Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen.

Abstract Despite the current pandemic season, reports on pathologic features of Coronavirus disease 19 (COVID-19) are exceedingly rare at the present time. Here we describe the pathologic features of early lung involvement by COVID-19 in a surgical sample resected for carcinoma from a patient who developed SARS-CoV-2 infection soon after surgery. The main histologic findings observed were pneumocyte damage, alveolar hemorrhages with clustering of macrophages, prominent and diffuse neutrophilic margination within septal vessels and interstitial inflammatory infiltrates, mainly represented by CD8+ T lymphocytes. These features are similar to those previously described in SARS-CoV infection. Subtle histologic changes suggestive pulmonary involvement by Covid-19 may be accidentally encountered in routine pathology practice, especially when extensive sampling is performed for histology. These findings should be carefully interpreted in light of the clinical context of the patient and could prompt a pharyngeal swab PCR test to rule out the possibility of SARS-CoV-2 infection in asymptomatic patients.

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Primary Lymphoma Presenting in an Ascending Aortic Aneurysm: A Case Report

Aorta ◽

10.1055/s-0040-1701529 ◽

2020 ◽

Vol 08 (02) ◽

pp. 038-040

Author(s):

Alexander M. Schurman ◽

David Mendoza ◽

Chris K. Rokkas

Keyword(s):

Management Strategies ◽

Ascending Aorta ◽

Aortic Aneurysms ◽

Prior History ◽

Primary Lymphoma ◽

Surgical Specimen ◽

Hematological Disorders ◽

Thoracic Aortic Aneurysms ◽

Asymptomatic Patients ◽

History Of

AbstractSmall lymphocytic lymphoma (SLL) is rarely associated with thoracic aortic aneurysms. Aneurysm of the ascending aorta associated with SLL has never been reported before. We describe the case of an asymptomatic 68-year-old woman who presented with a 5.5-cm aneurysm of the ascending aorta and no prior history of hematological disorders. Following excision and repair, the surgical specimen showed infiltration of the aortic wall by lymphocytes, expressing markers consistent with SLL. While symptomatic SLL carries a poor prognosis, risk stratification tools are applied to guide management strategies in asymptomatic patients.

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Pseudo-duplication of the Gallbladder

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.9.43332 ◽

2019 ◽

Vol 4 (1) ◽

pp. 103-104

Author(s):

Jamie Adamski ◽

Divya Mohan ◽

Christopher Waasdorp

Keyword(s):

Gallbladder Wall ◽

Correct Identification ◽

Radiologic Findings ◽

Ultrasound Evaluation ◽

Asymptomatic Patients ◽

Anatomic Variants ◽

Rule Out

Phrygian cap and its rare relative, pseudo-duplication of the gallbladder, are two radiologic findings that may be revealed on ultrasound evaluation. Correct identification of Phrygian cap and pseudo-duplication should trigger a careful survey of the gallbladder in its entirety to rule out pathology. These anatomic variants may lead to partial under-distension of the gallbladder and can cause the gallbladder wall to appear falsely thickened. Asymptomatic patients with this finding may be safely discharged while symptomatic patients may require further surgical consultation.

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Inflammatory Myofibroblastic Tumour: Report of a Rare Form with Exclusive Pleural Involvement

Case Reports in Pulmonology ◽

10.1155/2014/621941 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Gustavo Nobre de Jesus ◽

Sara Lemos Rocha ◽

João Madeira Lopes ◽

João Meneses Santos ◽

Pedro Soares Oliveira ◽

...

Keyword(s):

Pulmonary Involvement ◽

Rare Entity ◽

Inflammatory Myofibroblastic Tumour ◽

Rare Form ◽

New Form ◽

Inflammatory Infiltrates ◽

Pleural Involvement

Inflammatory myofibroblastic tumour (IMT) is a rare scleroinflammatory lesion, characterized by a myofibroblastic proliferation with inflammatory infiltrates, with many possible locations and diagnosis based on immunohistochemistry. Pleural IMT is uncommon and is usually an extension of a pulmonary involvement. We report on a 28-year-old woman with a new form of this rare entity, characterized by exclusive pleural involvement.

