multiple biopsies
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2022 ◽  
pp. 112067212110709
Author(s):  
Luping Wang ◽  
Mei Jia ◽  
Ruxiang Zhang ◽  
Giuseppe Casalino ◽  
Usha Chakravarthy ◽  
...  

Background To report a rare case of nasal natural killer/T (NK/T) cell lymphoma with bilateral intraocular and lung metastasis and to further describe the clinical features of intraocular manifestations. Case presentation A 54-year-old man presented with a 3-month history of left nasal congestion, and bilateral vision impairment of one week duration. Subsequent maxillary computed tomography (CT) and multiple biopsies confirmed the diagnosis of nasal NK/T-cell lymphoma. EBV-encoded small RNA (EBER) in situ hybridization revealed EBV infection. A comprehensive ophthalmic examination found lymphoma-associated retinopathy and choroidopathy, which presented as bilateral diverse patterns and retinal detachment. In addition, the chest CT showed multiple scattered nodules in both lungs, and soft-tissue mass in the left hilum with mediastinal and axillary lymphadenopathy. The condition of this patient deteriorated rapidly and he died shortly after diagnosis. Conclusions The rarity of secondary ocular NK/T-cell lymphoma makes it challenging to identify these tumors early. Both otolaryngologist and ophthalmologists should be aware of ocular involvement and other secondary manifestations of NK/T-cell lymphoma.


2022 ◽  
Vol 10 ◽  
pp. 232470962110633
Author(s):  
Oluyemisi Amoda ◽  
Elmarie Alexander ◽  
Hesham Abowali ◽  
Ese Uwagbale ◽  
Mohammed Zaman

Lung masses are becoming more common, and although most are tumors, benign or malignant, some are not solid masses. Many pathologies can present as lung nodules, including lung cancers, hamartomas, lung abscesses, granulomas, and eosinophilic pneumonia, to name a few. A 40-year-old woman with a long history of smoking presented with cough and left-sided chest pain. After multiple imaging studies, she was thought to have a lung malignancy; however, multiple biopsies proved this was not the case. The histology reports of 3 to 4 biopsies at separate times indicated chronic inflammation ongoing in the lungs without any cancer cells present. She was treated for chronic eosinophilic pneumonia with a resolution of symptoms. The purpose of this case report is to discuss a case that was initially thought to be a lung mass but found to be chronic eosinophilic pneumonia manifesting as a lung mass.


Author(s):  
Catarina Lombo ◽  
Carlos Matos ◽  
Rui Fonseca

<p class="abstract">Lymphomas of head and neck constitute 5-15% of malignancies in this region. However, its primary occurrence at the larynx is exceedingly rare due to the paucity of lymphoid tissue. Here, we reported a case of a 41 year old male who presented with a 1 month history of hoarseness and odynophagia. The examination revealed right vocal cord palsy and an ipsilateral subglottic exudate, that was misdiagnosed as infectious disease. The lesion quickly progressed to airway obstruction, requiring a tracheotomy. Multiple biopsies under general anesthesia were needed before reaching the final diagnosis of diffuse large B-cell lymphoma, Epstein-Barr positive. Selected treatment modality included 3 cycles of chemotherapy followed by radiotherapy in moderate dose with complete remission after 2 years of follow up. The tracheotomy was removed, however, the patient did not recover vocal quality. This case highlighted the heterogeneous presentation of extra-nodal head and neck lymphomas and emphasized the need for suspicion of neoplasm when an infection doesn’t respond to maximal medical therapy.</p>


2021 ◽  
Vol 84 (4) ◽  
pp. 684
Author(s):  
S Smeets ◽  
F Dedeurwaerdere ◽  
E Thomaere ◽  
B Houthoofd ◽  
L D’Hulst ◽  
...  

An 81-year-old male patient presented on the emergency ward for hematochezia, without any other complaints. Rectosigmoidoscopy showed a predominant patchy inflammation of the mucosa with several bluish blebs (submucosal hemorrhage) and small ulcerations. (Figure 1A). Subsequent elective colonoscopy (1) revealed multiple submucosal hematomas and mucosal lacerations throughout the entire colon in between normal mucosa. During the procedure spontaneous mucosal tears occurred. (Figure 1B). Multiple biopsies were taken.


2021 ◽  
Author(s):  
Wei Zheng So ◽  
Rachel Zui Chih Teo ◽  
Li Yin Ooi ◽  
Benjamin Yen Seow Goh ◽  
Jirong Lu ◽  
...  

