scholarly journals Pyothorax-associated Lymphoma: a Case Report and Review

2020 ◽  
Author(s):  
Fangyuan Dong ◽  
Yongzhi Wu ◽  
Sufen Wang ◽  
Guomin Sun ◽  
Qinqin Zhang ◽  
...  
Keyword(s):  
Chest Pain ◽  
Rare Disease ◽  
Single Case ◽  
Lower Lobe ◽  
Final Diagnosis ◽  
Patient Treatment ◽  
Ki 67 ◽  
Chronic Empyema ◽  
The Right ◽  
Fdg Pet Ct

Abstract Background: Pyothorax-associated lymphoma is a rare disease with variations in endemic prevalence. PAL arising from a posttraumatic empyema are a rare occurrence.Case presentation: a male patient, 83 years old. Twenty years earlier, the patient fell from a height, sustaining a fracture to the right rib, which improved after conservative treatment. In September 2018, the patient had right chest pain (ribs 9–10). In February 2019, the chest pain became worse during sleep. CT examination showed inflammation of the right lower lobe, chronic empyema on the right with subdiaphragmatic infection, fibrosis of the right lung, atherosclerosis, thickening of the left pleura with rib destruction, and membranous calcification around the lesion. After 5 days of treatment with cefoperazone, sulbactam sodium, and ornidazole, the patient’s chest pain did not improve. The results of 18F-FDG PET/CT showed the following: a solid mass in the lower right thoracic cavity. Immunohistochemistry showed that the tumor cells were negative for CD20 and CD3, positive for background mature T lymphocytes, positive for Pax-5, positive for MUM-1, Ki-67 (70%, +); AE1/AE3, CD138, Bcl-6, CD10, CD5, CD56, MPO (-); CD79α (part +), EMA (part +), CD38 (+), bcl-2 (+). In situ hybridization (CISH): EBER+. Mini-CHOP chemotherapy was implemented on April 11, 2019. The patient stopped taking analgesics on the day of chemotherapy. The pain disappeared one week later, and the EBV-DNA fell to the normal range. In the later stage, the family members of the patient declined further patient treatment and reexamination. The patient’s condition worsened in July 2019 and he died on September 25, 2019.Conclusion: Pathological morphology is vital important to make a final diagnosis and avoid misdiagnosis or miss diagnosis. This case is described by a combination of imaging and pathological examinations that reports the clinical pathological diagnosis and treatment process of a single case of pyothorax-associated lymphoma, and it provides some diagnostic information regarding the rare disease of PAL.

scholarly journals A case report of primary pulmonary meningioma masquerading as lung metastasis in a patient with rectal carcinoma: role of 18F-FDG PET/CT

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maoqing Jiang ◽  
Ping Chen ◽  
Rong Huang ◽  
Jingfeng Zhang ◽  
Jianjun Zheng
Keyword(s):  
Rare Disease ◽  
Lung Metastasis ◽  
Rectal Carcinoma ◽  
Fdg Pet ◽  
Lower Lobe ◽  
Contrast Enhanced Ct ◽  
Pet Ct ◽  
Enhanced Ct ◽  
The Right ◽  
Fdg Pet Ct

Abstract Background Primary pulmonary meningioma (PPM) is an extremely rare disease, which is often misdiagnosed as lung metastasis. Previous studies indicated that PPM usually showed homogeneous enhancement on enhanced CT and high uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography/CT (PET/CT). In this study, we report a case of PPM with atypical enhanced CT and 18F-FDG PET/CT features in a patient with rectal carcinoma. Case presentation A 70-year-old male was demonstrated to have rectal carcinoma by biopsy while a solitary pulmonary nodule (SPN) with well-defined edges measuring 13 × 13 × 15 mm was almost simultaneously found in the right lower robe on chest CT scan. Contrast-enhanced CT and PET/CT revealed mild centripetal enhancement of the nodule without accumulation of 18F-FDG. A thoracoscopic wedge resection of the right lower lobe was finally performed and histopathologic examinations and PET/CT imaging showed that the nodule was a PPM. Conclusion PPM is a rare disease with heterogeneity not only in blood supply but also in glucose metabolism. 18F-FDG PET/CT may be an effective method for differentiating benign and malignant SPNs. The diagnosis of PPM depends on pathological and radiological examinations.

Ping-Pong Ball, Tumor or Thrombus in the Right Atrium? A Case Report

2018 ◽  
Vol 9 (3) ◽  
pp. 350-351
Author(s):  
Stephanie Ghaleb ◽  
Bryant Roosevelt ◽  
James Cnota
Keyword(s):  
Clinical Judgment ◽  
Right Atrium ◽  
Frozen Section ◽  
Noninvasive Imaging ◽  
Neoadjuvant Treatment ◽  
Lower Lobe ◽  
Final Diagnosis ◽  
Right Atrial ◽  
Right Atrial Mass ◽  
The Right

Tumors and thrombi are the most common cardiac masses of the right atrium. The use of noninvasive imaging to differentiate between the two can be deceiving, and the clinical judgment of a cardiologist and the emergency of the situation should be partnered to decide on the next step of the management. We present the case of a 29-year-old lady who was receiving neoadjuvant treatment for her rhabdomyosarcoma and was incidentally found to have a very large, very mobile right atrial mass that was protruding in the right ventricle with each cardiac cycle along with findings of a small segmental right lower lobe pulmonary embolism. Along with noninvasive imaging, frozen section analysis procured the wrong diagnosis, and the mass was ultimately found to be a right atrial thrombus on definite pathology review. Exact management of right atrial masses continues to be not well delineated, and when in doubt, final diagnosis might need to be “a posteriori” and based on the treatment response.

Cryptogenic organising pneumonia: an unusual cause of pleuritic chest pain

2021 ◽  
Vol 14 (1) ◽  
pp. e238514
Author(s):  
Rebecca Ceci Bonello ◽  
Etienne Ceci Bonello ◽  
Christian Vassallo ◽  
Edward Giles Bellia
Keyword(s):  
Chest Pain ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Clinical Status ◽  
Lower Lobe ◽  
Pleuritic Chest Pain ◽  
Ct Guided ◽  
Atypical Pathogens ◽  
Ct Guided Biopsy ◽  
The Right

A 76-year-old woman presented with a 2-hour history of pleuritic chest pain with no other associated symptoms. Blood investigations revealed raised inflammatory markers and an elevated white cell count. On chest radiograph, an airspace shadow indicative of a consolidation was prominent. This was followed by a CT scan of her thorax which showed a spiculated lesion in the right upper lobe, a lesion in the posterior segment of the left lower lobe and mildly enlarged right hilar lymph nodes. She was started on dual antibiotic therapy; however, the patient’s clinical status and inflammatory markers did not improve. A bronchoscopy was performed which excluded malignancy and atypical pathogens. CT-guided biopsy confirmed the presence of cryptogenic organising pneumonia. Prednisolone 50 mg daily was prescribed with quick resolution of symptoms.

scholarly journals Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Farzana Arif ◽  
Susan Wu ◽  
Shahriyour Andaz ◽  
Stewart Fox
Keyword(s):  
Incidental Finding ◽  
Lower Lobe ◽  
Final Diagnosis ◽  
Myoepithelial Cells ◽  
Myoepithelial Carcinoma ◽  
Rare Entity ◽  
Lobe Bronchus ◽  
Epithelial Myoepithelial Carcinoma ◽  
Bronchial Glands ◽  
The Right

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

scholarly journals Malignant glomus tumor of the thyroid gland: a case report

2019 ◽  
Vol 47 (6) ◽  
pp. 2723-2727
Author(s):  
Yinhua Liu ◽  
Rongrong Wu ◽  
Tao Yu ◽  
Yingya Cao ◽  
Linming Lu
Keyword(s):  
Thyroid Gland ◽  
Smooth Muscle Actin ◽  
Final Diagnosis ◽  
Multiple Organ ◽  
Ki 67 ◽  
Glomus Tumors ◽  
Chemotherapy Drugs ◽  
Multiple Round ◽  
Initial Discovery ◽  
The Right

