroids. She had a history of hyaline-vascular unicentric Castleman’s disease (HBV, HIV, and HHV-8 negative) treated with surgery resection. After a first pharmacological attempt with sulfasalazine (suspended for urticarial rash), we managed the patient with monotherapy tocilizumab 8 mg/kg, with full response of rheumatologic manifestations. The efficacy of tocilizumab was confirmed even after a follow-up of three years. Our experience seems to describe a new late-onset autoimmune disease (only 21 cases described in literature) potentially related to Castleman’s disease. The patient experienced marked improvement from IL-6-based therapy (tocilizumab).

scholarly journals Hydroxychloroquine-Induced Hyperpigmentation: A Case Report

2020 ◽  
Author(s):  
Mona Talaschian ◽  
Anahita Sadeghi ◽  
Sara Pakzad
Keyword(s):  
Skin Diseases ◽  
Antimalarial Agents ◽  
The Face ◽  
History Of ◽  
Inflammatory Drugs ◽  
Skin Discoloration ◽  
Anti Inflammatory ◽  
One Year ◽  
Rheumatoid Diseases

Antimalarial agents, including chloroquine and hydroxychloroquine, have been used for the treatment of various rheumatoid diseases and skin diseases because of their anti-inflammatory and immune-modulating properties. Cutaneous adverse effects such as exacerbation of psoriasis, pruritus, and hyperpigmentation have been reported as side-effects of antimalarial drugs. In this case, we report a middle-aged man with a history of rheumatoid arthritis who was treated with non-steroidal anti-inflammatory drugs and hydroxychloroquine. He complainedof hyperpigmentation of the face after one year of initiating the hydroxychloroquine. It was discontinued and methotrexate was started. Skin biopsy was confirmed drug reaction. Aftermore than 10 years of follow up, his skin discoloration had not been improved.

scholarly journals Szaruhártya-lerakódások bizonytalan jelentőségű monoklonális gammopathiában. Irodalmi áttekintés és esetbemutatás

2018 ◽  
Vol 159 (39) ◽  
pp. 1575-1583 ◽  
Author(s):  
Orsolya Németh ◽  
Beáta Tapasztó ◽  
Sándor Tar ◽  
Viktória Szabó ◽  
Zoltán Zsolt Nagy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Monoclonal Gammopathy ◽  
Plasma Cells ◽  
Systemic Disease ◽  
Inflammatory Cells ◽  
Protein Deposition ◽  
Corrected Visual Acuity ◽  
History Of ◽  
Proper Diagnosis

Abstract: To summarize ophthalmological signs of monoclonal gammopathy of undetermined significance (MGUS) and to present a case report. Summary of the literature data and presentation of the history of a 46-year-old female patient. In MGUS, pathological, but non-malignant plasma cells produce abnormal monoclonal immunoglobulin. Its prevalence is 0.15%, but it increases with age. As yearly 1–2% of MGUS patients develop multiple myeloma, frequent hematological follow-up is necessary. Corneal opacifications in MGUS have been described in a few dozens of patients in the literature. These may be nummular or crystal-like, or even present with white or grey line-forming depositions in the stroma. They may be centrally or peripherally localized. In our patient, bilateral, branching, geographical corneal opacifications were detected predescemetally, that were progressing and reaching the optical centre during follow-up. With 0.15 best corrected visual acuity, penetrating keratoplasty was performed (postoperative best spectacle-corrected visual acuity 0.6). Masson trichrom staining of the explanted cornea verified protein deposition, immunhistochemistry identified kappa light chain immunglobulin deposition in the posterior stroma, surrounded with inflammatory cells. Serum electrophoresis and bone marrow biopsy of our patient proved MGUS, therefore, hematological follow-up is going on. In the case of progressive, atypical corneal opacification, the hematological diagnosis of monoclonal gammopathy must be excluded – monoclonal gammopathy of ocular significance –, as delay in proper diagnosis and treatment of the systemic disease may have devastating consequences. Orv Hetil. 2018; 159(39): 1575–1583.

Ibopamine Treatment in Chronic Hypotony Secondary to Long-Lasting Uveitis. A Case Report

2000 ◽  
Vol 10 (4) ◽  
pp. 332-334 ◽  
Author(s):  
P. Pivetti-Pezzi ◽  
S. Da Dalt ◽  
M. La Cava ◽  
M. Pinca ◽  
F. De Gregorio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Side Effects ◽  
Visual Field ◽  
Clinical Efficacy ◽  
Eye Drops ◽  
Days Of Therapy ◽  
History Of

Purpose To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. Methods Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl®) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. Results IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS®) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. Conclusions Ibopamine 2% eye drops in BSS® solvent seem effective in the treatment of uveitis-related hypotony.

scholarly journals A Study of Prevalence and Predictors of Acute Ischemic CVA Patients Admitted to Manipal Teaching Hospital, Pokhara, Nepal

