1/9. Unusual presentation of polyarteritis nodosa.We describe an unusual presentation of a localized form of polyarteritis nodosa (PAN) manifested by acute onset of severe calf pain. Biopsies of the gastrocnemius muscle and fascia revealed an acute necrotizing arteritis with fasciitis. The lumens of affected vessels were occluded by thrombi. PAN localized to calf muscles is extremely rare. To our knowledge this is the first report of evidence of fascial involvement believed to contribute to the severity of the clinical features of PAN. The occurrence of multiple intraluminal thrombi in conjunction with anticardiolipin antibodies suggested the possibility of a coexisting coagulopathy, and they were also likely contributors to the severity of the pain.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. aluminum phagocytosis in quadriceps muscle following vaccination in children: relationship to macrophagic myofasciitis.Macrophagic myofasciitis (MMF) is a rare, seemingly emerging entity among adult patients in france. We encountered two children with the first two cases of MMF in north america. A 5-year-old male with chronic intestinal pseudo-obstruction required nighttime parenteral nutrition. Abnormal pupillary reflexes and urinary retention suggested a diffuse dysautonomia, which prompted a neurological diagnostic work-up. A 3-year-old child had developmental delay and hypotonia. Both children received age-appropriate immunizations. quadriceps muscle biopsy from each child showed the typical patchy, cohesive centripetal infiltration of alpha-1-antitrypsin , alpha-1-antichymotrypsin , CD68 , PAS , CD1a-, S-100-, factor xiii- granular macrophages with adjacent myofiber atrophy, dilated blood vessels, and mild endomysial and perimysial fibrosis. No myonecrosis was observed and no discrete granulomas were seen. A single aluminum peak was demonstrated on energy dispersive X-ray microanalysis. The etiology of the clinical symptoms in these cases and in cases reported as MMF remains intriguing. Despite numerous stains to demonstrate organisms, most infectious causes leading to macrophage activation were ruled out. These cases are being reported to increase awareness of this condition and to encourage a systematic epidemiologic and clinicopathologic study in north america.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. Ischemic fasciitis: an unusual vulvovaginal spindle cell lesion.Ischemic fasciitis is a benign reactive lesion that most commonly occurs in elderly, immobile patients in weight-bearing areas that are subject to intermittent ischemia with subsequent tissue breakdown and regenerative changes. The lesion can be clinically and pathologically mistaken for malignancy. Here we describe the first reported case of ischemic fasciitis of the vulvovaginal region in a 20-year-old paraplegic woman who presented with a clinically suspicious vulvar swelling. Histologic examination showed surface ulceration and underlying fibrinoid necrosis with surrounding reactive atypical fibroblast-like cells and small blood vessels, the characteristic histologic features of ischemic fasciitis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Free ascending scapular flap.Four patients with free tissue transfer using ascending cutaneous branches of circumflex scapular vessels are herein presented. The free ascending scapular flap is located on the superior vertical axis, differentiated with the scapular flap horizontally and the parascapular flap vertically designed. The flap is an excellent choice because of easy dissection, a constant artery and venous system, 2- to 3-mm-diameter vessels, and sufficient length of the vascular pedicle. All flaps survived completely with a fairly thin skin. The shoulder donor site could be closed primarily. No functional deficit of the shoulder was observed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/9. debridement of periumbilical necrotizing fasciitis: importance of excision of the umbilical vessels and urachal remnant.The operation of a neonate with periumbilical necrotizing fasciitis consisted of (1) excision of infected skin, fat, and fascia (including the umbilicus); (2) a limited laparotomy, with ligation and excision of the umbilical vessels and urachal remnant; and (3) placement of a temporary silastic patch over the central abdominal defect. Pathological sections confirmed the spread of infection along the vessels and urachal remnant. Excision of the vessels and urachal remnant may be crucial to survival from periumbilical necrotizing fasciitis.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