Abstract Introduction:This study evaluated the initial use of label-free second harmonic generation (SHG) imaging with two-photon excitation (2PE) auto-fluorescence for the quantification of collagen/fibrosis on pre-implantation biopsies of extended criteria donors (ECD).Methods:A total of 20 core ECD kidney transplant biopsy specimen tissues from 7 ECD donors, taken at the time of pre-implantation were retrieved, cut into 5-micron sections, mounted on slides and deparaffinized. The core needle biopsies were imaged with 2X and 20X objective using the commercially available laser-based Genesis® 200 (Histoindex Pte Ltd and Clinnovate Pte Ltd, Singapore). The entire core was selected as the Region of Interest (ROI). Corresponding clinical information from transplant donors were retrieved. Histopathological review was performed, and all biopsies had Interstitial Fibrosis (IF)/Tubular Atrophy (TA) scores > 0. Collagen parameters measured included quantification by the Collagen Area Ratio in Tissue (CART) and qualitative measurements by Collagen Reticulation Index (CRI).Results: 20 explant core biopsies were extracted from 10 donor kidney samples, of which originated from 7 donors. Table 1 depicts the baseline ECD characteristics of the donors. For the kidneys with multiple biopsies done, we obtained an average score of the collagen parameters across the different samples. Biopsies classified with > 85% KDPI score had significantly higher CAR and CART than biopsies with ≤ 85% KDPI score.Conclusion:MPM is an evolving technology that enables the quantification of the amount (CART) and quality (CRI) of collagen deposition in unstained explant biopsies of ECD kidneys. This initial evaluation found significant differences in both parameters between ECD kidneys with more or less than 85% KDPI scores.


2021 ◽  
Author(s):  
Wei Zheng So ◽  
Rachel Zui Chih Teo ◽  
Li Yin Ooi ◽  
Benjamin Yen Seow Goh ◽  
Jirong Lu ◽  
...  

Abstract Introduction:This study evaluated the initial use of label-free second harmonic generation (SHG) imaging with two-photon excitation (2PE) auto-fluorescence for the quantification of collagen/fibrosis on pre-implantation biopsies of extended criteria donors (ECD).Methods:A total of 22 core ECD kidney transplant biopsy specimen tissues from 7 ECD donors, taken at the time of pre-implantation were retrieved, cut into 5-micron sections, mounted on slides and deparaffinized. The core needle biopsies were imaged with 2X and 20X objective using the commercially available laser-based Genesis® 200 (Histoindex Pte Ltd and Clinnovate Pte Ltd, Singapore). The entire core was selected as the Region of Interest (ROI). Corresponding clinical information from transplant donors were retrieved. Histopathological review was performed, and all biopsies had Interstitial Fibrosis (IF)/Tubular Atrophy (TA) scores > 0. Collagen parameters measured included quantification by the Collagen Area Ratio in Tissue (CART) and qualitative measurements by Collagen Reticulation Index (CRI).Results: 20 explant core biopsies were extracted from 10 donor kidney samples, of which originated from 7 donors. Table 1 depicts the baseline ECD characteristics of the donors. For the kidneys with multiple biopsies done, we obtained an average score of the collagen parameters across the different samples. Biopsies classified with > 85% KDPI score had significantly higher CAR and CART than biopsies with ≤ 85% KDPI score.Conclusion:MPM is an evolving technology that enables the quantification of the amount (CART) and quality (CRI) of collagen deposition in unstained explant biopsies of ECD kidneys. This initial evaluation found significant differences in both parameters between ECD kidneys with more or less than 85% KDPI scores.


2021 ◽  
pp. ASN.2021070998
Author(s):  
Darya Morozov ◽  
Neda Parvin ◽  
Mark Conaway ◽  
Gavin Oxley ◽  
Edwin Baldelomar ◽  
...  

Background: Accumulating evidence supports an association between nephron number and susceptibility to kidney disease. However, it is not currently possible to directly measure nephron number in a clinical setting. Recent clinical studies have used glomerular density from a single biopsy and whole kidney cortical volume from imaging to estimate both nephron number and single nephron glomerular filtration rate. However, the accuracy of these estimates from individual subjects is unknown. Furthermore, it is not clear how sample size or biopsy location may influence these estimates. These questions are critical to study design and to the potential translation of these tools to estimate nephron number in individual subjects. Methods: We measured the variability in estimated nephron number derived from needle or virtual biopsies and cortical volume in human kidneys declined for transplantation. We performed multiple needle biopsies in the same kidney, and examined the three-dimensional spatial distribution of nephron density by magnetic resonance imaging. We determined the accuracy of a single kidney biopsy to predict the mean nephron number estimated from multiple biopsies from the same kidney. Results: A single needle biopsy had a 15% chance and virtual biopsy had a 60% chance of being within 20% of whole kidney nephron number. Single needle biopsies could be used to detect differences in nephron number between large cohorts of several hundred subjects. Conclusions: The number of subjects required to accurately detect differences in nephron number between populations can be predicted based on natural intra-kidney variability in glomerular density. A single biopsy is insufficient to accurately predict nephron number in individual subjects.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yi Liu ◽  
Xuelei Liang ◽  
Haixuan Wu ◽  
Fenglin Zhuo

Introduction: Lichen planus/lupus erythematosus overlap syndrome is rarely seen in the clinic and has the characteristic clinical manifestations, histopathology, and immunopathology of lichen planus (LP) and lupus erythematosus (LE). This is the first reported case of bullous lichen planus (BLP)/systemic lupus erythematosus (SLE) overlap syndrome with hair loss as the first symptom.Case Presentation: A 48-year-old female presented with alopecia for half a year, and skin lesions accompanied by itching on her face, trunk, and limbs for 3 months. She had a history suggestive of photosensitivity. Laboratory tests and histopathology were performed for diagnosis. Histopathologic features of the upper arm and back of the hand were consistent with BLP, whereas the scalp lesion indicated LE. Laboratory examination indicated positive for antinuclear antibody (ANA) (1:160), leukopenia, increased urinary protein, decreased C3/C4, and normal BP180. The patient was given glucocorticoid combined with acitretin and immunosuppressive therapy after a definite diagnosis of BLP/SLE overlap syndrome. The lesions of the patient disappeared and some hair had regrown during the two years of follow-up.Conclusion: This is the first reported case of BLP/SLE overlap syndrome which responded well to glucocorticoids, retinoids, and immunosuppressive drugs. Multiple biopsies from characteristic lesions will guide doctors to avoid misdiagnoses and delayed treatment.


2021 ◽  
Vol 84 (4) ◽  
pp. 653-655
Author(s):  
G Van de Vyver ◽  
T Vandamme ◽  
P.H. Steger ◽  
D Staessen

In this case report, we describe two cases of gastric mucosa- associated lymphoid tissue (MALT) lymphoma. The first patient, who presented with complaints of indigestion, nausea and epigastralgy, had a solid ulcer on endoscopy. Biopsies showed, next to MALT, presence of Helicobacter Pylori. The second patient was admitted with hematemesis. The multiple ulcerations in his stomach were thought to be cocaine-induced. Only after multiple biopsies the diagnosis of MALT was made. No presence of Helicobacter Pylori could be detected. The first patient was successfully treated with Helicobacter Pylori eradication therapy. Localized radiotherapy resulted in complete remission in our second patient. Hence, in absence of Helicobacter Pylori, more aggressive treatment modalities are needed.


Author(s):  
Yusuf Taha Güllü ◽  
◽  
Büşra Adıgüzel Gündoğdu ◽  
Tibel Tuna ◽  
Nurhan Köksal ◽  
...  

Introduction: Bladder cancer is the 12th most common cancer type worldwide. The most common symptom is painless hematuria. The most common sites of distant metastasis are liver (47%), lung (45%) and bone (32%), respectively. Case report: 73-year-old male patient was admitted with the complaint of hematuria. With a preliminary diagnosis of bladder cancer transurethral resection of tumour (TUR-B) was performed and pathology reported invasive urothelial carcinoma. The patient applied to the pulmonary diseases outpatient clinic with the complaint of cough and wheezing. Bronchoscopy was performed with a pre-diagnosis of bladder cancer metastasis. Multiple biopsies from EBL reported in accordance with urothelial carcinoma metastasis. Result: Urothelial carcinoma of the bladder may present with different pulmonary involvement. Although endobronchial metastasis is a rare condition; it should always be kept in mind in patients with respiratory system complaints. Keywords: endobronchial metastasis; bladder carcinoma; urothelial carcinoma; pulmonary involvement.


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