Lacrimal ductal cyst of the medial orbit: a case report

Abstract Background The lacrimal ductal cyst (dacryops) is an uncommon clinical entity. It occurs anywhere that lacrimal gland tissue is present but most often appears as an expanding mass in the region of the lacrimal gland. The presence involving the medial part of the orbit is rare, ectopic location can be misleading in the differential diagnosis of orbital masses. The authors report a 53-year-old man who presented with dacryops occurred in an unusual location with significant clinical presentations. Case presentation A 53-year-old man had a painless mass located in the right superomedial orbit accompanied with foreign body sensation and lachrymation for two months, which had rapidly grown within 10 days. Decrease of visual acuity, high intraocular pressure (IOP) and limitation of extraocular movements in the right eye were present. The result of visual evoked potential (VEP) test suggested the impaired function of the optic nerve. Magnetic resonance imaging (MRI) studies revealed the presence of an isolated cystic lesion. The mass was completely removed via a transcutaneous approach, histopathologic findings were consistent with the lacrimal ductal cyst. The ocular motility and high IOP returned to normal. There had been no post-operative complications or signs of recurrence over five months follow-up. Conclusion Lacrimal ductal cysts can present in the medial orbit, clinicians should include this entity in the differential diagnosis of orbital masses and be aware of its variable presentations such as high IOP in this case. We comment on the fact that many reported cases of ectopic dacryops may be an extension of normal lacrimal gland tissue.

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Mesothelioma in two sheep with pericardial effusion and ascites

Veterinary Record Case Reports ◽

10.1136/vetreccr-2019-001031 ◽

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.

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Deep Learning-Based Classification and Voxel-Based Visualization of Frontotemporal Dementia and Alzheimer’s Disease

Frontiers in Neuroscience ◽

10.3389/fnins.2020.626154 ◽

2021 ◽

Vol 14 ◽

Author(s):

Jingjing Hu ◽

Zhao Qing ◽

Renyuan Liu ◽

Xin Zhang ◽

Pin Lv ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Differential Diagnosis ◽

Deep Learning ◽

Frontotemporal Dementia ◽

Image Data ◽

Rapid Acquisition ◽

Magnetic Resonance Imaging Mri ◽

The One ◽

The Right

Frontotemporal dementia (FTD) and Alzheimer’s disease (AD) have overlapping symptoms, and accurate differential diagnosis is important for targeted intervention and treatment. Previous studies suggest that the deep learning (DL) techniques have the potential to solve the differential diagnosis problem of FTD, AD and normal controls (NCs), but its performance is still unclear. In addition, existing DL-assisted diagnostic studies still rely on hypothesis-based expert-level preprocessing. On the one hand, it imposes high requirements on clinicians and data themselves; On the other hand, it hinders the backtracking of classification results to the original image data, resulting in the classification results cannot be interpreted intuitively. In the current study, a large cohort of 3D T1-weighted structural magnetic resonance imaging (MRI) volumes (n = 4,099) was collected from two publicly available databases, i.e., the ADNI and the NIFD. We trained a DL-based network directly based on raw T1 images to classify FTD, AD and corresponding NCs. And we evaluated the convergence speed, differential diagnosis ability, robustness and generalizability under nine scenarios. The proposed network yielded an accuracy of 91.83% based on the most common T1-weighted sequence [magnetization-prepared rapid acquisition with gradient echo (MPRAGE)]. The knowledge learned by the DL network through multiple classification tasks can also be used to solve subproblems, and the knowledge is generalizable and not limited to a specified dataset. Furthermore, we applied a gradient visualization algorithm based on guided backpropagation to calculate the contribution graph, which tells us intuitively why the DL-based networks make each decision. The regions making valuable contributions to FTD were more widespread in the right frontal white matter regions, while the left temporal, bilateral inferior frontal and parahippocampal regions were contributors to the classification of AD. Our results demonstrated that DL-based networks have the ability to solve the enigma of differential diagnosis of diseases without any hypothesis-based preprocessing. Moreover, they may mine the potential patterns that may be different from human clinicians, which may provide new insight into the understanding of FTD and AD.

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A case report of ectopic salivary gland tissue in the larynx

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1283 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

Sleurs K ◽

◽

Heijden S Van Der ◽

Vries B De ◽

Smit J ◽

...

Keyword(s):

Differential Diagnosis ◽

Salivary Gland ◽

Vocal Fold ◽

Histopathological Examination ◽

Anterior Portion ◽

Salivary Gland Tissue ◽

Gland Tissue ◽

Submucosal Mass ◽

The Right ◽

False Vocal

Submucosal laryngeal masses are challenging for ENT specialists as the diagnosis usually remains uncertain until histopathological examination is carried out. We report a case of a 54-year old man complaining of dysphonia and globus sensation. Flexible laryngoscopic examination showed a submucosal swelling in the right anterior laryngeal ventricle. Microlaryngoscopic excision of the submucosal mass was performed. Histological examination revealed salivary gland tissue. We found only a few cases in the literature of ectopic salivary gland tissue situated in the larynx. In these cases, the salivary gland tissue was also located at the anterior portion of the true or false vocal fold. Thus, it is necessary to consider this condition in the differential diagnosis of a submucosal mass in the anterior true or false vocal fold or laryngeal ventricle.

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Voluminous Myoepithelioma of the Minor Salivary Glands Involving the Base of the Tongue

Case Reports in Otolaryngology ◽

10.1155/2016/3785979 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Mario Policarpo ◽

Valentina Longoni ◽

Pietro Garofalo ◽

Paolo Spina ◽

Francesco Pia

Keyword(s):

Differential Diagnosis ◽

Salivary Glands ◽

Malignant Neoplasm ◽

Needle Aspiration ◽

Hyperintense Lesion ◽

Rare Tumour ◽

Weighted Magnetic Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Histology And Immunohistochemistry

Myoepithelioma is an extremely rare tumour subtype and diagnosis is based on a wide variation of cellular morphology. FNAC specimens do not always suffice for a definitive differential diagnosis which depends on histology and immunohistochemistry of the lesion.Case Presentation. A 54-year-old female came to our attention with dysphagia and dyslalia of 6-month standing. Ear, Nose, and Throat (ENT) examination revealed a voluminous mass on the right portion of the base of her tongue, where postcontrast T2-weighted Magnetic Resonance Imaging (MRI) evidenced a hyperintense lesion. The fine-needle aspiration specimen taken for cytology was not diagnostic, as a differential diagnosis between myoepithelioma and a malignant neoplasm of the salivary glands necessitates parameters that cytology alone cannot provide. Therefore, the whole lesion was excised by diode laser through a transoral approach. Histology and immunohistochemistry of the completely excised lesion confirmed a myoepithelioma.

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Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

Case Reports in Ophthalmology ◽

10.1159/000510392 ◽

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.

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Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor

Surgical Neurology International ◽

10.25259/sni_582_2020 ◽

2021 ◽

Vol 12 ◽

pp. 64

Author(s):

Yu Shimizu ◽

Katsuyoshi Miyashita ◽

Nozomu Oikawa ◽

Masaaki Kobayashi ◽

Yasuo Tohma

Keyword(s):

Differential Diagnosis ◽

Brain Tumor ◽

Metastatic Brain Tumor ◽

Vasa Vasorum ◽

Neurological Deficits ◽

Peripheral Edema ◽

Thrombosed Aneurysm ◽

Aneurysm Wall ◽

Magnetic Resonance Imaging Mri ◽

The Right

Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to guarantee the best surgical approach for these lesions. Case Description: Here, we report an extremely rare case of a right frontal mass mimicking a brain tumor, in which the surgery unveiled a CTIA of the right middle cerebral artery (MCA). A 56-year-old woman presented with right hemiparesis and mild headache. Magnetic resonance imaging (MRI) revealed a right frontal mass with peripheral edema. The lesion enhanced on initial and follow-up MRI of the brain. Subsequent vascular studies and metastatic workup were negative. A temporal craniotomy with neuronavigation (Brain Lab AG, Germany) was performed and an intraoperative diagnosis of a thrombosed aneurysm along the branch of the MCA was established. The aneurysm was successfully trapped and resected. The patient did not exhibit any postoperative neurological deficits. Conclusion: This is the rare report of a ring enhanced completely thrombosed aneurysm due to vasa vasorum which is misdiagnosed as metastatic brain tumor. In case of an intracranial ring enhanced mass with signs of intralesional hemorrhage and peripheral edema, CTIA should be considered as a possible differential diagnosis.

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Modified Muscle Transposition Procedure for a Case of Inferior Rectus Muscle Aplasia

Case Reports in Ophthalmology ◽

10.1159/000371508 ◽

2014 ◽

Vol 6 (1) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Shinji Makino ◽

Kozue Hozawa ◽

Reiko Kondo ◽

Mika Kanai ◽

Haruko Suto ◽

...

Keyword(s):

Rectus Muscle ◽

Ocular Motility ◽

Downward Movement ◽

Inferior Rectus ◽

Muscle Transposition ◽

Magnetic Resonance Imaging Mri ◽

Operative Findings ◽

The Right ◽

Superior Rectus Muscle ◽

Inferior Rectus Muscle

Purpose: We report a case of inferior rectus muscle aplasia in a 65-year-old woman. Methods: Images were obtained using ocular motility photography and magnetic resonance imaging (MRI), and operative findings were analyzed. Results: A 65-year-old woman presented with marked right hypertropia. The right eye also had microcornea, iris coloboma, and completely restricted downward movement. MRI showed absence of the inferior rectus muscle in both eyes. During surgery, it was confirmed that the right inferior rectus muscle was absent. The patient underwent a muscle transposition procedure without tenotomy or muscle splitting. A superior rectus muscle tenotomy was also performed. Postoperatively, the right eye showed hypotropia and improved downward movement. Conclusion: Muscle transposition without tenotomy or tendon splitting is a surgical option for the unusual abnormality presented in this paper.

