1/7. Hamartomatous endocervical polyp with heterologous mesenchymal tissue.We present an endocervical polyp with heterologous elements. Although a few neoplastic cervical lesions with cartilaginous and adipocytic heterologous tissue have been reported, an endocervical polyp with heterologous cartilage and adipose tissue has not been reported before our case. The patient was a 33-year-old woman who presented with abnormal uterine bleeding. On physical examination, there were no remarkable findings other than a cervical polyp protruding into the cervical canal. The polyp was removed. Pathological examination revealed an endocervical polyp with typical epithelial features. The stroma of the polyp contained mature cartilage islands and adipose tissue. There were also many thick-walled vascular structures. Neither stromal periglandular condensation nor atypia was found. Mitotic figures were not observed. Arteriolar structures did not contain internal elastic lamina. In our opinion, these pathological findings are all consistent with a hamartomatous lesion rather than with a true neoplasm.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/7. Fibroepithelial polyp of glans penis.A case of fibroepithelial polyp of the penis in a 59-year-old man is presented. The physical examination showed that the lesion affected the ventral surface of the glans, near the urethral meatus. No communication was found with the urethra. The patient had a history of long-term condom catheter use. He was successfully treated by wide local excision. The histopathologic diagnosis was a fibroepithelial polyp. Postoperatively, the follow-up examinations at 3, 6, 12, and 24 months showed normal findings and no recurrence.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/7. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging.We report a case of hairy polyp of the pharynx diagnosed on brain MRI in order to stress the need to examine carefully all tissues included on an imaging study, even those outside the clinically stated region of interest, and to remind practitioners to consider unusual as well as common etiologies for neonatal respiratory distress. Our case is unique in that thorough examination of a brain MRI, ordered in the evaluation of presumed central apnea, led to the correct diagnosis.- - - - - - - - - - ranking = 4keywords = physical examination, physical (Clic here for more details about this article) |
4/7. Colonic metaplasia with colonic-type polyps on an ileostomy stoma in polyposis coli. Report of a case.A unique case is reported in which chronic physical and chemical irritation of an ileostomy stoma (after proctocolectomy for polyposis coli) was associated with colonic metaplasia and formation of colonic-type tubular adenomas on the external surface of the ileostomy. The remainder of the terminal ileum and the upper gastrointestinal tract were normal, with no evidence of Gardner's syndrome. This case demonstrates that even metaplastic colonic epithelium is susceptible to the formation of adenomas in polyposis coli patients.- - - - - - - - - - ranking = 0.057470739061914keywords = physical (Clic here for more details about this article) |
5/7. Silence as resistance to medical intervention.A group of 47 individuals initially silent about their physical symptoms and/or dysfunction were studied after they finally had come to medical attention. They were then interviewed, using the associative anamnesis technique, to evaluate the psychologic aspects of their silence. It was found to be a key element in the defensive complex directed against intense neurotic feelings activated by the patient's current physical condition. The tendency toward silence appeared to have been reinforced by emotionally traumatic experiences involving physical illness or injuries in early life. Also found associated with silence were such different factors as a series of ostrich-like denying rationalizations, a fanatic commitment to cultist beliefs, a conviction that emotional conflict is the primary cause of organic illness, and motivations linked to retention of power in reality situations. Clinical examples drawn from these categories are given. Means of increasing the awareness that such silence exists and methods of dealing with it are discussed.- - - - - - - - - - ranking = 0.17241221718574keywords = physical (Clic here for more details about this article) |
6/7. Xanthogranulomatous pseudotumor of the vagina: evidence of a local response to an unusual bacterium (mucoid escherichia coli).Utilization of nonconventional bacterial strains and electron microscopy occasionally may aid in the recognition of unusual microorganisms which fail to be demonstrated by more conventional bacterial stains. We report an unusual case of recurrent vaginal polyps, initially thought by physical examination to represent a malignant neoplasm and histologically to represent a granular cell tumor. The lesions were comprised microscopically of sheets of large, polygonal, histiocytic-like cells with abundant eosinophilic granular cytoplasm. With the Dieterle silver stain, the cytoplasm of these cells contained large numbers of intracellular rod-shaped bacilliform bodies thought to be microorganisms. These organisms stained not at all or very poorly with more conventional bacterial stains, such as Gram and Giemsa stains. Electron microscopy was employed to confirm the presence of intra- and extracellular bacilliform bodies and the absence of large numbers of cytosegresomes, the latter characteristically seen in typical granular cell tumors. Cultures of tissue from the biopsy documented a pure strain of a mucoid form of escherichia coli. We were unable to identify any prior report describing a similar recurrent inflammatory vaginal lesion in which mucoid E. coli was demonstrated. We discuss possible pathogenesis of this case, and relate it to morphologically similar diseases, such as Whipple's disease and malakoplakia, in which there appears to be defective clearance of bacteria from a variety of tissues.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/7. A large inflammatory polyp of the gallbladder masquerading as gallbladder carcinoma.An inflammatory polyp of the gallbladder is a rare variant of benign gallbladder polyp. Differentiation between an inflammatory polyp and polypoid gallbladder carcinoma is difficult when the polyp is more than 1 cm in diameter. We report a rare case of a large inflammatory polyp of the gallbladder masquerading as gallbladder carcinoma in a 37-year-old Japanese woman who was incidentally diagnosed with a large gallbladder polyp, measuring 1 cm in diameter, by ultrasonography. She was asymptomatic and physical examination was unremarkable. Abdominal ultrasonography and endoscopic ultrasonography revealed three polypoid lesions in the gallbladder. One lesion was an isoechoic polyp, measuring 15 x 8 mm, showing a nodular surface and located in the fundus of the gallbladder. The other two lesions were hyperechoic polyps, measuring 5 x 5 mm, in the body of the gallbladder. Computed tomography and magnetic resonance imaging revealed marked enhancement of the largest polypoid lesion by dynamic study, and no lymph node enlargement was noted. Endoscopic retrograde cholangiography revealed a 12 x 8 mm polyp with an irregular surface in the fundus of the gallbladder. Superselective angiography of the cystic artery revealed neovascularity and a tumor stain in the fundus of the gallbladder. cholecystectomy with lymph node dissection was performed. Intraoperative frozen section diagnosis of the largest polyp was an inflammatory polyp of the gallbladder. The other two polyps were cholesterol polyps. Inflammatory polyp should be considered as a differential diagnosis of hypervascular gallbladder polyps that measure more than 1 cm in diameter.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |