Lymphedema As The Initial Symptom of Lymphoma

2021 ◽  
Author(s):  
Kun Hao ◽  
Jianfeng Xin ◽  
Yuguang Sun ◽  
Wenbin Shen
Keyword(s):  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Bone Marrow Aspiration ◽  
Clinicopathological Features ◽  
Initial Symptom ◽  
Initial Manifestation ◽  
Lymph Node Enlargement ◽  
Medical University ◽  
Ct And Mri

Abstract Background: To investigate the clinical features of lymphoma with lymphedema as the initial manifestation.Methods: We performed a retrospective study of 4676 patients with lymphedema treated at the Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, from May 22, 2007, to December 31, 2018. Clinical manifestations and a series of conventional analyses (laboratory tests, ultrasonography, magnetic resonance imaging, computed tomography, and radionuclide imaging) were used to study these cases. Bone marrow aspiration and biopsy tests were used to support the diagnosis of lymphoma. Eleven patients of lymphoma with lymphedema as the first symptom were selected, and their clinicopathological features were analyzed retrospectively.Results: A total of 11 cases of lymphedema caused or aggravated by lymphoma were found, including 1 case of upper extremity edema, 9 cases of lower extremity edema and 1 case of systemic edema. These patients often accompanied by clinical symptoms such as feeble, emaciation, pain, mass, lymph node enlargement and so on. The proportion of patients with abnormal tumor markers was 66.7% (4/6), the prevalence of anemia among patients with malignant lymphedema was 45.5% (5/11), and the positive rates of ultrasonography, CT and MRI were 100.0% (7/7), 100.0% (8/8) and 100.0% (2/2), respectively. Eleven cases with lymphoma were confirmed by pathological diagnosis. To analyze the clinicopathological features, the main points of diagnosis were summarized.Conclusions: Lymphoma with lymphedema as the first symptom is extremely rare. It has a hidden onset. To avoid delays in the diagnosis and therapy of lymphoma, physicians should actively look for signs or symptoms of lymphedema during the follow-up period and promptly manage patients developing problems.

scholarly journals Cervical lymph node enlargement as the initial manifestation of rectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tong-Hui Xie ◽  
Peng Su ◽  
Jian-Guo Hong ◽  
Hui Zhang
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Clinical Manifestations ◽  
Initial Symptom ◽  
Cervical Lymph Nodes ◽  
Supraclavicular Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

scholarly journals Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome

2004 ◽  
Vol 46 (3) ◽  
pp. 127-131 ◽  
Author(s):  
Ricardo Mendes Pereira ◽  
Fábio Bucaretchi ◽  
Eliana de Melo Barison ◽  
Gabriel Hessel ◽  
Antonia Teresinha Tresoldi
Keyword(s):  
Treatment Effectiveness ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Severe Malnutrition ◽  
Bone Lesions ◽  
First Line ◽  
Lymph Node Enlargement ◽  
Lytic Lesions ◽  
Lymphoproliferative Syndrome

From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean ± 1 SD = 8 ± 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia.

scholarly journals Spinal Capillary Hemangioma: Report of Five Surgical Cases and Literature Review

2017 ◽  
Vol 3 (4) ◽  
pp. 196-203
Author(s):  
Liang Zhang ◽  
Zhifeng Zhang ◽  
Jifeng Shang ◽  
Wenqing Jia ◽  
Jun Yang ◽  
...  
Keyword(s):  
Management Strategy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Capillary Hemangioma ◽  
Neurological Deficits ◽  
En Bloc ◽  
Limb Weakness ◽  
Intradural Extramedullary ◽  
Early Surgical Intervention

Objective Capillary hemangioma is a benign vascular malformation that is usually encountered in soft-tissue. Rarely, it may occur in the neuraxis, and spinal capillary hemangioma (SCH) is a rare variant of it. Existing literature on SCH is limited because of its rarity. As a result, epidemiological and clinical characteristics as well as management strategy for SCH are still lacking. Here, we present a report on five patients with pathologically proven SCH, treated in Beijing Tiantan Hospital between 2013 and 2015. Methods Patients' age, gender, clinical manifestations, radiological features, operative methods, and surgical outcomes were retrospectively reviewed, and an updated review of the literature was also provided. Results Four patients were men and one was a woman, with a median age at presentation of 43 years (range: 15–66 years). Two lesions were intramedullary, two epidural, and one intradural extramedullary. The thoracic segment was most commonly affected (n = 3, 60%), followed by the cervical (n = 1, 20%) and lumbar (n = 1, 20%) segments. Common symptoms, in descending order, were numbness and paresthesia, limb weakness, and pain. The surgical procedure was successfully performed with total resection of the tumor achieved in 4 patients and subtotal in 1 patient. During an average follow-up period of 32 months (range: 27–43 months), recovery of the clinical symptoms was observed in all five patients. Conclusions SCH is a rare benign vascular disease, for which surgical resection of the lesion, by the en bloc method, is recommended. Clinically, it usually manifests with progressive myelopathy, but early surgical intervention usually produces good results and may prevent permanent neurological deficits.

CLINICAL MANIFESTATIONS OF ANTI-NMDA RECEPTOR ENCEPHALITIS IN CHILDREN

2021 ◽  
Vol 100 (6) ◽  
pp. 113-120
Author(s):  
R.Ts. Bembeeva ◽  
◽  
U.M. Azizova ◽  
N.N. Zavadenko ◽  
E.S. Ilyina ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Neurological Dysfunction ◽  
Long Term Results ◽  
Impulsive Behavior ◽  
Speech Impairment ◽  
Prodromal Phase ◽  
Nmdar Encephalitis

The aim of the study was to determine the clinical features of anti-NMDAR encephalitis in children. Materials and methods of research: 11 patients were selected from the group of children with autoimmune encephalitis, who met the diagnostic criteria for reliable anti-NMDAR encephalitis. A retro-prospective analysis of clinical symptoms, laboratory, neurophysiological and neuroimaging data, treatment, duration of primary hospitalization and long-term results of treatment was carried out, neuropsychological testing of patients was performed in the follow-up. Results: the age of the patients was 8.5±4.4 years, the gender composition of boys/girls was 1/10 (9.1%/90.9%). The average follow-up period was 17±12 months. In 73% of cases, there was an acute onset of the disease without a prodromal phase and with rapidly growing signs of neurological dysfunction: behavior change (11/100%), epileptic seizures (11/100%), speech impairment (10/90.9%), movement disorders (10/90.9%), disturbed sleep/wakefulness rhythm (9/81.8%), hallucinations (5/45.5%), autonomic disorders (6/54.5%), sensory disturbance (1/9,1%). In 82% of cases, therapy was required in the intensive care unit. When analyzing EEG monitoring in children, the extreme delta brush pattern was revealed in only one patient. Neuroimaging revealed no specific changes in the substance of the brain. The paraneoplastic nature of the disease could not be established in any case. 4 patients (36.36%) had relapses of the disease after 1.5–27 months. from the onset of the disease. All children showed a favorable outcome without a gross neurological deficit, but complaints of increased fatigue, headaches, poor memory, a decrease in vocabulary, and impulsive behavior persisted.

scholarly journals Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran

2004 ◽  
Vol 132 (6) ◽  
pp. 1109-1114 ◽  
Author(s):  
M. R. HASANJANI ROUSHAN ◽  
M. MOHREZ ◽  
S. M. SMAILNEJAD GANGI ◽  
M. J. SOLEIMANI AMIRI ◽  
M. HAJIAHMADI
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Animal Husbandry ◽  
Neurological Complications ◽  
Northern Iran ◽  
Veterinary Profession ◽  
Epidemiological Features ◽  
Medical University

The epidemiological features and clinical manifestations of adult cases of brucellosis admitted to the Department of Infectious Diseases, Babol Medical University, Iran from 1997 to 2002 were investigated. Of 469 cases, 267 (56·9%) were males. The mean age of cases was 36·9±15 years. Most (60·8%) were from rural areas. Two thirds of cases (306, 66·3%) presented during spring or summer. Fresh cheese (22·4%), animal husbandry (11·3%), laboratory worker (8·1%) and veterinary profession (1·5%) were the main risk factors. Forty-five families (9·6%) had two cases. Sweating, fever, and arthralgia were the most frequent clinical symptoms. Complications were documented in 105 males (39·5%) and 41 females (20·3%, P=0·0001). Peripheral arthritis was seen in 24 (9%) males and 19 (9·4%) females, with knees and hips being the most common sites of infection. Sacroiliitis and spondylitis were seen in 28 (6%) and 32 (6·8%) cases respectively with spondylitis more common in males (P=0·023). Epididymo-orchitis was seen in 29 (10·9%) males. There were three cases each of endocarditis (0·6%) and neurological complications (0·6%). Most patients with brucellosis did not have any of the known risk factors for brucellosis. Thus consumption of unsafe dairy products could be the main route of infection. The disease manifested with a diversity of clinical manifestations and complications. Complications were more frequent in males than females.

scholarly journals Pituitary dysfunction in patients with ANCA associated vasculitis: prevalence, presentation, and outcomes

2020 ◽  
Vol 11 ◽  
pp. 204062232093063
Author(s):  
Chunjia Li ◽  
Yu Zou ◽  
Xin Lu ◽  
Guochun Wang ◽  
Xiaoming Shu
Keyword(s):  
Immunosuppressive Therapy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Magnetic Resonance Images ◽  
Initial Symptom ◽  
Pituitary Fossa ◽  
Pituitary Dysfunction ◽  
Anca Associated Vasculitis ◽  
Positron Emission

Background: The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are rare multisystem autoimmune diseases characterized by inflammatory cell infiltration causing necrosis of small blood vessels. Pituitary involvement in AAV is poorly described. This study aimed to describe the prevalence, clinical characteristics, and outcomes of pituitary involvement in patients with AAV. Methods: A total of 150 patients diagnosed with AAV and hospitalized in the China–Japan Friendship Hospital between 2009 and 2019 were enrolled in this retrospective study. Patients diagnosed with pituitary involvement in AAV were selected for inclusion. Results: Three patients (2%) were identified with pituitary involvement. Two patients had positive ANCA titers, one with proteinase 3 positive and one with myeloperoxidase positive antibodies. Pituitary dysfunction presented as an initial symptom in one patient and developed over the course of the diseases in the other two patients. All three patients had abnormal hormones. Among them, two patients had an enlarged pituitary, shown by magnetic resonance images (MRIs), and one patient had a normal sized pituitary, shown by MRI, but presented with increased linear radioactivity uptake in the pituitary fossa by positron emission tomography-computed tomography. All patients were treated with corticosteroid and immunosuppressive therapy. Both pituitary dysfunction and vasculitis were in remission. Conclusion: Pituitary involvement is uncommon in AAV and it can occur at any point during AAV. The main clinical manifestations are central diabetes insipidus and panhypopituitarism. Immunosuppressive therapy could significantly alleviate clinical symptoms as well as pituitary imaging.

scholarly journals Brucellar reproductive system injury: A retrospective study of 22 cases and review of the literature

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092454
Author(s):  
Yan Zhou ◽  
Songsong Xie ◽  
Rongjiong Zheng ◽  
Qinqi Dai ◽  
Zheng Xu ◽  
...  
Keyword(s):  
Reproductive System ◽  
Chronic Prostatitis ◽  
Clinical Symptoms ◽  
Drug Regimen ◽  
Review Of The Literature ◽  
Male Patients ◽  
Patient Prognosis ◽  
Medical University ◽  
Lost To Follow Up

Objective We aimed to describe the clinical characteristics and prognosis of 22 patients with Brucella-induced reproductive system injury. Methods We assessed 22 patients with reproductive system injury between 2010 and 2018 at The First Affiliated Hospital of Xinjiang Medical University. Results The disease is predominant in men. Male patients had orchitis, erectile dysfunction, prostatitis, and urethral stricture, while female patients had vaginitis and cervicitis. Some patients had laboratory abnormalities and liver injury. Patients received combination therapy of rifampicin and doxycycline. Doxycycline combined with levofloxacin or moxifloxacin was administered to patients with rifampicin intolerance. All patients had received antibiotic therapy for at least 6 weeks. One patient was lost to follow-up, one patient relapsed because of osteoarthropathy, and one patient had dysuria resulting from chronic prostatitis. The clinical symptoms resolved in the other patients, and the overall patient prognosis was good. Conclusion Clinicians should pay attention to brucellosis-induced reproductive system damage. The two-drug regimen of rifampicin+doxycycline is recommended for these patients. Doxycycline combined with levofloxacin or moxifloxacin should be used in patients with brucellosis-induced reproductive system damage who have rifampicin intolerance. The treatment course should be at least 6 weeks.

scholarly journals Pancreatic Leiomyosarcoma With Schistosomiasis Hematobia: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiang Li ◽  
Daniel Staiculescu ◽  
Yurong Zhou ◽  
Jiang Chen
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
Clinical Manifestations ◽  
Malignant Neoplasm ◽  
The Body ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship ◽  
Ct And Mri

Pancreatic leiomyosarcoma (PL) is a very rare, malignant neoplasm with a very poor prognosis. Here, we examine a novel case of PL with schistosomiasis hematobia. The patient had been initially misdiagnosed by the first magnetic resonance imaging (MRI). The second imaging examination demonstrated an enlarged heterogeneous tumor mass in the body-tail of pancreas. Following image analysis, the patient underwent a pancreatectomy, splenectomy and lymph node dissections. Sixteen months after the tumor resection, follow-up computed tomography (CT) and MRI revealed tumor metastasis in the liver and lung. PL has non-specific clinical manifestations and imaging characteristics, making early diagnosis very challenging. When it is difficult to distinguish between benign and malignant pancreatic lesions, short-term imaging follow-up is preferred. In this case report, we discuss the relationship between PL and schistosomiasis hematobia.

scholarly journals Diagnosis of malignancies in children with musculoskeletal complaints

2005 ◽  
Vol 123 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Marcela Gonçalves ◽  
Maria Teresa Ramos Ascensão Terreri ◽  
Cássia Maria Passarelli Lupolli Barbosa ◽  
Cláudio Arnaldo Len ◽  
Lucia Lee ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Clinical Features ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Lymphocytic Leukemia ◽  
Common Finding ◽  
Initial Symptom ◽  
Musculoskeletal Complaints ◽  
Initial Manifestation

CONTEXT: Musculoskeletal complaints may be associated with neoplasias as an initial manifestation of the disease. When these symptoms predominate at the onset of the disease, the differential diagnosis includes several rheumatic diseases. OBJECTIVE: To assess the frequency, clinical features and types of cancer manifested in children presenting with musculoskeletal complaints over a seven-year period. TYPE OF STUDY: Retrospective. SETTING: Discipline of Allergy, Clinical Immunology and Rheumatology, Universidade Federal de São Paulo - Escola Paulista de Medicina. METHODS: The medical records of patients with musculoskeletal complaints and final diagnosis of malignant disease were reviewed. The data collected were: age when symptoms initially presented, age at diagnosis, clinical features presented, laboratory findings, and the initial and final diagnoses. RESULTS: A final diagnosis of cancer was found in nine out of 3,528 patients (0.25%) whose initial symptom was musculoskeletal pain. The mean time between disease onset and final diagnosis was five months. The most common features presented were pauciarticular arthritis or arthralgia involving the large joints. Juvenile rheumatoid arthritis was the most frequent initial diagnosis, in four out of nine patients. Anemia was the most frequent initial hematological change. Six out of eight patients had an increased erythrocyte sedimentation rate. The lactate dehydrogenase level was raised in five out of eight patients. The malignancies found included acute lymphocytic leukemia, acute myeloid leukemia, lymphoma, neuroblastoma and Ewing's sarcoma. DISCUSSION: The frequency of neoplasia in patients with musculoskeletal pain resembled reports in the literature. Consumptive symptoms were not the warning signal in most of our patients. In subsidiary tests, progressive anemia was the most common finding, although the peripheral blood cell count may continue to be normal for weeks or months after symptom onset. CONCLUSION: Malignancy always needs to be ruled out in cases of children with musculoskeletal complaints. Uncharacteristic clinical manifestations and nonspecific laboratory tests may cause difficulty in the final diagnosis, and rigorous investigation should be performed.

scholarly journals Clinicopathological features of desmoplastic small round cell tumors: clinical series and literature review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ling-Ling Wang ◽  
Zhong-He Ji ◽  
Ying Gao ◽  
Hong Chang ◽  
Ping-Ping Sun ◽  
...  
Keyword(s):  
Gene Fusion ◽  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Clinicopathological Features ◽  
Molecular Diagnostic ◽  
Round Cell ◽  
Small Round Cell ◽  
Clinical Series

Abstract Background and purpose Desmoplastic small round cell tumor (DSRCT) is a highly malignant sarcoma that occurs in the abdominopelvic cavities of adolescents. The accurate diagnosis of DSRCT is challenging owing to limited literatures. Our study aimed to investigate the relationship between clinicopathological features and prognosis in patients with DSRCTs. Methods Data of 8 patients with DSRCT originating from the abdominal cavity were retrospectively reviewed. The clinical manifestations, pathological characteristics, treatment approaches, and prognosis were analyzed. The histopathological (identified using hematoxylin-eosin staining), immunohistochemical, and molecular diagnostic (using fluorescence in situ hybridization) features were also reviewed. Results All patients were male aged between 24 and 45 years (median age, 30 years). The main clinical symptoms included abdominal distension, abdominal pain, and constipation. Seven of the 8 patients developed metastases to either distant organs or lymph nodes. Multiple gray nodules with diameters of 1–10 cm and poorly defined boundaries were scattered throughout the omentum and mesentery. Histopathological examination demonstrated well-defined nests composed of small round blue cells separated by markedly desmoplastic stroma. Immunohistochemical analysis revealed positive expressions of desmin, vimentin and C-terminal of Wilm’s tumor suppressor (WT-1). The Ewing sarcoma breakpoint region 1 gene fused with WT1 (EWSR1-WT1) gene fusion was detected in all patients. Cytoreductive surgery (CRS) was performed in 6 patients. Follow-up period ranged from 7.5 to 28.5 months with a median of 17.2 months. Three patients died during follow-up. Conclusion DSRCT is highly aggressive and presents distinctive morphological features. CRS is the essential therapy for DSRCT. A test for the combined expression of desmin, cytokeratins, and C-terminal of WT-1, as well as the analysis of morphologic features, might be helpful during DSRCT diagnosis, and the EWSR1-WT1 gene fusion is the gold standard for definitive diagnosis. Our work will provide new insights into the diagnosis and treatment of DSRCTs.

Sign in / Sign up

Export Citation Format

Share Document