1/5. Chronological changes in cerebral air embolism that occurred during continuous drainage of infected lung bullae.We present a 43-year-old man with cerebral air embolism that occurred during continuous drainage of infected lung bullae. This complication is extremely rare, and may have been caused by the passage of air into the pulmonary venous circulation through a bronchovenous fistula and/or damaged pulmonary vessels. air densities were demonstrated along the right frontal gyri on a CT performed 1 h after the onset of embolism, then moved to the deep cortex after 2.5 h. Three days later, a cortical infarct accompanied with extensive white matter edema in the right frontal lobe was confirmed by MRI. These CT and MRI findings may indicate the passage of intravascular air from the superficial to the deep cortex and subsequent cerebral infarction.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. Henoch-Schonlein purpura with hemorrhagic bullae in children: report of two cases.Henoch-Schonlein purpura (HSP) is the most common form of acute vasculitis primarily affecting children. Clinical features include skin rashes, arthritis, abdominal pain and nephritis. skin biopsy on immunofluorescence often reveals granular depositions of immunoglobulin a (IgA) and C3 within the walls of the dermal vessels as well as in the connective tissue of the upper dermis. The diversity of skin rashes produces confusion in diagnosis of HSP, especially in the presence of bullous lesions. Bullous lesions are very rare in children with HSP, whereas they often appear in adults with HSP. We report 2 cases of HSP in whom hemorrhagic bullae manifested predominantly. In our report, the skin biopsies of both patients revealed typical leukocytoclastic vasculitis without IgA and complement depositions on direct immunofluorescence studies. Dramatic improvement of clinical symptoms and signs was observed within a few days after corticosteroids were administered. There was neither recurrence nor nephritis in these 2 patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. Pilomatricoma with a bullous appearance.A 15-year-old Japanese girl had an asymptomatic nodule on the right thigh of seven months' duration. The clinical appearance was similar to that of a bulla. There was a history of blunt trauma from dog scratch to the skin over the tumor shortly before tumor growth. Histopathological findings were consistent with pilomatricoma. In the overlying dermis, the collagen bundles were compressed to the tissue surrounding the tumor and the large space was seen. Around the tumor, some dilated endothelium-lined vascular channels were found, which were identified as lymphatic vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. hemoptysis from an emphysematous bulla developing after open-heart surgery: report of a case.We present herein the case of a 62-year-old woman with an emphysematous bulla who developed intractable hemoptysis 16 days after undergoing mitral and aortic valve replacement with tricuspid annuloplasty. A bronchoscopic examination with balloon occlusion of the bronchial lumen revealed that the blood source was the right middle lobe bronchus. A computed tomographic (CT) scan of the chest subsequently demonstrated a blood-filled emphysematous bulla in the right middle lobe. A right middle lobectomy was performed and the bulla was observed to be swollen with clotted blood. The respiratory tract bleeding stopped immediately after the lobectomy. Pathohistological examinations suggested that disruption of the pulmonary vessels in the wall of the bulla had caused the respiratory tract bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/5. Bullous lesions in Kaposi's sarcoma: case report.Bullous lesions have been only rarely described in Kaposi's sarcoma (KS), and their histopathologic features have never been described in detail. We report a case of bullous lesions of KS in an 82-year-old Italian woman. The patient had typical smooth pale reddish-grey slightly-raised KS plaques on the legs, present for at least 10 years. Several dull grayish-pink blisters (0.5 to 2 cm in diameter) affected both dorsa of her feet and ankles symmetrically. Two punch biopsies were taken, one from an infiltrated KS plaque on the right buttock and the other from a bullous lesion on the right foot. Histopathologically, the late KS plaque on the buttock showed typical features of KS, with an increased number of spindle cells arranged in short bundles and extravasation of erythrocytes. The bullous lesion on the foot showed a full-thickness vascular neoplasm involving the upper and lower dermis and the subcutaneous fat. The upper portion of the lesion contained many newly formed, highly-dilated blood vessels, touching the overlying epidermis and separated from it by a narrow band of collagen and endothelial cells; wide, empty spaces characterized the superficial dermis, in which preexisting venules and bands of collagen associated with non-atypical endothelial cells floated. All these findings would suggest a lymphangiomatous lesion, if the presence of specific diagnostic criteria of KS were not recognizable at a deeper level of the lesion. Various criteria actually suggest that the bullous lesion may be regarded as an epiphenomenon of a KS plaque lesion: (a) full-thickness involvement of the reticular dermis and, in this case, also of the subcutaneous fat; (b) dense and patchy lymphoplasmocytic infiltrate typical of plaque lesions and, much less frequently, of patch lesions; (c) presence of ectatic blood vessels, filled with plasma and erythrocytes (pseudoangiomatous findings), a nonpathognomonic but highly characteristic finding of the plaque lesion; and (d) as in the KS plaque lesions, in the bullous lesion as well the reticular dermis was characterized by an increased number of anastomosing bizarrely shaped vascular spaces lined by non-atypical endothelial cells. We hypothesize that the prevalence of lymphangiomatous differentiation in the upper dermis represents one of the many features of KS lesions. When present, it may correlate with the clinical feature of a blister.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |