scholarly journals A large retroperitoneal lipoblastoma as an incidental finding: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Gerhard-Hartmann ◽  
Verena Wiegering ◽  
Clemens Benoit ◽  
Thomas Meyer ◽  
Andreas Rosenwald ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Correct Diagnosis ◽  
Clear Cell Sarcoma ◽  
Final Diagnosis ◽  
The Body ◽  
Differential Diagnoses ◽  
Molecular Diagnostic ◽  
Mesenchymal Neoplasm ◽  
Retroperitoneal Tumors ◽  
The Right

Abstract Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.

scholarly journals Dedifferentiated Solitary Fibrous Tumor: A Concise Review

2018 ◽  
Vol 142 (6) ◽  
pp. 761-766 ◽  
Author(s):  
Nicholas J. Olson ◽  
Konstantinos Linos
Keyword(s):  
Solitary Fibrous Tumor ◽  
Correct Diagnosis ◽  
The Body ◽  
Molecular Alterations ◽  
Concise Review ◽  
Mesenchymal Neoplasm ◽  
Fibrous Tumor ◽  
Aggressive Clinical Course ◽  
Age Range ◽  
Ancillary Studies

Solitary fibrous tumor (SFT) is a unique mesenchymal neoplasm that was originally believed to be of submesothelial origin. Eventually, SFT expanded to include what was previously called hemangiopericytoma in other regions of the body that had similar immunohistochemical and morphologic features. Although most are benign, many studies have tried to identify histologic features that predict which tumors will behave in an aggressive manner. Recently, dedifferentiation has been described in rare cases of SFT and does appear to correlate with a more aggressive clinical course. Dedifferentiated SFT occurs in a similar age range and location as conventional SFT and can resemble multiple different malignant entities. Utilization of ancillary studies and thorough tissue sampling is important to reach the correct diagnosis. The morphologic features, immunohistochemistry, molecular alterations, and prognosis will be discussed.

scholarly journals Congenital Cystic Adenomatoid Malformation Of The Lung: A Case Report And Review Of The Literature

2015 ◽  
Vol 8 (2) ◽  
pp. 160-163
Author(s):  
Doroteya V. Malinova ◽  
Penka L. Kolova ◽  
Radoslav S. Radev
Keyword(s):  
Lung Development ◽  
Incidental Finding ◽  
Ct Scanning ◽  
Final Diagnosis ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Pulmonary Infections ◽  
Cystic Adenomatoid Malformation ◽  
Clinical Presentations ◽  
The Right

Summary Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. It was classified into 5 types by Stocker in 2002 and is also known under the name of congenital pulmonary airway malformation (CPAM). Cases are typically identified prenatally by routine ultrasonography screening. CCAM may present in the older child and adult as an incidental finding. The case presented is of a 21-year-old male patient who suffered from pulmonary infections with a recurrent productive cough 3-4 times the last 4 years. CT scanning of the thorax showed multiple cystic lesions in the right middle and lower lobes. The areas with the lesions were resected. The macroscopic and histological findings were typical for congenital cystic adenomatoid malformation type 2, which was the final diagnosis. Clinical presentations and prognosis depend on the type of lesion and its sequelae. The diagnosis is confirmed histologically.

scholarly journals Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Farzana Arif ◽  
Susan Wu ◽  
Shahriyour Andaz ◽  
Stewart Fox
Keyword(s):  
Incidental Finding ◽  
Lower Lobe ◽  
Final Diagnosis ◽  
Myoepithelial Cells ◽  
Myoepithelial Carcinoma ◽  
Rare Entity ◽  
Lobe Bronchus ◽  
Epithelial Myoepithelial Carcinoma ◽  
Bronchial Glands ◽  
The Right

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

scholarly journals Jaffe-Lichtenstein Syndrome Associated with a Simple Bone Cyst: Unprecedented Rare Case Report

2020 ◽  
Vol 31 (5) ◽  
pp. 557-561
Author(s):  
Poliana Gonçalves Miranda ◽  
João César Guimaraes Henriques ◽  
Luiz Fernando Barbosa de Paulo ◽  
Cizelene do Carmo Faleiros Veloso Guedes ◽  
Fabio Franceschini Mitri ◽  
...  
Keyword(s):  
Fibrous Dysplasia ◽  
Bone Cyst ◽  
Final Diagnosis ◽  
The Body ◽  
Bone Architecture ◽  
World Health ◽  
Ossifying Fibroma ◽  
Simple Bone Cyst ◽  
Single Bone ◽  
The Right

Abstract Lesions denominated fibro-osseous lesions of the jaw constitute a diversified group of disorders, in which the normal bone architecture is replaced by fibroblasts, collagen fibers and immature bone. At present, the World Health Organization recognizes four variants of these lesions, namely: bone-cement dysplasia, fibrous dysplasia, ossifying fibroma and Familial gigantiform cementoma. Fibrous dysplasia may present in the monostotic form, affecting one single bone or an isolated craniofacial region; and in the Polyostotic form, involving two or more bones of the skeleton, and eventual association with syndromic conditions. The patient, C.P.G., 43 years old, sought attendance due to symptomatic increase in the region of the mandibular body on the right side. Imaging exams revealed craniofacial areas with ground-glass aspect, beyond the extensive mandibular radiolucent lesion. During the physical exam, spots of the Café au lait type disposed on the right side of the body were identified, in addition to uncoordinated gait with distinct shortening of the right leg. Additional radiographic exams showed evidence of skeletal dissemination of the disease. The patient denied any sexual precocity, and the final diagnosis was fibrous dysplasia, expressed by means of the Jaffe-Lichtenstein syndrome, in association with a simple bone cyst.

The variability in how physicians think: a casebased diagnostic simulation exercise

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ashwin Gupta ◽  
Martha Quinn ◽  
Sanjay Saint ◽  
Richard Lewis ◽  
Karen E. Fowler ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Hospital Medicine ◽  
Final Diagnosis ◽  
Differential Diagnoses ◽  
Diagnostic Process ◽  
Academic Medical ◽  
Interview Format ◽  
Life Threatening ◽  
Diagnostic Simulation ◽  
Diagnostic Thinking

AbstractObjectivesLittle is known about how physician diagnostic thinking unfolds over time when evaluating patients. We designed a case-based simulation to understand how physicians reason, create differential diagnoses, and employ strategies to achieve a correct diagnosis.MethodsBetween June 2017 and August 2018, hospital medicine physicians at two academic medical centers were presented a standardized case of a patient presenting with chest pain who was ultimately diagnosed with herpes zoster using an interview format. Case information was presented in predetermined aliquots where participants were then asked to think-aloud, describing their thoughts and differential diagnoses given the data available. At the conclusion of the interview, participants were asked questions about their diagnostic process. Interviews were recorded, transcribed, and content analysis was conducted to identify key themes related to the diagnostic thinking process.ResultsSixteen hospital medicine physicians (nine men, seven women) participated in interviews and four obtained the correct final diagnosis (one man, three women). Participants had an average of nine years of experience. Overall, substantial heterogeneity in both the differential diagnoses and clinical reasoning among participants was observed. Those achieving the correct diagnosis utilized systems-based or anatomic approaches when forming their initial differential diagnoses, rather than focusing on life-threatening diagnoses alone. Evidence of cognitive bias was common; those with the correct diagnosis more often applied debiasing strategies than those with the incorrect final diagnosis.ConclusionsHeterogeneity in diagnostic evaluation appears to be common and may indicate faulty data processing. Structured approaches and debiasing strategies appear helpful in promoting diagnostic accuracy.

scholarly journals The histological patterns of inflammation in erythroderma

2016 ◽  
pp. 65-73
Author(s):  
D. Zaslavsky ◽  
I. Chuprov ◽  
R. Nasyrov ◽  
A. Sidikov ◽  
M. Maksimova ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Medical Condition ◽  
Correct Diagnosis ◽  
Molecular Genetic ◽  
Clinical Information ◽  
Final Diagnosis ◽  
The Body ◽  
Diagnostic Process ◽  
Correct Judgment ◽  
Histopathology Examination

Background: Erythroderma is a serious medical condition characterized by inflamed red skin, involving over 90% of the body. It can be a common presentation of different diseases, therefore clinical diagnosis can be problematic. Controversial data are reported regarding the diagnostic value of histological examination in erythroderma subjects. Methods: A retrospective study on histological skin specimens of patients admitted with a clinical diagnosis of erythroderma at the Department of Pathological anatomy with course of department of forensic medicine of State Pediatric Medical University, Saint-Petersburg, and derpatment of dermatolopathology of University clinic of Bonn from 2001 to 2014, was performed. Histopathology examination was performed in each case by a pathologist with a special interest in the skin disease who was blind to any clinical information as well as to final diagnosis. Results: Blinded histopathology examination alone was able to give the correct diagnosis in 61% (n=50/82) of cases when compared to final diagnosis. A diagnosis of psoriasis was made in 23.2% (n=19/82) of subjects, spongiotic dermatitis/eczema in 20.7% (n=17/82), mycosis fungoides in 8.5% (n=7/82) and drug eruption in 8.5%; histological diagnosis was inconclusive or not matching the final diagnosis when available in the remaining 39.1% of cases (n=32/82). Conclusion: Erythroderma remains a condition difficult to study and treat. We showed that a correct judgment about its cause can be based on objective histopathological criteria in up to 60% of cases. More studies are needed to try to find out further histological and/or immunohistochemical and molecular-genetic markers which could help the clinician in erythroderma aetiololgy diagnostic process.

Sonographic Clues in Suspicion of Compartment Syndrome in a Lower Extremities Venous Study: A Case Study

2021 ◽  
pp. 875647932110059
Author(s):  
Cassey Y. Noh
Keyword(s):  
Compartment Syndrome ◽  
Incidental Finding ◽  
Lower Extremities ◽  
The Body ◽  
Excessive Pressure ◽  
Saphenous Veins ◽  
Evaluation Strategies ◽  
Pseudo Aneurysm ◽  
The Right

Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. The dangerously high pressure in compartment syndrome impedes the flow of blood to and from the affected tissues. It can be an emergency, requiring surgery to prevent a permanent injury. In this case study, a lower extremities venous examination was performed on a male patient suspected of having compartment syndrome, as an incidental finding. Sonographic evaluation of the right leg revealed the absence of popliteal and small saphenous veins, and acute thrombus in the posterior tibial veins. The evaluation further revealed an incidental finding of double pseudo-aneurysm in the popliteal fossa, which was suspected for increasing the excessive compartmental pressure. This unique case study presents sonographical evaluation strategies when compartment syndrome is suspected.

