Differential Diagnosis of Benign and Malignant Mesothelial Proliferations on Pleural Biopsies

2005 ◽  
Vol 129 (11) ◽  
pp. 1421-1427 ◽  
Author(s):  
Philip T. Cagle ◽  
Andrew Churg
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Malignant Mesothelioma ◽  
The United States ◽  
Diagnostic Challenge ◽  
Pleural Biopsy ◽  
Reliable Criterion ◽  
Tissue Invasion ◽  
Reactive Hyperplasia ◽  
Diffuse Malignant Mesothelioma

Abstract Context.—Although much of the pathology literature focuses on differential diagnosis of diffuse malignant mesothelioma from other types of cancer, the primary diagnostic challenge facing the pathologist is often whether a mesothelial proliferation on a pleural biopsy represents a malignancy or a benign reactive hyperplasia. Design.—Based on previous medical publications, extensive personal consultations, and experience on the United States–Canadian Mesothelioma Reference Panel and the International Mesothelioma Panel, salient information was determined about interpretation of benign versus malignant mesothelial proliferations on pleural biopsies. Results.—Differentiation of benign reactive mesothelial hyperplasia from diffuse malignant mesothelioma is often difficult. Benign reactive mesothelial hyperplasia may mimic many features ordinarily associated with malignancy, and diffuse malignant mesothelioma may be cytologically bland. Entrapment of benign reactive mesothelial cells within organizing pleuritis may mimic tissue invasion. Conclusions.—Various histologic clues favor a benign over a malignant mesothelial proliferation and vice versa. Invasion is the most reliable criterion for determining that a mesothelial proliferation is malignant. When there is any doubt that a pleural biopsy represents a malignancy, we recommend a diagnosis of atypical mesothelial proliferation.

Recognition of Histopathologic Patterns of Diffuse Malignant Mesothelioma in Differential Diagnosis of Pleural Biopsies

2005 ◽  
Vol 129 (11) ◽  
pp. 1415-1420 ◽  
Author(s):  
Timothy Craig Allen
Keyword(s):  
Differential Diagnosis ◽  
Malignant Mesothelioma ◽  
Pleural Biopsy ◽  
Histologic Types ◽  
Diffuse Malignant Mesothelioma

Abstract Context.—Diffuse malignant mesothelioma is generally divided into 3 basic histologic types—epithelial, biphasic, or sarcomatous. However, a great diversity of histologic patterns exists within these 3 basic histologic types. Design.—The diverse histologic patterns of diffuse malignant mesothelioma are briefly described, including infrequently encountered patterns. Results. The histologic patterns of diffuse malignant mesothelioma provide a wide variation of features for the pathologist to consider in the differential diagnosis of a pleural biopsy. Conclusion.—Pathologists should be aware of the varied histologic patterns of diffuse malignant mesothelioma when evaluating pleural biopsies.

scholarly journals Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanchi Malhotra ◽  
Imran Masood ◽  
Noberto Giglio ◽  
Jay D. Pruetz ◽  
Pia S. Pannaraj
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chagas Disease ◽  
Latin American ◽  
Current Knowledge ◽  
Parasitic Infection ◽  
The United States ◽  
Cardiac Complications ◽  
The U.S

Abstract Background Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience. Results Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture. Conclusions Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

Cerebral Cysticercosis

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 761-763
Author(s):  
William G. Tasker ◽  
Stanley A. Plotkin
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Seizure Control ◽  
Febrile Seizures ◽  
The United States ◽  
American Child ◽  
Focal Seizures ◽  
Cerebral Cysticercosis ◽  
Csf Pleocytosis

A case of cerebral cysticercosis in an American child is described. The patient was only 2 years old and had never left the United States. Her symptoms began with febrile seizures and progressed to focal motor seizures. Cerebrospinal fuid pleocytosis with eosinophilia, candle-guttering of the walls of the ventricles on pneumoencephalography, and a titer of 1:4,096 against cysticercosis antigen in her blood led to the diagnosis. Over a five-year follow-up period, the patient's course has been one of resolution of her symptoms, improvement in her electroencephalogram, and excellent seizure control with anticonvulsant therapy. cysticercosis should be considered in the differential diagnosis of a child who shows CSF pleocytosis with eosinophilia, particularly if accompanied by focal seizures.

scholarly journals Primary Sternal Tuberculosis Osteomyelitis: A Case Report and Discussion

2009 ◽  
Vol 20 (4) ◽  
pp. e181-e184 ◽  
Author(s):  
Miten Vasa ◽  
Christine Ohikhuare ◽  
Leslea Brickner
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Case Report ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
The United States ◽  
Typical Case ◽  
Antituberculous Therapy ◽  
Sternal Osteomyelitis ◽  
The World

As immigration to the United States from countries endemic for tuberculosis (TB) increases, the incidence of pulmonary and extrapulmonary TB disease may increase. Primary tuberculous sternal osteomyelitis is one form of extrapulmonary TB that is exceedingly rare throughout the world, and falls under the differential diagnosis for chest wall masses. Management involves standard antituberculous therapy with antibiotics similar to treating other forms of extrapulmonary TB, as well as consideration of surgical intervention depending on the extent of osteomyelitis. A typical case of primary sternal TB osteomyelitis is reported, and the epidemiology, differential diagnosis, clinical manifestations and management are reviewed.

