Eosinophilic peritonitis with colon cancer: a case report

Abstract Background Eosinophilic gastrointestinal disorders (EGIDs) are a rare group of inflammatory disorders that can occur anywhere along the gastrointestinal tract, from the esophagus to the rectum. In particular, those with malignant or benign tumors are extremely rare. Case presentation A 62-year-old man was referred to our hospital with a chief complaint of abdominal fullness. The peripheral white blood cell count was 19,400/µL, and the eosinophil count was 13,300/µL. Abdominal computed tomography showed massive ascites. Cytology of the ascitic fluid showed a large amount of eosinophils and no malignancy. Upper and lower gastrointestinal endoscopies were performed on the suspicion of EGIDs, and colon cancer with no other abnormalities was found. The biopsies of the cancer lesions and non-cancer lesions also showed significant differences in eosinophil counts per high-power field (HPF) between the cancer and non-cancer lesions (median 77.5 [IQR 52–115] vs. 40.5 [35–56]/HPF, P < 0.05). Exploratory laparoscopy showed cloudy massive ascites and thickening of the mesentery. Pathological examination of the mesentery showed a large amount of eosinophils (median 177.5 [IQR 91–227]/HPF) and no malignancy. Based on these findings, it was suspected that the massive ascites due to eosinophilic peritonitis could be associated with colon cancer. Steroid administration resulted in immediate disappearance of the ascites, and laparoscopic left hemicolectomy was safely performed 6 weeks after steroid administration. Conclusion This report presented a case of eosinophilic peritonitis that could be related to colon cancer. Exploratory laparoscopy was useful to detect the cause of ascites. The possibility that eosinophilic peritonitis was associated with colon cancer is discussed based on the histopathological findings.

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An adrenocortical oncocytoma with unusual mitochondrial inclusions and cytoplasmic crystals

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100168980 ◽

1994 ◽

Vol 52 ◽

pp. 250-251

Author(s):

W.T. Gunning ◽

G.D. Haselhuhn ◽

E.R. Phillips ◽

S.H. Selman

Keyword(s):

Adrenal Gland ◽

Salivary Glands ◽

Mitotic Activity ◽

Diagnostic Criteria ◽

Vascular Invasion ◽

Benign Neoplasm ◽

Benign Tumors ◽

Nuclear Morphology ◽

Case Presentation ◽

Microscopic Evidence

Within the last few years, adrenal cortical tumors with features concordant with the diagnostic criteria attributed to oncocytomas have been reported. To date, only nine reported cases exist in the literature. This report is the tenth case presentation of a presumptively benign neoplasm of the adrenal gland with a rare differentiation. Oncocytomas are well recognized benign tumors of the thyroid, parathyroid, and salivary glands and of the kidney. Other organs also give rise to these types of tumors, however with less frequency than the former sites. The characteristics generally used to classify a tumor as an oncocytoma include the following criteria: the tumor is 1) usually a solitary circumscribed mass with no gross nor microscopic evidence of metastasis (no tissue nor vascular invasion), 2) fairly bland in terms of mitotic activity and nuclear morphology, and 3) composed of large eosinophillic cells in which the cytoplasm is packed full of mitochondria (Figure 1).

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Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review

BMC Infectious Diseases ◽

10.1186/s12879-021-05943-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Morichika Osa ◽

Akihiro Sato ◽

Maki Sakagami ◽

Masaki Machida ◽

Takao Sato ◽

...

Keyword(s):

Hiv Infection ◽

Pathological Examination ◽

Cmv Infection ◽

Case Presentation ◽

Immunodeficiency Virus ◽

Before And After ◽

Infected Cells ◽

Immunocompromised Hosts ◽

Inflammatory Syndrome ◽

Nonspecific Inflammation

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.

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Oesophageal squamous cell carcinoma mimicking submucosal tumour

BMC Gastroenterology ◽

10.1186/s12876-021-01731-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wen Wang ◽

Dazhou Li ◽

Linfu Zheng ◽

Hongli Zhan

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Squamous Epithelium ◽

Pathological Examination ◽

Muscularis Mucosa ◽

Case Presentation ◽

Duct Epithelium ◽

Tumour Spread ◽

Positron Emission

Abstract Background Oesophageal submucosal tumours are usually benign. We report a rare case of esophageal squamous cell carcinoma presenting as a submucosal tumour. Case presentation A 58-year-old man undergoing screening oesophago-gastroduodenoscopy was found to have a smooth-surfaced 0.6-cm sized submucosal tumour in the oesophagus 30 cm from the incisor. Endoscopic ultrasonography showed the tumour to be located in the muscularis mucosa; the lesion was heterogeneously hypoechoic and had a clear boundary. With a provisional diagnosis of leiomyoma, the tumour was removed by endoscopic submucosal dissection. Pathological examination showed it to be a moderately differentiated infiltrating squamous cell carcinoma, with normal overlying squamous epithelium. Immunohistochemistry indicated that it was caused by malignant transformation in mucosal glandular duct epithelium. Positron emission tomography–computer tomography showed no tumour spread to any other site. The patient was treated by oesophageal resection. Conclusion The clinician should be aware that oesophageal submucosal tumours with smooth overlying mucosa may not always be benign; malignancy must be ruled out.

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Successful treatment of hepatic lymphorrhea by percutaneous transhepatic lymphangiography followed by sclerotherapy using OK-432

Surgical Case Reports ◽

10.1186/s40792-019-0761-z ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Masayuki Kojima ◽

Masanori Inoue ◽

Seiichiro Yamamoto ◽

Toshio Kanai ◽

Seishi Nakatsuka ◽

...

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Intraperitoneal Administration ◽

Lymphatic Vessels ◽

Hepatoduodenal Ligament ◽

Massive Ascites ◽

Case Presentation ◽

Successful Case ◽

Leakage Site ◽

And Control

Abstract Background Conventional lymphangiography cannot detect leakage sites of hepatic lymphatic vessels. Percutaneous transhepatic lymphangiography can be used to visualize leakage sites, and once the leakage site has been confirmed, effective sclerotherapy can be performed. Case presentation A rare case of intractable hepatic lymphorrhea due to injury of the hepatoduodenal ligament following pancreaticoduodenectomy is reported. Drainage of massive ascites from the drainage tube continued after surgery. Percutaneous transhepatic lymphangiography visualized the intrahepatic lymphatic vessels and the leakage site at the hepatic hilum. An 8-Fr drainage catheter was inserted adjacent to the leakage point under fluoroscopic computed tomography guidance. Repeated sclerotherapy using intraperitoneal administration of OK-432 (picibanil) through the catheter was performed, which exposed the leakage site, and control of the ascites was finally achieved. Conclusions To the best of our knowledge, this is the first successful case of detection of a leakage site using intrahepatic lymphangiography, followed by sclerotherapy using OK-432.

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Synchronous NET and colorectal cancer development: a case report

Surgical Case Reports ◽

10.1186/s40792-020-0777-4 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Shinsei Yumoto ◽

Yuji Miyamoto ◽

Takahiko Akiyama ◽

Yuki Kiyozumi ◽

Kojiro Eto ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Systemic Therapy ◽

Multiple Organ ◽

Cancer Development ◽

Sigmoid Colon Cancer ◽

Synchronous Tumors ◽

Case Presentation ◽

The Difference ◽

Rectal Neuroendocrine Tumor

Abstract Background The incidence of synchronous gastrointestinal neuroendocrine tumors (GI-NETs) and colorectal cancer is very low. Case presentation We present a 72-year-old man diagnosed with a rectal neuroendocrine tumor (NET) with multiple organ metastases and simultaneous sigmoid colon cancer. Although the NET was his prognostic factor, he underwent a laparoscopic sigmoidectomy at first because it was expected that the colon cancer would cause obstruction or bleeding during NET treatment. Subsequently, he started taking everolimus. Conclusions We should consider surgical resection of the synchronous cancer before systemic therapy for a GI-NET regardless of the difference in prognosis between synchronous tumors, if the cancer may impair the continuation of systemic therapy.

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Rare presentation of a testicular angiofibroma treated with testis sparing surgery

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.4.330 ◽

2016 ◽

Vol 88 (4) ◽

pp. 330 ◽

Cited By ~ 1

Author(s):

Luca Leone ◽

Paola Fulvi ◽

Giulia Sbrollini ◽

Alessandra Filosa ◽

Enrico Caraceni ◽

...

Keyword(s):

Case Report ◽

Malignant Tumor ◽

Gold Standard ◽

Conservative Surgery ◽

Pathological Examination ◽

Benign Tumors ◽

Frozen Sections ◽

Rare Presentation ◽

Final Histology

Introduction: Testicular benign tumors are very rare (< 5%). Testicular Angiofibroma (AF) is one of those, however the gold standard of treatment and follow-up is still unclear. Case report: A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. Conclusion: We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

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Burkit-like lymphoma: subileus and ascites as dominant clinical manifestation

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0312458m ◽

2003 ◽

Vol 131 (11-12) ◽

pp. 458-460 ◽

Cited By ~ 1

Author(s):

Olivera Markovic ◽

Dragomir Marisavljevic ◽

Vesna Cemerikic-Martinovic

Keyword(s):

Gastrointestinal Tract ◽

Complete Remission ◽

Physical Examination ◽

X Rays ◽

Malignant Cells ◽

Massive Ascites ◽

Ki 67 ◽

Precise Diagnosis ◽

Night Sweats ◽

Abdominal Fullness

Nodal presentation of Burkitt-like lymphoma is common, particularly in gastrointestinal tract. However, only few cases with massive ascites and signs of subileus due to lymphoma proliferation are described. We report a 31-year-old male patient who presented with fever, night sweats, vomiting and abdominal fullness. Physical examination suggested much ascites. Abdominal X-rays showed hidroaeric levels. Diagnosis of Burkitt-like lymphoma was established on the basis of cytological and imunohistochemical examination of ascites (immune phenotype of malignant cells was EMA -, NSE -, LCA +, CD10 -/+, CD20 +, IgM +, Ki-67 +100%). After treatment with BMF protocol complete remission was achieved and retained for 2.5 years. Authors stressed that imunohistochemical examination of ascites has been proved as simple and efficient method for establishing precise diagnosis. In this way laparotomy was avoided, which otherwise would be necessary due to exclusive abdominal localization of the disease.

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The largest reported intrathoracic lipoma: a case report and current perspectives review

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1030-8 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Mohammed Aldahmashi ◽

Abdalmotaleb Elmadawy ◽

Mahmoud Mahdy ◽

Mohamed Alaa

Keyword(s):

Single Case ◽

Tumor Resection ◽

Pathological Examination ◽

Complete Excision ◽

Case Presentation ◽

Medical Checkup ◽

Excellent Outcome ◽

The Right ◽

Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

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Intrascrotal Abscess,Propionibacterium acnesandStaphylococcus cohniissp.cohnii: A Case Report and Review of the Literature

Case Reports in Urology ◽

10.1155/2012/313694 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Masciovecchio Stefano ◽

Alessandro Del Rosso ◽

Pietro Saldutto ◽

Giuseppe Paradiso Galatioto ◽

Carlo Vicentini

Keyword(s):

Blood Culture ◽

Pathogenic Bacteria ◽

Propionibacterium Acnes ◽

Granulomatous Inflammation ◽

Pathological Examination ◽

Review Of The Literature ◽

Case Presentation ◽

Scrotal Ultrasound ◽

Staphylococcus Cohnii ◽

Systemic Infections

Introduction. ThePropionibacterium acnesand theStaphylococcus cohnii ssp.cohniiare occasional pathogenic bacteria. The intrascrotal localization of thePropionibacterium acnesis exceptional. TheStaphylococcus cohniissp.cohniiis not able to colonize the urogenital apparatus but it is the most frequently responsible for blood culture contamination even if it can sustain, in particular conditions, systemic infections.Case Presentation. We report the case of a 72-year-old man who is under observation for pain and swelling of the left hemiscrotum associated to high fever. The scrotal ultrasound shows the presence of a left intra-scrotal abscess with didymus, epididymis, and intact didymus-epididymis tunicae. The blood culture executed for evening fever during antibiotic therapy has underlined an infection withPropionibacterium acnes. A following blood culture has shown an increase inStaphylococcus cohniissp.cohnii. Due to fever the patient has undergone left orchifunicolectomy with inguino-scrotal toilet. The anatomical pathological examination has also shown the presence of nonspecific granulomatous inflammation compatible withPropionibacterium acnesinfection.Conclusion. The onset of an intrascrotal abscess likely sustained byPropionibacterium acnescomplicated by a possible systemicStaphylococcus cohniissp.cohniisuprainfection is an exceptional event that, in our case, has been resolved with surgical toilet.

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A CASE PRESENTATION: RADIOLOGICAL AND PATHOLOGICAL ROLE IN DIAGNOSIS OF BENING RENAL MASS – ONCOCYTOMA

10.36106/gjra/7904429 ◽

2020 ◽

pp. 63-64

Author(s):

B. Keerthana ◽

N. Siva Durgesh ◽

B. Anji Naik

Keyword(s):

Renal Mass ◽

Renal Tumor ◽

Tumor Incidence ◽

Pathological Examination ◽

Renal Oncocytoma ◽

Pathological Findings ◽

Kidney Tumors ◽

Case Presentation ◽

Difficult Diagnosis ◽

Radiological Features

Oncocytoma is benign renal tumor. Incidence of oncocytoma is 3%– 7% among all the kidney tumors. A 45 year old female was presented with complaints of pain in right loin since 1 year. Conclusion Renal oncocytoma is difficult diagnosis to conclude with only radiological features and pathological findings, the diagnosis can be confirmed only by chemical staining in histo pathological examination, as radiologically oncocytoma closely resembles RCC and is challenging to differentiate between the two.

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