scholarly journals A diaphragmatic tumor mimicking gastric neoplasm: a clinical case report

2021 ◽  
Vol 49 (7) ◽  
pp. 503-507
Author(s):  
P. A. Burko ◽  
M. G. Fedorova ◽  
R. R. Iliasov ◽  
I. N. Mozhzhukhina
Keyword(s):  
Clinical Case ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Distant Metastases ◽  
Mass Effect ◽  
Gastric Fundus ◽  
Careful Consideration ◽  
Gastric Neoplasm ◽  
Pathological Examination ◽  
Diaphragmatic Tumor

The vast majority of patients with tumors arising from the diaphragm do not have any specific clinical symptoms, therefore, computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques required for the diagnosis. This is particularly relevant when a  pathological mass has grown to an extent producing a “mass effect” on the adjacent organs. In some cases, clinical symptoms of arise due to the local invasion of the neoplasm to the adjacent tissues or distant metastases. We present a rare clinical case of a mesenchymal diaphragmatic tumor in a  34-year-old patient. After a  review of her clinical status and imaging of the abdomen, including CT and MRI, the preliminary diagnosis of the gastric neoplasm of uncertain behavior (D37.1) was made, despite the initial diagnostic assumption of the exogastric location of the mass based on MRI. After careful consideration of the diagnostic assessment results, a  multidisciplinary decision was made to perform laparoscopic resection of the mass. The intraoperative finding was a  tumor originating from the left diaphragmatic cupula with no involvement of the stomach. The patient's recovery was uneventful. Pathological examination revealed a solitary calcifying fibrous tumor of the diaphragm. This clinical case shows that a  mass arising from the diaphragm can mimic one arising from the gastric fundus, leading to an incorrect diagnosis and subsequent inappropriate management.

scholarly journals Accessory spleen originating from the intrinsic muscularis of the stomach misdiagnosed as gastrointestinal stromal tumor: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093530
Author(s):  
Jing Zhang ◽  
Jin-Wei Zhong ◽  
Guang-Rong Lu ◽  
Yu-Hui Zhou ◽  
Zhan-Xiong Xue ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Clinical Symptoms ◽  
Accessory Spleen ◽  
Gastric Fundus ◽  
Stromal Tumor ◽  
Pathological Examination ◽  
Gastric Body ◽  
Spleen Tissue ◽  
Muscular Layer ◽  
Gastric Submucosal Tumors

A 34-year-old man presented to our hospital with a 2-month history of repeated dull upper abdominal pain. Gastroscopy and endoscopic ultrasonography indicated a hemispherical mass at the junction of the greater curvature and the gastric fundus, with hypoechogenicity originating from the intrinsic muscular layer. He was diagnosed with a gastric body submucosal lesion and gastrointestinal stromal tumor, and underwent endoscopic full-thickness resection. However, postoperative pathological examination of the mass unexpectedly revealed heterotopic spleen tissue (accessory spleen). Intragastric ectopic spleen tissue originating from the intrinsic muscular layer of the stomach is a rare clinical condition, with no specific clinical symptoms. This finding is of great clinical significance for the identification of gastric submucosal tumors.

scholarly journals A Case of Diffuse Pneumocephalus With Air Bubble Sign

2020 ◽  
Vol 2 (1) ◽  
pp. 62-64
Author(s):  
Birat Thapa Magar ◽  
Mubashir Malik ◽  
Rizwan Masood Butt ◽  
Faiq Sheikh
Keyword(s):  
Ct Scan ◽  
Subarachnoid Space ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Mass Effect ◽  
Air Bubble ◽  
History Of

 Background: Pneumocephalus is defined as presence of intracranial gas. It can be at any site in the cranium; isolated or at different sites simultaneously. Quantity of gas along with extent of mass effect caused by it & severity of clinical symptoms will determine the modality of treatment; i.e. conservative or surgical. Among many etiologies trauma is one, which is one of the most common cause as in our case. Multiple foci of gas scattered within the subarachnoid space, especially in the cisterns seen on CT scan of brain has been described as “Air bubble sign”, indicating of subdural tension PNC. Here we have presented our case with review of management of such condition, especially conservative. Case: A case of 55yrs male with history of road traffic accident was referred from another hospital. CT scan of Brain done in previous center showed diffuse PNC scattered throughout the subarachnoid space. The patient was managed conservatively and successive repeat CT scan showed gradual to complete resorption of gas and simultaneous clinical improvement of the patient. Conclusion: “Air bubble sign” described as a sign of tension PNC can be managed conservatively in absence of significant clinical symptoms and may not only be associated with subdural tension PNC. The modality of treatment of PNC as well for tension PNC should be tailored according to the patient’s clinical status.

scholarly journals The use of Lactobacillus casei DG® prevents symptomatic episodes and reduces the antibiotic use in patients affected by chronic bacterial prostatitis: results from a phase IV study

2021 ◽  
Author(s):  
Tommaso Cai ◽  
Luca Gallelli ◽  
Erika Cione ◽  
Gianpaolo Perletti ◽  
Francesco Ciarleglio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Well Being ◽  
Antibiotic Use ◽  
Chronic Bacterial Prostatitis ◽  
Symptomatic Recurrence ◽  
Bacterial Prostatitis ◽  
Phase Iv

Abstract Purpose To evaluate the efficacy of Lactobacillus paracasei CNCM I-1572 (L. casei DG®) in both prevention of symptomatic recurrences and improvement of quality of life in patients with chronic bacterial prostatitis (CBP). Methods Patients with CBP attending a single Urological Institution were enrolled in this phase IV study. At enrollment, all patients were treated with antibiotics in agreement with EAU guidelines and then were treated with L. casei DG® (2 capsules/day for 3 months). Clinical and microbiological analyses were carried out before (enrollment, T0) and 6 months (T2) after the treatment. Both safety and adherence to the treatment were evaluated 3 months (T1) after the enrollment. NIH Chronic Prostatitis Symptom Index (CPSI), International Prostate Symptom Score (IPSS) and Quality of Well-Being (QoL) questionnaires were used. The outcome measures were the rate of symptomatic recurrence, changes in questionnaire symptom scores and the reduction of antibiotic use. Results Eighty-four patients were included. At T2, 61 patients (72.6%) reported a clinical improvement of symptoms with a return to their clinical status before symptoms. A time dependent improvement in clinical symptoms with significant changes in NIH-CPSI, IPSS and QoL (mean difference T2 vs T0: 16.5 ± 3.58; − 11.0 ± 4.32; + 0.3 ± 0.09; p < 0.001), was reported. We recorded that L. casei DG® treatment induced a statistically significant decrease in both (p < 0.001) symptomatic recurrence [1.9/3 months vs 0.5/3 months] and antibiotic use [− 7938 UDD]. No clinically relevant adverse effects were reported. Conclusions L. casei DG® prevents symptomatic recurrences and improves the quality of life in patients with CBP, reducing the antibiotic use.

scholarly journals An extremely rare case of a gastric accessory spleen: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiqin Chen ◽  
Lei Nie ◽  
Tijiang Zhang
Keyword(s):  
Rare Case ◽  
Accessory Spleen ◽  
Gastric Fundus ◽  
Pathological Examination ◽  
Review Of The Literature ◽  
Gastric Bleeding ◽  
Computed Tomographic ◽  
Normal Spleen ◽  
Elevated Lesion ◽  
Lesser Curvature

Abstract Background The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature. Case presentation A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery. Conclusions The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.

scholarly journals Salmonellosis impacts the proportions of faecal microbial populations in domestic cats fed 1–3-d-old chicks

2014 ◽  
Vol 3 ◽  
Author(s):  
K. R. Kerr ◽  
S. E. Dowd ◽  
K. S. Swanson
Keyword(s):  
Clinical Symptoms ◽  
Clinical Status ◽  
Microbial Populations ◽  
Domestic Cats ◽  
Negative Data ◽  
Bacterial Dna ◽  
Faecal Samples ◽  
Pcr Method ◽  
Post Hoc ◽  
Pyrosequencing Method

AbstractThere has been a recent increase in the feeding of unconventional diets, including whole-prey diets, to domestic pet cats. Our objective was to characterise faecal microbial populations of domestic cats fed whole and ground (6·35 mm grind) raw 1–3-d-old chicks (Rodent Pro). Faecal samples were collected from neutered male domestic cats (mean age = 5·7 years) fed these diet items in a crossover design. Bacterial DNA was isolated from faecal samples and amplicons of the 16S rRNA V4–V6 region were generated and analysed by 454 pyrosequencing. Faecal microbial populations of cats fed whole v. ground chicks did not differ. During the study, three cats presented with symptoms of infection (anorexia or diarrhoea) and tested clinically positive for Salmonella using a standard PCR method. The remaining cats tested negative. Data were analysed post hoc to test for differences in microbial populations due to clinical status. The predominant genera were Clostridium (9–30 %), unidentified Lachnospiraceae (10–28 %), Blautia (4–19 %), Peptococcus (2–19 %) and Fusobacterium (2–14 %). Faeces of cats testing clinically positive for Salmonella had higher (P ≤ 0·05) proportions of the genera Coprococcus (5·6 v. 0·4 %) and Escherichia (subgenera Shigella; 1·1 v. 0·3 %). Salmonella was not detected in faecal samples utilising the pyrosequencing method; however, there was a shift in microbial populations due to clinical status. The clinical symptoms reported herein may be not only due to the Salmonella itself, but also shifts in other gut microbial populations.

ULTRASONIC STUDY IN DIAGNOSTICS OF PERIPHERAL NEUROPATHIES (CASE FROM PRACTICE)

2021 ◽  
pp. 144-146
Author(s):  
Hamanovich A.I. ◽  
◽  
Baida A.G. ◽  
Koyalo L.G. ◽  
Levantsevich V.V. ◽  
...  
Keyword(s):  
Nervous System ◽  
Gold Standard ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Nerve Trunk ◽  
Peripheral Neuropathies ◽  
Ultrasound Scanning ◽  
Electrophysiological Methods

Electrophysiological methods, such as electromyography and neuromyography, are traditionally recognized as the "gold standard" for detecting pathology of the peripheral nervous system. It should be noted, however, that the information obtained during the above examinations does not give an idea of the state of the surrounding tissues, does not indicate the nature and cause of damage to the nerve trunk, and does not always accurately reflect the localization of changes. At the same time, it is this information that helps to determine the tactics of conservative or surgical treatment of the patient. Ultrasound scanning is quite successfully used in the diagnosis of damage and diseases of the peripheral nerves. The article presents a clinical case of a diagnostic search for a causative disease in a patient with clinical symptoms of neuropathy of the peroneal nerve.

scholarly journals Rare incidence of non-secretory myeloma with talaromycosis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiting Qin ◽  
Ye Qiu ◽  
Yanmei Huang ◽  
Mianluan Pan ◽  
Dong Lan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Clinical Symptoms ◽  
Subcutaneous Tissue ◽  
Community Acquired Pneumonia ◽  
Pathological Examination ◽  
Subcutaneous Nodules ◽  
Lung Lymph

Abstract Background Talaromyces marneffei (TM) primarily infects patients with co-morbidities that cause immunodeficiency, but non-secretory myeloma (NSMM) is rare. TSM and NSMM are associated with fever, osteolysis, and swollen lymph nodes, thereby making it difficult for clinicians to make differential diagnosis. In this case, we describe TM infection coexisting with NSMM. Case presentation We retrospectively reviewed the case of a male (without human immunodeficiency virus infection) with fever, thoracalgia, swollen lymph nodes, and subcutaneous nodules who presented to the First Affiliated Hospital of Guangxi Medical University in February 2014. Chest computed tomography revealed patchy infiltration and positron emission tomography/computed tomography showed increased metabolic activity in the lower-right lung, lymph nodes, left ninth rib, and right ilium. Pathological examination of the lung, lymph nodes, subcutaneous nodules, and bone marrow showed no malignancy, he was diagnosed with community-acquired pneumonia. His clinical symptoms did not improve after anti-bacterial, anti-Mycobacterium tuberculosis, and anti-non-M. tuberculosis treatment. Later, etiological culture and pathological examination of the subcutaneous nodule proved TM infection, and the patient was re-diagnosed with disseminated TSM, which involved the lungs, lymph nodes, skin, bone, and subcutaneous tissue. After antifungal treatment, the patient showed significant improvement, except for the pain in his bones. Imaging showed aggravated osteolysis, and bone marrow biopsy and immunohistochemistry indicated NSMM. Thus, we conclusively diagnosed the case as NSMM with TSM (involving the lungs, lymph nodes, skin, and subcutaneous tissue). His condition improved after chemotherapy, and he was symptom-free for 7 years. Conclusion TM infection is rare in individual with NSMM. Since they have clinical manifestation in common, easily causing misdiagnosis and missed diagnosis, multiple pathological examinations and tissue cultures are essential to provide a differential diagnosis.

scholarly journals Clinical case of myocardial infarction with unspecified familial hypercholesterolemia

2022 ◽  
Vol 17 (4) ◽  
pp. 74-78
Author(s):  
N. G. Lozhkina ◽  
A. N. Spiridonov
Keyword(s):  
Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Clinical Case ◽  
Autosomal Dominant ◽  
Clinical Symptoms ◽  
Cholesterol Metabolism ◽  
Single Gene ◽  
Low Density Lipoproteins ◽  
Dominant Disease ◽  
Appropriate Therapy

Familial hypercholesterolemia is a hereditary autosomal dominant disease characterized by a violation of cholesterol metabolism. This nosology was first described in the late 1930s by the Norwegian clinician Karl Moeller, he proposed the idea that hypercholesterolemia and tendon xanthomas are associated with cardiovascular diseases through the inheritance of a single gene. In 1964, two clinical phenotypes of familial hypercholesterolemia were discovered: heterozygous and homozygous, associated with an unfavorable prognosis. To date, it is known that the long-running process of accumulation of low-density lipoproteins in the intima of blood vessels may not have clinical symptoms for many years due to the developed system of collaterals and the absence of hemodynamically significant stenosis. However, without timely diagnosis and appropriate therapy, this condition inevitably leads to the development of a cardiovascular event. The article presents a clinical case demonstrating the development of myocardial infarction in a patient with a late diagnosis of this disease.

scholarly journals SPLENIC CYST

2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Larissa L. Garcia ◽  
Fernanda L. Lomanto ◽  
Felipe Simões da Rocha Mata ◽  
Dilton Mendonça
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Clinical Case ◽  
Standard Treatment ◽  
Clinical Status ◽  
Exploratory Laparotomy ◽  
Splenic Cyst ◽  
Splenic Cysts ◽  
The Times ◽  
Total Splenectomy

Background: Splenic cysts are rare in children. They are classified into primary and secondary, also called pseudocysts. The primary feature capsule and can be congenital, vascular or neoclassical. The diagnosis, in most cases, is incidental because it is asymptomatic clinical status. The diagnosis is confirmed by Ultrasound and / or Computed Tomography (CT) of the abdomen. Case Report: Patient, I.T.S.A, female, 11 years old, complains of increasing abdominal size. The diagnosis of splenic cyst was confirmed with an exploratory laparotomy. The pathology suggests reactive mesothelial hyperplasia. The patient underwent a total splenectomy and recovered without complications. Conclusions: Splenic cysts are incidental findings, most of the times it has been an asymptomatic clinical status. In the clinical case described, the patient showed a significant increase in the abdomen. She underwent exploratory laparotomy and, consequently, total splenectomy, which is the standard treatment in cases of giants splenic cysts.

scholarly journals A case of late manifestation of primary adrenal insufficiency in the autoimmune polyglandular syndrome type 1

2019 ◽  
Vol 47 (2) ◽  
pp. 175-179
Author(s):  
V. V. Troshina ◽  
T. A. Grebennikova ◽  
Zh. E. Belaya
Keyword(s):  
Adrenal Insufficiency ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Syndrome Type ◽  
Primary Adrenal Insufficiency ◽  
Autoimmune Polyglandular Syndrome ◽  
Autoimmune Polyendocrine Syndrome ◽  
Autoimmune Polyglandular Syndrome Type ◽  
Timely Treatment

The article describes a clinical case of primary adrenal insufficiency which manifested at an atypically advanced age. Primary adrenal insufficiency combined with other clinical symptoms suggested the autoimmune polyendocrine syndrome type 1. Subsequently, the diagnosis was confirmed by the results of genetic testing. The particulars of the clinical case include the age of patient at manifestation of the disease (49  years). The lack of treatment resulted in dramatic clinical decompensation. This clinical case is intended to draw clinicians' attention to the necessity of detection of primary adrenal insufficiency and appropriate and timely treatment. Taking into account eventual diagnostic problems, it is necessary to raise awareness about this disease among practicing doctors of various specialties.

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