scholarly journals Deceptively complex diagnosis of early onset primary chronic osteomyelitis: a case report

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
T. Kavya Priya ◽  
Amith Hadhimane ◽  
Kirthi Kumar Rai ◽  
H. R. Shiva Kumar ◽  
Amarnath P. Upasi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Early Onset ◽  
Chronic Osteomyelitis ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Chronic Inflammatory Disease ◽  
Fistula Formation ◽  
Unknown Etiology ◽  
Disease Entity

Abstract Background Primary chronic osteomyelitis is a rare occurrence in the pediatric mandible though it exclusively affects the mandible with no age preference. The absence of pus, fistula and sequestration are characteristic with insidious onset lacking an acute state. It is a chronic inflammatory disease of unknown etiology. It has two peaks of incidence: initial peak at adolescence and the second peak after the age of 50 years. Clinical and radiological presentation does not suffice the diagnosis of Primary chronic osteomyelitis necessitating biopsy followed by histopathological examination. Use of several terms in the literature to describe this disease entity has led to further confusion. The Zurich classification system satisfactorily describes the early onset Primary Chronic Osteomyelitis based on etiology and pathogenesis. Case presentation A case of Early Onset Primary Chronic Osteomyelitis in a 10 year old boy is reported comprehensively from clinical presentation to diagnosis and treatment. A meticulous hierarchical order of investigations leads the way to final diagnosis with the aid of existing literature. Extra-oral biopsy, decortication and antibiotic therapy proved to be an effective treatment with no recurrence at 1 year follow-up. Conclusion The clinical and radiological features of Early Onset Primary Chronic Osteomyelitis are deceptively complex throwing an array of differential diagnosis including malignant tumors whilst histopathology reveals only chronic inflammation making this entity an enigma. This disease entity should be included in the differential diagnosis for a pediatric posterior mandibular swelling that occurs without an infectious nidus, pus discharge and fistula formation.

Dermal fibrosarcoma in a Cashmere goat

2019 ◽  
Vol 47 (03) ◽  
pp. 192-195
Author(s):  
Julia Schoiswohl ◽  
Bianca Lambacher ◽  
Andrea Klang ◽  
Reinhild Krametter-Frötscher
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Connective Tissue ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Low Grade ◽  
Cashmere Goat ◽  
Short Lifespan ◽  
Production Processes

AbstractFibrosarcomas are malignant tumors of the connective tissue, which are characterized by proliferation of fibroblasts. Most of these tumors are localized subcutaneously and cause different symptoms depending on their location. The case report describes a dermal tumor on the outside of the pinna in a 7-year-old female Cashmere goat. The tumor was surgically removed and histopathological examination revealed a low grade fibrosarcoma. Although tumors are rare in ruminants because of the animals’ short lifespan (age of slaughtering in most cases < 24 months) in modern production processes, they should be considered as a differential diagnosis.

scholarly journals HISTOPATHOLOGICAL SPECTRUM OF SALIVARY GLAND LESIONS WITH CLINICAL CORRELATION

2020 ◽  
pp. 1-3
Author(s):  
Radhika Mucharla ◽  
Ravikanth Kotagiri
Keyword(s):  
Salivary Gland ◽  
Clinical Laboratory ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Research Centre ◽  
Benign Tumors ◽  
Salivary Gland Tumours ◽  
Chronic Sialadenitis ◽  
Neoplastic Lesions

Salivary gland tumours account for 2-6.5% of all the neoplasms of the Head and Neck. Histopathology is most important in diagnosis of salivary gland tumors. AIMS and OBJECTIVES : To study age,sex and site distribution of various salivary gland lesions, to study the histomorphologic (gross &microscopic) aspect of these lesions to correlate clinical diagnosis with that of histopathologic features. MATERIALS AND METHODS: The study is conducted in the RAINBOW CLINICAL LABORATORY AND RESEARCH CENTRE, SIDDIPET during the period of September2018 to September 2020. Formalin fixed ,paraffin embedded sections and stained with hematoxylin and eosin slides were studied. RESULTS: Total number of specimens were 54. Out of these 39 were neoplastic (benign 70%,malignant 30%) and 15 were non neoplastic. Among the benign tumors majority are pleomorphic adenoma.Among the malignant tumors, mucoepidermoid carcinoma is the most common. Among the non neoplastic lesions chronic sialadenitis is most common. CONCLUSION: Histopathological examination of salivary gland lesions stands out to be the most important method in establishing the final diagnosis. It helps in differentiating non neoplastic and neoplastic lesions.

