1/22. Necrobiotic palisading granuloma at injection site of disodium clodronate: A case report.The authors describe an adverse localized cutaneous reaction caused by the injection of disodium clodronate, histologically presenting as a necrobiotic palisading granuloma. This lesion is considered as an immunological type of granuloma that can be caused by various chemical or physical stimuli. Disodium clodronate should be included among the medicaments that can trigger this infrequent type of tissue reaction.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/22. sarcoidosis presenting as an intramedullary spinal cord lesion.OBJECTIVES: sarcoidosis affects the spinal cord in only 0.43% of patients with sarcoidosis. Usually there is systemic involvement prior to the development of cord lesions. We present a case of sarcoid isolated to the intramedullary spinal cord, which was a diagnostic and therapeutic challenge. We review the case and then present a review of the literature with an emphasis on presentation, diagnosis and treatment. methods: We have reviewed a patient who presented with an isolated sarcoid granuloma affecting the cervical spinal cord. All pertinent history and physical information was extracted from the patient's chart and through patient interview. Laboratory, radiographic and pathological investigations are presented. RESULTS AND CONCLUSIONS: Fourteen patients have been reported with isolated intramedullary spinal cord sarcoidosis. Current practice supports the role of surgery for biopsy; mainstay of treatment is corticosteroids.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/22. Recurrent Wegener's granulomatosis with subglottic granulation.While following the course of patients with Wegener's granulomatosis (WG) in which it had been possible to achieve a remission, we encountered a patient in whom we observed granuloma formation in the subglottis. A tracheotomy was performed because of the risk of respiratory distress, and after that there was a recrudescence of the patient's WG. During the course of the above, the patient remained cANCA (anti-neutrophil cytoplasmis antibody with cytoplasmic pattern)-negative. When these facts were considered, it appeared that when the lesions are localized and progressing gradually, cANCA positivity does not develop. While cANCA test has gradually become a powerful tool for the diagnosis of WG, a comprehensive physical examination to identify localized lesions, together with biopsy and histopathological examination, should allow the diagnosis of WG.- - - - - - - - - - ranking = 10.08457972574keywords = physical examination, physical (Clic here for more details about this article) |
4/22. Granulomatous lymphangitis of the scrotum and penis. Report of a case and review of the literature of genital swelling with sarcoidal granulomatous inflammation.BACKGROUND: Acquired lymphedema of the genitalia is a rare childhood presentation and is more common in elderly individuals secondary to pelvic/abdomenal malignancy or its therapy or worldwide due to filariasis. OBJECTIVE: Herein, we report a case of a healthy 11-year-old boy who presented with a 1-year history of chronic, asymptomatic scrotal and penile swelling. biopsy revealed edema, lymphangiectases and peri- and intralymphatic sarcoidal type granulomas. This histologic pattern of granulomatous lymphangitis is most commonly associated with orofacial granulomatosis (granulomatous cheilitis and melkersson-rosenthal syndrome) and Crohn's disease. Treatment with topical steroids and physical support has resulted in marked improvement. No systemic disease (Crohn's disease) is evident 1 year later. literature review revealed 44 cases of genital lymphedema with non-infectious granulomas. The majority of these young patients had Crohn's disease, frequently with anal involvement and a minority, both with and without Crohn's disease, had orofacial granulomatosis. CONCLUSIONS: Granulomatous lymphangitis should be considered in the differential diagnosis of chronic idiopathic swelling of the genitalia, particularly in younger individuals. Further clinical examination, additional laboratory studies and close follow-up for co-existing or subsequent development of Crohn's disease should be performed. The overlap between granulomatous lymphangitis of the genitalia, Crohn's disease and orofacial granulomatosis suggest that granulomatous lymphangitis of the genitalia may represent a forme fruste of Crohn's disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/22. Sclerosing lipogranuloma of the testis.Sclerosing lipogranuloma is an uncommon, benign condition that can affect several organs, particularly of the genitourinary system in males. We describe a patient who presented with an intratesticular mass on physical examination. Pathologic evaluation confirmed the diagnosis of testicular sclerosing lipogranuloma. Most case reports involve self-injection with a foreign substance that is pathognomonic. Treatment is often conservative after establishing the diagnosis.- - - - - - - - - - ranking = 10.08457972574keywords = physical examination, physical (Clic here for more details about this article) |
6/22. Penile paraffinoma: self-injection with mineral oil.We present a 64-year-old patient with a 9-cm firm, irregular penile mass associated with phimosis, erectile dysfunction, and voiding difficulty. After he reluctantly admitted to multiple penile mineral oil self-injections for enlargement, surgical excision was performed. Pathologic examination was consistent with mineral oil granuloma (paraffinoma). Within several weeks after surgery, his erectile dysfunction and voiding complaints resolved. Paraffinomas have been encountered with the use of various oily substances injected for cosmetic purposes. Despite early warnings, these agents continued to be used to treat conditions ranging from hemorrhoids to wrinkles and even baldness. Fortunately, most of these fads have been abandoned by medical professionals, but the complicating lesions have been documented as having lag times as long as 30 years. Complete surgical excision remains the treatment of choice to prevent recurrence. Increased public awareness is needed for the prevention of this physically and psychologically debilitating problem.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/22. Sarcoid granulomatous nephritis occurring as isolated renal failure.A woman had clinically isolated renal failure caused by granulomatous sarcoid nephritis. At the onset of her illness, there were no historical, physical, or clinical features to suggest a definite causative diagnosis. After a renal biopsy specimen disclosed noncaseating epithelioid granulomas, a course of steroid therapy resulted in prompt disappearance of uremic symptoms and amelioration of her renal failure. Although leukopenia, delayed cellular immunity, and the response to steroids increased the suspicion that the patient had sarcoidosis, it was not until identical granulomas were obtained via mediastinal node biopsy that the diagnosis was confirmed. sarcoidosis may occur as isolated renal failure. Renal biopsy is indicated to ensure early diagnosis and prompt treatment of this steroid-responsive lesions.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/22. Resolution of orofacial granulomatosis with amalgam removal.A 61-year-old woman presented with a 2-year history of an abnormal erythematous swelling on the upper lip and cheek. Upon examination there were no other physical findings. Histological examination found discreet sarcoidal granulomas in the lower dermis. Routine laboratory studies, chest radiographs and pulmonary functions were all normal. Clinical presentation and histological findings were, therefore, compatible with the diagnosis of orofacial granulomatosis (OFG). The patient was patch tested with an extended standard series that included metal-salt, dental prosthesis, bakery and corticosteroids series. The patch test was positive (score ) after 48 and 72 h for mercury in the metal-salt and dental prosthesis series. During the past decade the patient had received amalgam fillings of several dental cavities, including one adjacent to the swollen cheek. The unilateral localization of the soft tissue swelling adjacent to the amalgam tooth fillings, along with the positive patch test for mercury, raised the possibility that the OFG was part of a delayed hypersensitive reaction to the fillings. The patient therefore underwent a total amalgam replacement procedure; complete disappearance of the swelling overlying the right cheek was observed within 7 weeks and the swelling of the upper lip subsided completely within 6 months. We propose that mercury in amalgam tooth fillings is another cause of OFG and suggest appropriate patch testing in patients who do not have an apparent cause of OFG.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/22. Blau syndrome: a new kindred.Blau syndrome is a rare condition typically defined by granulomatous arthritis, skin eruption, and uveitis occurring in the absence of lung or other visceral involvement. Other characteristic physical findings include synovial cysts and camptodactyly. We describe a new kindred demonstrating autosomal dominant inheritance and anticipation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/22. Ocular sarcoidosis presenting as a solitary choroidal mass.Ocular sarcoidosis presenting as a solitary choroidal mass without other signs of intraocular inflammation is a rare manifestation of systemic sarcoidosis. The authors describe a 26-year-old man who presented with a solitary choroidal tumour. Ocular and general physical examination as well as serum chemistry studies and pathological examination of a lymph node biopsy specimen confirmed sarcoidosis as the cause of the mass. Treatment with systemic steroids resulted in improvement in the appearance of the lesion; however, the visual acuity remained impaired. Other such cases reported in the literature are reviewed.- - - - - - - - - - ranking = 10.08457972574keywords = physical examination, physical (Clic here for more details about this article) |
| | Next -> |