To the Editor: Xanthogranulomatous cholecystitis(XGC) is an uncommon inflammatory disease of the gallbladder, and its incidence is reported to be 1.3%-5.2% [1]. XGC is diagnosed by histopathological examination, chara...To the Editor: Xanthogranulomatous cholecystitis(XGC) is an uncommon inflammatory disease of the gallbladder, and its incidence is reported to be 1.3%-5.2% [1]. XGC is diagnosed by histopathological examination, characterized by severe inflammatory destruction followed by a granulomatous reaction, marked proliferative fibrosis, and infiltration of inflammatory cells [2].展开更多
BACKGROUND Pyogenic granuloma(PG)is a localized,reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity.In most cases,the presence of this lesion does not show alveolar bo...BACKGROUND Pyogenic granuloma(PG)is a localized,reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity.In most cases,the presence of this lesion does not show alveolar bone resorption.The pathology is diagnosed clinically with some caution.However,the diagnosis and treatment are usually corroborated with histopathological evidence.CASE SUMMARY Three clinical cases of PG associated with bone loss were described in this study.The three patients presented tumor-like growth which bled on touch,and were associated with local irritant factors.Radiographs showed bone loss.All cases were treated with conservative surgical excision.The scarring was satisfactory,and there was no case of recurrence.The diagnoses were based on clinical findings,and were confirmed histopathologically.CONCLUSION The occurrence of oral PG with bone loss is unusual.Therefore,clinical and radiographic evaluations are important for the diagnosis.展开更多
BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between ...BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.展开更多
BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered genera...BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered generalized GA.CASE SUMMARY Herein,we describe the case of a pediatric patient who initially presented with papules and later developed generalized atrophic macules.Upon examination,two different morphologic lesions were histopathologically confirmed:Epithelioid nodular GA and scattered histiocytic infiltrative GA.This patient exhibited rare clinical manifestations that differed throughout the course of the disease.The varying histopathological types and clinical manifestations of GA may be linked to the different stages of the disease.CONCLUSION This rare case demonstrates the different histopathological features of different stages and clinical manifestations of granuloma annulare in an infant.展开更多
BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simpl...BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.展开更多
The imaging appearance of renal granuloma is very similar to that of a renal tumor.Granulomatous lesions usually do not require surgical treatment,while kidney tumors typically necessitate surgical removal.The diagnos...The imaging appearance of renal granuloma is very similar to that of a renal tumor.Granulomatous lesions usually do not require surgical treatment,while kidney tumors typically necessitate surgical removal.The diagnosis of renal granuloma typically relies on the history of bacillus Calmette-Guérin perfusion and the position of the renal pelvis in the image(malignant tumors usually destroy or compress the surrounding renal pelvis).However,in this case,the patient has no history of bacillus Calmette-Guérin perfusion,making the diagnosis more challenging.The ultrasound and enhanced CT findings were consistent with renal papillary carcinoma.Laparoscopic partial nephrectomy was performed,revealing degeneration and necrosis of the renal cortex and formation of granulomas.The imaging diagnosis of renal granuloma is difficult.Ultrasound-guided biopsy may be a preferable method to avoid unnecessary surgery.展开更多
Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients a...Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients after single-lumen endotracheal (SLT) tube intubation and tracheotomy, and giant granulomas of the vocal cords due to double-lumen bronchial tube insertion have rarely been reported. Case presentation: A 49-year-old female patient underwent single-port thoracoscopy after DLT intubation as well as a wedge resection of the lower lobe of the left lung, which caused giant vocal process granulomas (VPGs) postoperatively. Based on a retrospective analysis of the general condition, current medical history, past medical history, and visual laryngoscopic observation of the vocal folds tissue, which ruled out preoperative vocal fold granuloma formation, we hypothesized that double-lumen bronchial catheter intubation may have been the primary cause of her vocal fold granuloma formation. Conclusions: Giant granuloma of the vocal folds after DLT insertion is a rare postoperative complication;therefore, if DLT intubation is to be performed, the anesthesiologist should choose an appropriate intubation plan and deal with it promptly to avoid the risk factors to ensure that the patient’s perioperative period is safe and smooth. In addition, if postoperative complications are encountered, they should be followed up and observed on time.展开更多