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A Case of a Stafne Bone Defect Associated with Sublingual Glands in the Lingual Side of the Mandible

Case Reports in Dentistry ◽

10.1155/2020/8851174 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Kamichika Hayashi ◽

Takeshi Onda ◽

Takahiro Iwasaki ◽

Mitsuru Takata ◽

Kiyotaka Mori ◽

...

Keyword(s):

Salivary Gland ◽

Bone Defect ◽

Traffic Accident ◽

Lingual Side ◽

Salivary Gland Tissue ◽

Gland Tissue ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Similar Signal Intensity ◽

Stafne Bone Defect

A Stafne bone defect from the mandibular anterior to the premolar region is an extremely rare case. A case of a Stafne bone defect extending from the mandibular anterior to the premolar region was presented. Computed tomography (CT) and magnetic resonance imaging (MRI) suggested that salivary gland tissue connected to the sublingual glands was involved in the formation of the cavity. The patient was a 68-year-old man who was examined at our hospital’s emergency outpatient department after a traffic accident. He was referred to our department for the treatment of contusions of the lips and oral cavity. A bone defect in the lingual side of the mandible from the right anterior to the right premolar region was incidentally detected on CT. CT showed a rounded cavity in the lingual side of the mandible that had a lingual opening, was monocystic, and had a cortical margin. The margin of the cavity was relatively dull and regular. MRI showed that the tissue filling the cavity in the lingual side of the mandible had similar signal intensity as the sublingual glands and was contiguous with the normal sublingual glands. Based on these findings, the bone defect was diagnosed as a Stafne bone defect filled with salivary gland tissue connected to the sublingual gland tissue.

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State-of-the-art MR Imaging of Fat-containing Focal Lesions of the Liver

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666171218154838 ◽

2019 ◽

Vol 15 (5) ◽

pp. 435-442

Author(s):

Joanna Podgorska ◽

Agnieszka Anysz-Grodzicka ◽

Andrzej Cieszanowski

Keyword(s):

Differential Diagnosis ◽

Imaging Techniques ◽

Hepatobiliary Phase ◽

Focal Lesions ◽

Dysplastic Nodules ◽

Nodular Hyperplasia ◽

Specific Finding ◽

Magnetic Resonance Imaging Mri ◽

Adrenal Rest ◽

Mri Characteristics

Background: Fat can be identified in numerous liver lesions, and usually is not a specific finding. Distinguishing between different kinds of fatty deposits is an important part of differential diagnosis. Magnetic Resonance Imaging (MRI) is superior to other imaging techniques because it allows distinguishing intracellular from macroscopic fat. Discussion: Intracellular lipid may be found in focal hepatic steatosis, hepatic adenoma, hepatocellular carcinoma and, less commonly, in focal nodular hyperplasia as well as regenerative and dysplastic nodules. Macroscopic fat is seen in angiomyolipoma, lipoma, metastases from fatcontaining neoplasms, primary or metastatic liposarcoma, hydatid cyst, pseudolipoma of the Glisson capsule, pericaval fat collection, lipopeliosis, hepatic teratoma, focal hepatic extramedullary haematopoiesis and adrenal rest tumour. Conclusion: Liver nodules should be characterised with regard to underlying liver condition, MRI characteristics and contrast enhancement pattern, including hepatobiliary phase. In many cases, identification of fatty content may help narrowing the differential diagnosis.

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Fibroadenoma of Ectopic Breast Tissue in the Groin – A Rare Disease Entity

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.101 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S47-S48

Author(s):

D Emechebe ◽

M Alshal ◽

T Rana ◽

M Agaronov

Keyword(s):

Breast Tissue ◽

Tissue Mass ◽

Ectopic Breast Tissue ◽

The Common ◽

Painless Mass ◽

The Right ◽

Ectopic Breast ◽

Urogenital Anomalies ◽

Superficial Soft Tissue

Abstract Introduction/Objective Ectopic breast tissue (EBT) is a well-documented anomaly of the breast and commonly presents along the embryonic milk line extending between the axilla and groin. Reported incidence of accessory breast is 0.4–6% in females. Pathologies developing in an EBT are reported as a rare entity in the literature. Carcinoma is reported as the common pathology followed by inflammation and fibroadenoma Methods We present a case of 43-year- old female who presented with a painless mass in her right groin for the past year which gradually increased in size. CT abdomen pelvis with contrast showed a 2.2 x 3.0 x 4.4 cm superficial soft tissue mass in the right groin which was suspected to be a lymph node. Further investigation and histopathological report of biopsy showed ectopic breast tissue with admixed chronic inflammation and reactive changes.However, excision of the mass three months later showed showed proloferation of both glandular and stromal elements. Results The tissue from the biopsy was positive for GATA 3, mammoglobin, GCDFP and CD 10 and the histological features on excision was confirmatory of fibroadenoma. Conclusion In conclusion, when tumors or nodules are found along the mammary line, the presence of breast tissue should be considered during the investigation. It is clinically wise to evaluate and screen carefully cases of supernumerary breast for any pathology and for any associated urogenital anomalies such as supernumerary kidneys, polycystic kidneys and renal cell adenocaricnoma. In our case, patient had no associated urogenital anomalies and she is on follow up.

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