1/6. Focal acantholytic dyskeratosis: a snare for the pathologist. Report of two cases associated to psoriasis and fibrous papule of the nose.Two specimens containing clinically inapparent histologic features of acantholytic dyskeratosis (on the base of a fibrous papule of the nose and overlying a psoriatic lesion) are presented. The authors discuss the conduct to be followed by the pathologist in similar cases. The general pathologist should be well trained in dermatopathology since cutaneous biopsies account for 10 to 25% of the specimens submitted for histologic diagnosis or, even, form the major part of the workload (Berry). There is a wall between the physician who submits the skin biopsies (who may be or not a dermatologist) and the pathologist. The clinical information provided by dermatologists is scant and incomplete and physicians who are not dermatologists seldom submit any information. The histological pictures found in skin biopsies are, often, common to several nosological entities and an adequate understanding of their meaning is desirable for a thorough evaluation. We ought to assess it with the maximum scientific severity, searching to solve the puzzle without depreciating the information received. In this report the authors analyse the histopathological approach to the cutaneous lesions of two patients. They displayed the association between acantholytic dyskeratosis (AD) and another cutaneous pathology. Findings like these may obstruct the final diagnosis to be issued by the pathologist.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Interactive detection and visualization of breast lesions from dynamic contrast enhanced MRI volumes.mammography is currently regarded as the most effective and widely used method for early detection of breast cancer, but recently its sensitivity in certain high risk cases has been less than desired. The use of Dynamic Contrast Enhanced magnetic resonance imaging (DCE-MRI) has gained considerable attention in the past 10 years, especially for high risk cases, for smaller multi-focal lesions, or very sparsely distributed lesions. In this work, we present an interactive visualization system to identify, process, visualize and quantify lesions from DCE-MRI volumes. Our approach has the following key features: (1) we determine a confidence measure for each voxel, representing the probability that the voxel is part of the tumor, using a rough goodness-of-fit for the shape of the intensity-time curves, (2) our system takes advantage of low-cost, readily available 3D texture mapping hardware to produce both 2D and 3D visualizations of the segmented MRI volume in near real-time, enabling improved spatial perception of the tumor location, shape, size, distribution, and other characteristics useful in staging and treatment courses, and (3) our system permits interactive manipulation of the signal-time curves, adapts to different tumor types and morphology, thus making it a powerful tool for radiologists/physicians to rapidly assess probable malignant volumes. We illustrate the application of our system with four case studies: invasive ductal cancer, benign fibroadenoma, ductal carcinoma in situ and lobular carcinoma.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/6. Subfoveal nodule in Coats' disease.An atypical presentation of Coats' disease is reported with a prominent subfoveal nodule with peripheral retinal exudates. A 6-year old boy presented with 6/120 vision in the left eye associated with an elevated 1 mm subfoveal, circular lesion with peripheral exudates. The fluorescein angiogram showed peripheral retinal telangiectasias with leakage consistent with Coats' disease. The prominent subfoveal nodule is an uncommon initial presentation of Coats' disease and physicians should be aware of this atypical finding.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/6. nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis in 2 patients with end-stage renal disease on hemodialysis.nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis (NFD/NSF) is a newly recognized disorder occurring in patients with renal failure. It is manifested by progressive cutaneous and systemic fibrosis involving the extremities and the trunk with usual sparing of the face and internal organs. NFD/NSF can lead to joint contractures and painful disability. The etiology is unknown and there are no proven effective treatments. NFD/NSF must be distinguished from other clinically similar disorders such as scleroderma, scleromyxedema, and eosinophilic fasciitis among a myriad of others. NFD/NSF can pose many diagnostic challenges to physicians; however, a team of experienced rheumatologists, nephrologists, dermatologists, and dermatopathologists is essential in identifying this disorder. We report 2 new cases of NFD/NSF in patients on hemodialysis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/6. Multifocal fibrosclerosis. Report of a case of bilateral idiopathic sclerosing pseudotumor and retroperitoneal fibrosis.We describe a 56-year-old white man who presented with gradual and progressive visual loss and subsequent hypertension and pedal edema. A computed tomographic scan of the orbits showed bilateral diffuse retrobulbar masses, and an abdominal computed tomographic scan showed a diffuse retroperitoneal mass invading the aorta, ureters, and inferior vena cava. Biopsies of the orbit and abdomen confirmed a heterogeneous cell population and marked fibrosis consistent with a sclerosing inflammatory process. Bilateral sclerosing orbital inflammatory disease should cue the physician to suspect coexisting systemic disease. This report is the fourth to document bilateral sclerosing orbital inflammatory disease and the second to have obtained biopsies of the orbit and abdomen showing histologic similarities.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/6. Subretinal fibrosis and nonrhegmatogenous retinal detachment associated with multifocal central serous chorioretinopathy.PURPOSE: To report the rare occurrence of subretinal fibrosis in patients with multifocal central serous chorioretinopathy and evaluate the role of systemic corticosteroids and the effects of laser photocoagulation on multifocal leaks. methods: A total of 29 patients (mean age, 37.7 years; 89.7% male) treated for subretinal fibrosis and multifocal central serous chorioretinopathy from 1983-1995 were reviewed retrospectively. Mean follow up was 26 months (range, 6.8-81 months). RESULTS: retinal detachment involved the macula in 72.4% cases. fluorescein angiography showed a mean of 6.7 (range, 2-22) central serous chorioretinopathy leaks and a mean of 1.8 (range, 1-5) retinal pigment epithelial detachments. The fundus pictures of 23 patients who were taking systemic corticosteroids showed no improvement. Following laser treatment, however, retinal reattachment was obtained in all eyes, and improvement in visual acuity of > 2 Snellen lines was noted in 68.9% of patients. CONCLUSIONS: The presence of subretinal fibrosis with secondary retinal detachment in otherwise healthy young patients, particularly in men, should alert the physician to look for multifocal central serous retinopathy leaks. Systemic corticosteroids did not prove effective in treating these patients, although laser treatment is recommended for each leak identified on an angiogram.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |