Hypercalcaemia associated with disseminated cryptococcosis

We report an elderly man who presented with giddiness and right-sided weakness, constipation and constitutional symptoms for 6 months duration. Blood investigations indicated hypercalcaemia with normal serum phosphate and acute kidney injury. Serum intact parathyroid hormone was suppressed. CT revealed bilateral tiny lung nodules with right upper lobe tree in bud appearance and incidental findings of bilateral adrenal lesion. Tuberculosis was ruled out. CT adrenal showed multiseptated hypodense rim enhancement adrenal lesion bilaterally. Adrenal function tests were normal except for low dehydroepiandrosterone (DHEA). Right-sided cervical lymph node biopsy confirmed fungal infection with the presence of intracellular and extracellular fungal yeast. Serum cryptococcus antigen titre was positive. Our final diagnosis was disseminated cryptococcosis with lungs, bilateral adrenal gland and lymph nodes involvement. The patient was then treated with antifungal treatment. Serum calcium was normalised after 1 month with marked clinical improvement.

Sub internal limiting membrane hemorrhage followed by bilateral optic disc hemorrhage in Kikuchi-Fujimoto disease: a case report

Background Kikuchi-Fujimoto disease (KFD) is a necrotizing lymphadenitis, and presents fever of unknown origin and cervical lymphadenopathy. Ocular complications are unusual in KFD. Here we report a case of sub internal limiting membrane (ILM) hemorrhage followed by bilateral optic disc hemorrhage in KFD. Case presentation A 16-year-old Japanese man perceived a sudden decrease of right vision 3 days after onset of fever with unknown origin and left cervical lymphadenopathy. At presentation, visual acuity (VA) of right eye was 0.05 in decimal chart (1.30: converted to logarithm of minimum angle of resolution: logMAR). Fundus photograph showed extensive sub-ILM hemorrhage in right eye, and optic disc hemorrhages in both eyes. Fluorescein angiography presented hypo- and hyperfluorescences in optic disc of right eye, and hyperfluorescence in the disc of left eye. To make a definitive diagnosis, cervical lymph node biopsy was performed, and KFD was diagnosed pathologically. Thereafter, fever, headache and the cervical lymphadenopathy disappeared spontaneously. The sub-ILM hemorrhage was drained into the vitreous cavity by neodymium:yttrium-aluminum-garnet laser (Nd: YAG) hyaloidotomy. VA recovered to 1.5 (− 0.18: logMAR VA) in right eye. Conclusion Sub-ILM hemorrhage and optic disc hemorrhage are a KFD-related ocular complication.

Kikuchi-Fujimoto Disease: A Case Report and Review of the Literature

Kikuchi-Fujimoto disease is a rare benign, condition of necrotizing histiocytic lymphadenitis. Presenting complaints of neck masses in association with non-specific systemic signs and symptoms prompt investigation towards the more common diagnoses. However, rarer conditions must still be considered especially when a patient's condition fails to abate. Herein I discuss a case of female patient who presented with a neck mass that was not attributable to the more common causes. A 28 year old lady presented with feverish feeling, weight loss and tender cervical lymph nodes. Initially tuberculous lymphadenitis was suspected but Kikuchi-Fujimoto disease was diagnosed after cervical lymph node biopsy. Symptomatic treatment was provided and an eventful full recovery was made. Faridpur Med. Coll. J. Jan 2019;14(1): 50-53

Case Report: Rare case of classical Hodgkin’s lymphoma, mixed cellularity in a male boy aged 12 years.

Castleman disease was initially explained in 1956 as a syndrome that is lymphoproliferative, also recognized as angiofollicular lymph node hyperplasia. It is a rare disease and may proceed to malignant lymphoma that is difficult to diagnose while the treatment is complex. Hodgkin lymphoma (HL) is a malignancy that is related to lymphoid and can be characterized as Reed-Sternberg cells in the lymph nodes. Prognosis as well as treatment is complex and depends upon the Ann Arbor staging as well as age of the affected patient. HL is divided into 2 distinct subtypes, Nodular Lymphocyte Predominant HL (LPHL), and classical HL (cHL). The present case was a 12year old male boy who presented with fever, cough and swelling on the body at multiple sites. Diagnosis of cervical lymph node biopsy was labeled as classical Hodgkin’s Lymphoma, mixed cellularity. Early diagnosis, better understanding of the pathophysiology as well as the biology of HL can assure much better prognosis.

Frequency of Infection in Cervical Lymph Node Biopsy Site using Chlorhexidine and Povidine Iodine

Background: Lymph node are located throughout the lymphatic system, they are concentrated in certain areas of the body including head and neck. Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to several different pathological conditions including tumours, infection and inflammation.Methodology: The Povidine-iodine and chlorhexidine for preoperative skin preparation in cervical lymph node biopsy procedure were used in this study and patients were asked for follow up after a week. On follow up day their wounds were checked, assessed and withdraw all stiches and complications were recorded accordingly and analysed them. It was discussed and showed that which one of Povidine-iodine and chlorhexidine is best to use for preoperative skin preparation in cervical lymph node biopsy procedures to reduce surgical site infection and economical one.Results: Out of 150 patients, 46% (69) were males and 54% (81) were females that had cervical lymphadenopathy after skin preparation by chlorhexidine antiseptic solution showed frequency of infection in total of 150 patients 16.67% (25) were infected while the other 83.33%(125) were not infected. Out of 150 patients who were underwent cervical lymphadenopathy after using povidine iodine skin preparatory antiseptic solution, 42% (63) were males and 58% (87) were females and among those frequency of infection showed 44.67% (67) were infected while the others 55.33% (83) were not.Conclusion: Preoperative scrubbing of the patient’s skin with chlorhexidine–alcohol is better than scrubbing with povidone–iodine for preventing surgical-site infection after cervical lymph node biopsy.

Kikuchi Fujimoto lymphadenitis- an uncommon entity in the surgical outpatients: a case report

Kikuchi Fujimoto lymphadenitis is a benign self-limiting disease with subacute necrotizing lymphadenopathy of unknown cause. The clinical, histopathological and immunohistochemical features point to viral etiology hence delaying diagnosis commonly. Clinicians and pathologists awareness of this disorder may prevent misdiagnosis and inappropriate treatment. We describe here a case of a young woman admitted under our care with fever and cervical lymphadenopathy. Cervical lymph node biopsy revealed the rare clinical disorder of Kikuchi Fujimoto lymphadenitis which is not thought of as a primary cause of lymphadenopathy in the Indian subcontinent where tuberculosis is widely prevalent.