Intrathyroidal Ectopic Thymus and Sonoelastographic Findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Serkan Guneylı ◽  
Murat Serhat Aygun ◽  
Orhun Cig Taskın ◽  
Ergin Sagtas ◽  
Bulent Colakoglu
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Population ◽  
Posterior Part ◽  
Strain Ratio ◽  
Ectopic Thymus ◽  
Strain Elastography ◽  
Common Location ◽  
Asymptomatic Patients ◽  
Available Information

Background: Intrathyroidal ectopic thymus (IET) can be misdiagnosed as thyroid nodules. Purpose: To evaluate the sonoelastographic findings of IET in pediatric population. Methods: Twelve children who had been examined with ultrasound (US) and strain elastography between December 2012 and December 2019 were included in this retrospective study. The patients’ demographics and ultrasonographic findings including the location, margin, shape, diameters, volume, structure, vascularity, and elastography values of the lesions were evaluated. Results: Twelve lesions were detected in 12 asymptomatic patients (3 females and 9 males) with a mean age of 4.67 ± 2.27 years. The most common location of the IET was in posterior part and middle third of thyroid, and the most common appearance on US was a well-defined, ovoid-shaped, and predominantly hypoechoic solid lesion with punctate/linear branching hyperechogenities. The lesions were mostly hypovascular on Doppler US. The mean strain ratio on elastography was found to be 1.10 ± 0.04. In the follow-up of 7 patients with available information, there was not any significant change in size or appearance of IET on US. Conclusion: IET should be considered in the differential diagnosis of the lesions within the thyroid. The first step to accurately diagnose an IET is to consider it in the differential diagnosis. In addition to US, strain elastography findings can be used to distinguish IETs from papillary thyroid cancers which can have similar US appearance, and help avoid unnecessary biopsies.

Breast Vasculitis Presenting as a Tumor-Like Lesion. A Case Report

2005 ◽  
Vol 91 (4) ◽  
pp. 366-368 ◽  
Author(s):  
Fausto Famà ◽  
Arnaud Piquard ◽  
Francesco Fedele ◽  
Maria Antonietta Gioffrè Florio
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Clinical Characteristics ◽  
Systemic Vasculitis ◽  
Carcinoma Of The Breast ◽  
Common Location ◽  
Inflammatory Carcinoma ◽  
Assessment And Treatment ◽  
Cancerous Lesions

Breast vasculitis presenting as a tumor-like lesion is rare. The differential diagnosis in these cases can be extremely difficult but is very important for treatment and follow-up. We report the case of a 80-year-old woman who was admitted to our service with a lesion resembling an inflammatory carcinoma of the breast. We discuss the pathological and clinical characteristics, the presentation, assessment and treatment of this case and its resolution. Few reports in the literature have addressed the possible occurrence of systemic vasculitis mimicking cancerous lesions. The most common location of such lesions was shown to be the breast in one review. Although rare, such manifestations can be effectively recognized and treated.

Brain Aneurysms in the Pediatric Population of Slovenia: A Case Series

2019 ◽  
Vol 50 (03) ◽  
pp. 188-192
Author(s):  
Saša Ilovar ◽  
Mirjana Benedik ◽  
Tina Vesnaver ◽  
Damjan Osredkar
Keyword(s):  
Clinical Presentation ◽  
Pediatric Population ◽  
Case Series ◽  
Medical Documentation ◽  
Brain Aneurysm ◽  
Male Predominance ◽  
Presenting Symptoms ◽  
Asymptomatic Patients ◽  
Brain Aneurysms

Background Brain aneurysms are rare in the pediatric population. The diagnosis of a brain aneurysm in a child may be difficult because of its infrequency and often subtle or nonspecific clinical presentation. Endovascular therapy and microsurgical treatment are increasingly used approaches in treating children, possibly contributing to favorable outcomes if patients are treated in a timely manner. Objective We were interested in the clinical presentation, symptoms, diagnostics, treatment, and follow-up of pediatric patients with brain aneurysms in Slovenia. Methods This was a retrospective review of medical documentation of children with intracranial aneurysms treated at the University Children's Hospital in Ljubljana, Slovenia, from January 1998 to December 2017. Results We identified a cohort of eight children (median age: 14.9 years; range: 2.8–17.7). The estimated incidence of pediatric brain aneurysms in Slovenia is 0.12/100,000 children per year. We observed a male predominance (1.7:1). Half of the patients presented with acute onset of neurologic symptoms and three with subarachnoid hemorrhage. One of the patients had a related stroke. The presenting symptoms were tonic–clonic seizures, hemiparesis, paresthesias, speech disturbance, and cranial nerve palsy. The other half of aneurysms were identified incidentally. Five patients had anterior circulation aneurysms; the most prevalent location was the internal carotid artery. One patient was treated with surgical procedures, four patients were treated with endovascular procedures, and three patients were treated conservatively. Outcome was excellent in all patients. Conclusion Endovascular interventions and microsurgical procedures appear to be safe and effective in the treatment of brain aneurysms in the pediatric population. Asymptomatic patients with brain aneurysms need close follow-up.

scholarly journals Case Report: Pulmonary and Liver Sarcoidosis Suspected of Metastasis

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 288
Author(s):  
Behnam Jafari ◽  
Gholamabas Sabz ◽  
Elahe Masnavi ◽  
Roghaye Panahi ◽  
Saeid Jokar ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Posterior Part ◽  
Granulomatous Inflammation ◽  
Spiral Ct ◽  
Sputum Smear ◽  
Important Differential Diagnosis ◽  
The Right ◽  
Closed Environment

Introduction: Sarcoidosis is a granulomatous disease with unknown cause that can vary from an asymptomatic condition. Almost half of the patients with sarcoidosis have no symptoms. In this article, we describe a sarcoidosis patient with lung and liver engagement; it may be confused with metastasis. Case report: A 39-year-old man, with known as hypothyroidism who had come to the emergency ward with dyspnea and coughing after exposure to detergents in a closed environment. The patient smoked for 10 years (3 pack/year). No other findings were found in clinical examinations except for wheezing in the right lung. The patient's chest radiography was shown a mass. For further investigation, spiral CT scan was performed. Large lymph nodes on the right side of the trachea, measuring about 23 mm and a mass of 70 × 77 mm in the vicinity of the right lung hilum and a hypodense nodule in the posterior part of the liver with malignancy suspicious were reported. After several biopsy results was shown chronic granulomatous inflammation, the most important differential diagnosis is tuberculosis (TB) and sarcoidosis. Sputum smear, culture, and PCR were performed for tuberculosis. Also, the level of angiotensin-converting enzyme (ACE) was measured for sarcoidosis. the results ruled out TB and shown a higher level of ACE (ACE = 88 IU/L).After diagnosis treatment started with prednisolone. Now, the patient is in the follow- up. Conclusion: In hilar lymphadenopathy of lung sarcoidosis is the importance differential diagnosis that should be considered.

scholarly journals Lupus anticoagulant in children – a confounding factor in diagnosis and targeted therapy

2021 ◽  
Vol 29 (3) ◽  
pp. 287-298
Author(s):  
Cristian Jinca ◽  
Margit Serban ◽  
Emilia Ursu ◽  
Nicoleta Anamaria Pascalau ◽  
Oana Belei ◽  
...  
Keyword(s):  
Lupus Anticoagulant ◽  
Pediatric Patients ◽  
Confounding Factor ◽  
Pediatric Population ◽  
Coagulation Factor ◽  
Activated Partial Thromboplastin Time ◽  
Point Of View ◽  
Clinical Image ◽  
Asymptomatic Patients

