1/4. Orbital lymphoma misdiagnosed as Graves' ophthalmopathy.OBJECTIVE: To describe a case of bilateral orbital lymphoma mistakenly diagnosed as Graves' ophthalmopathy. methods: We present a case report, with laboratory data and photographic documentation, and discuss the differential diagnosis in patients with orbital masses. RESULTS: A 65-year-old man with bilateral exophthalmos and substantial weight loss was referred to the Endocrine Clinic for evaluation of possible Graves' disease. A 6-cm mass was detected in the left axilla. biopsy of this mass revealed the histopathologic diagnosis of anaplastic B-cell lymphoma. Treatment with intrathecally administered methotrexate and orally administered dexamethasone promptly resulted in decreased proptosis. CONCLUSION: The most frequent cause of bilateral proptosis is Graves' ophthalmopathy, and when it is associated with weight loss in an elderly patient, the initial diagnostic consideration is thyrotoxic Graves' disease. This case should remind physicians that bilateral orbital lymphoma, although uncommon, may mimic Graves' ophthalmopathy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Non-hodgkin disease in beta-thalassemia major.Thalassemia is a spectrum of diseases characterized by the decrease or absence of globin chains. The occurrence of lymphoma in thalassemia has rarely been reported, and our review of the English literature revealed only four cases. Because anemia is always masked by regular transfusions in thalassemic patients, physicians discover a hidden malignancy late in the course of the disease. We hereby report the case of a thalassemic patient developing non-hodgkin disease and discuss the possibility of a link between the two disease entities. This case is intended to alert physicians of the possibility of a malignancy in thalassemia patients.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
3/4. Human immunodeficiency virus--associated non-Hodgkin's lymphoma presenting as an auricular perichondritis.AIDS-related NHL is an aggressive neoplasm, usually of high or intermediate grade, frequently extranodal at initial treatment, and often the first manifestation of AIDS. Although complete remissions have been reported, they occur in only a minority of patients. We describe a patient with NHL of the external ear that masqueraded as an auricular perichondritis. This is the first case reported in which AIDS-related NHL first appeared in the ear, and this should alert physicians who treat patient with AIDS to be aware of the protean manifestations of this disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Long-term lumboureteral shunt removed secondary to iatrogenic meningitis.With the advent of ventriculoperitoneal cerebrospinal fluid shunts for communicating hydrocephalus, rarely does the physician see patients with alternate types of shunting devices. The once popularized lumboureteral shunt is unique for its potential complications of dehydration, electrolyte imbalances, infection, and the sacrifice of a functioning kidney. This article presents the case of a woman with a longstanding lumboureteral shunt that was removed after the onset of iatrogenic meningitis secondary to an ascending urinary tract infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |