Testicular pain as an atypical presentation of sarcoidosis

Sarcoidosis is a systemic granulomatous disease, with genitourinary tract involvement being very rare (0.2% of all sarcoidosis cases). Genitourinary sarcoidosis may present with a scrotal mass with or without testicular pain, often mimicking epididymo-orchitis or malignancy. Only 8 cases of genitourinary sarcoidosis have been reported in the literature in the last 14 years. We describe the case of a 25-year-old man who was referred with testicular pain. Scrotal ultrasonography demonstrated multiple bilateral hypoechoic testicular lesions that were of similar size and distributed unusually throughout the testicular parenchyma. Computed tomography detected a nodule in the middle lobe of the right lung, multiple small volume nodes in the retrocaval and left para-aortic regions, and enlarged bilateral external iliac and inguinal nodes, similar to those found in metastatic testicular cancer. Following ultrasound guided excision of one of the lesions, histopathological examination confirmed granulomatous inflammation consistent with sarcoidosis.

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Thyroid haemangiosarcoma in a seven-year-old female Shih Tzu

Veterinary Record Case Reports ◽

10.1136/vetreccr-2019-001012 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001012

Author(s):

Luis Pedro Rocha Moreira ◽

Emma Scurrell ◽

Paul Mahoney ◽

Stephen Baines

Keyword(s):

Histopathological Examination ◽

Abdominal Ultrasound ◽

Neck Mass ◽

Clinical Staging ◽

Ultrasound Guided ◽

Fine Needle ◽

Fine Needle Aspirates ◽

History Of ◽

The Right ◽

Mixed Tumours

Canine thyroid tumours are uncommon and the majority of tumours are carcinomas or adenomas, with only very few mixed tumours or metastases from distant sites described to date. A primary thyroid haemangiosarcoma has never been reported in veterinary medicine. In this case report, we describe a dog with a history of a large, non-painful, mobile ventral neck mass in the right paralaryngeal region. CT and ultrasound-guided fine needle aspirates were used for clinical staging. The mass was surgically excised and histopathological examination indicated a haemangiosarcoma. Abdominal ultrasound revealed the presence of splenic nodules and splenectomy indicated the presence of haemangiosarcoma. Chemotherapy with doxorubicin was started, but the dog was euthanased after three rounds of therapy, 97 days after the mass was discovered.

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Simultaneous use of FDG-18 and 68Ga-citrate PET/CT for the differential diagnosis of sarcoidosis and malignant disease

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1320 ◽

2020 ◽

Vol 90 (3) ◽

Author(s):

Cuneyt Tetikkurt ◽

Haluk Sayman ◽

Selin Ece Dedeoglu ◽

Bahar Kubat ◽

Seza Tetikkurt

Keyword(s):

Fdg Pet ◽

Malignant Disease ◽

Pulmonary Function Tests ◽

Granulomatous Inflammation ◽

Final Diagnosis ◽

Middle Lobe ◽

Pet Ct ◽

18F Fdg ◽

Simultaneous Use ◽

The Right

A 67-year-old male presented with cutaneous rash, lassitude and fatigue of three weeks. Personal history included psoriasis and sarcoidosis. Physical examination revealed macular rash on the anterior chest wall. Laboratory results were within normal limits. Chest X-ray showed normal findings. Pulmonary function tests demonstrated a mild obstructive pattern and a mild decrease in DLCO/VA. Thorax CT revealed two nodules in the right upper and middle lobe. 68Ga-citrate PET/CT did not demonstrate any active inflammatory reaction associated with sarcoidosis while 18F-FDG PET/CT revealed increased FDG uptake in the right middle lobe, upper division bronchus and in the left lower abdominal quadrant. Histopathologic examination of the colon biopsy was compatible with adenocarcinoma and bronchoscopic biopsy of the lung lesions revealed nonspecific granulomatous inflammation. BAL cytology was normal while BAL culture did not grow any pathologic organisms. Simultaneous use of 18F-FDG and 68Ga-citrate PET/CT was the hallmark for the final diagnosis in our patient. While FDG/PET has detected the pulmonary and colonic malignant foci in our patient, 68Ga-citrate PET/CT excluded the presence of active granulomatous inflammation of sarcoidosis. Simultaneous utility of these two imaging modalities in patients with sarcoidosis is of great importance in terms of guiding the clinician towards the accurate diagnostic pathway which is the hallmark for final diagnosis, especially in the presence of concomitant malignant disease.

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Unusual location of tuberculosis: laryngeal form

Biomedical and Translational Science ◽

10.33425/2768-4911.1001 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Mouna Lyoubi ◽

Bushra Abdulhakeem ◽

Hicham Lyoubi ◽

Sanaa mellouk ◽

Youssef Oukessou ◽

...

Keyword(s):

Weight Loss ◽

Direct Laryngoscopy ◽

Histopathological Examination ◽

Granulomatous Inflammation ◽

Acid Fast Bacillus ◽

Common Symptom ◽

Multiple Biopsies ◽

Lymph Node Tuberculosis ◽

The Right ◽

Laryngeal Tuberculosis

Introduction: Tuberculosis is a specific infectious disease caused by a mycobacterium: Koch's bacillus. In Morocco, the lung’s lesion is the most common site 52%, however lymph node tuberculosis is the most frequent extrapulmonary form. Laryngeal tuberculosis is rare. We present the case of a young man with a laryngeal location. Presentation of case: A 25-years-old young man, with 10-years history of alcohol and smoking consumption, was presented to our ENT department with a permanent dysphonia and dyspnea on exertion, the patient had fever and weight loss estimated to 15 kg. Clinical examination found a cachectic patient with a 38.5 ° C of temperature, without any palpable cervical mass or lymphadenopathy. A nasofibroscopy was performed showing a right vocal cord’s lesion. We performed a cervical CT scan revealing a process of the glottic and supraglottic level. Direct laryngoscopy was performed, objectifying ulcerative mass budding from the right vocal cord. Histopathological examination revealed a tuberculoid granuloma without caseating necrosis. Discussion and conclusion: Laryngeal tuberculosis is a rare and frequently under-recognized disease. It typically affects adults in the fifth decade. Literature reports dysphonia to be the most common symptom, followed by weight loss, cough, dysphagia, and odynophagia. Direct laryngoscopy allows direct visualization of the endolaryngeal lesions and performing multiple biopsies. Histopathological examination may identify granulomatous inflammation, caseating granulomas, and acid fast bacillus. However, the presence of pseudoepitheliomatous hyperplasia, which mimics squamous cell carcinoma, can make the diagnosis difficult. The pharmacologic treatment is the same as for the pulmonary forms, and results are generally excellent. Surgical intervention is reserved for those cases of airway compromise.

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Congenital lobar emphysema mimicking as persistent pneumonia in a newborn

Clinics and Practice ◽

10.4081/cp.2011.e101 ◽

2011 ◽

Vol 1 (4) ◽

pp. 101 ◽

Cited By ~ 2

Author(s):

Sriparna Basu ◽

Aditya Kumar Gupta ◽

Ashok Kumar

Keyword(s):

Respiratory Distress ◽

Histopathological Examination ◽

Middle Lobe ◽

Congenital Lobar Emphysema ◽

Mediastinal Shift ◽

Common Causes ◽

Lobar Emphysema ◽

Female Baby ◽

The Right ◽

High Index Of Suspicion

Congenital lobar emphysema (CLE) is an uncommon congenital malformation of the lung that can present with respiratory distress in early life. We report a full term female baby who presented with intermittent bluish discoloration of the lips and extremities during crying since birth. An initial diagnosis of left sided collapse-consolidation with right-sided compensatory emphysema was made from chest xray. When no improvement was noted after intravenous antibiotic therapy for 7 days, computerized tomographic scan of thorax was done which showed emphysema of the right middle lobe with transherniation and mediastinal shift to the left. Right middle lobectomy was done and postoperative period was uneventful. Histopathological examination of the specimen confirmed the diagnosis of CLE. CLE can mimic more common causes of respiratory distress in neonatal period and needs a high index of suspicion for diagnosis. Early diagnosis and effective surgical treatment is curative.

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Pulmonary Phaehyphomycosis in Retroviral Disease Patient

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v5i0-2.335 ◽

2021 ◽

Vol 5 (0-2) ◽

pp. 17

Author(s):

Ummu Afeera Binti Zainulabid ◽

Muhammad Naimmuddin Bin Abdul Azih ◽

Sasi Kumar A/L Maniyam ◽

Azliana Binti Abd Fuaa ◽

Mohd Radhwan Bin Abidin ◽

...

Keyword(s):

Viral Load ◽

Histopathological Examination ◽

Disease Patient ◽

Significant Loss ◽

Middle Lobe ◽

Fungal Culture ◽

Follicular Hyperplasia ◽

Lateral Segment ◽

Black Fungi ◽

The Right

Pulmonary phaeohyphomycosis is a rare infection in the lung caused by black fungi containing a cytoplasmic melanin-like pigment. A 42-year-old man with underlying retroviral disease on HAART was investigated for having constitutional symptoms. Despite undetectable viral load and a high CD4 count, he was found to have unexplained significant loss of weight and appetite over a period of 6 months. Clinical examination revealed a cachexic man with multiple inguinal lymphadenopathies. Excisional biopsy of the inguinal lymph node revealed reactive follicular hyperplasia. CT Thorax, Abdomen and Pelvis was arranged to look for occult malignancy or infection and he was found to have multiple non-enhancing subcentimeter lung nodules mainly at the lateral segment of the right middle lobe of his lung. The largest nodule measured about 0.8 x 1.5 x 0.5 (AP x W x CC), with some nodules having an irregular margin with no extension into the adjacent bronchi. Bronchoscopy was done and demonstrated a black patch at the right intermedius, lateral segment of the middle lobe which did not disappear upon bronchial flush or wash. Histopathological examination found focal areas of blackish pigment and the bronchial alveolar lavage sent for fungal culture grew Cladosporium species. The patient was treated with oral Itraconazole with marked clinical improvement. This case highlights an unusual black fungi infection in the lung that stands out not only for its rarity and it's responsiveness to treatment, but also the susceptibility of an RVD positive patient to this infection despite having suppressed viral load and normal CD4 count.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S17

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Mesenchymal Cystic Hamartoma Presenting with Spontaneous Pneumothorax

Canadian Respiratory Journal ◽

10.1155/2003/595082 ◽

2003 ◽

Vol 10 (5) ◽

pp. 280-281 ◽

Cited By ~ 7

Author(s):

J Glezos ◽

D Toppin ◽

T Cooney

Keyword(s):

Computed Tomography ◽

Spontaneous Pneumothorax ◽

Histopathological Examination ◽

Wedge Resection ◽

Middle Lobe ◽

Malignant Potential ◽

Right Middle Lobe ◽

The Right ◽

Mesenchymal Cystic Hamartoma ◽

Cystic Hamartoma

A 53-year-old woman presented with a spontaneous right-sided pneumothorax. Computed tomography chest scan demonstrated a large bulla involving the right middle lobe. Recurrence of the pneumothorax after initial closed chest tube drainage necessitated thoracotomy and wedge resection. Histopathological examination revealed features consistent with a benign mesenchymal cystic hamartoma. Pneumothorax is a recognized complication of mesenchymal cystic hamartoma, a lesion that also has malignant potential.

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Intraoperative ultrasound-guided enucleation of testicular nodule

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.4.335 ◽

2016 ◽

Vol 88 (4) ◽

pp. 335

Author(s):

Riccardo Boschian ◽

Giovanni Liguori ◽

Stefano Bucci ◽

Michele Bertolotto ◽

Carlo Trombetta

Keyword(s):

Therapeutic Option ◽

Young Patients ◽

Intraoperative Ultrasound ◽

Ultrasound Guided ◽

Testicular Lesions ◽

The Right ◽

Clinical Conditions ◽

Ultrasonography Guidance ◽

Diagnostic Investigations

Objective: We report a case of enucleation of a non-palpable right testicular lesion found incidentally at testicular ultrasonography during investigations in a patient with azoospermia. Materials and methods: In 2011 bilateral hypoechoic nonpalpable testicular lesions (5 mm and 3 mm to the right, 3 mm to the left) were found in a 28 years old patient, during diagnostic investigations for azoospermia. In March 2016, ultrasonography showed that the diameter of the right major nodule had grown to 12 mm, characterized by increased vascularization and increased texture. Blood exams showed serum FSH above normal levels with negative oncologic markers. The patients underwent surgical enucleation of the right nodule under ultrasonography guidance. Results: In post operative day 1 a control ultrasonography documented the disappearance of the lesion. Hystopathologic examination diagnosed a Leydig cell tumor, with negative surgical margins. The patient is in good clinical conditions and is under periodic ultrasonographic follow up. Conclusion: Organ sparing surgery represent a good therapeutic option for little intraparenchymal lesions, mostly in young patients in which is preferable to preserve fertility. Intraoperatory ultrasonography represent an important tool for the localization of the lesion.

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Fish Tank Granuloma – a Case Report

Serbian Journal of Dermatology and Venerology ◽

10.1515/sjdv-2017-0017 ◽

2017 ◽

Vol 9 (4) ◽

pp. 154-158

Author(s):

Tijana Boljević ◽

Željko Mijušković ◽

Lidija Kandolf Sekulović ◽

Biserka Vukomanović-Đurđević

Keyword(s):

Histopathological Examination ◽

Salt Water ◽

Parasitic Infection ◽

Granulomatous Inflammation ◽

Atypical Mycobacterium ◽

Dorsal Aspect ◽

History Of ◽

Fish Tank ◽

The Right ◽

Fish Tank Granuloma

Abstract Swimming-pool granuloma and fish tank granuloma refer to the infections caused by Mycobacterium marinum. After having been discovered in salt water fish in Philadelphia Aquarium and described in 1926, this skin infection was first reported in humans in 1951. It developed in people who had swum in contaminated swimming pools. M. marinum is a non-tuberculous, atypical mycobacterium, which is found on plants, soil and fish in freshwater and salt water worldwide. Humans become infected usually after trauma and contact with an aquatic environment. Infection is limited to the skin and usually occurs in healthy individuals, but in immunocompromised patients the infection may disseminate or spread to the subcutis and bone. The lesions usually appear as solitary nodules or plaques that may lead to suppurative ulcers after 2-3 weeks of incubation. Occasionally, there may be sporotrichoid spread along lymphatics. Its diagnosis is frequently delayed, probably because the infection is very rare and a history of aquatic exposure, which is present in the majority of cases, is often overlooked. Common misdiagnoses include fungal and parasitic infection, cellulitis, verrucous tuberculosis of the skin, gout, rheumatoid arthritis, a foreign body and a skin tumour. We present a case of a 39-year-old Caucasian male with a 12-month history of a single erythematous tender nodule on the right dorsal aspect of the right hand. Histopathological examination revealed longstanding suppurated granulomatous inflammation. The infection was not responsive to several courses of antibiotics until we introduced doxycycline capsules as monotherapy which led to complete remission after 5 months.

