Sclerosing Angiomatoid Nodular Transformation of the Spleen: Analysis of Clinical and Pathological Features in Five Cases

Objective: We aimed to summarize the clinical and pathological features of sclerosing angiomatoid nodular transformation (SANT) in spleen among five cases.Methods: Five cases (male: 3; female: 2; mean age: 47.6 years) with SANT confirmed by pathological analysis between July 2010 and November 2019 in our hospital were included in this study. The clinical, imaging, and pathological data were analyzed retrospectively.Results: Three patients presented with mild abdominal pain or discomfort, while the other two were symptom free. Two patients received ultrasonography (US), and all patients underwent a computerized tomography (CT) scan in our hospital. The typical “spoke wheel” pattern was seen in two cases, and central calcification was detected in one case on the CT scans. All patients indicated peripheral enhancement around the SANT lesion during the arterial phase. Open or laparoscopic splenectomy was performed for treatment. No patient showed recurrence in the follow-up. The pathological characteristics of our cases were in line with those of previous literatures.Conclusions: Peripheral enhancement around the SANT lesion during the arterial phase should be taken into consideration for the diagnosis of SANT as an imaging sign on CT scans. Special attention should be paid to the splenic integrality during the laparoscopic approach, due to the probability of malignancy and the fragility of the spleen.

Bovine tuberculosis: diagnosis in dairy cattle through the association of analyzes

ABSTRACT: Tuberculosis is a chronic anthropozoonosis of worldwide occurrence, caused by the bacterium Mycobacterium tuberculosis and its variants. In Brazil, the National Program for the Control and Eradication of Brucellosis and Tuberculosis in cattle, is responsible for diagnosing and the correctly allocate positive animals, but there is still a lack of definitive diagnosis of the disease. This study described the use of five diagnostic tools that can be used, preferably together, for the confirmation of suspected cases. These tools included the clinical examination comparative cervical tuberculin test, macroscopic findings during the slaughtering and histopathology of the damaged tissues followed by histochemistry. We evaluated a total of 211 dairy cattle, where 15.1% (32/211) had classic clinical signs of bovine tuberculosis, 74 (35%) showed reactivity in the comparative cervical tuberculin test. Of the total number of animals, 141 (66.8%) were referred for sanitary slaughter due to legal and control issues in the outbreaks of the disease. In the follow-up of slaughtering and inspection of viscera and carcasses, 74 (52.5%) had macroscopic lesions compatible with bovine tuberculosis, while 67 (47.5%) showed no visible changes. During the inspection, fragments of lymph nodes and liver and lung parenchyma were collected from five cattle with macroscopic lesions and five with no lesions. The histopathological analysis showed numerous areas of caseous necrosis with or without central calcification and granulomatous inflammatory infiltrate. In the special staining of Ziehl-Neelsen, numerous acid-fast bacilli were evidenced in all cases.

Intracardiac Teratoma in an Infant: Report of a New Case and Literature Review

Primitive intracardiac tumours are rare, especially in childhood, and are often discovered on autopsy. The intracardiac teratoma is the rarest intracardiac tumours of childhood. Herein, we report the case of an 11-month-old infant, which featured recurrent bronchoalveolitis since the age of 3 months, with a thoracic deformation. Physical examination did found discrete respiratory distress signs. Chest radiography showed large mediastinal enlargement. The computed tomography showed a solid cystic-cloisonned mass with fat and central calcification highly suggestive of an intracardiac teratoma. A radical surgical excision was made and the histological examination found a well circumscribed tumour containing elements of the three germ layers confirming the diagnosis of mature well-differentiated teratoma, with no need of immunohistochemical support.

An Intraarticular Osteoid Osteoma: A Case Report & Review of Literature

Osteoid osteoma (OO) is one of the common benign bone tumors but an uncommon cause of musculoskeletal pain. Its diagnosis is usually not difficult in classic clinical setup and in typical location in diaphyseal region. However, the diagnosis of juxta or intraarticular osteoid osteoma (IAOO) is challenging because of atypical clinical presentation responsible for delay in diagnosis and treatment. We report a rare case of IAOO as a cause of chronic shoulder pain to make clinician aware to help in its early diagnosis and management. A 28-year-old woman presented with chronic debilitating right shoulder pain. The diagnosis was established on CTscan after 2 years of onset of symptoms because of atypical clinical presentation as a chronic monoarthritis of the shoulder. CTscan demonstrated radiolucent nidus with central calcification with areas of surrounding sclerosis. The tumor was excised surgically and histopathologic examination confirmed the diagnosis of osteoid osteoma. So, in the scenario of an unexplained chronic monoarthritis, the possibility of intraarticular osteoid osteoma should also be kept in mind. CT-scan remains the investigation of choice for demonstrating the nidus and surgical exicision relieves the symptoms. DOI: http://dx.doi.org/10.3126/njr.v3i2.9615 Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 77-80