It is the habit of some drug consumers to dissolve the powder of crushed pills, intended for oral use, in water and inject this solution intravenously. Insoluble particles than obstruct pulmonary vessels causing micro...It is the habit of some drug consumers to dissolve the powder of crushed pills, intended for oral use, in water and inject this solution intravenously. Insoluble particles than obstruct pulmonary vessels causing microscopic pulmonary emboli. These foreign bodies migrate and penetrate into the perivascular space and interstitium, resulting in chronic inflammation and foreign body giant cell reaction. As a result of this a granulomatous interstitial fibrosis can develop, which has also been described as pulmonary talcosis. We are reporting the case of a 22 year old male with a history of long-term intravenous drug abuse. He presented to our hospital complaining of dyspnoea, cough and generalized weakness. We describe an extensive diagnostic process concluded by an open lung biopsy establishing a definitive diagnosis of this rare granulomatous lung disease. This case underlines the importance of a thorough diagnostic work up and the pathogenic potential of foreign material reaching the lung via blood circulation in amongst the differential diagnoses of interstitial lung diseases, especially occurring in this group of patients.展开更多
Fishbones are the most commonly ingested foreign bodies that cause gastrointestinal tract penetration.However,fishbones embedded in the gastrointestinal tract that lead to foreign body granulomas that mimic submucosal...Fishbones are the most commonly ingested foreign bodies that cause gastrointestinal tract penetration.However,fishbones embedded in the gastrointestinal tract that lead to foreign body granulomas that mimic submucosal tumors are rare.Herein,we describe a56-year-old woman who presented with a 20-dayhistory of upper abdominal pain.Endoscopy revealed an elevated lesion in the gastric antrum.An abdominal computed tomography scan showed a mass in the gastric antrum and a linear calcified lesion in the mass.An endoscopic ultrasonography examination revealed a 3.9 cm×2.2 cm,irregular,hypoechoic mass with indistinct margins in the muscularis propria layer.The patient was initially diagnosed as having a submucosal tumor,and subsequent surgical resection showed that the lesion was a foreign body granuloma caused by an embedded fishbone.Our case indicated that the differential diagnosis of a foreign body granuloma should be considered in cases of elevated lesions in the gastrointestinal tract.展开更多
INTRODUCTION Liver pseudotumor is a very rare benign lesion.Since the first case reported by Pack and Baker in1953,only 40 cases had been reported up to 1996.The diagnostic challenge of hepatic inflammatorypseudotumor...INTRODUCTION Liver pseudotumor is a very rare benign lesion.Since the first case reported by Pack and Baker in1953,only 40 cases had been reported up to 1996.The diagnostic challenge of hepatic inflammatorypseudotumor is emphasized by the fact that most ofthe reported cases were diagnosed by surgicalprocedures.Pathogenesis and etiology of展开更多
Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening l...Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening left eye pain, proptosis, tearing, gritty sensation, blurred vision and multiple lymphadenopathy. An axillary lymph node resection showed reactive follicular and interfollicular lymph node hyperplasia, and increased eosinophils and plasma cells(at least 80% of Ig G+ plasma cells were positive for IgG 4). A distinct feature was the presence of multifocal, perifollicular histiocytic granulomas, which formed a wreath around the entire follicles. The human herpes virus 8 was not detected by immunohistochemistry. In addition, an extensive panel of special stains, immunohistochemistry, and flow cytometry was negative for lymphoma, fungal, or mycobacterial infection. The findings were suggestive of IgG 4-related sclerosing disease-associated lymphadenopathy. Further laboratory testing showed a significant increase of serum immunoglobulin E(> 23000 IU/mL) and slight increase of total Ig G, but normal serum Ig G4. Even though perifollicular granuloma is a nonspecific histopathologic feature and can be seen in other diseases, such as nodular lymphocyte predominant Hodgkin lymphoma, Ig G4-related lymphadenopathy should be listed in the differential diagnoses of benign reactive lymph nodes, especially when perifollicular granuloma and plasmacytosis coexist.展开更多
AIM: To understand the pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma (FBGT) in vitro , and to provide laboratory evidence for diagnosis. MET...AIM: To understand the pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma (FBGT) in vitro , and to provide laboratory evidence for diagnosis. METHODS: The FBGT pathogens were isolaated and cultured with reformed rabbit-brain anaerobic enriched broth (RRAB), and identified by ATB/API 20A system. The minimum inhibiting concentration (MIC) was determined by anaerobic broth dilution method. RESULTS: A total of 22 strains of pathogen were separated from 21 patients with FBGT and identified as Propionibacterium acnes (PA) by ATB/API 20A system. The MIC of ciprofloxacin for 22 PA strains was 0.0625-0.5mg/L, the MIC of penicillin, ampicillin, ampicillin/sulbactam, cefoperazone, lincomycin, and imipenem/cilastatin were 0.125-0.5mg/L, the MIC of ticarcillin/clavulanic acid was 0.250-1.000mg/L, and the MIC of metronidazole was 64-256mg/L. The pathogen of FBGT was strictly anaerobic PA, which growed slowly and better in nutritious RRAB broth. All PA were resistant to metronidazole, but susceptive to other routine antimicrobial agents, such as penicillin, ampicillin and lincomycin. CONCLUSION: FBGT should not be treated with metron- idazole. Clinicians should choose combined use of drugs or operation to treat FBGT according to patients' individual condition and the results of drug sensitivity test.展开更多
Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-li...Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-like substance展开更多
Objective:To evaluate the possible anti-inflammatory effect of garden egg[Solatium aethiopieum (S.aethiopieum)]using experimentally induced inflammatory models in rals.Methods:Oedema was induced on the rat hind paw In...Objective:To evaluate the possible anti-inflammatory effect of garden egg[Solatium aethiopieum (S.aethiopieum)]using experimentally induced inflammatory models in rals.Methods:Oedema was induced on the rat hind paw In the injection of 0.1 mL undiluted fresh egg albumin(pbilogistic agent) into the subplantar surface of the rat paw.Tissue granuloma was induced in the rats by the implantation of two autoelaved cotton pellets(30 mg) under the flank o(previously shaved back of anaesthetised rats.Garden egg extract doses were administered to the rats for seven consecutive davs.On dav 8.the animals were killed and the pellets surrounded by granuloma tissue were disseeled out and dried.Results:Extracts of garden egg significanlly(P【0.05) reduced the fresh egg albumin-induced ral paw oedema and also significantly(P【0.05) reduced the granuloma tissue formation in the treated groups when compared to the control.Conclusions:This stud) shows that the fruits of garden egg(S.aethiopieum) have anti-inflammatory activity in the models studied.展开更多
Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cho...Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cases of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and bloody otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Temporal bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well-developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases, enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplasty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological etiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location, extension and severity of the lesion, The purpose of surgery is to remove the lesion and create an adequate drainage.展开更多
Bacillus Calmette-Guerin(BCG) intravesical instillation has been adopted in the treatment of patients with superficial bladder cancer.BCG-induced disseminated infection,though rare,has been associated with the histolo...Bacillus Calmette-Guerin(BCG) intravesical instillation has been adopted in the treatment of patients with superficial bladder cancer.BCG-induced disseminated infection,though rare,has been associated with the histological finding of epithelioid granulomas in different organs,including the liver.We report the case of an adult patient with multi-organ failure,who developed sepsis,acute respiratory failure and acute hepatic failure with encephalopathy whose liver biopsy confirmed the presence of atypical,granulomatous-like lesions.Recovery was observed only after empirical therapy for Mycobacterium bovis with isoniazid,rifampicin,ethambutol and steroids was introduced.This case highlights the importance of a thorough patient assessment in order to exclude other more common causes of hepatic granulomas and to confirm diagnosis.Histological findings may be non-specific when the liver is involved in BCGinduced disseminated infection.展开更多
A 60-year-old man,with a background history of insulin dependent diabetes,after a treated Escherichia coli urinary tract infection(Amoxicillin-Clavulanic acid for 10 days),experienced symptom recurrence.His main sympt...A 60-year-old man,with a background history of insulin dependent diabetes,after a treated Escherichia coli urinary tract infection(Amoxicillin-Clavulanic acid for 10 days),experienced symptom recurrence.His main symptoms included feeling unwell,burning in urination and pelvic pain.A digital rectal examination revealed a tender swelling in the pelvic area.His prostate-specific antigen(PSA)was 0.8 ng/mL,while the 2-glass MeareseStamey test was negative.展开更多
Dear Editor,I am Dr.Jungyul Park from the Department of Ophthalmology,Pusan National University Hospital,Busan,Korea.I am writing to present a case of eosinophilic granulomatosis with polyangiitis(EGPA)with central re...Dear Editor,I am Dr.Jungyul Park from the Department of Ophthalmology,Pusan National University Hospital,Busan,Korea.I am writing to present a case of eosinophilic granulomatosis with polyangiitis(EGPA)with central retinal artery occlusion(CRAO).It provides important information about the relationship between ANCA and CRAO in a patient who was diagnosed with EGPA who had ophthalmic symptoms.We believe that our study makes a significant contribution to the literature because to our knowledge,the literature of EGPA with CRAO are rare worldwide and this is even the first case of EGPA with CRAO in Republic of Korea.展开更多
文摘To the Editor: Xanthogranulomatous cholecystitis(XGC) is an uncommon inflammatory disease of the gallbladder, and its incidence is reported to be 1.3%-5.2% [1]. XGC is diagnosed by histopathological examination, characterized by severe inflammatory destruction followed by a granulomatous reaction, marked proliferative fibrosis, and infiltration of inflammatory cells [2].
