1/1251. Systemic infection with Alaria americana (trematoda).Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
2/1251. Bilateral fat necrosis of the scrotum.The typical patient with fat necrosis of the scrotum is a prepuberal heavy set male subject who has extratesticular scrotal masses, usually bilateral, with mild to moderate pain but no systemic complaints or symptons related to voiding. The masses are firm, tender and do not transmit light. With a firm diagnosis expectant treatment will allow spontaneous resolution of the lesions. If doubt exists appropriate surgical intervention is advocated. Hypothermic injury, such as swimming in frigid water, is the most probable etiologic agent.- - - - - - - - - - ranking = 0.75711895920483keywords = rate (Clic here for more details about this article) |
3/1251. Hurthle cell carcinoma of the thyroid gland with extensive tumor necrosis: a case report.Hurthle cell neoplasm of the thyroid gland is rarely associated with tumor necrosis. We report a case of Hurthle cell carcinoma of the thyroid gland with extensive necrosis. An 82-year-old man had had a right neck mass for more than 10 years. Approximately two to three weeks before he was hospitalized, this neck mass became progressively enlarged. An 131I scan could not demonstrate the right lobe of the thyroid gland, while the contralateral lobe was unremarkable. A 99mTc-sestamibi scan showed increased uptake on the lesion side. Fine needle aspiration cytology showed necrosis with macrophages in the initial aspirate, and the secondary aspirate appeared suspicious for a Hurthle cell tumor. The patient had a total thyroidectomy, and the pathology proved to be Hurthle cell carcinoma with tumor necrosis.- - - - - - - - - - ranking = 1.1356784388072keywords = rate (Clic here for more details about this article) |
4/1251. Acute corneal necrosis after excimer laser keratectomy for hyperopia.OBJECTIVE: To describe a new, rare clinical complication after routine excimer laser photorefractive keratectomy to correct hyperopia. DESIGN: Case report with clinicopathologic correlation. MAIN OUTCOME MEASURES: Four weeks after treatment with excimer laser, a perforating keratoplasty was performed for persistent corneal opacities. The corneal button was examined using light and electron microscopy. Special immunohistochemical stains were used to detect apoptosis. RESULTS: The patient developed corneal opacities, endothelial precipitates, and a fibrinous exudate in the anterior chamber after the laser treatment. The changes did not respond to therapy directed against bacteria, fungi, and acanthamoeba. All examinations and special stains were negative for micro-organisms. By light microscopy, an anterior zone of corneal necrosis was present with a moderate amount of acute inflammatory cells. At the interface between necrotic and viable corneal stroma, keratocytes with typical features of apoptosis were detected by immunohistochemistry and electron microscopy. CONCLUSION: This is the first full histopathologic report of a case of acute corneal necrosis with signs of apoptosis after excimer laser therapy of the cornea. Surgeons should be aware of this rare but potentially severe complication.- - - - - - - - - - ranking = 2.2713568776145keywords = rate (Clic here for more details about this article) |
5/1251. Descending necrotizing mediastinitis caused by odontogenic infections.Intrathoracic dissemination of an odontogenic infection is very infrequent. The resulting clinical manifestation, known as descending necrotizing mediastinitis, causes high mortality. Due to the absence of early clinical or radiological signs, diagnosis is usually made only when the process is completely established. Treatment is a combination of intravenous antibiotics and mediastinal drainage, via either a cervical or a transthoracic approach. We report the clinical and microbiological characteristics of 4 patients with descending necrotizing mediastinitis, and their clinical course over a period of 10 years.- - - - - - - - - - ranking = 6.6667345959298keywords = mortality (Clic here for more details about this article) |
6/1251. Sickle cell-like crisis and bone marrow necrosis associated with parvovirus B19 infection and heterozygosity for haemoglobins S and E.In the literature, heterozygosity for haemoglobins S and E is known as a clinically benign condition. Nevertheless, we present a case of double heterozygosity manifesting as an infarctive sickle cell-like crisis with acute chest syndrome and reversible bone marrow necrosis. Importantly, these complications were associated with serologically documented parvovirus B19 infection. Reviewing the literature, this case emphasizes a specific role of parvovirus B19 as a precipitating cause. Furthermore, it demonstrates how important the consideration of haemoglobin disorders can be even outside of the historically known areas.- - - - - - - - - - ranking = 0.37855947960241keywords = rate (Clic here for more details about this article) |
7/1251. bone marrow metastases in disseminated alveolar rhabdomyosarcoma: case report with ultrastructural study and review.A case of desseminated alveolar rhabdomyosarcoma in an 18-year-old male with leuco-erythroblastic anaemia is described. Numerous bizarre malignant cells, including frequent multinucleated giant cells, were seen in bone marrow aspirates, and osteolytic lesions appeared late in the clinical course. The primary site of the neoplasm remained undertermined during life and also at necropsy, which revealed minute pulmonary metastases and extensive lymph nodal, pleural and skeletal deposits. The diagnosis was confirmed on necropsy tissue by ultrastructural examination which demonstrated numerous thin (5 nm) and thick (15 nm) intracytoplasmic filaments in tumour cells, sometimes organized in bundles; scattered dense Z-band-like bodies, and rod-shaped structures were also seen. The fine structure of the rhabdomyosarcoma in the present case is compared with previous ultrastructural studies. Elongated, thick intracytoplasmic filaments whose diameter corresponds to that of myosin myofilaments are strong evidence for rhabdomyoblastic differentiation and are considered to be the sine qua non of a positive electron microscopic diagnosis of rhabdomyosarcoma. Orgaized bundles of filaments and Z-band-like dense bodies are usually present, and rod-shaped structures are found infrequently, but none of these are necessary for the ultrastructural diagnosis.- - - - - - - - - - ranking = 0.75711895920483keywords = rate (Clic here for more details about this article) |
8/1251. Utility of immunophenotypic and immunogenotypic analysis in the study of necrotic lymph nodes.We report a case of complete lymph node necrosis. No specific aetiology could be determined by morphology, but a B lymphoid population and clonal rearrangement of the immunoglobulin heavy chain gene were demonstrated in immunophenotypic and immunogenotypic studies performed using dna extracted from paraffin embedded necrotic tissue. In the setting of lymph node necrosis, we suggest that immunohistochemical and gene rearrangement studies may provide additional diagnostic information.- - - - - - - - - - ranking = 0.37855947960241keywords = rate (Clic here for more details about this article) |
9/1251. Cutaneous necrosis as a terminal paraneoplastic thromboembolic event in a patient with non-Hodgkin's lymphoma.Thrombotic complications in non-Hodgkin's lymphoma often originate in the large veins. We describe a patient with refractory advanced high-grade lymphoma who presented with the rare complication of extensive cutaneous necrosis due to thrombosis of dermal vessels; there was also a recent new peak of monoclonal IgM-kappa protein. Direct immunofluorescence demonstrated immune deposits with complement in the dermal vessel wall. Based on these observations and on published data, we suggest that these complexes were the trigger for the thrombotic events and that the monoclonal IgM acted as xenoreactive antibodies, initiating a cascade of events. The first step of this cascade was activation of the complement and the membrane attack complex, which caused secretion of IL-1 alpha by endothelial cells, followed by overexpression of tissue factor on the surface of the dermal vessel wall endothelium. Dermal vessel thrombosis was the final event in this cascade.- - - - - - - - - - ranking = 0.37855947960241keywords = rate (Clic here for more details about this article) |
10/1251. diagnosis and physiopathology of laryngeal deposits in autoimmune disease.We report the clinical features and pathology of a previously unreported form of vocal fold disease seen in 4 patients, 3 of whom were diagnosed as autoimmune disease. The characteristic features of these lesions were found as bilateral transverse lesions in the mid portion of the vocal folds. The patients had dysphonia and diplophonia. Stroboscopic examinations showed 180-degree phase shifts between the anterior and posterior portion of the vocal folds. Case 1 had systemic lupus erythematosus, case 2 had Hashimoto's thyroiditis, and case 3 had progressive systemic sclerosis. Prior to the onset of hoarseness, autoimmune antibody titers were increased. These cases need differential diagnosis from vocal fold nodules and cysts. Two cases were recurrent after endoscopic surgery, 1 recurring 3 times. Glucocorticoid was effective in preventing the recurrence in the early phase. recurrence may have occurred because the surgical strategy was the same as that used for vocal fold nodules or cysts.- - - - - - - - - - ranking = 0.37855947960241keywords = rate (Clic here for more details about this article) |
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