scholarly journals Clinical history of HIV infection may be misleading in cytopathology

CytoJournal ◽  
2010 ◽  
Vol 7 ◽  
pp. 7 ◽  
Author(s):  
Liron Pantanowitz* ◽  
Michael Kuperman ◽  
Robert A. Goulart
Keyword(s):  
Differential Diagnosis ◽  
Hiv Infection ◽  
Primary Effusion Lymphoma ◽  
Clinical History ◽  
Hiv Status ◽  
Ct Guided ◽  
Increased Risk ◽  
Spindle Cell Proliferation ◽  
Atypical Cells ◽  
History Of

Human immunodeficiency virus (HIV)-infected patients are at an increased risk for developing opportunistic infections, reactive conditions and neoplasms. As a result, a broad range of conditions are frequently included in the differential diagnosis of HIV-related lesions. The clinical history of HIV infection may, however, be misleading in some cases. Illustrative cases are presented in which knowledge of a patient's HIV status proved to be misleading and increased the degree of complexity of the cytologic evaluation. Case 1 involved the fine needle aspiration (FNA) of a painful 3 cm unilateral neck mass in a 38-year-old female with generalized lymphadenopathy. Her aspirate revealed a spindle cell proliferation devoid of mycobacteria that was immunoreactive for S-100 and macrophage markers (KP-1, PGM1). Multiple noncontributory repeat procedures were performed until a final excision revealed a schwannoma. Case 2 was a CT-guided FNA of a positron emission tomography positive lung mass in a 53-year-old man. The acellular aspirate in this case contained structures resembling fungal spore forms that were negative for mucicarmine and GMS stains, as well as cryptococcal antigen immunocytochemistry. A Von Kossa stain confirmed that these pseudo-fungal structures were calcified debris. Follow up revealed multiple calcified lung and hilar node based granulomata. Case 3 involved the cytologic evaluation of pleural fluid from a 47-year-old man with Kaposi sarcoma and recurrent chylous pleural effusions. Large atypical cells identified in his effusion were concerning for primary effusion lymphoma. Subsequent pleural biopsy revealed extramedullary hematopoiesis, documenting these atypical cells as megakaryocytes. These cases demonstrate that knowledge of a patient's HIV status can be misleading in the evaluation of cytology specimens, with potential for misdiagnosis and/or multiple procedures. To avoid this pitfall in the setting of HIV infection, common entities unrelated to HIV infection and artifacts should always be included in the differential diagnosis.

scholarly journals Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I

2021 ◽  
Author(s):  
Annamaria Biczok ◽  
Philipp Karschnia ◽  
Raffaela Vitalini ◽  
Markus Lenski ◽  
Tobias Greve ◽  
...  
Keyword(s):  
Medical History ◽  
Tumor Recurrence ◽  
Clinical History ◽  
Study Endpoint ◽  
Past Medical History ◽  
Who Grade ◽  
Increased Risk ◽  
History Of ◽  
Meningioma Recurrence ◽  
The Impact

Abstract Background Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before. Methods We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models. Results Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis. Conclusion Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.

Differentiation between Melanin-Laden Macrophages and Melanoma Cells in Vitreous Aspirates

2016 ◽  
Vol 60 (1) ◽  
pp. 25-30
Author(s):  
Ernest Iakovlev ◽  
Zeina Ghorab ◽  
Hatem Krema ◽  
Vladimir Iakovlev ◽  
Peter Kertes ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Retinal Detachment ◽  
Melanoma Cells ◽  
Melanoma Metastasis ◽  
Vitreous Fluid ◽  
Diagnostic Features ◽  
Pigmented Lesions ◽  
Atypical Cells ◽  
History Of ◽  
A Current

Objective: The differential diagnosis between retinal detachment and melanoma metastatic to the vitreous can be challenging, both clinically and cytologically. We demonstrate the diagnostic features and pitfalls of the cytological assessment. Study Design: A case of a metastatic melanoma to the vitreous is compared to a case of retinal detachment initially suspected as melanoma metastasis. Case 1 was a 54-year-old patient with a vague history of pigmented lesions 20 years previously and a current presentation of a visual defect. Case 2 was a 68-year-old patient with a history of melanoma and a presentation of floaters and flashing lights. Results: The vitreous fluid of case 1 contained atypical, pigment-laden cells positive for HMB-45 and assessed as melanoma. On enucleation, a melanoma metastatic to the vitreous was diagnosed. The vitreous fluid of case 2 revealed atypical cells containing pigment granules. The cells were negative for melanocytic markers, while the granules stained positive for melanin. Macrophage marker CD163 was positive in all cells. The interpretation was one of macrophages reactive to the retinal detachment. Conclusion: Melanin-laden macrophages can mimic melanoma cells. This needs to be considered in the differential diagnosis. Additional stains can help the distinction.

scholarly journals Urachal Adenocarcinoma: A Case Report with Key Imaging Findings and Radiologic-Pathologic Correlation

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Willian Schmitt ◽  
Marta Baptista ◽  
Marco Ferreira ◽  
António Gomes ◽  
Ana Germano
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Clinical History ◽  
Imaging Findings ◽  
Lesion Location ◽  
Patient Demographics ◽  
Pathologic Correlation ◽  
Associated Symptoms ◽  
History Of ◽  
Urachal Adenocarcinoma

Urachal pathologies are rare and can mimic numerous abdominal and pelvic diseases. Differential diagnosis of urachal anomalies can be narrowed down by proper assessment of lesion location, morphology, imaging findings, patient demographics, and clinical history. We report a case of a 60-year-old male, with a history of unintentional weight loss without associated symptoms, who was diagnosed with locally invasive urachal adenocarcinoma. With this article, we pretend to emphasize urachal adenocarcinoma clinical features along with its key imaging findings with radiologic-pathologic correlation.

scholarly journals Timing, Dosage, and Adherence of Antiretroviral Therapy and Risk of Osteoporosis in Patients With Human Immunodeficiency Virus Infection in Taiwan: A Nested Case-Control Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Mu-Lin Chiu ◽  
Wen-Miin Liang ◽  
Ju-Pi Li ◽  
Chi-Fung Cheng ◽  
Jian-Shiun Chiou ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
History Of ◽  
High Doses ◽  
Nested Case Control ◽  
Control Study ◽  
Current Exposure

The progression of acquired immunodeficiency syndrome is delayed in patients with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART). However, long-term ART is associated with adverse effects. Osteoporosis is one of the adverse effects and is a multifactorial systemic skeletal disease associated with bone fragility and an increased risk of fracture. We performed a longitudinal, comprehensive, nested case-control study to explore the effect of ART on the risk of osteoporosis in 104 osteoporotic and 416 non-osteoporotic patients with HIV infection at their average age about 29 years old in Taiwan. Patients with history of ART, current exposure to ART, higher cumulative defined daily doses (DDDs), or higher ART adherence were at a higher risk of osteoporosis (p < 0.05). Patients receiving nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-containing regimen (zidovudine-lamivudine combination, lamivudine-abacavir combination, and abacavir alone) and protease inhibitor (PI)-containing regimen (lopinavir-ritonavir combination, ritonavir, and atazanavir) had a higher risk of osteoporosis (p < 0.05). Especially, patients receiving high doses of the PIs lopinavir-ritonavir combination had an increased risk of osteoporosis (p < 0.05). In conclusion, history of ART, current exposure to ART, higher cumulative DDDs, and higher ART adherence were associated with an increased risk of osteoporosis. Furthermore, NRTI- and PI-containing regimens and high doses of PIs lopinavir-ritonavir combination may be associated with an increased risk of osteoporosis in patients with HIV infection in Taiwan.

Abstract 3640: Diabetes Mellitus is Associated with Increased Risk of Fatal and Non-Fatal Cardiovascular Events in Heart Failure Patients with Preserved Ejection Fraction - Findings From the Irbesartan in Heart Failure with Preserved Systolic Function Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robert S McKelvie ◽  
Michel Komajda ◽  
Barry M Massie ◽  
John J McMurray ◽  
Michael R Zile ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Clinical History ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
History Of ◽  
One Year

