1/23. infarction after fine needle aspiration biopsy of pleomorphic adenoma of the parotid gland.BACKGROUND: Fine needle aspiration (FNA) is a well-established and safe method for the rapid diagnosis of pleomorphic adenoma. A few clinically important complications, including bleeding, infection and inflammatory reactions, result from FNA. In a small number of cases FNA has been followed by varying degrees of necrosis in some organs. In the literature there are a few reports associated with necrosis in a pleomorphic adenoma of the parotid gland following FNA. CASE: A 27-year-old female had a two-year history of a right parotid mass. FNA revealed pleomorphic adenoma. A histologic diagnosis of pleomorphic adenoma of the right parotid with infarction was made. CONCLUSION: necrosis associated with infarction may cause diagnostic problems. It is not a sufficient sign of malignant transformation.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/23. Acute adrenocortical insufficiency due to heparin-induced thrombocytopenia with subsequent bilateral haemorrhagic infarction of the adrenal glands.A 56 year old male developed bilateral massive adrenal haemorrhage (BMAH) resulting in chronic adrenal insufficiency in the course of heparin-induced thrombocytopenia (HIT)-syndrome. thrombosis of the central adrenal vein (CAV) with subsequent adrenal haemorrhagic infarction is the most probable cause of the rare association of HIT and BMAH. The exorbitantly high catecholamine plasma levels within the CAV in addition to immunogenic platelet activation are discussed as possible underlying pathophysiological mechanisms.- - - - - - - - - - ranking = 0.8keywords = gland (Clic here for more details about this article) |
3/23. abscess-like formation concomitant with pituitary adenoma in Cushing's disease: case report and pathological considerations.Pituitary abscess is a rare condition and a histological misnomer since cultures of abscess material are often negative or non-pathogenic. We report the first case of pituitary abscess-like formation concomitant with pituitary adenoma and discuss the physiopathological mechanism. A 37-year-old woman presented classic symptoms of Cushing's disease. Endocrine studies indicated the presence of adenocorticotropin (ACTH)-producing pituitary adenoma. Preoperative magnetic resonance imaging revealed two separate tumours of the pituitary. During transsphenoidal surgery, a 14-mm adenoma was removed from the right side of the gland and a pus-filled cystic tumour was opened and drained on the left. Histological diagnosis was ACTH-producing pituitary adenoma and cyst material compatible with pituitary abscess. association of separate adenoma and abscess of the pituitary gland has not been reported previously. We speculate that spontaneous adenoma infarction may provide a more comprehensible pathophysiological explanation than abscess formation.- - - - - - - - - - ranking = 0.4keywords = gland (Clic here for more details about this article) |
4/23. Spontaneous infarction of a parotid gland pleomorphic adenoma. Report of a case with cytologic and radiographic overlap with a primary salivary gland malignancy.Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly enlarging, firm, well-circumscribed, painless nodule. Occasional cases have presented after a short period of rapid growth or have been associated with pain. The vast majority of these tumors are solid, but rare examples have been associated with cystic degeneration or hemorrhage. Spontaneous and tumor-associated infarction of the parotid has been reported, but these examples have been limited to infarctions of Warthin's tumors and postoperative infarctions of salivary glands. We present the case of a 48-year-old male with a one-year history of a painful, enlarging, left parotid mass associated with paresthesia of the tongue. Computed tomographic examination of the parotid demonstrated a left superficial lobe mass with a rim of enhancement and low attenuation center. Fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with carcinoma. A superficial parotidectomy with intraoperative frozen section revealed a pleomorphic adenoma with extensive central necrosis. To our knowledge, this represents the first reported case of an infarcted pleomorphic adenoma and illustrates the potential for misinterpretation of these cytologic and radiologic findings as indicative of malignancy.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
5/23. infarction of acinic cell carcinoma in a patient infected with hiv: a complication of fine-needle aspiration cytology obscuring definitive diagnosis.infarction of salivary gland tumors has been reported following fine-needle aspiration cytology (FNAC) and, rarely, as a spontaneous event. patients infected with the human immunodeficiency virus (hiv) often have salivary gland lesions and FNAC plays a role in the preliminary investigation of such swellings. We report a case of a parotid swelling in a patient infected with hiv where infarction of acinic cell carcinoma following FNAC lead to difficulty in cytological evaluation of the subsequent aspirate.- - - - - - - - - - ranking = 0.4keywords = gland (Clic here for more details about this article) |