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(F)utility of “routine” postprocedural chest radiograph after hemodialysis catheter (central venous catheter) insertion

The Journal of Vascular Access ◽

10.1177/1129729820907259 ◽

2020 ◽

pp. 112972982090725 ◽

Cited By ~ 1

Author(s):

Malvinder S Parmar

Keyword(s):

Central Venous Catheter ◽

Chest Radiograph ◽

Venous Catheter ◽

Catheter Insertion ◽

Central Venous Catheter Insertion ◽

Central Venous ◽

Hemodialysis Catheter ◽

Asymptomatic Patients ◽

Catheter Tip ◽

Rule Out

A routine postprocedural chest radiograph had been a safe, checklist-based final step of the procedure, since the start of central venous catheter insertion for hemodialysis to check the position of the catheter tip and to rule out complications. However, the chest radiograph is a suboptimal method to rule out complications like pneumothorax and is not a reliable test to confirm its position. Although it is relatively inexpensive, it is labor-intensive and exposes patient to unnecessary radiation exposure, cost, and often results in delayed use of the catheter. Various studies question the value of a routine chest radiograph as a screening test to rule out the mechanical complications of catheter insertion. We, in this brief viewpoint, present evidence to support the futility of a routine postprocedural chest radiograph in majority of asymptomatic patients and support Choosing Wisely Initiative to avoid low-value studies. However, it should be considered under specific indications, as discussed.

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Clinicopathologic Analysis of Chondroblastoma in Adults: A Single-Institution Case Series

International Journal of Surgical Pathology ◽

10.1177/1066896920927794 ◽

2020 ◽

pp. 106689692092779 ◽

Cited By ~ 2

Author(s):

Stefano Negri ◽

Sintawat Wangsiricharoen ◽

Leslie Chang ◽

John Gross ◽

Adam S. Levin ◽

...

Keyword(s):

Benign Tumor ◽

Adult Population ◽

Case Series ◽

Pathologic Features ◽

Extensive Calcification ◽

Rare Benign Tumor ◽

Cartilage Cells ◽

Hands And Feet ◽

Histologic Changes

Chondroblastoma is a rare benign tumor of immature cartilage cells that generally occurs in an epiphyseal location of skeletally immature individuals. However, a few studies have reported cases in older patients. The purpose of this study was to evaluate the clinical, radiographic, and pathologic features of chondroblastoma in an adult population. The pathology archives of our institution were searched for cases of chondroblastoma diagnosed in patients ≥25 years of age. Of 14 patients identified, 8 were male and 6 were female with a median age of 34 years (range = 29-54 years). Most lesions occurred in short bones of hands and feet (N = 7, 50%), followed by the long tubular bones (N = 4, 28%). All demonstrated typical histologic features of chondroblastoma, but more extensive calcification, necrosis, and degenerative changes were also seen. At follow-up (median = 73.5 months), 2 patients (17%) had local recurrence. None had metastasis. In summary, chondroblastoma in adults tends to involve the short bones of the hands and feet and demonstrate histologic changes associated with long-standing growth of a benign tumor.

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Gastric Metastasis 14 Years after Mastectomy for Breast Lobular Carcinoma: Case Report and Literature Review

The American Surgeon ◽

10.1177/000313480607200518 ◽

2006 ◽

Vol 72 (5) ◽

pp. 456-460 ◽

Cited By ~ 4

Author(s):

Paolo Aurello ◽

Francesco D'Angelo ◽

Giulia Cosenza ◽

Sergio Petrocca ◽

Antonella Stoppacciaro ◽

...

Keyword(s):

Breast Carcinoma ◽

Lobular Carcinoma ◽

Subtotal Gastrectomy ◽

Immunohistochemical Analysis ◽

Gastric Neoplasm ◽

Surgical Specimen ◽

Symptomatic Disease ◽

Lobular Breast Carcinoma ◽

Previously Treated ◽

Rule Out

In planning treatment of a gastric neoplasm in a patient previously treated for lobular breast carcinoma, it is important to differentiate a primary gastrointestinal tract tumor from a metastatic form. We report a case of a breast lobular carcinoma metastatic to the stomach. The patient underwent a subtotal gastrectomy for symptomatic disease. Although gastric symptoms appeared 14 years after the breast carcinoma, immunohistochemical analysis of the surgical specimen helped to establish that the gastric lesion, thought to be primary, was effectively a metastatic repetition of the breast neoplasm. To better define treatment in a gastric neoplasm patient previously treated for breast carcinoma, the preoperative diagnosis should rule out a metastatic disease. The patient described received an adjuvant chemotherapy according to breast cancer protocol after gastric resection for symptomatic disease. The patient is still alive and undergoing chemotherapy for peritoneal carcinosis.

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Tomographic findings in bronchial atresia

Radiologia Brasileira ◽

10.1590/0100-3984.2019.0136 ◽

2021 ◽

Vol 54 (1) ◽

pp. 9-14

Author(s):

Elazir Barbosa Mota Di Puglia ◽

Rosana Souza Rodrigues ◽

Pedro Augusto Daltro ◽

Arthur Soares Souza Jr. ◽

Marilene Monteiro Paschoal ◽

...

Keyword(s):

Lower Lobe ◽

Lung Parenchyma ◽

Pulmonary Involvement ◽

Middle Lobe ◽

Pathological Examination ◽

Surgical Specimen ◽

Distal Lung ◽

The Right ◽

Ct Finding ◽

Bronchial Atresia

Abstract Objective: To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. Materials and Methods: The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). Results: The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. Conclusion: The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.

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Abdominal Aortic Aneurysm Screening

10.1093/med/9780190223700.003.0024 ◽

2016 ◽

Cited By ~ 1

Author(s):

Christoph I. Lee

Keyword(s):

Aortic Aneurysms ◽

Clinical Implications ◽

Clinical Context ◽

Additional Information ◽

Asymptomatic Patients ◽

Abdominal Aortic ◽

All Cause Mortality ◽

Study Methodology ◽

Abdominal And Pelvic Pain ◽

Related Mortality

This chapter, found in the abdominal and pelvic pain section of the book, provides a succinct synopsis of a key study examining the use of ultrasound for screening asymptomatic patients for abdominal aortic aneurysms (AAAs). This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study showed that screening for AAAs can decrease aneurysm-related mortality rates. However, since AAAs contribute to less than 3% of all deaths, screening provides no significant decrease in all-cause mortality. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

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Screening for Coronary Artery Disease in Asymptomatic Patients with Diabetes

10.1093/med/9780190223700.003.0019 ◽

2016 ◽

Author(s):

Michael E. Hochman

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Stress Tests ◽

Clinical Context ◽

Additional Information ◽

Asymptomatic Patients ◽

Patients With Diabetes ◽

Study Methodology ◽

Artery Disease

This chapter, found in the chest pain section of the book, provides a succinct synopsis of a key study examining the use of computed tomography (CT) for screening asymptomatic patients with diabetes for coronary artery disease. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study showed that screening stress tests in patients with type 2 diabetes are abnormal 22% of the time. However, detecting these abnormalities does not appear to aid in patient management. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

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Overview of chest involvement at computed tomography in children with coronavirus disease 2019 (COVID-19)

Pediatric Radiology ◽

10.1007/s00247-020-04826-7 ◽

2020 ◽

Author(s):

Xuehua Peng ◽

Yu Guo ◽

Han Xiao ◽

Wei Xia ◽

Aiguo Zhai ◽

...

Keyword(s):

Computed Tomography ◽

Young Children ◽

Pulmonary Involvement ◽

Chest Ct ◽

Chi Square ◽

Asymptomatic Group ◽

Lung Lesions ◽

Viral Shedding ◽

Ct Findings ◽

Asymptomatic Patients

Abstract Background Chest computed tomography (CT) findings in children with coronavirus disease 2019 (COVID-19) have been rarely reported in a comprehensive and systematic manner. Objective We investigated the chest CT findings in children with COVID-19, and explored the differences in these findings between symptomatic patients and asymptomatic patients. Materials and methods Demographic findings, clinical characteristics, duration of hospital stay and viral shedding, and chest CT findings in 201 children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were retrospectively analyzed from January 15 to March 20, 2020, and divided into two groups: symptomatic group (n=136) and asymptomatic group (n=65). Chi-square test and Student’s t-test were used for statistical analysis. Results Symptomatic patients were mainly young children ≤3 years old (54/63, 86%),while asymptomatic patients were mainly children ≥ 6 years old (51/111, 46%). Fever (41%) and cough (41%) were the most common symptoms. Overall, 119/201 (59%) patients had chest CT findings, and symptomatic patients accounted for 82% (98/119). The CT findings presented as bilateral multiple lesions (60/119, 50.4%), ground-glass opacities (83/119, 70%) and/or consolidation (44/119, 37%) with a peripheral and subpleural distribution (62/83, 75%). Fifteen of 87 (7.2%) patients with lung lesions showed complete lesion absorption, and 42/87 (48%) improved within a mean of 9.1 (standard deviation [SD] 3.2) days. The mean duration of viral shedding was 8.7 (SD 4.9) days. Pleural effusion was very rare. No lymphadenopathy was found in either group. Conclusion Symptoms associated with pulmonary involvement were most common in infants and young children. The lung lesions of most patients were absorbed and improved in about 9 days.

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