6/9. The syndrome of palmar fibromatosis (fasciitis) and polyarthritis.A 45-year-old woman developed simultaneously a form of palmar and digital fibromatosis and an unusual polyarticular disorder with painful capsular contraction. The features of the bilateral shoulder involvement were consistent with the adhesive capsulitis/frozen shoulder syndrome. The other affected joints were painfully contracted and tender but without signs of inflammation in synovial fluid (knee) or associated abnormalities in hematologic status. Histologically, there was extensive fibrosis with increased numbers of fibroblasts, dilated blood vessels and scant perivascular lymphocytic infiltration. The clinical and pathological features were similar to cases described as palmar fasciitis and polyarthritis occurring in association with malignant tumors and with antituberculous chemotherapy. Several months after removal of an endometrial cyst of the ovary and after symptomatic treatment, the palmar fibromatosis and polyarticular disorder had almost completely resolved.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/9. Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli.Four patterns of tissue involvement can be distinguished in sepsis due to gram-negative enteric bacilli. When intense local inflammation predominates, cellulitis or thrombophlebitis results, often with venous or arterial obstruction. bacteria are present in the affected tissues, but not in sufficient numbers to be seen microscopically. When bacterial proliferation is unchecked by an appropriate leukocyte response, ecthyma gangrenosum, erythema multiforme, or diffuse bullous lesions may occur with minimal clinical or histologic signs of inflammation. In symmetric peripheral gangrene associated with disseminated intravascular coagulation, bland fibrinous deposits are seen in small vessels but neither inflammatory cells nor bacteria are present. The fourth kind of lesion is that seen in bacterial endocarditis. In all four patterns a vascular component is prominent clinically and histologically. The pathogenesis of these lesions is multifactorial; in each individual case the interaction between bacterial and host factors probably determines which clinical picture will result. The appearance of symmetric soft tissue lesions of the extremities in the absence of predisposing local conditions suggests the possibility of sepsis due to gram-negative bacilli, especially if other clinical features indicate that sepsis might be present.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Nodular fasciitis (pseudosarcomatous fasciitis) of the vulva.Nodular fasciitis (pseudosarcomatous fasciitis) is a benign nonneoplastic connective tissue proliferation of unknown pathogenesis, which most commonly involves the upper limb subcutaneous fascia. Nodular fasciitis of the vulva is an entity rarely encountered by gynecologists or pathologists, but has considerable potential for misdiagnosis as sarcoma and for inappropriate treatment. The patient, a 32-year-old black female, presented with a 3-cm right labial mass, which was nodular, rubbery, and yellowish-white on section. Microscopically, there was an admixture of large mesenchymal cells, small blood vessels, and lymphocytes in a sparsely collagenous matrix. Other features included extravasated erythrocytes, intercellular clefts, and pseudocysts. Although mitoses were common (8 per 10 high power fields), there were no atypical mitoses and no bizarre tumor giant cells. The large mesenchymal cells were identified by electron microscopy as myofibroblasts, cells which abound in a variety of other reactive and non-neoplastic conditions. It is important not to misdiagnose nodular fasciitis as a vulvar sarcoma, because nodular fasciitis requires only simple excision and does not recur or metastasize.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. Woody hands in a patient with pancreatic carcinoma: a variant of cancer-associated fasciitis--panniculitis syndrome.We report an elderly woman with rapidly progressive painless, woody induration of the hands. Mild diabetes mellitus was demonstrated. skin biopsy features included broad fibrous bands extending deeply into subcutaneous fat, a mild mononuclear cell infiltrate, and post-thrombotic recanalization of a deep vessel in one specimen. The patient developed uncontrolled haematemesis and was demonstrated at laparotomy to have disseminated pancreatic carcinoma. The unusual clinical features and temporal relationship between the skin changes and the tumour suggest a paraneoplastic eruption. Which appears best classified as an example of cancer-associated fasciitis-panniculitis syndrome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |