1/88. fever of unknown origin due to inflammatory pseudotumour of lymph nodes.The clinical features of inflammatory pseudotumour of lymph nodes, a distinct non-malignant histopathological entity firstly described in 1988, are summarized based upon a detailed analysis of 4 personal cases and 47 cases reported in the literature. The mean age of the patients is 38 years (range 8 to 82 years) and there is no gender predilection. One third present with asymptomatic lymphadenopathy and 47% present with fever, nearly all meeting the criteria of fever of unknown origin. Abdominal complaints are occasionally present. Intermittence of symptoms is common. Hepatosplenomegaly is unusual. All lymph node areas may be involved but abnormalities are mostly confined to one or two anatomic regions. No extranodal involvement has been reported although inflammatory pseudotumour may occur in several organs with similar morphological features and identical signs of inflammations. Routine blood tests are normal except for signs of inflammation. The lesions are gallium-avid. diagnosis is based upon typical histopathological features. The prognosis is favorable and surgical resection frequently leads to cure. Spontaneous resolution of symptoms has been reported and nonsteroidal anti-inflammatory drugs may suppress the clinical manifestations.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/88. granuloma inguinale (donovanosis) presenting as a neck mass in an infant.A case of granuloma inguinale (GI) presenting as a lateral neck mass in a 4-month-old, hiv-positive infant is described. The histological features of the mass were typical of GI, with numerous macrophages containing intracellular organisms with a "closed-safety-pin" appearance. This is a rare occurrence, and the mode of transmission of infection is discussed. An awareness of GI in infants by both clinicians and pathologists is important to prevent morbidity and allow for prompt institution of appropriate treatment.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
3/88. Primary amyloidosis presenting as massive cervical lymphadenopathy with severe dyspnea: a case report and review of the literature.amyloidosis is an end point of several diseases in which the unifying characteristic is the association and extracellular deposition of the insoluble protein fibrils within various tissues and organs. We have discussed a variety of clinical findings of primary amyloidosis with emphasis on its otolaryngologic manifestations. This case represents the second report in the literature of a neck mass resulting from a plasma cell dyscrasia and the first report of AL disease producing such extensive cervical lymphadenopathy as to cause significant respiratory compromise.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/88. Respiratory failure as a complication of pharyngitis: Lemierre's syndrome.The emergence of drug-resistant organisms has promoted increased calls for judicious use of antibiotics in cases of pediatric pharyngitis. Although these recommendations are largely justified, the case of a 16-year-old girl with pharyngitis is reported to alert readers to an unusual complication, Lemierre's syndrome. This complication of pharyngitis and its relevance to changing practice habits are discussed.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
5/88. colitis may be part of the antiepileptic drug hypersensitivity syndrome.PURPOSE: To show that colitis may be part of the antiepileptic hypersensitivity syndrome. methods: Description of two case histories. RESULTS: The first patient was a 47-year-old man who developed fever, lymphadenopathy, influenza-like symptoms, facial edema, skin rash and diarrhea after 3 weeks of carbamazepine (CBZ) treatment. laparotomy because of severe abdominal pain 2 weeks later showed severe colitis with perforations. The second patient was a 41-year-old woman who developed fever, diarrhea, and skin rash 4 weeks after start of CBZ treatment. A colon biopsy confirmed colitis. Stool examinations did not show pathogenic microorganisms, and there was no evidence of Crohn's disease or ulcerative colitis. Both patients had elevated liver enzymes, peripheral eosinophilia, and eosinophils in the infiltrate of the colon. CONCLUSIONS: In view of the close temporal relation between start of CBZ intake and development of colitis, the presence of fever, lymphadenopathy, and rash, and improvement after discontinuation of CBZ, we conclude that the two patients developed an AED hypersensitivity syndrome. Our case histories demonstrate that severe colitis may be part of this syndrome.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
6/88. Fine needle aspiration cytology in systemic lupus erythematosus lymphadenopathy. A case report.BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology characterized by inflammation in various organ systems, including lymph nodes, due to the production of antinuclear antibodies. The onset of disease is between ages 13 and 40 years, with a female preponderance. CASE: A 30-year-old female presented with right cervical lymphadenopathy and gave a history of intermittent fever and swollen joints of 2.5 years' duration. The patient was on intermittent corticosteroids. With a suggestion of tuberculous lymphadenitis, the patient underwent fine needle aspiration (FNA). The diagnosis of lupus adenopathy was established by FNA of enlarged right cervical lymph nodes. Smears showed predominantly typical and atypical immunoblasts, plasma cells, occasional Reed-Sternberg-like cells and dispersed hematoxylin bodies. Smears were negative for acid-fast bacilli. CONCLUSION: When SLE patients develop lymphadenopathy, FNA cytology helps differentiate lupus adenopathy from infectious conditions, such as tuberculous adenitis, and from Kikuchi's lymphadenitis.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/88. actinomyces and actinobacillus actinomycetemcomitans-actinomyces-associated lymphadenopathy mimicking lymphoma.We present 2 unusual cases of long-standing, extensive reactive lymphadenopathy secondary to actinomyces infection, 1 of which was also accompanied by actinobacillus actinomycetemcomitans-actinomyces complex infection. To our knowledge, histologic features of lymph node involvement by these organisms have not been previously reported in the literature. One patient had extensive cervical, posterior mediastinal, and abdominal lymphadenopathy. The second patient presented with a submandibular mass and cervical lymphadenopathy. Clinical features strongly suggested lymphoma. The histologic examination of the lymph nodes from both patients revealed reactive follicular hyperplasia, marked interfollicular and capsular fibrosis, and multiple interfollicular microabscesses. Characteristic actinomyces colonies were identified at the center of the microabscesses in deep sections. Cultures were obtained from the lymph nodes of 1 patient, and were positive for A actinomycetemcomitans. Both patients had poor dental hygiene. Lymphadenopathy subsided with antibiotic therapy and appropriate dental care.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
8/88. Intestinal inflammatory pseudotumour with regional lymph node involvement: identification of a new bacterium as the aetiological agent.Inflammatory pseudotumours are the morphological expression of diverse processes such as reactive/reparative, infective, and neoplastic. This paper reports an example of intestinal inflammatory pseudotumour, with identification of a newly characterized bacterium in the lesion. The patient presented with intestinal obstruction. laparotomy revealed a tumour in the terminal ileum causing stricture, and multiple enlarged regional lymph nodes. Histologically, the tumour and lymph nodes were composed of plump spindle cells disposed in a vague storiform pattern, and associated with lymphocytes and plasma cells. Immunohistochemical studies showed that most of the spindle cells were histiocytes (CD68 positive), prompting a search for a bacterial aetiology, akin to mycobacterial spindle cell pseudotumour. All histochemical stains for micro-organisms were unrewarding. Ultrastructural studies, however, revealed abundant bacteria within the spindle histiocytes. polymerase chain reaction, using conserved oligonucleotide primers complementary to the 16S rRNA genes of eubacteria, was employed to amplify 16S rRNA gene fragments directly from the involved lymph node tissue. Phylogenetic analysis of the amplified dna sequences revealed an organism with 99% sequence conformity to pseudomonas veronii, a bacterium which has hitherto not been implicated in human infection. The importance of searching for an infective agent in inflammatory pseudotumour in the appropriate setting is re-emphasized.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
9/88. prevalence of American trypanosomiasis (chagas disease) among dogs in oklahoma.OBJECTIVE: To determine the prevalence of trypanosoma cruzi infection among dogs in oklahoma. DESIGN: Cross-sectional study. animals: 301 owned or impounded dogs related by ownership or general geographic location to 3 dogs determined to have trypanosomiasis. PROCEDURES: blood samples were obtained from dogs between November 1996 and September 1997. infection status was determined by use of a radioimmunoprecipitation assay. Second blood samples were obtained from some of the seropositive dogs for study by hemoculture and polymerase chain reaction (PCR) assay. Sites where infected dogs were found were inspected for triatomine insects, and light traps were used for vector trapping. RESULTS: 11(3.6%) dogs were seropositive for T. cruzi infection. Ten of the 11 were owned rural hunting dogs. Protozoal organisms isolated from the blood of 1 seropositive dog were identified as T. cruzi by PCR testing. Only 1 adult triatoma sanguisuga was captured in a light trap at a site near infected dogs; this insect was not infected. CONCLUSIONS AND CLINICAL RELEVANCE: Our findings suggest that T. cruzi is enzootic in eastern oklahoma. Measures that would reduce the risk of dogs acquiring T. cruzi infection are unlikely to be acceptable to their owners, and no effective drugs are available for treatment. The presence of T. cruzi-infected dogs poses a threat of transmission to persons at risk of exposure to contaminated blood veterinarians who practice in the southern united states should be cognizant of this blood borne zoonosis and educate all personnel about appropriate precautions.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
10/88. Langerhans cell histiocytosis infiltration in cerebrospinal fluid: a case report.Langerhans cell histiocytosis (LCH) is a disease of unknown etiology characterized by a proliferation of histiocytic cells resembling the integumentary cells bearing the name of langerhans cells. LCH can be unifocal or multifocal, with one- or many-organ involvement. We present a case of LCH diagnosed in the cerebrospinal fluid of a patient with generalized lymphadenopathy and central nervous system involvement.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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