文摘BACKGROUND Pyogenic granuloma(PG)is a localized,reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity.In most cases,the presence of this lesion does not show alveolar bone resorption.The pathology is diagnosed clinically with some caution.However,the diagnosis and treatment are usually corroborated with histopathological evidence.CASE SUMMARY Three clinical cases of PG associated with bone loss were described in this study.The three patients presented tumor-like growth which bled on touch,and were associated with local irritant factors.Radiographs showed bone loss.All cases were treated with conservative surgical excision.The scarring was satisfactory,and there was no case of recurrence.The diagnoses were based on clinical findings,and were confirmed histopathologically.CONCLUSION The occurrence of oral PG with bone loss is unusual.Therefore,clinical and radiographic evaluations are important for the diagnosis.
基金Supported by Spring City Project Famous Doctor Special
文摘BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.
文摘BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered generalized GA.CASE SUMMARY Herein,we describe the case of a pediatric patient who initially presented with papules and later developed generalized atrophic macules.Upon examination,two different morphologic lesions were histopathologically confirmed:Epithelioid nodular GA and scattered histiocytic infiltrative GA.This patient exhibited rare clinical manifestations that differed throughout the course of the disease.The varying histopathological types and clinical manifestations of GA may be linked to the different stages of the disease.CONCLUSION This rare case demonstrates the different histopathological features of different stages and clinical manifestations of granuloma annulare in an infant.
基金Supported by the Natural Science Foundation of Fujian Province,No.2021J01546the Innovation and Entrepreneurship Star Fund Project of Zhangzhou,No.ZCZZ[2019]17.
文摘BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.
文摘The imaging appearance of renal granuloma is very similar to that of a renal tumor.Granulomatous lesions usually do not require surgical treatment,while kidney tumors typically necessitate surgical removal.The diagnosis of renal granuloma typically relies on the history of bacillus Calmette-Guérin perfusion and the position of the renal pelvis in the image(malignant tumors usually destroy or compress the surrounding renal pelvis).However,in this case,the patient has no history of bacillus Calmette-Guérin perfusion,making the diagnosis more challenging.The ultrasound and enhanced CT findings were consistent with renal papillary carcinoma.Laparoscopic partial nephrectomy was performed,revealing degeneration and necrosis of the renal cortex and formation of granulomas.The imaging diagnosis of renal granuloma is difficult.Ultrasound-guided biopsy may be a preferable method to avoid unnecessary surgery.
文摘Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients after single-lumen endotracheal (SLT) tube intubation and tracheotomy, and giant granulomas of the vocal cords due to double-lumen bronchial tube insertion have rarely been reported. Case presentation: A 49-year-old female patient underwent single-port thoracoscopy after DLT intubation as well as a wedge resection of the lower lobe of the left lung, which caused giant vocal process granulomas (VPGs) postoperatively. Based on a retrospective analysis of the general condition, current medical history, past medical history, and visual laryngoscopic observation of the vocal folds tissue, which ruled out preoperative vocal fold granuloma formation, we hypothesized that double-lumen bronchial catheter intubation may have been the primary cause of her vocal fold granuloma formation. Conclusions: Giant granuloma of the vocal folds after DLT insertion is a rare postoperative complication;therefore, if DLT intubation is to be performed, the anesthesiologist should choose an appropriate intubation plan and deal with it promptly to avoid the risk factors to ensure that the patient’s perioperative period is safe and smooth. In addition, if postoperative complications are encountered, they should be followed up and observed on time.
文摘It is the habit of some drug consumers to dissolve the powder of crushed pills, intended for oral use, in water and inject this solution intravenously. Insoluble particles than obstruct pulmonary vessels causing microscopic pulmonary emboli. These foreign bodies migrate and penetrate into the perivascular space and interstitium, resulting in chronic inflammation and foreign body giant cell reaction. As a result of this a granulomatous interstitial fibrosis can develop, which has also been described as pulmonary talcosis. We are reporting the case of a 22 year old male with a history of long-term intravenous drug abuse. He presented to our hospital complaining of dyspnoea, cough and generalized weakness. We describe an extensive diagnostic process concluded by an open lung biopsy establishing a definitive diagnosis of this rare granulomatous lung disease. This case underlines the importance of a thorough diagnostic work up and the pathogenic potential of foreign material reaching the lung via blood circulation in amongst the differential diagnoses of interstitial lung diseases, especially occurring in this group of patients.
文摘Fishbones are the most commonly ingested foreign bodies that cause gastrointestinal tract penetration.However,fishbones embedded in the gastrointestinal tract that lead to foreign body granulomas that mimic submucosal tumors are rare.Herein,we describe a56-year-old woman who presented with a 20-dayhistory of upper abdominal pain.Endoscopy revealed an elevated lesion in the gastric antrum.An abdominal computed tomography scan showed a mass in the gastric antrum and a linear calcified lesion in the mass.An endoscopic ultrasonography examination revealed a 3.9 cm×2.2 cm,irregular,hypoechoic mass with indistinct margins in the muscularis propria layer.The patient was initially diagnosed as having a submucosal tumor,and subsequent surgical resection showed that the lesion was a foreign body granuloma caused by an embedded fishbone.Our case indicated that the differential diagnosis of a foreign body granuloma should be considered in cases of elevated lesions in the gastrointestinal tract.
文摘INTRODUCTION Liver pseudotumor is a very rare benign lesion.Since the first case reported by Pack and Baker in1953,only 40 cases had been reported up to 1996.The diagnostic challenge of hepatic inflammatorypseudotumor is emphasized by the fact that most ofthe reported cases were diagnosed by surgicalprocedures.Pathogenesis and etiology of
基金Supported by Department of Pathology,the University of Texas Health Science Center at Houston,United States
文摘Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening left eye pain, proptosis, tearing, gritty sensation, blurred vision and multiple lymphadenopathy. An axillary lymph node resection showed reactive follicular and interfollicular lymph node hyperplasia, and increased eosinophils and plasma cells(at least 80% of Ig G+ plasma cells were positive for IgG 4). A distinct feature was the presence of multifocal, perifollicular histiocytic granulomas, which formed a wreath around the entire follicles. The human herpes virus 8 was not detected by immunohistochemistry. In addition, an extensive panel of special stains, immunohistochemistry, and flow cytometry was negative for lymphoma, fungal, or mycobacterial infection. The findings were suggestive of IgG 4-related sclerosing disease-associated lymphadenopathy. Further laboratory testing showed a significant increase of serum immunoglobulin E(> 23000 IU/mL) and slight increase of total Ig G, but normal serum Ig G4. Even though perifollicular granuloma is a nonspecific histopathologic feature and can be seen in other diseases, such as nodular lymphocyte predominant Hodgkin lymphoma, Ig G4-related lymphadenopathy should be listed in the differential diagnoses of benign reactive lymph nodes, especially when perifollicular granuloma and plasmacytosis coexist.
文摘AIM: To understand the pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma (FBGT) in vitro , and to provide laboratory evidence for diagnosis. METHODS: The FBGT pathogens were isolaated and cultured with reformed rabbit-brain anaerobic enriched broth (RRAB), and identified by ATB/API 20A system. The minimum inhibiting concentration (MIC) was determined by anaerobic broth dilution method. RESULTS: A total of 22 strains of pathogen were separated from 21 patients with FBGT and identified as Propionibacterium acnes (PA) by ATB/API 20A system. The MIC of ciprofloxacin for 22 PA strains was 0.0625-0.5mg/L, the MIC of penicillin, ampicillin, ampicillin/sulbactam, cefoperazone, lincomycin, and imipenem/cilastatin were 0.125-0.5mg/L, the MIC of ticarcillin/clavulanic acid was 0.250-1.000mg/L, and the MIC of metronidazole was 64-256mg/L. The pathogen of FBGT was strictly anaerobic PA, which growed slowly and better in nutritious RRAB broth. All PA were resistant to metronidazole, but susceptive to other routine antimicrobial agents, such as penicillin, ampicillin and lincomycin. CONCLUSION: FBGT should not be treated with metron- idazole. Clinicians should choose combined use of drugs or operation to treat FBGT according to patients' individual condition and the results of drug sensitivity test.
