scholarly journals A Puzzling Case of Biliary Stricture with Calcified Liver Nodules

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Leow VM ◽  
Faizah MS ◽  
Yang KF ◽  
Hasnan MN ◽  
Manisekar SS
Keyword(s):  
Obstructive Jaundice ◽  
Biliary Stricture ◽  
Histopathological Examination ◽  
Chronic Infections ◽  
Liver Nodules ◽  
Mycobacterium Infection ◽  
Granulomatous Lymphadenitis ◽  
Clinical Phenomenon ◽  
Work Up ◽  
Proximal Bile Duct

Tuberculous (TB) biliary stricture with calcified liver nodules rendering obstructive jaundice is a rare clinical phenomenon. Recently, we encountered a young patient with obstructive jaundice who was investigated in a general hospital. He was sent to our hospital for subsequent management after undergoing a series of investigations and biliary stenting. The radiological imagings performed revealed multiple calcified lesions in the liver with proximal bile duct strictures. Blood investigations, tumor markers and tuberculous work up were not remarkable. Subsequently, he underwent laparotomy and biliary reconstruction. Postoperatively, he was discharged well. Histopathological examination of the hepatoduodenal nodes showed chronic infections and granulomatous lymphadenitis, suspicious of a mycobacterium infection.

scholarly journals Androgenic alopecia in post-menopausal female: a clinical presentation

2020 ◽  
Vol 9 (5) ◽  
pp. 2157
Author(s):  
Kirty Nahar ◽  
Usha Bohra ◽  
Vivek Arya
Keyword(s):  
Hair Loss ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Abdominal Hysterectomy ◽  
Androgenic Alopecia ◽  
Clinical Signs And Symptoms ◽  
Significant Regression ◽  
Post Menopausal ◽  
Work Up

Androgenic alopecia is a patterned hair loss occurring due to systemic androgens and genetic factors. It is the most common cause of hair loss in both genders. The appearance of this condition is the cause of significant stress and psychological problems, making appropriate management important. A 68-year-old postmenopausal female presented with complaints of increased hair loss from scalp, excessive hair growth at undesired sites and hirsutism not corrected with medications. On thorough investigations, CT scan whole abdomen and endocrinological workup, a clinical diagnosis of alopecia and hirsutism due to hyperandrogenemia secondary to ovarian tumor made. Abdominal hysterectomy with B/L salpingo-oophorectomy was done. Histopathological examination revealed an encapsulated tumor in right ovary-sex cord stromal tumor consistent with Leydig cell tumor in right ovary, no evidence of malignancy. Left ovary was normal. Patient showed significant regression of clinical signs and symptoms on follow up after 1 month. All women with severe hirsutism or androgenic alopecia needs further work up to locate the source of androgen over production.

scholarly journals Postpartum Spontaneous Subcapsular Hepatic Hematoma Related to Preeclampsia

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios Anyfantakis ◽  
Miltiades Kastanakis ◽  
Georgios Fragiadakis ◽  
Paraskevi Karona ◽  
Nikolaos Katsougris ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Emergency Caesarean Section ◽  
Maternity Ward ◽  
Hepatic Hematoma ◽  
Pregnancy And Postpartum ◽  
Life Threatening ◽  
Clinical Phenomenon ◽  
Diagnostic Work ◽  
Work Up ◽  
Severe Epigastric Pain

Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

scholarly journals A Surgically Resected Pancreatic Schwannoma with Obstructive Jaundice with Special Reference to Differential Diagnosis from Other Cystic Lesions in the Pancreas

2018 ◽  
Vol 12 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Takayoshi Watanabe ◽  
Kenichiro Araki ◽  
Norihiro Ishii ◽  
Takamichi Igarashi ◽  
Akira Watanabe ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Protein Expression ◽  
Histopathological Examination ◽  
S100 Protein ◽  
Pancreatic Head ◽  
Pancreatic Tumors ◽  
Cystic Lesions ◽  
Cystic Tumors ◽  
Pancreatic Schwannoma

Pancreatic schwannomas are uncommon. About 60% of pancreatic schwannomas develop cystic lesions, and the differential diagnosis from other cystic pancreatic tumors is difficult. A 43-year-old man presented for evaluation of liver dysfunction detected during a medical checkup. Blood testing detected obstructive jaundice. A computed tomography scan revealed a well-defined polycystic tumor of about 5 cm at the pancreatic head. We performed surgical resection to treat the patient’s symptoms and facilitate long-term management. Histopathological examination revealed spindle-shaped cells. Immunohistochemical studies showed S100 protein expression and the absence of CD34 and c-kit protein expression. Finally, we diagnosed a schwannoma. Pancreatic schwannoma is usually asymptomatic. The present case presented with obstructive jaundice, which is reportedly a rare symptom. Pancreatic schwannomas should be considered as a differential diagnosis of pancreatic cystic tumors. Dilatation of the pancreatic duct and the 18-fluorodeoxyglucose positron emission tomography findings are important for the differential diagnosis.

