scholarly journals Angiectatic nasal polyp diagnostic quandary of sinonasal malignancy

2020 ◽  
Vol 6 (4) ◽  
pp. 769
Author(s):  
Nur Afeena A. F. A. Kashaf ◽  
Andrew H. K. Chin ◽  
Zambri M. Ibrahim ◽  
Irnawati W. A. Rahman ◽  
Shakir K. A. Rahman
Keyword(s):  
Nasal Polyp ◽  
Clinical Presentation ◽  
Malignant Neoplasm ◽  
Malignant Tumour ◽  
Nasolabial Fold ◽  
Nasal Discharge ◽  
Diagnostic Dilemma ◽  
Post Surgery ◽  
Histopathology Result ◽  
Medial Maxillectomy

<p class="abstract">Angiectatic nasal polyp (ANP) is a rare entity of inflammatory nasal polyp accounts for only 4 to 5% of all nasal polyp.It is often misdiagnosed as a malignant neoplasm due to its aggressive clinical presentation and radiological findings mimicking a neoplastic characteristic. achieving the diagnosis of ANP can be a challenge but crucial as management and prognosis of malignant and benign sinonasal tumour differs significantly. We describe a unique case of an ANP in a 33 year old gentleman presented with left sided nasal obstruction associated with blood stained nasal discharge, facial pain and left eye epiphora. There was proptosis of the left eye and his left nasolabial fold was obliterated due to a vague left cheek swelling. Clinical presentation was highly suspicious of malignancy. CT scan finding was also suggestive of malignant tumour with surrounding bony bowing and erosions, while MRI was reported as haemangioma. Post-surgery of left endoscopic medial maxillectomy, histopathology result was negative for malignancy. After revision of specimen done and further discussions, the diagnosis of ANP was made. Patient was postoperatively well with regression of symptoms along 5 months follow-up. ANPs are relatively uncommon pseudoneoplastic lesion that can cause a significant diagnostic dilemma as illustrated in this case. awareness of distinctive radiological and histopathological findings of ANP is important to establish the diagnosis and managed accordingly. However, little is known to guide the approach in such cases, therefore we find the case report to be noteworthy in this field.</p>

scholarly journals Abdominal Tuberculosis

2017 ◽  
Vol 28 (1) ◽  
pp. 39-45
Author(s):  
Md Ismail ◽  
Golam Azam
Keyword(s):  
Clinical Presentation ◽  
Imaging Study ◽  
Abdominal Tuberculosis ◽  
Clinical Feature ◽  
Ascending Colon ◽  
Diagnostic Dilemma ◽  
Mdr Tb ◽  
Colon And Rectum ◽  
Frequent Site ◽  
High Index Of Suspicion

Abdominal tuberculosis constitute up to 12% of extrapulmonary TB and is sixth frequent site of extrapulmonary involvement. The most common sites of involvement is the ileocaecalregion. Other site of involvement in descending order are ascending colon jejunum, appendix, duodenum, stomach, esophagus, sigmoid colon and rectum. Abdominal TB has diagnostic dilemma due to its diverse and non-specific clinical presentation and has no single most specific, sensitive diagnostic test. A high index of suspicion, common and rare clinical feature, adequate imaging study, endoscopy, enteroscopy, laparoscopy, laparotomy, biopsy with histopathology, Mycobacterial isolation, Quantiferon-TB Gold, GeneXpert Assay, MULTIPLEX PCR and clinical response to anti TB therapy are considered for early diagnosis to reduce morbidity and mortality. Six month antiTB regime is effective as nine or 12month therapy. MDR TB and frequent interruption of therapy should considered in nonresponder to standard therapy. Surgery is required for minority cases that developed complications not responding to medical therpy.Medicine Today 2016 Vol.28(1): 39-45

Endoscopic Transnasal Resection of Ectopic Esthesioneuroblastoma in the Pterygopalatine Fossa: Technical Case Report