Sclerochoroidal calcification as an incidental finding during oncological staging of a patient with parotid malignancy: A case report

2021 ◽  
pp. 112067212199962
Author(s):  
Nicola Vito Lassandro ◽  
Luca Danieli ◽  
Michele Nicolai ◽  
Vittorio Pirani ◽  
Paolo Pelliccioni ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Preoperative Staging ◽  
Malignant Lesion ◽  
Enhanced Depth Imaging ◽  
Elevated Lesion ◽  
Retinal Artery ◽  
Challenging Situation ◽  
The Right

Introduction: Incidental finding of mass lesion in the choroid represents a very challenging situation for the ophthalmologist. We describe a case of an incidental, computed tomography (CT)-hyperintense, choroidal lesion in a patient with parotid malignancy and renal failure, and how multimodal imaging helped us reaching the correct diagnosis. Case description: A 63-year-old man with parotid gland malignancy was brought to our attention because preoperative staging CT showed a hyperintense choroidal lesion of the right eye. Fundus examination showed a yellow elevated lesion near the superior temporal branch retinal artery. Enhanced depth imaging optical coherence tomography (EDI-OCT), A- and B-scan ultrasonography, and Indocyanine Green Angiography (ICGA) allowed us to exclude a malignant lesion and to diagnose a sclerochoroidal calcification. Conclusion: Multimodal imaging can guide the clinician to choose the appropriate therapeutic approach even in case of uncommon conditions like sclerochoroidal calcification.

scholarly journals Brain Abscess of Dental Origin: A Case Report and Literature Review

2021 ◽  
pp. 1-5
Author(s):  
Selmi wissal ◽  
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Correct Diagnosis ◽  
Final Diagnosis ◽  
Oral Infections ◽  
Pubmed Database ◽  
Dental Origin ◽  
Life Threatening ◽  
The Right

Introduction: Brain abscess (BA)of dental origin is a rare but potentially life-threatening complication of odontogenic infection that requires immediate neurosurgical attention. It is defined as an encapsulated collection of pus in various areas of the brain. The infectious process spreads from the dental site and occurs in 2 ways: haematogenous route or by contiguity. Treatment should ideally be based on the etiological factor excision, combined with drainage and adjuvant antibiotic therapy. The aim of this article was to report a case of frontal brain abscess of dental origin and to review the literature. Case report: We present the case of a 36-year-old man diagnosed with a brain abscess located in the frontal lobe and caused by a periodontal lesion of the right upper first molar. The final diagnosis was established due to the availability of computed tomography and magnetic resonance imaging. Drainage of the pus combined with extraction of the tooth and antibiotic therapy was followed by an excellent recovery. Clinical and radiological features, treatment and follow-up data were documented. A review of the literature using the PubMed database was performed Conclusion: Oral infections can lead to life-threatening infections, such as brain abscesses. Early detection of this condition through correct diagnosis is essential to give the patient the best treatment; in addition, improving of the oral environment and treating oral infections is highly recommended to limit this serious condition.

Our Bodies, Whose Property?

2013 ◽  
Author(s):  
Anne Phillips
Keyword(s):  
Labor Markets ◽  
Personal Autonomy ◽  
The Body ◽  
Body Parts ◽  
Complex Issue ◽  
Human Organs ◽  
Property Owners ◽  
The Common ◽  
The Difference ◽  
The Right

No one wants to be treated like an object, regarded as an item of property, or put up for sale. Yet many people frame personal autonomy in terms of self-ownership, representing themselves as property owners with the right to do as they wish with their bodies. Others do not use the language of property, but are similarly insistent on the rights of free individuals to decide for themselves whether to engage in commercial transactions for sex, reproduction, or organ sales. Drawing on analyses of rape, surrogacy, and markets in human organs, this book challenges notions of freedom based on ownership of our bodies and argues against the normalization of markets in bodily services and parts. The book explores the risks associated with metaphors of property and the reasons why the commodification of the body remains problematic. The book asks what is wrong with thinking of oneself as the owner of one's body? What is wrong with making our bodies available for rent or sale? What, if anything, is the difference between markets in sex, reproduction, or human body parts, and the other markets we commonly applaud? The book contends that body markets occupy the outer edges of a continuum that is, in some way, a feature of all labor markets. But it also emphasizes that we all have bodies, and considers the implications of this otherwise banal fact for equality. Bodies remind us of shared vulnerability, alerting us to the common experience of living as embodied beings in the same world. Examining the complex issue of body exceptionalism, the book demonstrates that treating the body as property makes human equality harder to comprehend.

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