Objective Primary malignant glomus tumors of the thyroid gland are a rare occurrence. Methods A 68-year-old man found a mass on the right side of his neck in October 2017. An X-ray examination on 9 January 2018 showed multiple round reinforced masses in both sides of the lung. Computed tomography imaging of the neck showed a low-density mass on the right side of the thyroid gland. Results The immunohistochemistry results were positive for smooth muscle actin, calponin, collagen IV, and Ki-67 60%. The patient received chemotherapy starting on 17 January 2018, 8 February 2018, and 11 March 2018. The chemotherapy drugs included ifosfamide, epirubicin, and cisplatin. However, the patient subsequently developed multiple organ failure and died in April 2018, approximately 6 months after the initial discovery of the mass in his neck. Conclusions Primary malignant glomus tumors of the thyroid gland are rare, and examination of their pathology and immunohistochemistry is vital for making an accurate final diagnosis. This case also indicates that primary malignant glomus tumors of the thyroid gland may have a poor prognosis, despite chemotherapy.

scholarly journals Intraosseous schwannoma of the proximal humerus with pathologic fracture

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Jiang Huajun ◽  
Qu Wei ◽  
Wu Yuxuan ◽  
Yang Jingjing
Keyword(s):  
Proximal Humerus ◽  
Pathologic Fracture ◽  
Bone Allograft ◽  
Excisional Biopsy ◽  
Final Diagnosis ◽  
Pathological Examination ◽  
Ki 67 ◽  
Intraosseous Schwannoma ◽  
S 100 ◽  
The Right

Abstract Background Intraosseous schwannomas are extremely rare in the humerus, and less than five cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. We herein present this case to discuss the reason for its rarity and share our experience of management. Case presentation A 55-year-old female patient presented with pain in the right shoulder, which was caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, the tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The Ki-67 index was about 10%. No mitoses or features of malignancy were identified. The final diagnosis of intraosseous schwannoma was made. The treatment for intraosseous schwannoma with pathologic fracture includes excisional biopsy, curettage, bone allograft, and fracture fixation. The patient recovered well. After the surgery, the patient gradually regained mobility and the pain subsided. There was no recurrence after 6 months of follow-up by X-ray. Conclusions Although very rare, intraosseous schwannoma should be taken under consideration in the differential diagnosis of benign-appearing osseous tumor in the proximal humerus with pathologic fracture.

scholarly journals Primary Ewing’s Sarcoma of the Kidney in a 73-Year-Old Man

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
T. B. Wedde ◽  
I. V. K. Lobmaier ◽  
B. Brennhovd ◽  
F. Lohne ◽  
K. S. Hall
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Single Case ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Patient Treatment ◽  
Renal Tumours ◽  
Tumour Entity ◽  
The Right

Objective. Ewing’s sarcoma of the kidney is rare and is usually found in young adults. We present here a single case study of Ewing's sarcoma found in an elderly man.Material and methods. A 73-year-old man underwent routine surgery for hydrocoele of the testis. He developed urinary obstruction symptoms, and radiological examinations revealed a tumour in the right kidney.Results.Microscopical, immunohistochemical, and molecular pathological analysis of the tumour was consistent with Ewing's sarcoma. FISH showed rearrangement of chromosomes 22q12 (EWSR1). The patient subsequently underwent nephrectomy followed by 6 adjuvant chemotherapy cycles. Follow-up after 7 months shows no recurrence.Conclusion. This case report presents not only the rare finding of Ewing's sarcoma in the kidney, but also the occurrence of this tumour entity in an elderly patient. Treatment options for the different types of renal tumours are vastly different and the need for a correct diagnosis is, therefore, vital.