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. onsE112-onsE113 ◽  
Author(s):  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki
Keyword(s):  
Clinical Presentation ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Complete Removal ◽  
Pterygopalatine Fossa ◽  
Open Approach ◽  
Transnasal Approach ◽  
Olfactory Neuroepithelium ◽  
Endoscopic Transnasal Approach ◽  
Left Maxillary Sinus

Abstract Objective: Esthesioneuroblastoma is a rare, malignant neoplasm arising from the olfactory neuroepithelium in the upper nasal cavity. Even more rare is ectopic esthesioneuroblastoma developing from the region outside the olfactory epithelium. In addition, tumors occurring in the pterygopalatine fossa (PPF) are uncommon, and the endoscopic transnasal approach for the resection of malignant tumors in this region is also uncommon. Clinical Presentation: We describe an esthesioneuroblastoma arising from the left maxillary sinus and PPF. The tumor was resected using the endoscopic transnasal approach, followed by treatment with radiotherapy. The patient showed no evidence of recurrence 12 months postoperatively. Technique: The endoscopic transnasal approach could be successfully used for the complete removal of malignant tumors in the PPF. Conclusion: The PPF is an anatomic area that is difficult to access. The endoscopic transnasal approach improves access and visualization; it also has the potential to reduce complications compared with the open approach. The endoscopic transnasal approach might become the treatment of choice for malignant tumors in the PPF.

scholarly journals Case report of a sub-occluding thrombus in thoracic aorta: what is the origin?

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Federica Campana ◽  
Matteo Nardin ◽  
Anna Coppini ◽  
Maria Lorenza Muiesan
Keyword(s):  
Thoracic Aorta ◽  
Aortic Wall ◽  
Clinical Presentation ◽  
Bone Lesion ◽  
Malignant Neoplasm ◽  
Ct Imaging ◽  
Atherosclerotic Disease ◽  
Rare Tumour ◽  
Ct Guided ◽  
Aortic Thrombosis

Abstract Background Aortic thrombosis represents a consequence of atherosclerotic disease. In few cases, it can be secondary to large vessel or infective vasculitis. More rarely, aortic thrombosis is the manifestation of a primary malignant neoplasm of the aortic wall. Aortic angiosarcoma is a rare tumour, its clinical presentation is often non-specific and associated signs and symptoms may vary greatly. An early diagnosis is difficult to reach and the presence of metastatic disease is not uncommon at the time of diagnosis. The prognosis is poor overall. Case summary We report the case of a female patient who presented to her GP because of fatigue, hyporexia, weight-loss, and anaemia. An ultrasound of the abdomen showed two small pancreatic lesions, confirmed and described as benign cystic pancreatic lesions on computed tomography (CT) imaging; an incidental thrombus in the superior mesenteric artery was also found on CT imaging. The thoracic CT identified a large thrombotic lesion in the descending thoracic aorta with significant narrowing of the aortic lumen and confirmed the presence of an osteolytic bone lesion on the VIII right rib, in the absence of atherosclerotic disease. Signs of increased metabolic activity in the aortic lumen and in the VIII posterior right rib were shown at a subsequent positron emission tomography. A CT-guided biopsy of the bone lesion was performed and at histology the diagnosis of metastatic angiosarcoma of the aortic wall was made. Discussion Aortic angiosarcoma is a rare cause of aortic thrombosis, to be taken into consideration in a patient with thrombotic lesions of the aorta in the absence of atherosclerotic disease. The differential diagnosis is difficult because of clinical presentation and radiological features similar to those of inflammatory aortic disease. In our case, the final diagnosis of angiosarcoma was made only by a biopsy of a bone metastatic lesion.

scholarly journals 781. Non-Tuberculous Mycobacterium: Often a Missed Entity

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S280-S280
Author(s):  
Sairam B ◽  
Atul Gogia ◽  
Atul Kakar ◽  
S P Byotra
Keyword(s):  
Pulmonary Infection ◽  
Clinical Presentation ◽  
Mycobacterial Infection ◽  
Molecular Techniques ◽  
Drug Resistant ◽  
First Line ◽  
Diagnostic Dilemma ◽  
Mycobacterial Diseases ◽  
Back Ache ◽  
Anti Tubercular Therapy

Abstract Background Initially referred to as Lady Windermere syndrome, the prevalence of Non-Tuberculous Mycobacterium (NTM) is on the rise globally. In India, the TB capital of the world, these infections still go unrecognized, as the clinical presentation of all mycobacterial diseases are similar. This is of clinical relevance as misdiagnosis may lead to unwarranted or inappropriate therapy. Methods We conducted a retrospective study of adults suspected of having mycobacterial infection. Records of patients admitted with suspected TB from January 2015 to December 2017 were reviewed; clinicoradiological features were correlated with the organism isolated; treatment given and outcomes were recorded. Results Out of 877 suspected patients, 245 patients had microbiologically proven Mycobacterium tuberculosis and 34 had NTM (3.8%). Pulmonary infection was seen in 19 cases (56%), rest were extra pulmonary (34%). Fever was the commonest symptom (62%) others being cough (50%), breathlessness (41%), hemoptysis (15%), weight loss (3%), chest pain (3%), and back ache (12%). Symptoms were prolonged (&gt;1 month) in 65% of cases. Radiologically, cavitations (42%), lung nodules (32%), and infiltrates (32%) were commonly seen. Upper zone predilection was noted in 68% of cases. Past tuberculosis was the major risk factor seen in 42% of cases while 26% were immunocompromised. Macrolide resistance was noted in none of our patients. Twenty-four out of 34 cases were AFB smear positive (71%), but MTB gene Xpert was negative. Our series includes four patients who did not respond to first-line anti-tubercular therapy (ATT) and were suspected to have multi-drug-resistant (MDR) tuberculosis. Cultures later grew NTM and the patients improved with macrolide regime. Conclusion NTM is an underreported infection in a developing country like India with a high TB prevalence. Similar clinical features and morphology create a greater diagnostic dilemma. Usage of molecular techniques and AFB culture should be made mandatory in all suspected cases of tuberculosis. NTM should always be considered in ATT nonresponders before starting them on MDR regime. Disclosures All authors: No reported disclosures.

Co-occurrence of Nasal Polyps and Neoplasms of the Canine Nasal Cavity

2019 ◽  
Vol 56 (6) ◽  
pp. 885-888
Author(s):  
James C. Tarrant ◽  
David E. Holt ◽  
Amy C. Durham
Keyword(s):  
Nasal Polyp ◽  
Nasal Polyps ◽  
Malignant Neoplasm ◽  
Primary Diagnosis ◽  
Surgical Biopsy ◽  
Biopsy Specimens ◽  
Nasal Tumors ◽  
Soft Tissue Masses ◽  
Nasal Carcinoma

Nasal polyps in dogs are space-occupying soft-tissue masses that have been encountered concurrently with intranasal neoplasia in surgical biopsy specimens. The proportion of nasal polyp co-occurrence with primary nasal tumors was examined, and follow-up biopsies on dogs initially diagnosed with nasal polyp were reviewed. Histologic sections from 321 cases of intranasal neoplasia and 50 cases of nasal polyp from 2004 to 2017 were reviewed. Of the 321 cases of intranasal neoplasia, 51 (16%) had concurrent nasal polyps, and most of these (47/51) had intranasal carcinoma. Twenty-five of the 50 dogs with a primary diagnosis of nasal polyp were rebiopsied, and the diagnoses in these subsequent biopsies were nasal polyp in 15, malignant neoplasm in 9, and intranasal nematode in 1. Nasal polyps occurred frequently in conjunction with nasal carcinoma. In dogs with a diagnosis of nasal polyp, repeat biopsy to reveal possible neoplasia is warranted.

