scholarly journals Malignant melanoma presenting as an isolated pleural effusion

2015 ◽  
Vol 75 (2) ◽  
Author(s):  
M. Shameem ◽  
J. Akhtar ◽  
U. Baneen ◽  
N. Ahmad Khan ◽  
R. Bhargava ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Melanoma ◽  
Pleural Fluid ◽  
Past History ◽  
Mediastinal Lymphadenopathy ◽  
Rare Presentation ◽  
Pigmented Lesion ◽  
S 100 ◽  
History Of ◽  
Enhanced Computed Tomography

Isolated pleural effusion is a very rare presentation of malignant melanoma. A 46 year-old male patient presented to us with complaints of shortness of breath during the previous month. A contrast enhanced computed tomography (CECT) imaging scan of his thorax showed right-sided pleural effusion with the absence of any mass lesion or mediastinal lymphadenopathy. Cytology of his pleural fluid showed pigmented cells suggestive of malignant melanoma. Staining of the pleural fluid cells with immunohistological markers for melanoma (HMB 45 and S 100) were positive. An examination of his skin did not reveal any pigmented lesion, nor was there a past history of malignant melanoma for this patient. The patient responded well to therapy for malignant melanoma and has remained asymptomatic for the last year. This patient was diagnosed with a rare case of primary malignant melanoma of the pleura presenting as isolated pleural effusion.

scholarly journals A secondary jejunal malignant melanoma from nasal mucosal melanoma: Case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110537
Author(s):  
Yingying Xu ◽  
Zongkui Duan ◽  
Wenqing Hu ◽  
Kaixuan Zhu ◽  
Peng Cui ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Past History ◽  
Tumor Therapy ◽  
Gastrointestinal Symptoms ◽  
Primary Melanoma ◽  
Mucosal Melanoma ◽  
The Body ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen

Melanomas most commonly localized in the skin can arise anywhere in the body, and approximately 5% of all melanomas appear in other sites of mucosal surfaces out of skin. Primary melanoma from nasal mucosa is quite rare. We present this case: a 46-year-old man had complained a pain in the left upper abdomen for 2 months when he was admitted to the Northern Jiangsu People’s Hospital. The pain was paroxysmal and enhanced when eating. There was no nausea, vomiting, or anorexia. There had been no change in weight in previous months. This patient had a past history of surgery for nasal mucosal malignant melanoma 2 years ago. Abdominal enhanced computed tomography (CT) indicated that a mass originated from small bowel and occupied the left upper abdomen. The patient underwent a laparotomy during which a black lesion measuring about 5 cm × 5 cm × 4 cm was found at the jejunum and resected totally together with partial jejunum. The patient was eventually diagnosed as secondary jejunal malignant melanoma from nasal mucosal melanoma. For patients with a history of melanoma, gastrointestinal metastasis should be considered when patients develop gastrointestinal symptoms. In addition, we recommend positive anti-tumor therapy after surgery.

scholarly journals Tuberculous pleural effusion in a patient with sympathetic ophthalmia on immunosuppression: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Dharshana Thiagarajan ◽  
Daphne Ai Lin Teh ◽  
Nor Azita Ahmad Tarmidzi ◽  
Hamisah Ishak ◽  
Zamzurina Abu Bakar ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lung Injury ◽  
Pleural Fluid ◽  
Sympathetic Ophthalmia ◽  
Mediastinal Lymphadenopathy ◽  
Mononuclear Leukocytes ◽  
Low Grade ◽  
Tuberculous Pleural Effusion ◽  
Breath Sounds ◽  
History Of

Abstract Background Tuberculous pleural effusion (TPE) is paucibacillary, making its diagnosis difficult based on laboratory investigations alone. We present a case of a patient with a TPE who was initially misdiagnosed to have azathioprine-induced lung injury. The diagnosis of TPE was arrived at with the help of clinical assessment, laboratory and radiological investigations. Case presentation A 25-year-old chronic smoker with sympathetic ophthalmia on long-term immunosuppression, latent tuberculosis infection and a significant family history of tuberculosis presented with a three-week history of productive cough, low-grade fever, night sweats and weight loss. Examination of the lungs showed reduced breath sounds at the right lower zone. Chest x-ray showed minimal right pleural effusion with a small area of right upper lobe consolidation. The pleural fluid was exudative with predominant mononuclear leukocytes. Direct smears of sputum and pleural fluid; polymerase chain reaction of pleural fluid; and sputum, pleural fluid and blood cultures were negative for M. tuberculosis (MTB) and other organisms. As he did not respond to a course of broad-spectrum antibiotics, he was then treated as a case of azathioprine-induced lung injury. However, his condition did not improve despite the cessation of azathioprine. A contrast-enhanced computed tomography of the thorax showed right upper lobe consolidation with tree-in-bud changes, bilateral lung atelectasis, subpleural nodule, mild right pleural effusion and mediastinal lymphadenopathy. Bronchoalveolar lavage was negative for malignant cells and microorganisms including, MTB. However, no pleural biopsy was done. He was empirically treated with anti-tubercular therapy for 9 months duration and showed complete recovery. Conclusion A high index of suspicion for TPE is required in individuals with immunosuppression living in regions endemic to tuberculosis. Targeted investigations and sound clinical judgement allow early diagnosis and prompt treatment initiation to prevent morbidity and mortality.

scholarly journals Pancreatico‑pleural Fistula: Case Series

2018 ◽  
Vol 09 (01) ◽  
pp. 026-031 ◽  
Author(s):  
Manoj Munirathinam ◽  
Pugazhendhi Thangavelu ◽  
Ratnakar Kini
Keyword(s):  
Magnetic Resonance ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Case Series ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Fluid Analysis ◽  
High Index Of Suspicion ◽  
Enhanced Computed Tomography ◽  
Acute And Chronic Pancreatitis ◽  
Pancreatic Pathology

ABSTRACTPancreatico‑pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico‑pleural fistula is usually massive and recurrent. It is predominately left‑sided but right‑sided and bilateral effusion does occur. We report four cases of pancreatico‑pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow‑up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X‑ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast‑enhanced computed tomography abdomen) would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD) reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.

Malignant Melanoma Presenting as an Intrathymic Tumor

2000 ◽  
Vol 124 (1) ◽  
pp. 130-134
Author(s):  
P. M. Alli ◽  
B. J. Crain ◽  
R. Heitmiller ◽  
P. Argani
Keyword(s):  
Malignant Melanoma ◽  
Previous History ◽  
Clinical History ◽  
Computed Tomographic ◽  
Eosinophilic Cytoplasm ◽  
S 100 ◽  
History Of ◽  
Solitary Metastases ◽  
Physical Findings ◽  
Pleomorphic Cells

Abstract The identification of malignant melanoma in a visceral organ of nonepidermal origin is not an uncommon occurrence. Frequently, these cases are solitary metastases that present years after a thin epidermal melanoma has been diagnosed (and sometimes forgotten). However, primary visceral melanomas have been reported that have not been preceded by an epidermal lesion. We describe herein a unique case of melanoma presenting as a primary intrathymic tumor. The patient had no previous history of epidermal melanoma, and extensive workup did not reveal evidence for an alternative primary site. The tumor exhibited histologic features characteristic of melanoma, including an abundance of large pleomorphic cells with eosinophilic cytoplasm, prominent nucleoli, and occasional intranuclear inclusions. Tumor cells stained for HMB-45 and S-100 protein and ultrastructural analysis revealed stage II and stage III melanosomes. The patient remained free of disease until intrathoracic recurrence was detected on a computed tomographic scan 14 months later. The lack of clinical history and physical findings of melanoma at presentation, the intrathymic location of the tumor, and the pattern of recurrence suggest that this case likely represents a primary thymic melanoma, a previously unreported entity.

scholarly journals Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Reumatismo ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 108-112 ◽  
Author(s):  
G. Tansir ◽  
P. Kumar ◽  
A. Pius ◽  
S.K. Sunny ◽  
M. Soneja
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Abdominal Distension ◽  
Ca 125 ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
The Past ◽  
History Of

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

scholarly journals Malignant Pleural Mesothelioma with Marked Lymphatic Involvement: A Report of Two Autopsy Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Reiko Ideguchi ◽  
Kazuto Ashizawa ◽  
Saori Akashi ◽  
Michiko Shindo ◽  
Kazunori Minami ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Mesothelioma ◽  
Histopathological Examination ◽  
Lymphatic Spread ◽  
Mediastinal Lymphadenopathy ◽  
Pleural Mesothelioma ◽  
Pleural Thickening ◽  
History Of ◽  
Pulmonary Parenchyma ◽  
Lymphangitic Carcinomatosis

We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.

scholarly journals URINOTHORAX: AN UNUSUAL CAUSE OF MASSIVE PLEURAL EFFUSION

2019 ◽  
Vol 2 (1) ◽  
pp. 18-19
Author(s):  
Jose Luis Bauza Quetglas ◽  
Maria Isabel Fullana ◽  
Javier Asensio ◽  
Manuel Díaz ◽  
A.M. Pinheiro ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Diffuse Abdominal Pain ◽  
Thoracic Drainage ◽  
History Of ◽  
Chest X Ray ◽  
Blood Leukocyte ◽  
Diagnostic Criterion ◽  
Serum Ratio

