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https://www.readbyqxmd.com/read/29332705/cutaneous-squamous-cell-carcinoma-management-of-advanced-and-high-stage-tumors
#1
REVIEW
Syril Keena T Que, Fiona O Zwald, Chrysalyne D Schmults
While the majority of cutaneous squamous cell carcinomas (cSCCs) can be treated surgically, the additional work-up and treatments indicated for high-risk cSCC remain undefined. In recent years, improvements in tumor staging systems have allowed for the more accurate stratification of tumors into high- and low-risk categories. This insight, along with the publication of cSCC guidelines, brings us closer to the development of a consensus approach. The second article in this continuing medical education series addresses in question and answer format the most common questions related to advanced and high-stage cSCCs, with a simplified flowchart...
February 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29332311/otolaryngology-head-and-neck-region-manifestations-of-brucella
#2
Anna Lazutkin, Maya Korem, Jeffrey M Weinberger, Ron Eliashar, Nir Hirshoren
OBJECTIVES/HYPOTHESIS: Patients with Brucella infection present with nonspecific symptoms originating from different organs. In this study, we investigated the manifestations involving principally the otolaryngology/head and neck region. STUDY DESIGN: Retrospective cohort chart review. METHODS: A retrospective analysis of patients diagnosed with brucellosis in a tertiary medical center. Medical records of 55 patients treated for positive Brucella blood cultures between 2007 and 2016 were analyzed...
January 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29332062/cytologic-features-of-malignant-melanoma-with-osteoclast-like-giant-cells
#3
José A Jiménez-Heffernan, Magdalena Adrados, Patricia Muñoz-Hernández, Paloma Fernández-Rico, Ana I Ballesteros-García, Javier Fraga
BACKGROUND: Malignant melanoma showing numerous osteoclast-like giant cells (OGCs) is an uncommon morphologic phenomenon, rarely mentioned in the cytologic literature. The few reported cases seem to have an aggressive clinical behavior. Although most findings support monocyte/macrophage differentiation, the exact nature of OGCs is not clear. CASE: A 57-year-old woman presented with an inguinal lymphadenopathy. Sixteen years before, cutaneous malignant melanoma of the lower limb had been excised...
January 13, 2018: Acta Cytologica
https://www.readbyqxmd.com/read/29331570/meningeal-marginal-zone-b-cell-lymphoma-the-meningioma-trap
#4
Alexandre Villeneuve, François Rubin, Pierre Bonfils
OBJECTIVE: To report a case of marginal zone MALT lymphoma of the temporal dura mater, initially mistaken for temporal meningioma. CASE REPORT: A 60-year-old immunocompetent woman, followed for more than 10 years for temporal meningioma causing vertigo and mixed hearing loss, presented with cervical lymphadenopathy, revealing marked progression of an intracranial lesion, leading to a diagnosis of marginal zone MALT lymphoma based on histological examination of a cervical lymph node...
January 10, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29331008/atypical-presentation-of-rickettsial-spotted-fever
#5
Uday Prabhakar, Anup Singh
Acute febrile illness is a common entity in tropics and often is challenging due a host of pathogenic bacteria, viruses and fungi. Extensive work up is required for better management. Rickettsiosis is uncommon and hence comes lower down in the differentials of multiorgan failure being superseded by the more common diseases as malaria, enteric fever and Dengue. We document a case of young male presenting with high grade fever, multiorgan dysfunction (hepatic, renal, neurological and respiratory involvement), conjunctival suffusion, retiform rash and without lymphadenopathy...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330673/vacuum-assisted-closure-therapy-of-paradoxical-reaction-in-tuberculous-lymphadenopathy-caused-by-mycobacterium-africanum
#6
H F Geerdes-Fenge, P Pongratz, J Liese, E C Reisinger
A 26-year-old HIV-negative male from Ghana was treated for cervical, intrathoracic and abdominal lymph node tuberculosis (TB) and tuberculous hepatitis. Penetration of the thoracic trachea by a mediastinal lymph node had caused bronchomucosal TB. Sputum culture grew M. africanum, sensitive to all first-line antituberculous drugs. Four weeks after the beginning of directly observed treatment with isoniazid, rifampin, pyrazinamide and ethambutol, the right cervical lymph node increased in size, liquefied and caused a spontaneous fistula...
January 12, 2018: Infection
https://www.readbyqxmd.com/read/29330011/mutations-in-pi3k110%C3%AE-cause-impaired-nk-cell-function-partially-rescued-by-rapamycin-treatment
#7
Raquel Ruiz-García, Alexander Vargas-Hernandez, Ivan K Chinn, Laura S Angelo, Tram N Cao, Zeynep Coban-Akdemir, Shalini N Jhangiani, Qingchang Meng, Lisa R Forbes, Donna M Muzny, Luis M Allende, Mohammed S Ehlayel, Richard A Gibbs, James R Lupski, Gulbu Uzel, Jordan S Orange, Emily M Mace
BACKGROUND: Heterozygous gain-of-function mutations in PI3K110 lead to lymphadenopathy, lymphoid hyperplasia, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) viremia, and sinopulmonary infections. OBJECTIVE: The known role of NK cell function in the control of EBV and CMV prompted us to investigate the functional and phenotypic effect of PI3K110δ mutations on NK cell subsets and cytotoxic function. METHODS: Patient mutations were identified by whole exome or targeted sequencing...
January 9, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29327734/clinical-study-of-extrapulmonary-head-and-neck-tuberculosis-in-an-urban-setting
#8
S Monga, J N Malik, S Jan, S Bahadur, S Jetley, H Kaur
Tuberculosis (TB) of the head and neck region is quite common in endemic countries, but is still misdiagnosed due to its varied presentation and different sites of involvement. The aims of the present study were to present the diversities of presentation of head and neck tuberculosis with the diagnostic predicaments faced during evaluation and to assess treatment response to anti-tubercular treatment (ATT). We analysed 48 patients with head and neck tuberculosis who presented to the Department of Otorhinolaryngology in our tertiary care urban hospital over a period of two years from 2013 to 2015 and recorded their data, which included presenting complaints, local and systemic examination findings, investigation results and treatment outcomes...
December 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29327683/clinical-manifestation-of-malignant-lymphomas-of-the-head-and-neck-region
#9
Katarzyna Bojanowska-Poźniak, Monika Nurkowska, Marian Danilewicz, Wioletta Pietruszewska
INTRODUCTION: Malignant lymphoma (ML) is a neoplasm caused by clonal expansion of undifferentiated B, T and NK-lymphoid cells. WHO classification divides lymphomas into two main types, i.e. Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL), with numerous subtypes. The majority of MLs are localized in lymph nodes, but extranodal locations are also possible. MLs represent approximately 3-5% of all malignant neoplasms in Poland, but their incidence has been increasing in recent years, especially in young patients...
December 30, 2017: Otolaryngologia Polska
https://www.readbyqxmd.com/read/29326339/ninety-year-old-man-with-hypereosinophilia-lymphadenopathies-and-pruritus
#10
José Guilherme Freitas, Ana Jorge, Daniel Rei, Joana Graça
We report a case of a 90-year-old man with hypereosinophilia, lymphadenopathies and skin lesions, namely lichenification and pruritus. An aetiological investigation was performed, and a bone marrow (BM) biopsy and aspirate showed a hypercellular marrow with hypereosinophilia without dysmorphia or abnormal elements, and the BM and inguinal node's immunophenotyping denied any presence of abnormal lymphoid cell population. The inguinal node biopsy revealed a multinodular proliferation of large cells S100 and CD1a+, and a diagnosis of Langerhans cell histiocytosis was made...
January 10, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29321413/remission-of-refractory-ascites-and-discontinuation-of-hemodialysis-after-additional-rituximab-to-long-term-glucocorticoid-therapy-in-a-patient-with-tafro-syndrome
#11
Hanako Tsurumi, Yoshihide Fujigaki, Tadashi Yamamoto, Risa Iino, Kei Taniguchi, Michito Nagura, Shigeyuki Arai, Yoshifuru Tamura, Tatsuru Ota, Shigeru Shibata, Fukuo Kondo, Nozomu Kurose, Yasufumi Masaki, Shunya Uchida
Thrombocytopenia, ascites, myelofibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome is a newly recognized but rare disease, and its treatment has not yet been established. We reported a 50-year-old woman with TAFRO syndrome diagnosed 2 years after the initial symptoms of a fever, fatigue, epigastric pain, edema, ascites, lymphadenopathy, thrombocytopenia and renal insufficiency. The patient showed refractory ascites and required hemodialysis under corticosteroid mono-therapy for suspected immune-mediated disease but was successfully treated with additive rituximab, resulting in improvement in her laboratory data, the withdrawal of hemodialysis and the disappearance of ascites...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29316546/tuberculosis-associated-chylothorax-case-report-and-systematic-review-of-the-literature
#12
Srinivas Rajagopala, Roopa Kancherla, Ramanathan Palaniappan Ramanathan
Tuberculosis (TB) is a rare cause of chylothorax. We describe a case and the results of a systematic review of all reported cases of TB-chylothorax. We identified 37 cases of TB-chylothorax. The symptoms at presentation were constitutional (85.7%; 30/35), dyspnea (60.6%; 20/33), and cough (54.5%; 18/33). Chylothorax developed subsequent to the diagnosis of TB in 27.8% (10/36) of the patients, after a median of 6.75 weeks (IQR 4-9). Chylothorax developed during an immune reconstitution syndrome (IRS) in 16.7% (10/36) of the patients, including immunocompetent ones...
January 9, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29314206/follicular-lymphoma-2018-update-on-diagnosis-and-management
#13
Arnold Freedman
DISEASE OVERVIEW: Follicular lymphoma is generally an indolent B cell lymphoproliferative disorder of transformed follicular center B cells. Follicular lymphoma (FL) is characterized by diffuse lymphadenopathy, bone marrow involvement, splenomegaly and less commonly other extranodal sites of involvement. In general, cytopenias can occur but constitutional symptoms of fever, nightsweats, and weight loss are uncommon. DIAGNOSIS: Diagnosis is based on histology of preferably a biopsy of a lymph node...
February 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29313588/paraneoplastic-inverse-myasthenic-syndrome-as-a-presentation-of-bronchogenic-carcinoma
#14
G S Chowdhary, Malav Jhala
Tumours may produce growth factors and cytokines responsible for signs and symptoms distant to the primary or metastatic site. This may be the first sign of a malignancy and its recognition may be critical for early cancer detection. Moreover, proper diagnosis spares the patient of extensive and expensive search for an alternate cause of the neurological dysfunction. In neurological paraneoplastic syndromes like Lambert Eaton Myasthenic syndrome associated with small cell lung cancer, evidence of autoimmunity against presynaptic neuro-muscular junction by anti voltage gated calcium channel anti bodies is well documented...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29306252/the-diagnostic-accuracy-of-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-ebus-tbna-in-mediastinal-tuberculous-lymphadenitis
#15
Onur Fevzi Erer, Serhat Erol, Ceyda Anar, Can Biçmen, Zekiye Aydoğdu, Serir Aktoğu
Background/aim: Mediastinal lymph nodes are the second most commonly affected lymph nodes in tuberculous lymphadenitis. It is often difficult to diagnose tuberculosis in patients with lymphadenopathy without parenchymal lesions. The aim of this study was to describe the diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with isolated mediastinal tuberculous lymphadenitis (MTLA). Materials and methods: This study included 527 patients who had undergone EBUS-TBNA between December 2012 and December 2014...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29304824/patient-characteristics-associated-with-response-to-nsaid-monotherapy-in-children-with-systemic-juvenile-idiopathic-arthritis
#16
Anjali Sura, Christopher Failing, Julie Sturza, Jasmine Stannard, Meredith Riebschleger
BACKGROUND: Systemic juvenile idiopathic arthritis (sJIA) is an auto-inflammatory disease characterized by fever, arthritis, and ≥1 of rash, generalized lymphadenopathy, hepato/splenomegaly, and serositis. Non-steroidal anti-inflammatory drugs (NSAIDs) are among the initial treatments of sJIA, but there is currently no evidence indicating which children should undergo a trial of NSAID monotherapy and which should not. Our objective is to identify presentation characteristics which are associated with response and lack of response to a trial of NSAID monotherapy...
January 5, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29302559/peripheral-t-cell-lymphoma-not-otherwise-specified
#17
Kunal Kishor Jha, Suresh K Gupta, Harpreet Saluja, Nuwadatta Subedi
The peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) belongs to a heterogeneous class of aggressive neoplasms. Although several morphologic subtypes of this tumor have been described, no particular genetic, immunological, or distinct clinical features define this disease. Patients can experience night sweats, fever, lymphadenopathy, weight loss, splenomegaly, and/or skin changes. Common laboratory tests reveal that patients have anemia, thrombocytosis, lymphocytosis, eosinophilia, hypergammaglobulinemia, or increased lactate dehydrogenase...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29302484/inadvertent-parathyroidectomy-risk-factors-in-1-373-thyroidectomies-male-gender-and-presence-of-lymphadenopathy-but-not-size-of-gland-independently-increase-the-risk
#18
Ioannis Christakis, Penny Zacharopoulou, Georgios Galanopoulos, Ilias-Demetrios Kafetzis, Spiros Dimas, Nikolaos Roukounakis
Background: Inadvertent parathyroidectomy (IP) during thyroid operations is a recognised phenomenon. We evaluated the incidence of IP during thyroid operations in a large case-series and identified the risk factors involved. Methods: Retrospective review of all thyroidectomy operations [total thyroidectomies (TT) and near-total thyroidectomies (NTT)] performed in a single institution from January 2004 to January 2009. We excluded re-operative cases, combined thyroid and parathyroid pathology, hemithyroidectomies and neck lymph nodes (LN) dissections...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29301812/syphilitic-jaundice-a-rare-manifestation-of-the-secondary-stage-presenting-a-missed-opportunity-to-prevent-ocular-syphilis
#19
Joanne Curran, Stephen Peter Higgins
The classical presentation of secondary syphilis comprises skin rashes, mucosal ulceration and lymphadenopathy. However, this disseminated stage can also present with symptoms and signs of ocular, neurological, pulmonary, renal, musculoskeletal and digestive tract disease. We report the case of a gay man who presented with icteric hepatitis. Although he underwent an exhaustive series of investigations (some of which were invasive), syphilis was not initially considered in the differential diagnosis. His jaundice resolved spontaneously, but he subsequently developed an acute optic neuritis...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29301803/extramedullary-plasmacytoma-rare-neoplasm-of-parotid-gland
#20
Sehrish Abrar, Nasir Ali, Bilal Mazhar Qureshi, Ahmed Nadeem Abbasi
A 45-year-old man presented with left-sided facial swelling. Initial excisional biopsy was done somewhere else without prior imaging and it came out to be pleomorphic adenoma; local imaging after biopsy showed mass over the left parotid gland with ipsilateral lymphadenopathy. On examination, there was a well-circumscribed mass with signs of left facial nerve palsy. He underwent left radical parotidectomy with ipsilateral modified radical neck dissection, and per operatively, it came out to be neoplastic lesion...
January 4, 2018: BMJ Case Reports
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