2020 ◽  
Vol 2 (1) ◽  
pp. 42-46
Author(s):  
Bishnu Jwarchan ◽  
Nikunja Yogi ◽  
Suman Adhikari ◽  
Prabin Bhandari ◽  
Subita Lalchan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Statistical Significance ◽  
World Health ◽  
Systemic Hypertension ◽  
Female Ratio ◽  
History Of ◽  
Artery Disease ◽  
Health Organization

 Background: According to the World Health Organization (WHO), 15 million people suffer stroke worldwide each year. Of these, 5 million die, and another 5 million are left permanently disabled. Materials and methods: A retrospective hospital based observational study was carried out in patients with ischemic CVA. Modified Ranking Scale (MRS) on the follow up on 30 days after discharge was obtained. MRS 0-2 was categorized and good outcome and MRS 3-6 was categorized as poor outcome. Results: Out of 56 patients studied 33.9 % were less than 60 years of age and 63.1% were greater than 60 years of age. Male to female ratio was 1.55. MCA territory infarct was the most common with the frequency of 76.8%. There was significant association of HTN, DM, coronary artery disease and other factors as well with the outcome of the patients. Conclusion: On regards to clinic-social demographic parameters there was statistical significance between the gender of the patient, history of systemic hypertension, history of diabetes mellitus and coronary artery disease and outcome of the patient in 30 days follow up.

scholarly journals Male with rhinosporidiosis of urethra: A case report

2016 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Tanvir Ahmed ◽  
Faruk Hossain ◽  
Mohammad Ershad Ahsan Sohel ◽  
Mohammad Al Amin ◽  
A.K.M. Khurshidul Alam ◽  
...  
Keyword(s):  
Inflammatory Cells ◽  
Routine Examination ◽  
General Physical Examination ◽  
The Past ◽  
Urethral Orifice ◽  
History Of ◽  
Water Pond ◽  
General Physical ◽  
Local Examination

A 45-year old male presented with a six months history of a polypoidal lesion at external urethral meatus. There was a history of dysuria with bloody discharge from the lesion. The past and personal history was insignificant except for occasional bathing in a water pond. General physical examination and examination of nose, oral cavity and eyes was unremarkable. On local examination, a small red, fleshy, sessile lesion was seen at the external urethral orifice measuring 0.7 x 0.6 x 0.2 cm, clinically resembling a urethral caruncle. Urine routine examination showed presence of red cells. The lesion was completely resected under spinal anaesthesia. Histopathology showed stratified squamous lined tissue which reveals many sporangia containing endospore. Subepithelial region shows granulation tissue and is infiltrated with chronic inflammatory cells suggestive ofrhinosporidiosis. No other treatment was given. Patient was well after 3 months with no evidence of recurrence during follow up.

Rare intraparenchymal choroid plexus carcinoma resembling atypical teratoid/rhabdoid tumor diagnosed by immunostaining for INI1 protein

2009 ◽  
Vol 4 (4) ◽  
pp. 368-371 ◽  
Author(s):  
E. Andrew Stevens ◽  
Constance A. Stanton ◽  
Kyle Nichols ◽  
Thomas L. Ellis
Keyword(s):  
Choroid Plexus ◽  
Rhabdoid Tumor ◽  
Choroid Plexus Carcinoma ◽  
Nuclear Staining ◽  
Atypical Teratoid Rhabdoid Tumor ◽  
Imaging Studies ◽  
Atypical Teratoid ◽  
History Of ◽  
The Right

The authors present the case of a rare extraventricular, intraparenchymal choroid plexus carcinoma (CPC). This 6-year-old girl presented to the emergency department with a 1-week history of headaches, nausea, and vomiting. Imaging studies revealed an intraaxial cystic and solid mass located in the right frontal lobe with central nodular enhancement and minimally enhancing cyst walls. Gross-total resection was accomplished via craniotomy without complications. The initial pathological diagnosis was atypical teratoid/rhabdoid tumor (AT/RT); however, immunostaining for INI1 protein (using the BAF47/SNF5 antibody) showed retention of nuclear staining in the tumor cells, resulting in a change in the diagnosis to CPC. There was no evidence of recurrence at the last follow-up 2.5 years after treatment, which supports the diagnosis of CPC over AT/RT. This case emphasizes the importance of immunostaining for INI1 protein for distinguishing CPC from AT/RT in cases with atypical or indeterminate features.

scholarly journals An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma

2017 ◽  
Vol 8 (2) ◽  
pp. 294-300 ◽  
Author(s):  
Sara Filipa Teixeira Ribeiro ◽  
Tatiana Queirós ◽  
José M. Amorim ◽  
Ana M. Ferreira ◽  
Marco Sales-Sanz
Keyword(s):  
Differential Diagnosis ◽  
Cavernous Hemangioma ◽  
Histopathological Examination ◽  
Imaging Studies ◽  
Complete Excision ◽  
Bone Changes ◽  
Tumoral Lesion ◽  
History Of ◽  
Degenerative Alterations

Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications.

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