scholarly journals A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

2021 ◽  
Vol 8 ◽  
Author(s):  
Alexandr V. Kurkov ◽  
Viktoriya M. Pominalnaya ◽  
Viktor V. Nechay ◽  
Igor A. Ratke ◽  
Sergej V. Mishugin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Tumors ◽  
Kidney Tissue ◽  
Morphological Observation ◽  
Unknown Etiology ◽  
Epidermal Cyst ◽  
Type I ◽  
Pelvicalyceal System ◽  
Calyceal Diverticulum ◽  
Benign Nature

Calyceal diverticula and epidermal cysts are extremely rare kidney lesions with unknown etiology and pathogenesis. They have non-specific clinical and radiological picture. Despite the benign nature, sometimes these disorders mimic malignant tumors leading to unjustified nephrectomy. We present a clinical and morphological observation of a multicystic lesion in a 76-year-old patient's right kidney filled with keratinized masses and imitating a malignant solid tumor. The detailed gross, histological and immunohistochemical (desmin, cytokeratin 7, uroplakin and p63) analyses of the kidney tissue excluded the malignant nature of the lesion. The final differential diagnosis was between an epidermal cyst and calyceal diverticulum with pronounced squamous cell metaplasia of urothelium. The upper pole localization of the lesion, its connection with the pelvicalyceal system through the unobstructed isthmus, the presence of urothelial lining and smooth muscle cells in its wall let us diagnose a calyceal diverticulum type I. Knowledge of the key clinical and morphological features of epidermal cysts and diverticula of the pelvicalyceal system will help the practicing physicians suspect the benign nature of such lesions and perform organ-preserving operations.

scholarly journals Primary Heterotopic Meningioma of Nasal Cavity: Case Report and Literature Review

2020 ◽  
pp. 014556132097486
Author(s):  
Xianwen Hu ◽  
Maoyan Jiang ◽  
Zelong Feng ◽  
Juan Wang ◽  
Pan Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Nasal Cavity ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Ectopic Meningioma ◽  
Pathological Type ◽  
Immunohistochemistry Analysis ◽  
The Right ◽  
Histopathological Subtype

Primary heterotopic meningiomas are lesions that are not associated with a cranial nerve foramen, vertebral canal, or intracranial structure. The most common histopathological subtype is meningeal epithelioma. In clinical practice, primary heterotopic nasal meningioma occurs relatively rarely, and its most common pathological type is psammomatous meningioma, whereas nasal fibrous meningioma is infrequent. In our case, a 31-year-old male patient was admitted to the hospital with “progressive nasal obstruction on the right side for half a year.” Computed tomography examination of the paranasal sinuses revealed a polyploid mass in the right nasal cavity. The patient underwent surgical resection of the mass under nasal endoscopy. Histopathological examination confirmed that the mass was an ectopic meningioma of the nasal cavity. The patient was regularly followed up for 2 years without recurrence of the tumor. Primary heterotopic fibrous meningioma of the nasal cavity is clinically rare but should be considered as a differential diagnosis for hemangioma of the nasal cavity, inverted papilloma, and nasal polyp. The final diagnosis is based on pathology and immunohistochemistry analysis results.

scholarly journals Clinicopathological Evaluation of Eyelid and Conjunctival Lesions in Patients of Farshchian Hospital in Hamadan

2018 ◽  
Vol 3 (3) ◽  
pp. 120
Author(s):  
Fateme Eslami ◽  
Hamidreza Ghasemibasir
Keyword(s):  
Clinical Diagnosis ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Age Groups ◽  
Final Diagnosis ◽  
Histological Diagnosis ◽  
Bulbar Conjunctiva ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Clinical Appearance

Introduction: The lesions of the eyelid and conjunctiva are benign and malignant. The ratio of benign lesions is more than the malignant, increases with age, and are easily diagnosed clinically. However, in some cases, the clinical diagnosis of malignant tumors is impossible, necessitating the final diagnosis by histopathological examination. The incidence of benign and malignant tumors differs between countries according to the genetics of the racial population or environmental factors.Materials and methods: This cross-sectional descriptive study was conducted on 424 patients with eyelid and conjunctival lesions from the Farshchian Hospital of Hamadan between 2010–2014. The final pathological report, clinical diagnosis, demographic variables including age and gender, site of lesions, and clinical appearance were extracted from medical records.Results: The lesions consisted of 159 (37.5%) eyelid and 265 (62.5%) conjunctival lesions. The predominant location was bulbar conjunctiva (35.1%), and the least was external canthus (1.7%). The most frequent lesion based on clinical diagnosis was pterygium (51.7%), and the least frequent was sebaceous glands carcinoma. The most frequent lesion based on histological diagnosis was pterygium (52.5%), and the least frequent was xanthelasma. In this study, the concordance between clinical and histological diagnosis was 90.3% that indicated the physician’s accurate diagnosis.Conclusion: According to this study, the frequency of eyelid and conjunctival lesion was similar in males and females. The prevalence of lesions in >60-year-olds is more common than that in other age groups. The benign lesions of eyelids and conjunctiva are common than malignant lesions. Despite high clinicopathological concordance, the physician should always consider the rare cases, and the pathological diagnosis must be considered for all specimens.

Increased Number of Perivascular CD20-Positive B Lymphocytes in the Neuropathology of CLIPPERS: Findings of 6 Patients from Mainland China

2021 ◽  
pp. 1-9
Author(s):  
Baifeng Yang ◽  
Fan Liu ◽  
Jing Li ◽  
Yanbin Wen
Keyword(s):  
Histopathological Examination ◽  
Mainland China ◽  
Clinical Manifestations ◽  
Lymphocytic Infiltration ◽  
Final Diagnosis ◽  
Chronic Inflammatory Disease ◽  
The Other ◽  
Cell Infiltration ◽  
T Cell Infiltration ◽  
Pepper Powder

<b><i>Introduction:</i></b> Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome is a recently described chronic inflammatory disease of the central nervous system. There are few reports of CLIPPERS in the Chinese population to date. We summarized the clinical characteristics of 6 CLIPPERS patients to deepen the understanding of this disease. <b><i>Methods:</i></b> The clinical manifestations and treatment of 6 CLIPPERS patients confirmed by pathology or clinical diagnosis in our hospital were retrospectively analyzed. <b><i>Results:</i></b> The common clinical manifestations included ataxia, dysarthria, diplopia, dysphagia, dizziness, cognitive impairment, facial paresthesia, and paralysis. Most of the lesions showed typical symmetric “pepper powder”-like dot and nodular enhancement centered in the pontine and cerebellum except 1 patient with unilateral nodular enhancement. The brain histopathological examination of the 5 biopsied patients indicated that, with the exception of patient 4 with no lymphocyte infiltration, a large amount of perivascular lymphocytic infiltration was found in the other 4 patients, among whom only 1 patient was dominated by CD3+ T cell infiltration and the other 3 patients were dominated by CD20+ B cell infiltration. After treatment with intravenous methylprednisolone, all patients had significant clinical recovery associated with complete or significant MRI recovery, but they were prone to relapse after withdrawal or reduction of the corticosteroid. <b><i>Conclusion:</i></b> Our reports highlight the importance of neuropathological examinations when encountering atypical imaging manifestations, such as unilateral and large nodular Gd+ lesions, in order to establish a final diagnosis of CLIPPERS. In addition, the lymphocytic infiltration in the lesions of CLIPPERS may be dominated by CD20+ B cells instead of CD3+ T cells.

F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Bhawana Pant ◽  
Sanjay Gaur ◽  
Prabhat Pant
Keyword(s):  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Clinical Information ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Cytological Diagnosis ◽  
Tertiary Referral Centre ◽  
Clear Cut ◽  
Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the  department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated  Contrast enhanced computerized tomography(CECT) and  Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of  parotid surgeries  were done. . Final diagnosis was made on  histopathological  examination. Result :The most common tumour  came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten  cases there was no clear cut  association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

Ultrasonic differential diagnostics of cyst and cystic tumors of the spleen

2020 ◽  
Vol 24 (3) ◽  
pp. 63-75
Author(s):  
Yu. A. Stepanova ◽  
M. Z. Alimurzaeva ◽  
D. A. Ionkin
Keyword(s):  
Differential Diagnosis ◽  
Cancer Metastasis ◽  
Malignant Tumors ◽  
Dynamic Control ◽  
Differential Diagnostics ◽  
Epithelial Lining ◽  
Focal Lesions ◽  
Morphological Form ◽  
Cystic Tumors ◽  
Number Of Patients

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.

TUMOR GANAS OVARIUM RESIDIF METASTASIS KARSINOMA MUSIN KE UMBILIKUS, PERITONEUM, DAN CAIRAN ASITES TANPA DITEMUKAN TANDA KEGANASAN PADA PEMERIKSAAN HISTOPATOLOGIS PASCA OPERATIF SEBELUMNYA

2019 ◽  
Vol 3 (2) ◽  
pp. 130-136
Author(s):  
Arif Fadillah ◽  
Andi Friadi
Keyword(s):  
Ovarian Carcinoma ◽  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Ovarian Tumors ◽  
Postoperative Chemotherapy ◽  
Definitive Treatment ◽  
Malignant Ovarian Tumor ◽  
Patient Will ◽  
Optimal Debulking

Background : Malignant ovarian tumor are still the number one cause of death and the second most  of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.Method : Case reportCase : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluidKeywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

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