Background: Diabetes mellitus (DM), present in about a quarter of heart failure (HF) patients with reduced ejection fraction (HF-REF), is associated with increased risk of fatal and non-fatal cardiovascular (CV) events. Less is known about the prevalence and impact of DM in HF patients with preserved ejection fraction (HF-PEF). The prevalence and effect of DM on clinical outcomes were examined in patients enrolled in the Irbesartan in Heart Failure with Preserved Systolic Function Trial (I-PRESERVE). Methods: The I-PRESERVE trial randomized 4128 HF-PEF patients (EF≥45%) to receive irbesartan or placebo. The primary outcome of time to all-cause mortality or CV hospitalization (myocardial infarction [MI], stroke, worsening HF, atrial or ventricular arrhythmia or unstable angina) was compared between patients with and without DM over one year of follow-up. A combined HF endpoint (HF mortality and hospitalization) was also evaluated. Comparison of the outcomes between patients with and without DM was expressed as a hazard ratio (HR). The independent predictive role of DM was examined in a multivariable model (which included symptoms, signs, clinical history, CV examination, biochemical, and hematological findings). Results: In I-PRESERVE 27% had a history of DM at baseline. DM patients more often had a body mass index ≥30 (51% vs 38%), history of stroke (12% vs 9%), history of MI (28% vs 22%), estimated glomerular filtration rate <60 ml/min/1.73m 2 (34% vs 29%), and pulmonary congestion on chest x-ray (46% vs 38%). In patients with DM, 17% and 11% had primary and HF events, respectively within 1 year; for patients without DM, 11% and 6% had primary and HF events. In a multivariate analysis DM remained a significant predictor of primary events (HR 1.48; 95% CI 1.22, 1.79) or HF events (HR 1.67; 95% CI 1.32, 2.12). Conclusions: The prevalence of DM in HF-PEF is similar to that reported in HF-REF. HF-PEF patients with DM have a significantly worse outcome than those without DM and this increased risk is independent of other factors associated with a worse prognosis.

scholarly journals Latex Allergy in Dental Care

2014 ◽  
Vol 18 (2) ◽  
pp. 70-77 ◽  
Author(s):  
A. Dermata ◽  
A. Arhakis
Keyword(s):  
Natural Rubber Latex ◽  
Clinical History ◽  
Latex Allergy ◽  
Allergic Reactions ◽  
Rubber Latex ◽  
Dental Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
History Of ◽  
Latex Production

SUMMARYNatural rubber latex is found in numerous medical and dental products. Adverse latex reactions in dental patients and practitioners have significantly increased since the introduction of universal precautions for infection control. These reactions range from contact dermatitis to potentially life-threatening hypersensitivity. Patients with a history of spina bifida, urogenital anomalies, multiple surgical procedures, allergic reactions or atopy, health care personnel and latex production workers are at increased risk of latex allergy. Diagnosis is based on a combination of clinical history and laboratory tests. Identification of latex sources and the avoidance of latex exposure are critical for protecting both dental patients and dental personnel.

Clear Cell Adenocarcinoma of the Cervix in a Child without in Utero Exposure to Diethylstilbestrol: A Case Report and Review of the Literature

2005 ◽  
Vol 8 (6) ◽  
pp. 690-695 ◽  
Author(s):  
William A. Ahrens ◽  
L. Patricia Barrón-Rodriguez ◽  
Millisa McKee ◽  
Scott Rivkees ◽  
Miguel Reyes-Múgica
Keyword(s):  
Differential Diagnosis ◽  
Clear Cell ◽  
Clinical History ◽  
In Utero ◽  
Embryonal Rhabdomyosarcoma ◽  
In Utero Exposure ◽  
Clear Cell Adenocarcinoma ◽  
Review Of The Literature ◽  
Cervical Tumor ◽  
History Of

We describe the case of a primary cervical tumor in a 6-year-old child that was originally suspected to be an embryonal rhabdomyosarcoma botryoides. Histologic analysis revealed a clear cell adenocarcinoma. Despite a direct search and questioning for maternal exposure to diethylstilbestrol, this was not documented. Clear cell adenocarcinoma is an extremely rare neoplasm that should be kept in the differential diagnosis of cervicovaginal lesions in children, even in the absence of a clinical history of in utero diethylstilbestrol exposure. We discuss the hypothesized pathogenesis and review the literature on this unusual tumor.

HIV infection in psychiatric patients: An unlinked anonymous study

1997 ◽  
Vol 170 (2) ◽  
pp. 181-185 ◽  
Author(s):  
José L. Ayuso-Mateos ◽  
Francisco Montañés ◽  
Ismael Lastra ◽  
Juan J. Picazo De La Garza ◽  
José L. Ayuso-Gutiérrez
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Psychiatric Patients ◽  
Risk Behaviour ◽  
Injecting Drug Use ◽  
Antibody Testing ◽  
Increased Risk ◽  
The Us ◽  
History Of ◽  
Blood Specimens

