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Alison M Condliffe, Anita Chandra
The activated phosphoinositide 3-kinase δ syndrome (APDS), also known as p110δ-activating mutation causing senescent T cells, lymphadenopathy, and immunodeficiency (PASLI), is a combined immunodeficiency syndrome caused by gain-of-function mutations in the phosphoinositide 3-kinase (PI3K) genes PIK3CD (encoding p110δ: APDS1 or PASLI-CD) and PIK3R1 (encoding p85α: APDS2 or PASLI-R1). While the disease is clinically heterogeneous, respiratory symptoms and complications are near universal and often severe...
2018: Frontiers in Immunology
Branimir Gjurašin, Snježana Židovec Lepej, Michelle J Cole, Rachel Pitt, Josip Begovac
We report an HIV-infected person who was treated for lymphogranuloma venereum cervical lymphadenopathy and proctitis in Croatia in 2014. Infection with a variant L2b genovar of Chlamydia trachomatis was detected in a cervical lymph node aspirate. A prolonged course of doxycycline was required to cure the infection.
April 2018: Emerging Infectious Diseases
Habiba Hashimi, David T Cooke, Elizabeth A David, Lisa M Brown
Accurate staging for non-small cell lung cancer (NSCLC) is essential to guide therapy. While computed tomography (CT) and positron emission tomography (PET) scan can indicate whether mediastinal lymphadenopathy is present, histologic confirmation is required to complete the staging evaluation. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique associated with similar diagnostic yield and improved postoperative pain and complication rates compared to mediastinoscopy...
2018: Journal of Visualized Surgery
Yuki Tanisaka, Shomei Ryozawa, Masanori Kobayashi, Maiko Harada, Tsutomu Kobatake, Kumiko Omiya, Hirotoshi Iwano, Shin Arai, Kouichi Nonaka, Yumi Mashimo
Lymphadenopathy may be difficult to diagnose using imaging results alone. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) may help to diagnose and determine the appropriate management of lymphadenopathy. EUS-FNA has been used as a safe and less invasive method for obtaining pathologic specimens from extraluminal lesions using endoscopic ultrasound. The present study evaluated the usefulness of EUS-FNA for lymphadenopathy. Between July 2013 and December 2016, 72 patients undergoing EUS-FNA for lymphadenopathy that could not be diagnosed solely using imaging were included...
April 2018: Oncology Letters
Lina Husienzad, Ben Friedman, Sherry X Yang, Amber Tran, Jason B Lee
An otherwise healthy man in his 50s presented complaining of pruritic lesions on the left side of his scalp. The lesions had slowly been growing in size over the preceding 30 years. They would occasionally bleed, and this is what ultimately prompted him to seek medical advice. Physical examination revealed multiple aggregated and soft, flesh-colored nodules on the left posterior auricular area of the scalp (Figure 1). No appreciable clinical lymphadenopathy was identified on examination. A shave biopsy of one of the nodules was performed for diagnostic clarification...
2018: Skinmed
Chao Ma, Jing Lu, Guoqiang Chen, Weixing Wang, Fu Su, Xinhui Su
Inflammatory myofibroblastic tumor (IMT) is an uncommon neoplasm that has been described in various locations throughout the body, but is rarely observed in systemic lymph nodes. We present a case of a 63 years old woman with left inguinal lymphadenopathy accompanied by low-grade fever. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) revealed abnormal higher18 F-FDG uptake on the neck, axillar, pulmonary hilar, mediastinal, mesenteric, retroperitoneal, pelvic and inguinal lymph nodes...
March 20, 2018: Hellenic Journal of Nuclear Medicine
Simon A Sarkisian, Daniel Brillhart
In the United States, the rate of primary and secondary syphilis has increased by 18% in 2016, the highest rate since 1993. These patients can often present to the emergency department (ED) in various stages. Although syphilis is well described in the literature, there is a paucity of ED reports of atypical cases. A 22-yr-old male presented to the ED complaining of neck pain. The patient was found to have right-sided tender cervical lymphadenopathy causing neck pain. A thorough physical exam revealed diffuse lymphadenopathy...