Coronariaeredési anomáliák kardio-CT-vizsgálatok során

2020 ◽  
Vol 161 (47) ◽  
pp. 1995-1999
Author(s):  
László Barna ◽  
Zsuzsanna Takács-Szabó ◽  
László Kostyál
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Sinus Of Valsalva ◽  
Coronary Anomalies ◽  
Coronary Computed Tomography ◽  
Left Circumflex Artery ◽  
The Right ◽  
Left Sinus Of Valsalva

Összefoglaló. Bevezetés: Congenitalis coronariaanomáliának tekintik azokat a coronariamorfológiai rendellenességeket, melyek 1%-nál kisebb gyakorisággal fordulnak elő. Többségük nem jár tünettel, olykor azonban okozhatnak mellkasi fájdalmat, eszméletvesztést, és hirtelen halálhoz is vezethetnek. A coronariaanomáliák gyakoriságáról Magyarországon eddig csak invazív koronarográfiás adatok alapján jelent meg közlemény. Célkitűzés: Jelen vizsgálatunkban a coronariák eredési rendellenességeinek gyakoriságát mértük fel intézetünk coronaria-komputertomográfiás angiográfián átesett betegeinél. Módszer: A coronaria-komputertomográfiás vizsgálatra került betegek felvételeinek értékelésekor rögzítettük a coronariaanomália jelenlétét. A vizsgálat indikációja általában mellkasi fájdalom volt. 128 szeletes berendezést használtunk, a vizsgálatok során részben retrospektív, részben prospektív EKG-kapuzást alkalmaztunk. Eredmények: 1751 beteg komputertomográfiás angiográfiás felvételeit elemeztük. A betegek között a férfiak aránya 38,4%, a vizsgálatra kerülők életkorának átlaga pedig 58,07 ± 11,07 év volt. Eredési anomáliát 1,83%-ban találtunk, ezen belül a leggyakoribb volt a körbefutó ág (ramus circumflexus) és az elülső leszálló ág különálló eredése a bal Valsalva-sinusból (1%). A további rendellenességek a következők voltak: a jobb coronaria eredése magasan az aortából (0,34%), ramus circumflexus a jobb sinusból vagy a jobb coronariából (0,34%), jobb coronaria a bal Valsalva-sinusból (0,057%), elülső leszálló ág részben a bal Valsalva-sinusból a circumflexustól külön, részben a jobb coronariából (kettős elülső leszálló ág, 0,057%). Következtetés: Mindössze 0,057%-ban fordult elő potenciálisan tünetet okozó coronariaeredési rendellenesség (a bal sinusból eredő jobb coronaria). A komputertomográfiás angiográfia segítségével a coronariaeredés helye pontosan megállapítható, tisztázható az ér lefutása és ennek során viszonya a környező struktúrákhoz. Orv Hetil. 2020; 161(47): 1995–1999. Summary. Introduction: Congenital coronary artery anomaly is defined as a coronary morphology which occurs in less than 1% of the cases. Usually these anomalies do not result in symptoms but sometimes they can cause chest pain, syncope and sudden death. In Hungary, the prevalence of these abnormalities was published only from data of invasive coronary angiography. Objective: In this study, we evaluated the prevalence of the anomalies of coronary origin in the patients of our institution undergoing coronary computed tomography. Method: While reading the computed tomography angiograms of our patients, we registered the presence of coronary anomalies. In most of the cases, the indication of the coronary computed tomography was chest pain. A scanner with 128 detectors was used, scans were performed partly with prospective, partly with retrospective ECG gating. Results: We assessed 1751 patients. The ratio of males was 38.4%, while the average age of patients 58.07 ± 11.07 years. Anomaly of coronary origin was present in 1.83% of our patients, with the separate origin of left anterior descending and left circumflex artery being the most frequent (1%) among them. Other anomalies were as follows: high take-off of the right coronary artery from the ascending aorta (0.34%), left circumflex arising from the right sinus of Valsalva or from the right coronary (0.34%), right coronary artery from the left sinus of Valsalva (0.057%), left anterior descending arising partly from the left sinus of Valsalva, apart from the left circumflex, partly from the right coronary (dual left anterior descending artery, 0.057%). Conclusion: The prevalence of potentially symptomatic coronary anomalies was only 0.057% in our series (right coronary from the left sinus of Valsalva). The computed tomography angiography can precisely define the origin of the coronary artery, depict its run-off and its relationship to the neighbouring structures. Orv Hetil. 2020; 161(47): 1995–1999.