BackgroundRecent surveys suggest that psychiatric patients are at increased risk of being infected with HIV, although very little information is available concerning the seroprevalence of HIV infection among this population outside the US. The aim of this study is to determine the seroprevalence of HIV-I among patients admitted to a psychiatric in-patient unit and to gather linked anonymous risk-factor information.MethodAn unlinked serosurvey was made, using HIV-1 antibody testing of remnant blood specimens collected for routine medical purposes, of patients consecutively admitted to an acute psychiatric unit in Madrid.ResultsBlood was obtained from 390 of the 477 eligible patients (81.8%). The prevalence of HIV was 5.1% (20/390). Patients aged between 18 and 39 accounted for 63.4% of the admissions and 75% of the positive results. Of the 29 patients who presented with injecting drug use, 14 were HIV-infected (48.3%; 95% CI 29.4 67.5). Of the 51 patients for whom any risk behaviour was noted on the admission chart, 18 were HIV-infected (35.3%; 95% CI 22.4 49.9).ConclusionsThis study demonstrates that there is a substantial prevalence of HIV infection in psychiatric patients admitted to an acute in-patient unit. History of injecting drug use was strongly associated with seropositivity. Clinicians recognised risk factors for HIV infection in the majority of the HIV-infected cases.

scholarly journals CLINICOPATHOLOGICAL STUDY OF CORRELATION BETWEEN FNAC SMEAR , ZN STAINED SMEAR & HIV STATUS IN CLINICALLY SUSPECTED CASES OF LYMPH NODE TUBERCULOSIS IN URBAN EASTERN INDIA

2020 ◽  
pp. 59-62
Author(s):  
Susmita Nag ◽  
Abantika Konar ◽  
Sumitra Basuthakur
Keyword(s):  
Lymph Node ◽  
Hiv Infection ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Tuberculous Lymphadenitis ◽  
Pulmonary Medicine ◽  
Hiv Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
Caseation Necrosis

BACKGROUND: Tuberculous lymphadenitis (TBL) is the commonest form of extra pulmonary tuberculosis. Fine Needle Aspiration Cytology (FNAC) is a simple outpatient diagnostic procedure used in the diagnosis of TBL and all stages of Human Immunodeficiency Virus (HIV) infection are associated with increased risk of tuberculosis (TB). AIM & OBJECTIVE: To correlate different cytomorphologies of FNAC smears and presence or absence of Acid fast bacilli (AFB) in the Ziehl Neelsen (ZN) stained smear prepared from the same aspirate. Association of HIV infection are also to be evaluated. METHOD: An observational cross-sectional study was conducted at department of pathology in collaboration with department of pulmonary medicine, Medical College & Hospital, Kolkata from January 2015 to June 2016.It included 305 cases with enlarged palpable lymph nodes. FNAC done; aspirated smears were stained with papanicolaou, Leishman-Giemsa and ZN stains. HIV status were also noted. RESULTS: 251 aspirates were reported on cytomorphology as suggestive of TBL with 117 (47.01 %) AFB positivity in ZN stained smears. Cervical lymph node were most commonly involved site (86.84 %) and females (63.75%) were affected more than males (36.25%).Most cases of AFB positive smears were associated with caseation necrosis only (71.8 %). 17 (6.77 %) out of 251 cases were co infected with HIV. CONCLUSION: Special stains should be done in all suspected cases of TB lymphadenitis and most common cytomorphology associated with AFB positivity is caseation necrosis without granuloma. Also it can be concluded that TB/HIV co infection is not predominant in India.

scholarly journals Common Variable Immunodeficiency (CVID): A Case Report

2017 ◽  
Vol 2 (1) ◽  
pp. 26
Author(s):  
Maryam Montazeri ◽  
Mohammad Reza Ebadpour ◽  
Farideh Kouchak ◽  
Naser Esmaeili
Keyword(s):  
Immune Deficiency ◽  
Respiratory Infections ◽  
Immunoglobulin A ◽  
Clinical History ◽  
Chronic Infections ◽  
Regular Treatment ◽  
Increased Risk ◽  
History Of ◽  
Acquired Immune Deficiency ◽  
Common Variable

Common variable immune deficiency disease is the most prevalent acquired immune deficiency in human being after selective immunoglobulin A deficiency. It causes reduction of immunoglobulin levels and specific antibodies production and enhancement of recurrent and chronic infections risk, especially respiratory infections. CVID patients faces increased risk of granulomatous disease, autoimmune and phenomenon and malignancy. The disease involves males and females equally. Some studies showed that early diagnosis of CVID disease and regular treatment of patients with IVIG may have an efficient role in decreasing pneumonia and frequency of hospitalization due to infections and its complications. In this study we report a 16 years old girl with CVID, without clinical history of determined infection with recurrent sinusitis.

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