Leiomyosarcoma of the Foot

2007 ◽  
Vol 97 (6) ◽  
pp. 475-479 ◽  
Author(s):  
Erin Engel ◽  
Michael Butler ◽  
Joseph Anain
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Malignant Tumor ◽  
Clinical Presentation ◽  
Spindle Cell ◽  
Pyogenic Granuloma ◽  
The United States ◽  
Spindle Cell Sarcoma ◽  
Cell Sarcoma ◽  
History Of

Leiomyosarcoma is a very rare malignant tumor, with only 28 new cases diagnosed in the United States each year. The prognosis varies, with average 5-year survival of 65%. Although most leiomyosarcomas occur in the lower extremity, there is a paucity in the literature on these sarcomas in the foot. Only 15 cases of leiomyosarcoma in the foot have been reported in the literature since the mid-1930s. We describe a 31-year-old man with a history of an ingrown toenail and nonhealing pyogenic granuloma. His clinical presentation suggested atypical tissue. Biopsy findings confirmed the diagnosis of spindle cell sarcoma, specifically, leiomyosarcoma. The patient was treated with amputation of the affected hallux and adjuvant therapy. The similar presentations of a pyogenic granuloma and a malignant tumor necessitate a thorough differential diagnosis with even common foot ailments. (J Am Podiatr Med Assoc 97(6): 475–479, 2007)

Haemophilus influenzae Lymphadenopathy in a Patient With Agammaglobulinemia: Clinical-Histologic-Microbiologic Correlation and Review of the Literature

2005 ◽  
Vol 129 (1) ◽  
pp. 100-103
Author(s):  
Candice Black ◽  
Matthew B. Zavod ◽  
Benoit J. Gosselin
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Haemophilus Influenzae ◽  
Surgical Intervention ◽  
The United States ◽  
Lymph Node Biopsy ◽  
Recurrent Infections ◽  
Review Of The Literature ◽  
Node Biopsy ◽  
Increased Susceptibility

Abstract Agammaglobulinemia is the most common primary immunodeficiency, with an incidence of approximately 1 in 250 000 males in the United States. These patients are at risk for frequent recurrent infections, which may become fatal if untreated. Patients have increased susceptibility to encapsulated pyogenic bacteria. Haemophilus influenzae is second only to Streptococcus pneumoniae as the bacteria most frequently implicated in infections in these patients. We present a case involving an adolescent boy with X-linked agammaglobulinemia and H influenzae cervical adenopathy, confirmed twice by culture. We correlate the clinical, microbiologic, and histologic findings. Owing to the severity of infections in this population, surgical intervention is more common than in the immunocompetent population. This description may help the pathologist in considering a differential diagnosis when examining a diagnostic lymph node biopsy in these patients.

Syphilis and the Nonvenereal Treponematoses

2014 ◽  
Author(s):  
Michael Augenbraun
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Congenital Syphilis ◽  
Clinical Manifestations ◽  
The United States ◽  
Dark Field ◽  
Sexual Contact ◽  
Disease Course ◽  
Special Cases ◽  
The World

Syphilis is an infectious disease with complex acute and chronic manifestations that is transmitted primarily through sexual contact. The disease has been recognized for many centuries, although its origin remains unknown. This chapter’s discussion of the epidemiology of syphilis includes figures illustrating the rate of syphilis in the United States by state and county and the rate of syphilis in the United States from 1941 to 2009. The etiology, pathogenesis and disease course, diagnosis, differential diagnosis, treatment, and complications of syphilis are discussed. Special cases of syphilis—in pregnant women, in children, in HIV-infected patients, and congenital syphilis—are also considered. Illustrations include a dark-field microphotograph of treponemes and photographs of a syphilitic chancre, the classic aculopapular rash from spirochetemia, condylomata lata, and a gumma. Tables outline the clinical manifestations of syphilis in adults and the treatment of syphilis. The nonvenereal treponematoses—yaws, endemic syphilis, and pinta—are a group of infections distributed throughout tropical and semitropical areas of the world. They are primarily noted to cause a variety of skin and skeletal lesions. There is little biologic difference between the treponemes that cause these conditions. The epidemiology, pathogenesis, diagnosis, differential diagnosis, and treatment of the nonvenereal treponematoses are discussed. This chapter contains 7 highly rendered figures, 2 tables, 60 references, 1 teaching slide set, and 5 MCQs.

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