scholarly journals Voluminous Myoepithelioma of the Minor Salivary Glands Involving the Base of the Tongue

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Mario Policarpo ◽  
Valentina Longoni ◽  
Pietro Garofalo ◽  
Paolo Spina ◽  
Francesco Pia
Keyword(s):  
Differential Diagnosis ◽  
Salivary Glands ◽  
Malignant Neoplasm ◽  
Needle Aspiration ◽  
Hyperintense Lesion ◽  
Rare Tumour ◽  
Weighted Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Histology And Immunohistochemistry

Myoepithelioma is an extremely rare tumour subtype and diagnosis is based on a wide variation of cellular morphology. FNAC specimens do not always suffice for a definitive differential diagnosis which depends on histology and immunohistochemistry of the lesion.Case Presentation. A 54-year-old female came to our attention with dysphagia and dyslalia of 6-month standing. Ear, Nose, and Throat (ENT) examination revealed a voluminous mass on the right portion of the base of her tongue, where postcontrast T2-weighted Magnetic Resonance Imaging (MRI) evidenced a hyperintense lesion. The fine-needle aspiration specimen taken for cytology was not diagnostic, as a differential diagnosis between myoepithelioma and a malignant neoplasm of the salivary glands necessitates parameters that cytology alone cannot provide. Therefore, the whole lesion was excised by diode laser through a transoral approach. Histology and immunohistochemistry of the completely excised lesion confirmed a myoepithelioma.

A Septuagenarian With Progressive Hemiparesis

2021 ◽  
pp. 48-50
Author(s):  
Roman Kassa ◽  
B. Mark Keegan
Keyword(s):  
Multiple Sclerosis ◽  
Late Onset ◽  
Progressive Multiple Sclerosis ◽  
Oligoclonal Bands ◽  
Hyperintense Lesion ◽  
Fluid Analysis ◽  
Hemiparetic Gait ◽  
Magnetic Resonance Imaging Mri ◽  
Disease Modifying Agents ◽  
The Right

A 78-year-old man with no pertinent medical history sought care for an 18-month history of progressive right lower extremity weakness, gait impairment, and falls. On neurologic examination, he had a hemiparetic gait. He had normal higher cognitive function and cranial nerve function. Motor examination showed decreased bulk over the right hand with no fasciculations, mild spasticity over the right leg, and right hemiparesis with an upper motor neuron pattern. Deep tendon reflexes were brisk throughout his limbs, and he had an extensor plantar reflex on the right side. He had impaired vibratory sense at the toes, with otherwise normal sensory and coordination examinations. Magnetic resonance imaging (MRI) of the brain showed ovoid periventricular and punctate subcortical and deep white matter T2 hyperintense foci. Some of these had corresponding T1 hypointensity. MRI of the cervical spine showed 1 eccentrically located T2 hyperintense lesion over the right lateral aspect of C2. Cerebrospinal fluid analysis showed no pleocytosis, an increased protein concentration of 66 mg/dL, and 4 unique oligoclonal bands. A diagnosis of primary progressive multiple sclerosis, very late onset, was made. With any diagnosis of late-onset multiple sclerosis, a decision about whether multiple sclerosis disease-modifying agents are indicated should be carefully considered. Our older patient had a progressive disease course, and neuroimaging studies did not reveal evidence of active disease. Based on this, a decision was made to monitor him clinically and radiologically. Management of spasticity with regular daily stretching exercises was discussed with him. A first clinical manifestation of multiple sclerosis can occur at a later-than-typical age. Most studies consider an onset at age 50 years or older to be late-onset multiple sclerosis, whereas first symptoms occurring at age 60 years or older are commonly referred to as very late–onset MS.

scholarly journals Pleomorfik Adenoma pada Palatum

2012 ◽  
Vol 19 (1) ◽  
pp. 39
Author(s):  
Cahya Yustisia Hasan ◽  
Muhammad Masykur Rahmat
Keyword(s):  
Salivary Glands ◽  
Pleomorphic Adenoma ◽  
Fine Needle Aspiration Biopsy ◽  
Hormonal Contraception ◽  
Needle Aspiration ◽  
Clinical Feature ◽  
Mixed Tumor ◽  
Cell Adenoma ◽  
First Case ◽  
The Right

Latar Belakang: Pleomorfik adenoma (mixed tumor) adalah tumor kelenjar ludah yang paling sering terjadi (65%) pada kelenjar ludah mayor dan minor. Lokasi intraoral yang paling sering ditemukan adalah palatum. Tujuan: membahas gambaran klinis dan penatalaksanaan pleomorfik adenoma pada platinum. Kasus: dilaporkan 2 buah kasus pleomorfik adenoma pada palatum. Kasus pertama seorang laki-laki usia 29 tahun dengan benjolan pada palatum kanan ukuran 3x2 cm, konsistensi kenyal, berbatas tegas, warna seperti jaringan sekitar dan tidak nyeri. Pasien pernah menjalani operasi pada palatum kanan pada tahun 2005, dan kira-kira 3 tahun setelah operasi benjolan tersebut kambuh di tempat yang sama. Hasil biopsi aspirasi jarum halus adalah mixed tumor. Kasus kedua seorang wanita 22 tahun dengan benjolan pada palatum kiri ukuran 2x1,5 cm, timbul sejak 3 tahu yang lalu, warna seperti jaringan sekitar, konsistensi kenyal, dan tidak nyeri. Riwayat pesien menggunakan kontrasepsi hormonal. Hasil biopsi condong pada adenoma pleomorfik dengan bagian onkositik adenoma dan clear sel adenoma. Penatalaksanaan: dilakukan eksisi luas di bawah anestesi umum pada kedua kasus tersebut, dengan batas 1 cm dari tepi lesi pada jaringan sehat. Kesimpulan : telah dilakukan eksisi luas untuk penanganan kedua kasus pleomorfik adenoma dan palatum. Tidak di temukan rekurensi 1 tahun setelah operasi (kasus 1) dan 2 tahun setelah operasi (kasus 2). Blackground: pleomorphic adenoma (mixed tumor) is the most common tumor of the salivary glands (65%) of the major dan minor salivary glands. Palatum is the most common site in intraoral. Purpose: to elaborate clinical feature and management of pleomophic adenoma of palate. Cases: we reported 2 cases pleomorphic adenoma of palate. The first case was a29 years old male patient with a swelling at the right side of the palate, 3x2 cm sized mass, rubbery in consistency, well demarcated, pinkish in color, and pain less. He had undergone an operation at the right palate in 2005, but 3 years after the operation he got reccurence. The result of fine needle aspiration biopsy was mixed tumor. The second case was fermale 22 years old patient with a swelling at the left side of palate, 2x1,5 cm sized mass, was present 3 years before coming to the clinic, pinkish color, rubbery consistency and painless. She has been using hormonal contraception. The result of incisional biopsy was pleomorphic adenoma with the oncocityc adenoma part and clear cell adenoma. Management: widw exicion was performed under general anesthesia in both cases, with a limit 1 cm clinical margin at its periphery. Conclusion: both patients with pleomorphic adenoma ao palate were treated by wide excision. No recurrence were observed in 1 year (firs case) and 2 years (second case) after the surgery.

scholarly journals Deep Learning-Based Classification and Voxel-Based Visualization of Frontotemporal Dementia and Alzheimer’s Disease

2021 ◽  
Vol 14 ◽  
Author(s):  
Jingjing Hu ◽  
Zhao Qing ◽  
Renyuan Liu ◽  
Xin Zhang ◽  
Pin Lv ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Deep Learning ◽  
Frontotemporal Dementia ◽  
Image Data ◽  
Rapid Acquisition ◽  
Magnetic Resonance Imaging Mri ◽  
The One ◽  
The Right

Frontotemporal dementia (FTD) and Alzheimer’s disease (AD) have overlapping symptoms, and accurate differential diagnosis is important for targeted intervention and treatment. Previous studies suggest that the deep learning (DL) techniques have the potential to solve the differential diagnosis problem of FTD, AD and normal controls (NCs), but its performance is still unclear. In addition, existing DL-assisted diagnostic studies still rely on hypothesis-based expert-level preprocessing. On the one hand, it imposes high requirements on clinicians and data themselves; On the other hand, it hinders the backtracking of classification results to the original image data, resulting in the classification results cannot be interpreted intuitively. In the current study, a large cohort of 3D T1-weighted structural magnetic resonance imaging (MRI) volumes (n = 4,099) was collected from two publicly available databases, i.e., the ADNI and the NIFD. We trained a DL-based network directly based on raw T1 images to classify FTD, AD and corresponding NCs. And we evaluated the convergence speed, differential diagnosis ability, robustness and generalizability under nine scenarios. The proposed network yielded an accuracy of 91.83% based on the most common T1-weighted sequence [magnetization-prepared rapid acquisition with gradient echo (MPRAGE)]. The knowledge learned by the DL network through multiple classification tasks can also be used to solve subproblems, and the knowledge is generalizable and not limited to a specified dataset. Furthermore, we applied a gradient visualization algorithm based on guided backpropagation to calculate the contribution graph, which tells us intuitively why the DL-based networks make each decision. The regions making valuable contributions to FTD were more widespread in the right frontal white matter regions, while the left temporal, bilateral inferior frontal and parahippocampal regions were contributors to the classification of AD. Our results demonstrated that DL-based networks have the ability to solve the enigma of differential diagnosis of diseases without any hypothesis-based preprocessing. Moreover, they may mine the potential patterns that may be different from human clinicians, which may provide new insight into the understanding of FTD and AD.

scholarly journals Parotid gland adenocarcinoma in a cow: case report

2018 ◽  
Vol 70 (3) ◽  
pp. 758-766
Author(s):  
P.J.B. Queiroz ◽  
T.D. Queiroz ◽  
P.L. Magalhães ◽  
N.C. Borges ◽  
D.B. Martins ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Lymph Nodes ◽  
Polyclonal Antibodies ◽  
Malignant Neoplasm ◽  
Needle Aspiration ◽  
Undifferentiated Carcinoma ◽  
Submandibular Region ◽  
Parotid Region ◽  
Needle Aspiration Cytology ◽  
The Right

ABSTRACT A 9-year-old Girolando dairy cow, weighing 400kg, with a history of increased volume in the right parotid region, which extended to the submandibular region, was assisted. Fine needle aspiration cytology was performed, and the cytological findings were consistent with malignant neoplasm of epithelial origin (carcinoma). Because of the unfavorable prognosis, the animal was euthanized and submitted to an anatomopathological examination. Samples of the increased parotid and affected lymph nodes were collected for histopathological evaluation. The microscopic changes were accentuated features of anaplasia, moderate cell proliferation, atypical mitotic figures, and necrosis. Stroma ranged from delicate to scirrhous, and the tumor boundaries were not distinct. These findings substantiated the preliminary histomorphological diagnosis of undifferentiated carcinoma with metastasis in lymph nodes. Immunohistochemical tests were performed with anti-CK Pan (clone AE1AE3), anti-CK HMW (clone 34βE12), anti-CK19 (clone RCK108), anti-vimentin (clone V9), anti-S100 (polyclonal), and anti-androgen (polyclonal) antibodies. The immunophenotype favored the diagnosis of salivary gland adenocarcinoma. Despite the rareness in cattle, salivary gland adenocarcinoma should be considered in the differential diagnosis of diseases that occur with increased volume in the head, lymphadenopathy, drooling, dysphagia, and progressive weight loss.

scholarly journals Lacrimal ductal cyst of the medial orbit: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu Zhang ◽  
Changhong Zeng ◽  
Ningshao Chen ◽  
Chunling Liu
Keyword(s):  
Differential Diagnosis ◽  
Lacrimal Gland ◽  
Ocular Motility ◽  
Body Sensation ◽  
Clinical Presentations ◽  
Orbital Masses ◽  
Gland Tissue ◽  
Magnetic Resonance Imaging Mri ◽  
Painless Mass ◽  
The Right

Abstract Background The lacrimal ductal cyst (dacryops) is an uncommon clinical entity. It occurs anywhere that lacrimal gland tissue is present but most often appears as an expanding mass in the region of the lacrimal gland. The presence involving the medial part of the orbit is rare, ectopic location can be misleading in the differential diagnosis of orbital masses. The authors report a 53-year-old man who presented with dacryops occurred in an unusual location with significant clinical presentations. Case presentation A 53-year-old man had a painless mass located in the right superomedial orbit accompanied with foreign body sensation and lachrymation for two months, which had rapidly grown within 10 days. Decrease of visual acuity, high intraocular pressure (IOP) and limitation of extraocular movements in the right eye were present. The result of visual evoked potential (VEP) test suggested the impaired function of the optic nerve. Magnetic resonance imaging (MRI) studies revealed the presence of an isolated cystic lesion. The mass was completely removed via a transcutaneous approach, histopathologic findings were consistent with the lacrimal ductal cyst. The ocular motility and high IOP returned to normal. There had been no post-operative complications or signs of recurrence over five months follow-up. Conclusion Lacrimal ductal cysts can present in the medial orbit, clinicians should include this entity in the differential diagnosis of orbital masses and be aware of its variable presentations such as high IOP in this case. We comment on the fact that many reported cases of ectopic dacryops may be an extension of normal lacrimal gland tissue.

The Utility of In-Office Ultrasound in the Diagnosis of Parotid Lesions

2017 ◽  
Vol 156 (3) ◽  
pp. 511-517 ◽  
Author(s):  
Yarah M. Haidar ◽  
Omid Moshtaghi ◽  
Amin Mahmoodi ◽  
Mohammad Helmy ◽  
Julie A. Goddard ◽  
...  
Keyword(s):  
Head And Neck ◽  
Tertiary Care ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Needle Aspiration ◽  
Additional Information ◽  
Academic Center ◽  
Positron Emission ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri

Objective To determine whether the use of in-office ultrasound (US) by a head and neck surgeon is a useful adjunct to clinical assessment of parotid lesions and decrease the need of additional imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT). Study Design Case series with chart review. Setting Tertiary care academic center. Subjects Seventy patients presenting with a parotid lesion who obtained an in-office US and ultrasound-guided fine-needle aspiration (USGFNA) from a head and neck surgeon from 2006 to 2015. Methods US images were retrospectively reviewed for 70 patients and characterized by a radiologist and a head and neck surgeon. Results Of the 70 patients, 6 had US characteristics that demonstrated a statistically significant association with a benign/malignant diagnosis: depth from surface; irregular borders; presence of calcifications, which included either micro- or macro-calcifications; posterior echogenicity enhancement; irregular shape; and homogeneous/heterogeneous echotexture. Imaging was performed prior to referral in 25 cases (35.7%); of those, 17 (68%) were for superficial, small (<2 cm) tumors where prereferral imaging studies did not provide additional information to that obtained with US. Of the 55 patients without MRI or CT performed prior to referral, MRI or positron emission tomography–CT scan was obtained in only 4 patients (7.3%) in cases involving recurrent parotid lesions, large tumors, or workup of a malignant neoplasm. Conclusions Several US characteristics individually assist in lesion characterization. In-office US and USGFNA are an appropriate first-line modality in the assessment of parotid lesions, can allow for immediate parotid lesion assessment, and can decrease the need for additional imaging.

scholarly journals Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor

2021 ◽  
Vol 12 ◽  
pp. 64
Author(s):  
Yu Shimizu ◽  
Katsuyoshi Miyashita ◽  
Nozomu Oikawa ◽  
Masaaki Kobayashi ◽  
Yasuo Tohma
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumor ◽  
Metastatic Brain Tumor ◽  
Vasa Vasorum ◽  
Neurological Deficits ◽  
Peripheral Edema ◽  
Thrombosed Aneurysm ◽  
Aneurysm Wall ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to guarantee the best surgical approach for these lesions. Case Description: Here, we report an extremely rare case of a right frontal mass mimicking a brain tumor, in which the surgery unveiled a CTIA of the right middle cerebral artery (MCA). A 56-year-old woman presented with right hemiparesis and mild headache. Magnetic resonance imaging (MRI) revealed a right frontal mass with peripheral edema. The lesion enhanced on initial and follow-up MRI of the brain. Subsequent vascular studies and metastatic workup were negative. A temporal craniotomy with neuronavigation (Brain Lab AG, Germany) was performed and an intraoperative diagnosis of a thrombosed aneurysm along the branch of the MCA was established. The aneurysm was successfully trapped and resected. The patient did not exhibit any postoperative neurological deficits. Conclusion: This is the rare report of a ring enhanced completely thrombosed aneurysm due to vasa vasorum which is misdiagnosed as metastatic brain tumor. In case of an intracranial ring enhanced mass with signs of intralesional hemorrhage and peripheral edema, CTIA should be considered as a possible differential diagnosis.

scholarly journals Bilateral Thalamic Glioma –A Rare Tumour

2014 ◽  
Vol 3 (1) ◽  
pp. 71-73
Author(s):  
Vivek Rauniyar ◽  
Bing Qin ◽  
Huan Yang
Keyword(s):  
Personality Change ◽  
Rare Tumour ◽  
Ct Guided ◽  
Weighted Image ◽  
Medical College ◽  
Fibrillary Astrocytoma ◽  
Rare Tumours ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Astrocytoma Grade Iii

We report a case of 48-year old woman who presented with dementia, progressive mental decline, personality change, paresis of the right lower extremity, and gait ataxia. Magnetic resonance imaging (MRI) T1-weighted image revealed bilateral thalamic swelling with homogenous low signal intensity and mild contrast enhancement with gadolinium. The T2- weighted image showed high intensity lesions in the bilateral thalamus, septum pellucidum and fornix. A CT-guided stereotactic biopsy of the lesion revealed fibrillary astrocytoma grade III as per WHO classification. Bilateral thalamic gliomas are very rare tumours and when present may resemble other benign diseases having similar clinical presentations DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10059   Journal of Nobel Medical College Vol.3(1) 2014; 71-73

scholarly journals Altered hypothalamic microstructure in human obesity

2019 ◽  
Author(s):  
K. Thomas ◽  
F. Beyer ◽  
G. Lewe ◽  
R. Zhang ◽  
S. Schindler ◽  
...  
Keyword(s):  
Animal Studies ◽  
Energy Homeostasis ◽  
Structural Changes ◽  
Right Hemisphere ◽  
Large Samples ◽  
Weighted Magnetic Resonance Imaging ◽  
Important Regulator ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
And Diffusion

AbstractObesity is a multifactorial disorder driven by sustained energy imbalance. The hypothalamus is an important regulator of energy homeostasis and therefore likely involved in obesity pathophysiology. Animal studies suggest that obesity-related diets induce structural changes in the hypothalamus through inflammation-like processes. Whether this translates to humans is however largely unknown. Therefore, we aimed to assess obesity-related differences in hypothalamic macro- and microstructure based on a multimodal approach using T1-weighted and diffusion-weighted magnetic resonance imaging (MRI) acquired at 3 Tesla in a large well-characterized sample of the Leipzig Research Center for Civilization Diseases (LIFE) cohort (n1 = 338, 48% females, age 21-78 years, BMI 18-43 kg/m2). We found that higher body mass index (BMI) selectively predicted higher mean proton diffusivity (MD) within the hypothalamus, indicative of compromised microstructure in the underlying tissue. Results were independent from confounders and confirmed in another independent sample (n2 = 236). In addition, while hypothalamic volume was not associated with obesity, we identified a sexual dimorphism and larger hypothalamic volumes in the left compared to the right hemisphere. Using two large samples of the general population, we showed that a higher BMI specifically relates to altered microstructure in the hypothalamus, independent from confounders such as age, sex and obesity-associated co-morbidities. This points to persisting microstructural changes in a key regulatory area of energy homeostasis occurring with excessive weight. These findings may help to better understand the pathomechanisms of obesity and other eating-related disorders.

Parotid Mass

2020 ◽  
Author(s):  
Neil Bhattacharyya ◽  
Yarah M Haidar ◽  
Monica S Trent
Keyword(s):  
Differential Diagnosis ◽  
Salivary Gland ◽  
Parotid Gland ◽  
Malignant Neoplasm ◽  
Needle Aspiration ◽  
Salivary Gland Tumors ◽  
Major Salivary Gland ◽  
Clinical Behavior ◽  
Fine Needle ◽  
Key Words Facial Nerve

Major salivary gland tumors constitute 3 to 6% of all tumors of the head and neck in adults, and about 85% of these salivary gland tumors are found in the parotid gland. Approximately 70% of parotid lesions are neoplastic, and roughly 16% of these neoplasms are malignant. The spectrum of histopathologic entities encompassed by the term parotid mass is exceedingly broad and continues to evolve as our understanding of the origin and clinical behavior of the various tumors arising from the parotid gland expands. This review discusses the anatomy, etiology, differential diagnosis, diagnostic workup and imaging, surgical management, and overall prognosis for parotid masses. This review contains 6 figures, 11 tables, and 84 references. Key words: facial nerve, fine-needle aspiration, imaging, malignant neoplasm, neck dissection, parotid mass, parotidectomy, pleomorphic adenoma 

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