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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
M Stanik, A Poprach, D Macik, I Capak, D Maluskova, N Mareckova, R Lakomy, J Jarkovsky, J Dolezel
Patients with clinically node-positive bladder cancer have a poor prognosis, with many receiving only palliative chemo- therapy. We evaluated oncological results in bladder cancer patients with clinically regional and supraregional lymph- adenopathy treated with induction chemotherapy (IC) and consolidative cystectomy. Twenty-five patients with clinically node-positive bladder cancer (including pelvic and retroperitoneal nodes) were treated with 2-4 cycles of IC followed by consolidative cystectomy between 2010 and 2016...
2018: Neoplasma
Alberto Testori, Emanuele Voulaz, Marco Alloisio, Valentina Errico, Umberto Cariboni, Matilde De Simone, Ugo Cioffi
A 67-year-old patient presented for persistent cough. Computed tomography showed right lower lung opacity associated with mediastinal adenopathy. On suspicion of metastatic pulmonary neoplasm, the patient was submitted to right lower lobectomy with lymphadenectomy. Postoperative histopathology led to the diagnosis of multicentric Castleman's disease.
March 2018: Clinical Case Reports
S Ibrahimi, A A Mroué, E Francois, R Jagodzinski
A 34-year-old woman in the 22nd week of gestation presented with generalized pruritis and weight loss since the first trimester of pregnancy. Physical examination revealed cutaneous scratch lesions, jaundice, and hepatomegaly. Blood tests revealed cholestasis with elevated direct bilirubinemia. Auto-antibody and viral hepatitis tests were negative. Liver ultrasound was normal. The initial diagnosis was cholestasis of pregnancy. However despite treatment with ursodeoxycholic acid, the patient did not improve...
July 2017: Acta Gastro-enterologica Belgica
Masahiro Hashimoto, Kohei Murata, Yoshinori Kagawa, Atsushi Naito, Kenji Kawai, Takuya Sakamoto, Kohei Murakami, Yoshiteru Katsura, Akihisa Omura, Toru Masuzawa, Atsushi Takeno, Michiko Yoshimura, Yutaka Takeda, Takeshi Kato, Shigeyuki Tamura
Appendiceal mucinous adenocarcinoma accompanied by cysts ruptures by surgical operation and leakage of mucus into the peritoneal cavity results in deterioration of prognosis.We report a case where the appendix mucinous adenocarcinoma was safely excised by laparoscopically preceding vascular treatment, lymph node dissection and intestinal dissection.The case was a woman in her forty-age suffering from the right lower quadrant and fever; no improvement was observed even when antibiotics were administered.A cystic lesion with a maximum diameter of 75mm was found on the right side of the pelvis with CT, and numerous lymph adenopathy was observed along the iliac artery...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Agazi Gebreselassie, Alem Mehari, Rahel Dagne, Firehiwet Berhane, Angesom Kibreab
RATIONALE: The usual presentation of sarcoidosis is hilar adenopathy, pulmonary reticular opacities, skin, joint, or eye lesions. Pancreatic involvement is unusual and hypercalcemic pancreatitis as initial manifestation is very rare. PATIENT CONCERNS: We present a case that presented with 1-day history of vomiting, diffuse abdominal pain, and altered mental status. DIAGNOSES: Initial investigations showed highly elevated calcium levels, acute pancreatitis, and kidney failure...
January 2018: Medicine (Baltimore)
Paula San-José, Vicente Aguadero, Granada Perea, Meritxell Estrada, Eugenio Berlanga
Heavy chain diseases (HCD) are B-cell lymphoprolipherative disorders characterized by the production of monoclonal heavy chains without associated light chains. Some cases of gamma-HCD (γ-HCD) are concurrent with other lymphoid neoplasm. The monoclonal component is not always detectable by serum electrophoresis, and often an immunofixation procedure is necessary to detect this component. Prognosis is variable, and no established guidelines for follow-up are available. We describe a case of a challenging diagnosis of γ-HCD due to the absence of clinical signs frequently reported in the disease (anaemia and palatal oedema among others)...
February 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Naman S Shetty, Ira Shah
Kawasaki's disease (KD) is a systemic vasculitis often seen with viral and bacterial infections. Cholangitis is a known complication in biliary atresia patients post Kasai Portoenterostomy (KP). However KD, in a biliary atresia patient post KP has not been previously reported. A 1 years old girl who had previously undergone a KP for BA, presented with cholangitis which was presumed to be caused by a previous enterobacter infection that she had 2 months ago. However, on treating the cholangitis, the patient developed fever again after ten days which persisted even after changing the antibiotics...
March 1, 2018: Annals of Hepatology
H Kassem Youssef, A Blind, F Chouta Ngaha, B Drenou, H Nojavan, C Michel
INTRODUCTION: Syphilis is a sexually transmitted disease that can affect numerous organs in its secondary or tertiary stages. We describe a case of secondary syphilis with pulmonary involvement and we present a literature review. PATIENTS AND METHODS: A 69-year-old male patient was admitted to hospital for dyspnoea and extended papular exanthema with palmoplantar involvement. The serological test for syphilis was positive. Ocular examination showed bilateral papillitis and retinal haemorrhage...
February 17, 2018: Annales de Dermatologie et de Vénéréologie
Yoshihiro Aoki, Katsuhiko Kitazawa, Hironobu Kobayashi
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is rare in children and is characterised as necrotising vasculitis predominantly affecting small and medium-sized vessels. Propylthiouracil (PTU), an antithyroid drug, has been implicated in drug-induced AAV. In contrast, Kawasaki disease (KD) is a common systemic vasculitis, typically observed in children, which affects the medium-sized vessels, including the coronary arteries. An 11-year-old girl who developed AAV while receiving PTU therapy for Graves' disease is described...
February 19, 2018: Paediatrics and International Child Health
Kutty Sharada Vinod, Nitin Gupta, Harsh Sahu, Naveet Wig
A 15-year old male patient presented to us with dyspnoea for four days. He had a history of fever, pseudo-membranous tonsillitis and cervical adenopathy twenty-five days prior to the presentation. On examination and laboratory investigations, he had features suggestive of myocarditis with biventricular failure. There was no reliable history of immunisation and he had a positive history of contact. He was planned for anti-diphtheria toxin but before the anti-toxin could be initiated, the patient succumbed to refractory cardiogenic shock...
October 2017: JNMA; Journal of the Nepal Medical Association
Gilles Claro, Nicolas Meyer, Thomas Meresse, Dimitri Gangloff, Jean-Louis Grolleau, Benoit Chaput
BACKGROUND: Needle biopsy is a rapid, reliable, and reproducible procedure for histological confirmation of metastatic melanoma localization. Nonetheless, this procedure presents a theoretical risk of a mechanical weakening of the lymph node capsule with perinodal tumor seeding. The objective of the study was to evaluate the incidence of extracapsular extension after needle biopsy in comparison with surgical adenectomy in patients suspected of metastatic lymph node of melanoma. METHODS: We conducted a retrospective study of 1056 patients who underwent lymphadenectomy for melanoma between 2000 and 2016 in our unit...
February 12, 2018: International Journal of Dermatology
Lauren E Yue, Muhammad Qazi, Kimberly Kiplagat, Fred M Baik, Azita Khorsandi, Margaret Brandwein-Weber, Mark Urken
BACKGROUND: Leiomyosarcoma of the head and neck region is very rare. Primary parotid leiomyosarcoma has only been reported nine times in the medical literature. METHODS: A 68-year-old female presented with a left facial mass. Physical examination revealed a firm immobile mass at the level of the left parotid tail. No facial nerve dysfunction or palpable adenopathy was noted at the time of presentation. This patient underwent a superficial parotidectomy with a facial nerve dissection and left selective neck dissection...
January 27, 2018: American Journal of Otolaryngology
Burke A Cunha, Alena Varantsova, Ismail Jimada
An index case of Legionnaires's disease with mediastinal adenopathy prompted us to review our recent experience with Legionnaires' disease to determine the incidence of mediastinal adenopathy of this finding in Legionnaires' disease. We reviewed the radiographic findings of 90 hospitalized adults with Legionnaires' disease from 2015 to 2017. Excluded were 11 patients with mediastinal adenopathy due to non-Legionnaires' disease causes, e.g., lymphoma. Thirty-seven of the remaining patients had both chest films and chest computed tomography (CT) scans...
January 27, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Benjamin Wybrand Barnard, Anne-Marie Du Plessis, Pierre Goussard, Richard Denys Pitcher
Background There has been no detailed analysis of the cause of intrathoracic large airway obstruction in infants in a resource-limited environment with a high prevalence of pulmonary tuberculosis (PTB) and human immunodeficiency virus (HIV). Aim To define the aetiology and severity of intrathoracic large airway obstruction in infants in a tertiary South African hospital with a high prevalence of PTB and HIV. Methods A retrospective study of infants was conducted with computerised tomography (CT) evidence of intrathoracic large airway obstruction from 1 January 2011 to 31 May 2014...
January 22, 2018: Paediatrics and International Child Health
Diana H Yu, David Feller-Kopman
The field of interventional pulmonology (IP) is a rapidly maturing subspecialty of pulmonary medicine, which emphasizes advanced diagnostic and therapeutic bronchoscopy for the evaluation and management of central airway obstruction, mediastinal/hilar adenopathy and lung nodules/masses, as well as minimally invasive diagnostic and therapeutic pleural procedures. Areas covered: This review describes advances in diagnostic and therapeutic bronchoscopic techniques. Expert commentary: In the past decade, there has been a remarkable growth in available technology and equipment, as well as clinical and translational research efforts focused on patient-centered outcomes...
March 2018: Expert Review of Respiratory Medicine
Nuri A Sahbaz, Firat Tutal, Nihat Aksakal, Sami Acar, Kadir I Aksu, Umut Barbaros, Yesim Erbil
Retrosternal goiter prevalence is 5 to 40 per cent according to classifications in goiter series. Goiters with mediastinal extension were reported to be related with higher cancer rates. In our study, we aimed to investigate whether cancer incidence increased in retrosternal goiters compared with the cervical ones. Three hundred and ninety consecutive patients, who had surgery because of retrosternal goiter in Istanbul University Medical Faculty Department of General Surgery between 2005 and 2015 were included in the study (Group 1)...
December 1, 2017: American Surgeon
Lisa M Deuel, Marjorie E Bunch
Neuromyelitis optic spectrum disorders are demyelinating conditions that are typically idiopathic, though various case reports have demonstrated an association with malignancy. We present the case of a 64year old woman with NMOSD in the setting of small cell lung cancer. She had longitudinally extensive transverse myelitis and left eye optic neuritis; aquaporin-4 antibodies were elevated. Biopsy of mediastinal adenopathy was positive for SCLC. Malignancy should be considered in any patient with an atypical presentation of NMOSD, or who does not respond to traditional therapies...
January 3, 2018: Journal of Neuroimmunology
Jing Yan, Ju Yang, Yang Yang, Wei Ren, Juan Liu, Shanbao Gao, Shuangshuang Li, Weiwei Kong, Lijing Zhu, Mi Yang, Xiaoping Qian, Baorui Liu
BACKGROUND: Most tumor cell lines exhibited low-dose hyperradiosensitivity (LDHRS) to radiation doses lower than 0.3 Gy. Pulsed low-dose rate radiotherapy (PLDR) took advantage of LDHRS and maximized the tumor control process. In this study, we retrospectively analyzed patients receiving PLDR for refractory malignancies. PATIENTS AND METHODS: In total, 22 patients were included in our study: 9 females and 13 males. The median age was 61 years old. All the patients previously received multiline treatments and failed with an estimated survival less than 6 months...
January 3, 2018: Translational Oncology
Ramón Pérez-Tanoira, Jose Manuel Ramos, Laura Prieto-Pérez, Abraham Tesfamariam, Seble Balcha, Gabre Tissiano, Alfonso Cabello, Juan Cuadros, Natalia Rodríguez-Valero, Pablo Barreiro, Francisco Reyes, Miguel Górgolas
INTRODUCTION: Cutaneous anthrax is a zoonotic disease caused by the spore-forming bacterium Bacillus anthracis, which typically presents with ulcers after contact with animals or animal products, and is rarely seen in high-income countries but is common in those with low- and middle-incomes. Objective. The aim of this study is to show the main clinical characteristics of cutaneous anthrax in endemic areas. MATERIAL AND METHODS: The study describes the main clinical characteristics of cutaneous anthrax in eight patients (six female and two male, age range 1 - 56 years) admitted to the rural General Hospital of Gambo, West Arsi Province of Ethiopia from 2010-2013...
December 23, 2017: Annals of Agricultural and Environmental Medicine: AAEM
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