Multidisciplinary Approach of a Very Rare Infected Verrucous Carcinoma of the Scrotum

2019 ◽  
Vol 70 (4) ◽  
pp. 1476-1478
Author(s):  
Laura Raducu ◽  
Adelaida Avino ◽  
Cristina-Nicoleta Cozma ◽  
Sorin Nedelea ◽  
Andra-Elena Balcangiu-Stroescu ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Rare Disease ◽  
Chronic Inflammation ◽  
Male Patient ◽  
Multidisciplinary Approach ◽  
Verrucous Carcinoma ◽  
Surgical Excision ◽  
Diagnosis And Treatment ◽  
Wide Surgical Excision ◽  
The Right

Verrucous carcinoma of the scrotum is an extremely rare disease and most cases are thought to result from poor hygiene and chronic inflammation. Currently, it has not been well characterized, the etiology, diagnosis and treatment remaining poorly understood. We present the case of a 50-year-old male patient diagnosed with verrucous carcinoma of the right hemiscrotum. Wide surgical excision was performed. Favorable outcomes can be achieved by surgery, even without any adjuvant therapy, but patients should be carefully followed up.

Prevalence and Localization of Hibernating Myocardium Among Patients with Left Ventricular Dysfunction

2019 ◽  
Vol 15 (9) ◽  
pp. 884-889
Author(s):  
Emine Acar ◽  
Ayşegül Aksu ◽  
Gökmen Akkaya ◽  
Gamze Çapa Kaya
Keyword(s):  
Scar Tissue ◽  
Left Ventricular ◽  
Hibernating Myocardium ◽  
Circumflex Artery ◽  
Irrigation Area ◽  
Left Circumflex Artery ◽  
Pet Ct ◽  
Perfusion Defects ◽  
The Right ◽  
Fdg Pet Ct

Objective: This study evaluated how much of the myocardium was hibernating in patients with left ventricle dysfunction and/or comorbidities who planned to undergo either surgical or interventional revascularization. Furthermore, this study also identified which irrigation areas of the coronary arteries presented more scar and hibernating tissue. Methods: At rest, Tc-99m MIBI SPECT and cardiac F-18 FDG PET/CT images collected between March 2009 and September 2016 from 65 patients (55 men, 10 women, mean age 64±12) were retrospectively analyzed in order to evaluate myocardial viability. The areas with perfusion defects that were considered metabolic were accepted as hibernating myocardium, whereas areas with perfusion defects that were considered non-metabolic were accepted as scar tissue. Results: Perfusion defects were observed in 26% of myocardium, on average 48% were associated with hibernation whereas other 52% were scar tissue. In the remaining Tc-99m MIBI images, perfusion defects were observed in the following areas in the left anterior descending artery (LAD; 31%), in the right coronary artery (RCA; 23%) and in the Left Circumflex Artery (LCx; 19%) irrigation areas. Hibernation areas were localized within the LAD (46%), LCx (54%), and RCA (64%) irrigation areas. Scar tissue was also localized within the LAD (54%), LCx (46%), and RCA (36%) irrigation areas. Conclusion: Perfusion defects are thought to be the result of half hibernating tissue and half scar tissue. The majority of perfusion defects was observed in the LAD irrigation area, whereas hibernation was most often observed in the RCA irrigation area. The scar tissue development was more common in the LAD irrigation zone.

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