scholarly journals The forgotten exotic tapeworms: a review of uncommon zoonotic Cyclophyllidea

Parasitology ◽  
2020 ◽  
Vol 147 (5) ◽  
pp. 533-558 ◽  
Author(s):  
Sarah G. H. Sapp ◽  
Richard S. Bradbury
Keyword(s):  
Clinical Presentation ◽  
Taxonomic Status ◽  
Molecular Data ◽  
Life Cycles ◽  
Accurate Data ◽  
Diagnostic Features ◽  
Diagnostic Dilemma ◽  
True Incidence ◽  
Medical Microbiology ◽  
Intestinal Infections

AbstractAs training in helminthology has declined in the medical microbiology curriculum, many rare species of zoonotic cestodes have fallen into obscurity. Even among specialist practitioners, knowledge of human intestinal cestode infections is often limited to three genera, Taenia, Hymenolepis and Dibothriocephalus. However, five genera of uncommonly encountered zoonotic Cyclophyllidea (Bertiella, Dipylidium, Raillietina, Inermicapsifer and Mesocestoides) may also cause patent intestinal infections in humans worldwide. Due to the limited availability of summarized and taxonomically accurate data, such cases may present a diagnostic dilemma to clinicians and laboratories alike. In this review, historical literature on these cestodes is synthesized and knowledge gaps are highlighted. Clinically relevant taxonomy, nomenclature, life cycles, morphology of human-infecting species are discussed and clarified, along with the clinical presentation, diagnostic features and molecular advances, where available. Due to the limited awareness of these agents and identifying features, it is difficult to assess the true incidence of these ‘forgotten’ cestodiases as clinical misidentifications are likely to occur. Also, the taxonomic status of many of the human-infecting species of these tapeworms is unclear, hampering accurate species identification. Further studies combining molecular data and morphological observations are necessary to resolve these long-standing taxonomic issues and to elucidate other unknown aspects of transmission and ecology.

Risks of Premature Death and Cancer Predicted by Body Weight in Early Adult Life

1991 ◽  
Vol 10 (4) ◽  
pp. 285-288 ◽  
Author(s):  
F.J.C. Roe ◽  
P.N. Lee ◽  
G. Conybeare ◽  
G. Tobin ◽  
D. Kelly ◽  
...  
Keyword(s):  
Body Weight ◽  
Adult Life ◽  
Malignant Neoplasm ◽  
Premature Death ◽  
Malignant Tumour ◽  
Pituitary Tumour ◽  
Anaplastic Carcinoma ◽  
Female Wistar Rats ◽  
Early Adult Life ◽  
Dietary Regime

In a study of 30 months duration, involving 600 male and 600 female Wistar rats fed on 12 different diets/dietary regimes, none of which involved deliberate exposure to any known genotoxic carcinogen, highly significant between-group differences were observed in survival and incidence of various neoplastic and non-neoplastic diseases. A full report of the findings is being prepared. Here we report that, irrespective of diet or dietary regime, there were highly significant correlations of body weight at 29 weeks of age with premature death (P < 0.0001 in both males and females), with development of benign or malignant neoplasm of any site ( P < 0.0001 in males and P < 0.01 in females) and with development of malignant neoplasm at any site ( P < 0.0001 for sexes combined). Numerous kinds of neoplasm contributed to these overall correlations. The most significant were pituitary tumour ( P < 0.0001), mammary gland tumour ( P < 0.0001), squamous or anaplastic carcinoma of the jaw ( P < 0.001), and subcutaneous mesodermal tumours ( P < 0.05). The 20% of rats that were heaviest at 29 weeks were more than twice as likely to die prematurely than the lightest 20% (2.56 times - males, and 2.11 times - females), and almost twice as likely to develop a malignant tumour (1.87 times for the sexes combined). These findings have important implications for the design and interpretation of carcinogenicity tests in rodents and of laboratory and human studies of relationships between diet, ageing-related degenerative diseases, and cancer.

scholarly journals Calcific myonecrosis: diagnostic dilemma

2018 ◽  
Vol 100 (6) ◽  
pp. e158-e160
Author(s):  
HE Matar ◽  
P Stritch ◽  
S Connolly ◽  
N Emms
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Malignant Tumour ◽  
Resonance Imaging ◽  
Diagnostic Dilemma ◽  
Benign Condition ◽  
Calcific Myonecrosis ◽  
History Of ◽  
Growing Mass

Calcific myonecrosis is a rare benign condition affecting mainly the muscles of a single leg compartment. It is thought to follow a history of trauma with a latent period of years. Patients present with a slowly growing mass. Differential diagnosis from a malignant tumour can be made from the history and the distinctive radiographical features of a fusiform lesion with predominantly peripheral calcifications. Magnetic resonance imaging may be necessary to confirm the diagnosis; treatment is largely symptomatic.

Acral, Pure Cutaneous, Self-Healing, Late-Onset, Cellulitis-Like Langerhans Cell Histiocytosis

2009 ◽  
Vol 13 (1) ◽  
pp. 43-47
Author(s):  
Prafulla Kumar Sharma ◽  
Sunil Sabhnani ◽  
Minakshi Bhardwaj ◽  
Hemanta Kumar Kar
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Clinical Presentation ◽  
Late Onset ◽  
Early Adulthood ◽  
Langerhans Cell ◽  
Self Healing ◽  
Diagnostic Dilemma

Background: An unusual and not yet reported clinical presentation of pure cutaneous Langerhans cell histiocytosis (LCH) that was a diagnostic dilemma. Objective: To bring to light the newer presentation of this disease. Method: The case was managed on clinical grounds initially as cellulitis. However, after the investigations and confirmation of the diagnosis, she was managed symptomatically. Results: Pure cutaneous LCH may manifest in early adulthood with features of cellulitis, erythematous edematous vesicular plaques, and nodules distributed in the flexural acral areas. Conclusion: Pure cutaneous LCH may have an acute late onset with unusual morphology as cellulitis, inverse acral distribution, and self-healing.

Presentation of Telangiectasia Macularis Eruptiva Perstans as a Long-Standing Solitary Plaque Associated with Renal Carcinoma

2003 ◽  
Vol 7 (5) ◽  
pp. 399-402 ◽  
Author(s):  
José Carlos Pascual ◽  
José Bañuls ◽  
Ma Pilar Albares ◽  
Gloria Vergara ◽  
Isabel Belinchón ◽  
...  
Keyword(s):  
Renal Carcinoma ◽  
Clinical Presentation ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Systemic Mastocytosis ◽  
Malignant Neoplasm ◽  
Renal Clear Cell Carcinoma ◽  
Good Prognosis ◽  
Uncertain Significance ◽  
Cutaneous Mastocytosis

Background: Mastocytosis is a rare disease characterized by a primary pathological increase in mast cells in different tissues. The skin is the most frequently affected organ. Cutaneous mastocytosis, including urticaria pigmentosa, solitary mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptiva perstans (TMEP), is usually distinguished from systemic mastocytosis. TMEP is characterized mainly by telangiectatic macules. Objective and Methods: We report a case of TMEP with an unusual clinical presentation as a solitary plaque of telangiectatic macules. A renal clear cell carcinoma was detected in a workup for systemic mastocytosis. We discuss the clinical and histological findings and treatment of TMEP. Conclusions: TMEP is a rare form of mastocytosis, which occurs mainly in adults, generally has a good prognosis, and little tendency to urticate or show constitutional symptoms. Clinicians should consider this disorder when confronted with a progressive atypical telangiectatic lesion. However, the malignant neoplasm also found in this patient is of uncertain significance.

Sign in / Sign up

Export Citation Format

Share Document