文摘Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-like substance
文摘Objective:To evaluate the possible anti-inflammatory effect of garden egg[Solatium aethiopieum (S.aethiopieum)]using experimentally induced inflammatory models in rals.Methods:Oedema was induced on the rat hind paw In the injection of 0.1 mL undiluted fresh egg albumin(pbilogistic agent) into the subplantar surface of the rat paw.Tissue granuloma was induced in the rats by the implantation of two autoelaved cotton pellets(30 mg) under the flank o(previously shaved back of anaesthetised rats.Garden egg extract doses were administered to the rats for seven consecutive davs.On dav 8.the animals were killed and the pellets surrounded by granuloma tissue were disseeled out and dried.Results:Extracts of garden egg significanlly(P【0.05) reduced the fresh egg albumin-induced ral paw oedema and also significantly(P【0.05) reduced the granuloma tissue formation in the treated groups when compared to the control.Conclusions:This stud) shows that the fruits of garden egg(S.aethiopieum) have anti-inflammatory activity in the models studied.
文摘Summary: To investigate the etiology and pathogenesis of cholesteatoma otitis media accompanied by cholesterol granuloma and the relationship between cholesteatoma and cholesterol granuloma, 63 cases of middle ear cholesterol granuloma treated in our hospital during the period from March 1988 to May 2000 were retrospectively reviewed. All cases were surgically and pathologically verified. 15 cases of cholesteatoma coexisting with cholesterol granuloma were found among the 63 patients. All 15 cases had a long-term history of otitis media, such as otorrhea (sanguine purulent otorrhea and bloody otorrhea in 8 cases) and perforation of the eardrum (perforation of pars flaccida in 8 cases). Temporal bone CT scans showed cholesteatoma in 11 cases. All patients were treated surgically, and cholesteatoma and cholesterol granuloma were found coexisting alternately, the latter lying mainly in the tympanic antrum, attic and mastoid air cells. Chocolate-colored mucus was accumulated in well-developed mastoid air cells, and glistening dotty cholesterol crystals were also found. In most cases, enlarged aditus, destruction of lateral attic wall, erosion of ossicular chain, exposure of horizontal segment of facial nerve and tegmen of attic were observed. Occlusion of Eustachian tube was noted in 6 cases, and occlusion of tympanic isthmus was revealed in all cases. A post-operative dry ear was achieved in all patients, and hearing improvement was achieved in all 12 cases following tympanoplasty. Cholesteatoma and cholesterol granuloma in middle ear may share a common pathophysiological etiology: occlusion of ventilation and disturbance of drainage. The diagnosis should be considered when patients presented with chronic otitis media with bloody otorrhea. CT and magnetic resonance imaging are useful for the diagnosis before operation. The surgical approach depends on the location, extension and severity of the lesion, The purpose of surgery is to remove the lesion and create an adequate drainage.
文摘Bacillus Calmette-Guerin(BCG) intravesical instillation has been adopted in the treatment of patients with superficial bladder cancer.BCG-induced disseminated infection,though rare,has been associated with the histological finding of epithelioid granulomas in different organs,including the liver.We report the case of an adult patient with multi-organ failure,who developed sepsis,acute respiratory failure and acute hepatic failure with encephalopathy whose liver biopsy confirmed the presence of atypical,granulomatous-like lesions.Recovery was observed only after empirical therapy for Mycobacterium bovis with isoniazid,rifampicin,ethambutol and steroids was introduced.This case highlights the importance of a thorough patient assessment in order to exclude other more common causes of hepatic granulomas and to confirm diagnosis.Histological findings may be non-specific when the liver is involved in BCGinduced disseminated infection.
文摘A 60-year-old man,with a background history of insulin dependent diabetes,after a treated Escherichia coli urinary tract infection(Amoxicillin-Clavulanic acid for 10 days),experienced symptom recurrence.His main symptoms included feeling unwell,burning in urination and pelvic pain.A digital rectal examination revealed a tender swelling in the pelvic area.His prostate-specific antigen(PSA)was 0.8 ng/mL,while the 2-glass MeareseStamey test was negative.
文摘Dear Editor,I am Dr.Jungyul Park from the Department of Ophthalmology,Pusan National University Hospital,Busan,Korea.I am writing to present a case of eosinophilic granulomatosis with polyangiitis(EGPA)with central retinal artery occlusion(CRAO).It provides important information about the relationship between ANCA and CRAO in a patient who was diagnosed with EGPA who had ophthalmic symptoms.We believe that our study makes a significant contribution to the literature because to our knowledge,the literature of EGPA with CRAO are rare worldwide and this is even the first case of EGPA with CRAO in Republic of Korea.