The additional value of diagnostic laparoscopy in the work-up of patients with a proximal bile duct tumor

2001 ◽  
Vol 120 (5) ◽  
pp. A89-A89
Author(s):  
E TILLEMAN ◽  
S CASTRO ◽  
O BUSCH ◽  
T GULIK ◽  
H OBERTOP ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Laparoscopy ◽  
Bile Duct Tumor ◽  
Additional Value ◽  
Work Up ◽  
Proximal Bile Duct

Pathologically confirmed diffuse alveolar haemorrhage in lymphangioleiomyomatosis

2021 ◽  
Vol 14 (11) ◽  
pp. e238713
Author(s):  
Jane Kobylianskii ◽  
Adam Hutchinson-Jaffe ◽  
Michael Cabanero ◽  
John Thenganatt
Keyword(s):  
Lung Biopsy ◽  
Histopathological Examination ◽  
Chest Ct ◽  
Ground Glass ◽  
Alveolar Haemorrhage ◽  
Vascular Endothelial ◽  
Diffuse Alveolar Haemorrhage ◽  
Endothelial Growth Factor ◽  
Work Up

A 40-year-old woman was referred to pulmonology after presenting with dyspnoea and self-limiting haemoptysis. Chest CT revealed diffuse ground glass opacities and small thin-walled cysts. Bronchoalveolar lavage cultures were negative and cytology revealed haemosiderin-laden macrophages. Transthoracic echocardiogram was normal. Connective tissue disease and vasculitis work-up were negative. Vascular endothelial growth factor-D level was indeterminate. Lung function was normal. She underwent video-assisted thoracoscopic lung biopsy. In addition to findings consistent with lymphangioleiomyomatosis, histopathological examination identified haemosiderosis without capillaritis, confirming a diagnosis of diffuse alveolar haemorrhage in the context of the associated clinical and radiographic features. Follow-up imaging after 5 months showed resolution of the diffuse ground glass opacities. Pharmacotherapy with sirolimus was not initiated due to absence of deterioration in pulmonary function. Diffuse alveolar haemorrhage in patients with lymphangioleiomyomatosis is a rare but important presentation. The few previously reported cases progressed to respiratory failure requiring mechanical ventilation.

Value of percutaneous transhepatic cholangiobiopsy for pathologic diagnosis of obstructive jaundice: analysis of 826 cases

2016 ◽  
Vol 58 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Zhen Li ◽  
Teng-Fei Li ◽  
Jian-Zhuang Ren ◽  
Wen-Cai Li ◽  
Jing-Li Ren ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Biliary Stricture ◽  
False Negative ◽  
Bile Leakage ◽  
True Positive Rate ◽  
True Positive ◽  
Biliary Carcinoma ◽  
Pathologic Diagnosis ◽  
Pathologic Findings ◽  
Positive Rate

Background Obstructive jaundice (OJ) is insensitive to radiation and chemotherapy, and a pathologic diagnosis is difficult to make clinically. Percutaneous transhepatic cholangiobiopsy (PTCB) is simple to perform and minimally invasive, and clinical practice has shown it to be an accurate and reliable new method for bile duct histopathologic diagnosis. Purpose To investigate the value of PTCB for pathologic diagnosis of causes of OJ. Material and Methods From April 2001 to December 2011, PTCB was performed in 826 consecutive patients. Data on pathologic diagnosis, true positive rate, and complications were analyzed retrospectively. Patients with negative pathologic findings were diagnosed using clinical, imaging, laboratory, and prognostic data. The feasibility and safety of PTCB for OJ were evaluated and true positive rates for biliary carcinoma and non-biliary carcinoma compared. Results PTCB was successful in all cases. Of 740 patients clinically diagnosed with malignant biliary stricture and 86 with benign biliary stricture, 727 received a positive pathologic diagnosis; in 99, the pathologic findings were considered false negative. The true positive rate for PTCB was 88.01% overall, differing significantly for biliary and non-biliary carcinoma ( χ2 = 12.87, P < 0.05). Malignancy accounted for 89.59% of OJ cases; well, moderately, and poorly differentiated carcinoma represented 57.88%, 19.97%, and 22.15%. Biliary adenocarcinoma was the predominant malignant pathologic type (96.41%). Transient bilemia, bile leakage, and temporary hemobilia occurred in 47, 11, and 28 cases, respectively, with no serious complications. Conclusion PTCB is safe, feasible, and simple, with a high true positive rate for definitive diagnosis of OJ causes. Well differentiated adenocarcinoma was the predominant pathologic type.

scholarly journals Multifocal Tuberculosis with Prolonged Paradoxical Reaction

2019 ◽  
Vol 26 (1) ◽  
pp. 51-57
Author(s):  
Ebrahim K. Al-Ebrahim ◽  
Tariq A. Madani
Keyword(s):  
Lymph Nodes ◽  
Complete Resolution ◽  
Histopathological Examination ◽  
Male Student ◽  
Lymph Node Biopsy ◽  
Paradoxical Reaction ◽  
Antituberculosis Therapy ◽  
The Family ◽  
Granulomatous Lymphadenitis ◽  
Tuberculosis Therapy

This is a case report describing successful treatment of a challenging case of an 18-year old previously healthy high school male student with multifocal tuberculosis involving the spleen and mediastinal and abdominal lymph nodes confirmed by histopathology of splenectomy tissue. The patient initially responded well to antituberculosis therapy with complete resolution of fever and improvement in his general health and weight. However, two months after initiation of anti-tuberculosis therapy, the patient developed paradoxical reaction manifest as recurrence of fever that persisted for five months and was associated with enlargement of lymph nodes. The fever failed to abate with continuation of the same antituberculosis therapy. Despite reassurance that the fever was due to a prolonged paradoxical reaction, a decision was made by the family to seek advice in another hospital where lymphoma was excluded again by histopathological examination of an excisional lymph node biopsy that revealed caseating granulomatous lymphadenitis and negative tuberculosis stain, culture, and polymerase chain reaction. The patient was continued on anti-tuberculosis therapy and treated with corticosteroids that resulted in complete resolution of fever and subsequent full recovery from his tuberculosis.

Sign in / Sign up

Export Citation Format

Share Document