A 74 year-old male with a history of high blood pressure and hyperuricemia was admitted to the hospital with asthenia, unquantified weight loss, dyspnea on moderate exertion for 2 weeks, and diffuse abdominal pain. Blood leukocyte count was 12400/uL, creatinine 0.98 mg/dL, CRP 19 mg/dL, and LDH 318 U/L. The chest X-ray showed a right pleural effusion and the pleural fluid was suggestive of an exudate. Thorax and abdominal CT scan revealed a polycystic right kidney with grade IV hydronephrosis and suggested the presence of a nephropleural fistula. The thoracocentesis was repeated and the pleural fluid / serum ratio of creatinine obtained was higher than 1 (1.35 mg/dL), which is a diagnostic criterion for urinothorax. Finally, a retrograde pyelography was carried out, and confirmed the passage of urinary tract fluid into the pleural cavity. A thoracic drainage tube and a nephrostomy through the superior calyx were placed, both draining purulent material. One month later, the control CT shows a right atrophic kidney and a reduction of the size of the fistulous path. Urinothorax is an infrequent and underdiagnosed pathology, with few cases reported. It is usually presented as a transudative pleural effusion. Currently, no test is available to confirm the diagnosis, although the ratio of serum creatinine/pleural creatinine could suggest the presence of urinothorax. Radiographic imaging is useful to support the diagnosis. Management of a urinothorax requires a multidisciplinary approach with an emphasis on the correction of the underlying urinary tract pathology, and once corrected, this often leads to a rapid resolution of the pleural effusion.

scholarly journals URINOTHORAX: AN UNUSUAL CAUSE OF MASSIVE PLEURAL EFFUSION

2019 ◽  
Vol 2 (1) ◽  
pp. 18-19
Author(s):  
Jose Luis Bauza Quetglas ◽  
Maria Isabel Fullana ◽  
Javier Asensio ◽  
Manuel Díaz ◽  
A.M. Pinheiro ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Diffuse Abdominal Pain ◽  
Thoracic Drainage ◽  
History Of ◽  
Chest X Ray ◽  
Blood Leukocyte ◽  
Diagnostic Criterion ◽  
Serum Ratio

A 74 year-old male with a history of high blood pressure and hyperuricemia was admitted to the hospital with asthenia, unquantified weight loss, dyspnea on moderate exertion for 2 weeks, and diffuse abdominal pain. Blood leukocyte count was 12400/uL, creatinine 0.98 mg/dL, CRP 19 mg/dL, and LDH 318 U/L. The chest X-ray showed a right pleural effusion and the pleural fluid was suggestive of an exudate. Thorax and abdominal CT scan revealed a polycystic right kidney with grade IV hydronephrosis and suggested the presence of a nephropleural fistula. The thoracocentesis was repeated and the pleural fluid / serum ratio of creatinine obtained was higher than 1 (1.35 mg/dL), which is a diagnostic criterion for urinothorax. Finally, a retrograde pyelography was carried out, and confirmed the passage of urinary tract fluid into the pleural cavity. A thoracic drainage tube and a nephrostomy through the superior calyx were placed, both draining purulent material. One month later, the control CT shows a right atrophic kidney and a reduction of the size of the fistulous path. Urinothorax is an infrequent and underdiagnosed pathology, with few cases reported. It is usually presented as a transudative pleural effusion. Currently, no test is available to confirm the diagnosis, although the ratio of serum creatinine/pleural creatinine could suggest the presence of urinothorax. Radiographic imaging is useful to support the diagnosis. Management of a urinothorax requires a multidisciplinary approach with an emphasis on the correction of the underlying urinary tract pathology, and once corrected, this often leads to a rapid resolution of the pleural effusion.

scholarly journals Rare Presentation of Gall Bladder Adenomyomatosis

2021 ◽  
pp. 510-512
Author(s):  
M. Ishwarya ◽  
R. Anantharamakrishnan ◽  
K. Senthil Kumar ◽  
K. Pranay
Keyword(s):  
Gall Bladder ◽  
Bladder Wall ◽  
Young Male ◽  
Complete Disappearance ◽  
Rare Presentation ◽  
Contrast Enhanced ◽  
Gall Bladder Wall ◽  
History Of ◽  
The Right ◽  
Enhanced Computed Tomography

Introduction: Adenomyomatosis is a benign alterations of gall bladder wall that can be found in 9% of patients. We present a case of gall bladder adenomyomatosis of young male presented with right upper quadrant pain. Case Report: A 22 year old male admitted with a history of pain over right upper quadrant for 8 months. The patient’s physical examination revealed tenderness over the right hypochondrium region. Contrast enhanced computed tomography showed - gall bladder wall appeared diffusely thickened with multiple small cystic areas noted. Conclusion: Symptomatic gall bladder adenomyomatosis is an indicator for cholecystectomy, which results in complete disappearance of symptoms. Asymptomatic cases are not an indication for surgery, but the radiological diagnosis must be beyond any doubt. If there is a any diagnostic doubt about the possibility of gall bladder cancer, a cholecystectomy is justified.

Sign in / Sign up

Export Citation Format

Share Document