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Epibulbar complex choristoma with simultaneous involvement of eyelid: a case report

BMC Ophthalmology ◽

10.1186/s12886-019-1234-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yun Hsia ◽

Huang-Chun Lien ◽

I-Jong Wang ◽

Shu-Lang Liao ◽

Yi-Hsuan Wei

Keyword(s):

Case Report ◽

Histopathological Examination ◽

Atypical Presentation ◽

Fundus Examination ◽

Upper Eyelid ◽

Case Presentation ◽

Ectopic Cilia ◽

The Right ◽

Nevus Sebaceous

Abstract Background Epibulbar complex choristoma, a rare congenital epibulbar tumor, has many diverse forms. Reviewing the literature, it can present clinically as either a circumferential or isolated epibulbar mass, limbal tumor, lateral canthal mass, aggregate of ectopic cilia in the upper eyelid, eyelid mass mimicking chalazion, or lacrimal caruncle mass. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. Here, we report an atypical presentation of epibulbar complex choristoma with simultaneous eyelid involvement. Case presentation A 1-month-old full-term boy was brought to our clinic with congenital epibulbar mass of the right eye with simultaneous eyelid involvement. Dilated fundus examination was unremarkable. Survey for linear nevus sebaceous Jadassohn was negative. Due to concerns of possible amblyopia and cosmetics, lamellar keratectomy, sclerotomy, and conjunctivoplasty were performed to remove the epibulbar lesion. The eyelid defect was reconstructed with 6–0 Vicryl sutures. Histopathological examination reported complex choristoma. Upon three-year follow-up, low astigmatism and favorable cosmetics results were achieved. Conclusions Congenital complex choristoma can present clinically as an epibulbar mass with eyelid involvement. The management depends on the extent of involvement, the risk of amblyopia, and cosmetic concerns. The method of eyelid reconstruction should be tailored according to the residual eyelid defect.

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Emphysematous lesions in the right cranial lung lobe and torsion of the right medial lung lobe in a British shorthair cat: a case report

Veterinární Medicína ◽

10.17221/8586-vetmed ◽

2017 ◽

Vol 60 (No. 12) ◽

pp. 706-711 ◽

Cited By ~ 1

Author(s):

Z. Dokic ◽

W. Pirog

Keyword(s):

Histopathological Examination ◽

Serum Biochemistry ◽

Postoperative Recovery ◽

Clinical Findings ◽

Acute Onset ◽

Middle Lobe ◽

Venous Flow ◽

Lung Lobe ◽

The Right ◽

Lung Lobes

A three-year-old male British shorthair cat that had exhibited progressive lethargy and intermittent dyspnoea for 14 days was referred for evaluation of acute respiratory deterioration. Clinical findings included rapid and shallow breathing, pale mucous membranes, sound suppression on the right side, and a subcutaneous haematoma in the right epigastric area. Serum biochemistry analysis showed leukocytosis and thrombocytosis. Radiographs revealed hydropneumothorax, a broken eighth right rib, atelectatic right cranial lung lobe (RCrL), and consolidation of the right middle lobe (RML). Doppler examination revealed sonographic changes in the echotexture of both lobes and venous flow was absent in the twisted RML. Furthermore, bronchoscopy showed proximal narrowing of the cat’s RML bronchus. Exploratory surgery via medial sternotomy confirmed torsion of the RML and identified deteriorated gas-containing lesions in the collapsed RCrL. Both lung lobes were removed by standard lobectomy, and postoperative recovery was without major complications. Histopathological examination diagnosed multiple bullae and blebs, with significant subpleural haemorrhages in the atelectatic RCrL, whereas tissue congestion with haemorrhages, necrosis, and thrombosis typical for lung lobe torsion were observed in the RML. No other underlying aetiology was apparent. Two months post-operatively, the cat presented with similar acute onset of dyspnoea and spontaneous pneumothorax and was euthanised at the owner’s request. The autopsy revealed identical new emphysematous changes in the contra-lateral lung lobes that had been absent at the time of surgery. Emphysematous lesions, regardless of their origin, should be considered in the etiopathology of lung lobe torsion.

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