Abstract Introduction: Lupus anticoagulant (LAC) belongs to a heterogeneous group of antibodies directed against negatively charged phospholipid-binding proteins, inhibiting phospholipid-dependent reactions. We assessed the frequency, etiological background, clinical and biological expression as well as the appropriate management and outcome of LAC in a pediatric population. Patients and methods: We included 19 pediatric patients diagnosed with a positive LAC test during a period of 1 year. LAC detection was carried out according to the ISTH/SCC guidelines 2012. Coagulometric assays were performed in order to check for coagulation factor activities. The presence of specific inhibitors has been tested by the Bethesda assay. Results: LAC was positive in 0.4% of the patients monitored for increased activated partial thromboplastin time (aPTT) during the study period of 1 year. In contrast to the asymptomatic clinical image presented by the majority of our patients, the biological picture was dominated by an elevated aPTT (79 %), the aPTT ratio correlating significantly with the strength of LAC. In 58 % of the patients LAC became negative within 12 weeks, in another 4 (21%) patients within 20 weeks, whereas in 4 (21%) patients LAC remained positive throughout the follow-up. Conclusion: Albeit usually innocent in asymptomatic patients, LAC needs to be seriously taken into consideration from the diagnostic point of view in order to avoid dangerous therapeutic attitudes..

scholarly journals Case Report: Pulmonary and Liver Sarcoidosis Suspected of Metastasis

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 288
Author(s):  
Behnam Jafari ◽  
Gholamabas Sabz ◽  
Elahe Masnavi ◽  
Roghaye Panahi ◽  
Saeid Jokar ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Posterior Part ◽  
Granulomatous Inflammation ◽  
Spiral Ct ◽  
Sputum Smear ◽  
Emergency Ward ◽  
The Right ◽  
Closed Environment

Introduction: Sarcoidosis is a granulomatous disease with unknown cause that can vary from an asymptomatic condition. Almost half of the patients with sarcoidosis have no symptoms. In this article, we describe a sarcoidosis patient with lung and liver engagement; it may be confused with metastasis. Case report: A 39-year-old man, known as hypothyroidism who had come to the emergency ward with dyspnea and coughing after exposure to detergents in a closed environment A 39-year-old man, known as hypothyroidism who had come to the emergency ward with dyspnea and coughing after exposure to detergents in a closed environment. The patient smoked for 10 years (3 pack/year). No other findings were found in clinical examinations except for wheezing in the right lung. The patient's chest radiography was shown a mass. For further investigation, spiral CT scan was performed. Large lymph nodes on the right side of the trachea, measuring about 23 mm and a mass of 70 × 77 mm in the vicinity of the right lung hilum and a hypodense nodule in the posterior part of the liver with malignancy suspicious were reported. After several biopsy results was shown chronic granulomatous inflammation, the most important differential diagnosis is tuberculosis (TB) and sarcoidosis. Sputum smear, culture, and PCR were performed for tuberculosis. Also, the level of angiotensin-converting enzyme (ACE) was measured for sarcoidosis. the results ruled out TB and shown a higher level of ACE (ACE = 88).After diagnosis treatment started with prednisolone. Now, the patient is in the follow- up. Conclusion: In hilar lymphadenopathy of lung sarcoidosis is the importance differential diagnosis that should be considered

scholarly journals Solitary round pulmonary lesions in the pediatric population: a pictorial review

2019 ◽  
Vol 8 (5) ◽  
pp. 205846011985199
Author(s):  
Nikolaos-Achilleas Arkoudis ◽  
Angeliki Pastroma ◽  
Georgios Velonakis ◽  
Athanasios Tsochatzis ◽  
Argyro Mazioti ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Population ◽  
Clinical Information ◽  
Pulmonary Lesion ◽  
Radiological Findings ◽  
Pulmonary Lesions ◽  
Pictorial Review ◽  
Work Up

The purpose of this current pictorial review is to define the solitary round pulmonary lesion (SRPL), to familiarize with its prevalence in the pediatric population, and, moreover, to educate radiologists on its vast differential diagnosis and imaging manifestations. Furthermore, by highlighting valuable clues, it intends to assist radiologists efficiently partake in its diagnosis, work-up, and follow-up in order to narrow down the differential diagnosis by working alongside the clinician and combining clinical information, lab results, and radiological findings.

scholarly journals Primary breast tuberculosis: imaging findings of a rare disease

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ali H. Baykan ◽  
Hakan S. Sayiner ◽  
Ibrahim Inan ◽  
Elcin Aydin ◽  
Sukru M. Erturk
Keyword(s):  
Differential Diagnosis ◽  
Rare Disease ◽  
Extrapulmonary Tuberculosis ◽  
Reproductive Age ◽  
Malignant Diseases ◽  
Imaging Findings ◽  
Granulomatous Mastitis ◽  
Rare Form ◽  
Breast Tuberculosis

AbstractBreast tuberculosis is a rare form of extrapulmonary tuberculosis which tends to affect females of reproductive age, and is much rarer in males, postmenopausal women, and pre-pubescent girls. It is difficult to diagnose because it can mimic benign conditions such as a fibroadenoma, as well as malignant diseases like a carcinoma. It is also particularly difficult to distinguish breast tuberculosis from granulomatous mastitis, so other possible diagnoses should be ruled out first. The diagnosis of breast tuberculosis has three essential pillars: clinical examination, radiological evaluations, and histopathological sampling. Radiological evaluations are not only critical in diagnosis but are also important in the planning of the treatment and during the follow-up. This paper aims to review the imaging findings and the differential diagnosis of breast tuberculosis.

scholarly journals Pediatric endoscopic pilonidal sinus treatment (PEPSiT): what we learned after a 3-year experience in the pediatric population

2021 ◽  
Author(s):  
Ciro Esposito ◽  
Ernesto Montaruli ◽  
Giuseppe Autorino ◽  
Mario Mendoza-Sagaon ◽  
Maria Escolino
Keyword(s):  
Patient Satisfaction ◽  
Laser Therapy ◽  
Pilonidal Sinus ◽  
Pediatric Population ◽  
Treatment Protocol ◽  
Pilonidal Sinus Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clavien Grade

AbstractThis paper aimed to report a multi-institutional 3-year experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT) and describe tips and tricks of the technique. We retrospectively reviewed all patients < 18 years, with primary or recurrent pilonidal sinus disease (PSD), undergoing PEPSiT in the period 2017–2020. All patients received pre-operative laser therapy, PEPSiT and post-operative dressing and laser therapy. Success rate, healing rate/time, post-operative management, short- and long-term outcome and patient satisfaction were assessed. A total of 152 patients (98 boys) were included. Median patient’s age was 17.1 years. Fifteen/152 patients (9.8%) presented a recurrent PSD. All patients resumed full daily activities 1 day after surgery. The post-operative course was painless in 100% of patients (median VAS pain score < 2/10). Patient satisfaction was excellent (median score 4.8). The median follow-up was 12.8 months (range 1–36). Complete healing in 8 weeks was achieved in 145/152 (95.4%) and the median healing time was 24.6 days (range 16–31). We reported post-operatively immediate Clavien grade 2 complications (3 oedema, 2 burns) in 5/152 (3.3%) and delayed Clavien grade 2 complications (3 granulomas, 8 wound infections) in 11/152 (7.2%). Disease recurrence occurred in 7/152 (4.6%), who were re-operated using PEPSiT. PEPSiT should be considered the standard of care for surgical treatment of PSD in children and teenagers. PEPSiT is technically easy, with short and painless post-operative course and low recurrence rate (4.6%). Standardized treatment protocol, correct patient enrollment and information, and intensive follow-up are key points for the success of the procedure.

scholarly journals Paranasal Mass in a Healthy Male Toddler

2021 ◽  
pp. 014556132110079
Author(s):  
Melonie Anne Phillips ◽  
Meredith Lind ◽  
Gerd McGwire ◽  
Diana Rodriguez ◽  
Suzanna Logan
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Group ◽  
Significant Morbidity ◽  
Healthy Male ◽  
Neck Tumors ◽  
Complete Surgical Resection ◽  
Maxilla And Mandible ◽  
Benign Mass

Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.

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