6/23. churg-strauss syndrome (CSS) manifested as necrosis of fingers and toes and liver infarction.We report a case of churg-strauss syndrome (CSS) with necrosis of the fingers and toes and liver infarction. A 59-year-old man with asthma suddenly noticed that his fingers and toes felt unusually cold. This condition worsened progressively, and some digits became necrotic within several weeks. Laboratory studies revealed hypereosinophilia and an extremely elevated serum level of IgE. Digital subtraction angiography of the extremities revealed extensive irregular narrowing of small and medium-sized arteries in the extremities. Abdominal computed tomography (CT) revealed an area of low density at the periphery of the right lobe of the liver. angiography revealed irregular narrowing of small arteries that corresponded to the ischemic area. A nerve conduction study suggested sensory nerve neuropathy. The preceding asthma, acute onset of digital necrosis, liver infarction, neuropathy, and hypereosinophilia strongly suggested a diagnosis of CSS. The patient was treated with 40 mg of prednisolone and 120 micro g of intravenous prostaglandin E1 daily, and all the digits that had turned black and necrotic were amputated. After the amputation, the dose of prednisolone was gradually reduced, and no new lesions appeared on the skin or in the liver. The rare possible complications of CSS, including necrosis of digits and liver infarction, should not be ignored.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
7/23. spinal cord infarction secondary to intervertebral foraminal disease.STUDY DESIGN: The 5 year review of patients referred to one center. OBJECTIVE: To report spinal cord infarction secondary to vascular occlusion from disease in a lower thoracic intervertebral foramen. METHOD: The clinical and imaging findings of two cases with acute spinal cord dysfunction are presented. SETTING: Midlands Centre for spinal injuries, england. RESULTS: The CT and MR imaging features revealed lower thoracic unilateral foraminal occlusion due to acute facet joint septic arthritis in a diabetic patient, and secondary to chronic hypertrophic osteophytes in a second hypertensive individual. The presumed mechanism of infarction was occlusion of the artery of Adamkiewicz. CONCLUSION: Foraminal disease in the lower thoracic levels needs to be entertained in cases of unexplained nontraumatic acute spinal cord dysfunction.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
8/23. infarction of mediastinal parathyroid gland causing spontaneous remission of secondary hyperparathyroidism.Secondary hyperparathyroidism is a serious complication in long-term hemodialysis patients. The authors report on 2 patients on long-term hemodialysis who suffered from persistent secondary hyperparathyroidism due to missed mediastinal parathyroid gland after total parathyroidectomy with forearm autograft. reoperation was planned. In both cases, severe hypocalcemia suddenly developed; serum parathyroid hormone (PTH) level decreased markedly after this episode. The serum calcium level increased gradually in response to administration of vitamin D and calcium carbonate, but serum PTH level remained low. A follow-up computed tomography scan showed that the formerly enlarged mediastinal parathyroid gland was markedly reduced in size. Moreover, a hot spot formerly detected by technetium 99m-MIBI (methoxy-isobutyl-isonitrile) scintigraphy in the mediastinum disappeared after this episode. The authors considered that necrosis of the enlarged ectopic parathyroid gland, probably due to infarction, resulted in hypocalcemia. To the authors' knowledge, this is the first case report of spontaneous mediastinal parathyroid autoinfarction after parathyroidectomy in hemodialysis patients.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
9/23. Spontaneous infarction of a pleomorphic adenoma in parotid gland: diagnostic problems and review.Although infarction of parotid gland pleomorphic adenoma (PA) following fine-needle aspiration (FNA) has been well-documented, spontaneous infarction of PA has remained as an uncommon entity in the literature. To our knowledge, we report the second case of spontaneous infarction occurring in a parotid gland PA. A 44-yr-old man presented with a 2-yr history of slowly enlarging right parotid mass, which had become painful 1 mo before performing FNA biopsy. Smears revealed abundant necrotic debris, atypical squamous cells, and small cells with dark nuclei suggestive of a carcinoma. Histologic examination of the tissue fragments demonstrated degenerated clusters of cells and chondromyxoid matrix. The parotidectomy specimen had features consistent with those of an infarcted PA. Although appears to be rare, spontaneous infarction of PA should be considered in the differential diagnosis, since necrosis may mimic carcinoma and cause misinterpretation of necrosis as an indication of malignancy, in an otherwise benign salivary gland neoplasm.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
10/23. Repeated remissions of Cushing's disease due to recurrent infarctions of an ACTH-producing pituitary macroadenoma.infarction of prolactin-secreting or growth hormone-secreting pituitary adenomas is not unusual. However, infarction of ACTH-secreting adenomas has rarely been reported. Cyclical course of Cushing's syndrome alternating with adrenal insufficiency due to recurrent infarction of an acth-secreting pituitary adenoma has not been reported. We report here a 20-year-old lady who presented with florid signs of Cushing's syndrome but was found to have adrenal insufficiency on biochemical evaluation. magnetic resonance imaging (MRI) of the pituitary gland showed that she had infarction of an ACTH-secreting macroadenoma. Over the next 6 years, her disease ran a cyclical course characterized by periods of hypercortisolism alternating with adrenal insufficiency due to repeated episodes of infarctions of the ACTH-secreting pituitary macroadenoma with corresponding changes in the pituitary adenoma on serial MRIs. The case alerts clinicians to this possibility when a patient presents with clinical picture of Cushing's syndrome but has adrenal insufficiency on biochemical testing. It also suggests that silent or subclinical infarction of pituitary adenomas is not uncommon and is probably under diagnosed.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
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