March 14, 2018: Military Medicine
K Blouhos, K A Boulas, A Paraskeva, I Kariotis, N Barettas, A Hatzigeorgiadis
INTRODUCTION: Secondary pancreatic tumors are uncommon and account for 2-5% of pancreatic cancer. Tumors characterized most commonly with pancreatic involvement are lymphoma, renal cell and lung carcinomas. PRESENTATION OF CASE: A 76-year-old female patient with obstructive jaundice as the primary symptom and inguinal lymphadenopathy is presented. Imaging revealed a bulky solitary solid pancreatic head mass along with paraaortic and mesenteric lymphadenopathy. The absence of a previous history of malignancy and the presence of a dominant pancreatic mass along with distal lymphadenopathy confined differential diagnosis to advanced secondary pancreatic lymphoma, which is the most common secondary pancreatic tumor, and locally advanced/metastatic pancreatic adenocarcinoma...
March 7, 2018: International Journal of Surgery Case Reports
Yong Cui, Xiaoting Li, Shunyu Gao, Zhongwu Li, Yanling Li, Ming Lu, Yingshi Sun
Objective: To determine the capability of dynamic enhanced computed tomography (CT) to differentiate liver metastases (LMs) of well-differentiated from poorly-differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Methods: Patients with LMs of GEP-NENs who underwent dynamic enhanced CT examination in Peking University Cancer Hospital from January 2009 to October 2015 were included and data were retrospectively analyzed. We assessed the qualitative and quantitative CT features to identify the significant differentiating CT features of LMs of poorly-differentiated GEP-NENs from those of well-differentiated GEP-NENs using univariate analysis and a multivariate logistic regression model...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Kenji Nishida, Yuka Gion, Mai Takeuchi, Takehiro Tanaka, Tatsuki R Kataoka, Tadashi Yoshino, Yasuharu Sato
Immunoglobulin G4 (IgG4)-related disease is characterized by elevated serum IgG4 levels and increased numbers of IgG4-positive cells. However, its pathogenesis is not fully understood. We previously suggested that mast cells may play an important role in IgG4-related disease. In this study, we confirmed the characteristics of mast cells in IgG4-related lymphadenopathy by using immunohistochemistry and dual immunofluorescence. We analyzed 23 cases of IgG4-related lymphadenopathy and compared them with 23 cases of non-specific lymphoid hyperplasia...
March 15, 2018: Scientific Reports
Tsutomu Namikawa, Kazune Fujisawa, Eri Munekage, Masaya Munekage, Yusuke Oki, Hiromichi Maeda, Hiroyuki Kitagawa, Hiroshi Ueta, Michiya Kobayashi, Kazuhiro Hanazaki
The present case report presents a rare case of Epstein-Barr virus (EBV)-associated early gastric carcinoma with lymphoid stroma, accompanied by lymph node metastasis. A 61-year-old woman was referred to our hospital following observation of a gastric mass lesion that was initially diagnosed at a medical check-up. Esophagogastroduodenoscopy revealed a slightly elevated lesion with a central irregular depression in the middle third of the stomach. Endoscopic ultrasonography revealed a well-circumscribed hypoechoic mass located predominantly within the submucosa and the mucosa...
April 2018: Molecular and Clinical Oncology
Nauman Ahmed, Hammad Naeem Rana
Primary Small bowel adenocarcinoma, a rare entity and having varied clinical presentation, makes its clinical detection a diagnostic challenge. Moreover, its true prevalence in sub-continent population has not yet been established, which makes it more difficult for its detection. We present the case of a 60 year old male who came with abdominal pain and weight loss for two years as the only symptoms. A series of tests in the two year period remained inconclusive. Later Computed tomography showed a suspicious mass at the terminal ileum...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Jirka Grosse, Karin Menhart, Benedikt Schmidbauer, Dirk Hellwig
Sarcoidosis, a granulomatous T-cell-mediated multisystem disease with a yearly incidence of 10.9 to 35.5 cases per 100,000 in the United States, affects a variety of organ systems. Although the characteristic radiological finding of a bihilar lymphadenopathy still plays a diagnostic key role, FDG PET/CT is more sensitive in detecting and monitoring various manifestations. We present a rare case of a 37-year-old woman with bihilar, mediastinal, and abdominal lymphadenopathy in conjunction with a histologically proven cutaneous manifestation of sarcoidosis in a tattoo of the lower back exhibiting an increased uptake of FDG...
March 13, 2018: Clinical Nuclear Medicine
Naghmehossadat Eshghi, Tamara F Lundeen, Lea MacKinnon, Ryan Avery, Phillip H Kuo
An 85-year-old man with stage IIIA Merkel cell carcinoma of the left arm was initially treated with local excision and axillary node dissection followed by radiation therapy. Eight months after surgery, whole-body FDG PET/CT demonstrated intensely hypermetabolic hepatic metastases and abdominal lymphadenopathy. Given his age and comorbidities, he was considered a poor candidate for chemotherapy, and therefore the novel programmed cell death ligand 1 inhibitor avelumab was initiated. FDG PET/CT after 4 cycles showed complete resolution of hepatic and nodal metastases...
March 13, 2018: Clinical Nuclear Medicine
John Ward, Ariela Noy, Gary Ulaner, Christopher Riedl
Adalimumab is a fully human chimeric tumor necrosis factor inhibitor used to treat immune-mediated disorders such as psoriatic arthritis. We present a 51-year-old woman with psoriatic arthritis on methotrexate and infliximab for 12 years. Adalimumab replaced infliximab because of worsening symptoms. Following 3 doses administered 1 week apart, rapidly enlarging cervical lymph nodes developed. Biopsy revealed Epstein-Barr virus-related polymorphic lymphoproliferative disorder. F-FDG PET/CT demonstrated widespread hypermetabolic lymphadenopathy; follow-up at 5 weeks off adalimumab revealed almost complete resolution of this adenopathy...
March 13, 2018: Clinical Nuclear Medicine
David K Tso, Ajay K Singh
OBJECTIVE: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease. CONCLUSION: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, US, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis...
March 14, 2018: British Journal of Radiology
P Wei, Y L Zhang, J L Xie, Y Y Zheng, W Liu, X G Zhou
Objective: To analyze clinical, pathological, molecular and genetic characteristics of Burkitt-like lymphoma with chromosome 11q aberration. Methods: A case of Burkitt-like lymphoma with 11q aberration was presented at Beijing Friendship Hospital in November 2016 with detailed clinicopathological features, immunophenotypes, Epstein-Barr virus(EBV) status and molecular genetic characteristics. Results: The patient was a 38-year-old man presenting with the cervical lymphadenopathy. In morphology, the tumor had the similar characteristics of Burkitt lymphoma, including diffuse infiltration of medium to large lymphoid cells, and presence of"starry sky"phenomenon...
March 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Noman Lateef, Abdul Haseeb, Uzair K Ghori, Abubakar Tauseef, Mustafa Dawood, Syed M Hasan Kazmi
Rosai-Dorfman disease (RDD) is a rare, benign, and predominantly nodal disease that most commonly presents as bilateral, painless cervical lymphadenopathy; although inguinal, axillary, mediastinal, and hilar lymphadenopathy has also been reported. Apart from nodal involvement, RDD has extranodal manifestations involving bone, soft tissue, and liver as well as constitutional symptoms of fever, night sweats, and weight loss, which make it reasonable to rule out the infectious, autoimmune, and malignant conditions as the differential diagnosis...
January 2, 2018: Curēus
Li Liu, Xuyan Zhang, Sizhou Feng
Epstein-Barr virus related post-transplant lymphoproliferative disorders (EBV-PTLDs) are rare but potentially fatal complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by uncontrolled proliferation of EBV-infected lymphocytes. The most frequent risk factors include T cell depletion of graft, HLA mismatch, severe graft versus host disease (GVHD), EBV sero-mismatch (recipient-/donor+) and so on. EBV-PTLDs commonly manifest as fever and lymphadenopathy and may rapidly progress to multi-organ failure and even death...
March 9, 2018: Biology of Blood and Marrow Transplantation
Abhishek De, Murlidhar Rajagopalan, Aarti Sarda, Sudip Das, Projna Biswas
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, is also known as drug induced hypersensitivity syndrome and by various other names. It is now recognised as one of the severe cutaneous adverse reaction (SCAR) and can be potentially life-threatening. Historically, it was most frequently linked with phenytoin and was initially described as phenytoin hypersensitivity syndrome. However, it was later found to be caused by various other medications. Anticonvulsants and sulfonamides are the most common offender...
January 2018: Indian Journal of Dermatology
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