scholarly journals Inflammatory pseudotumor of the spleen

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Georgia McMahon ◽  
Kirsty Rady ◽  
Henry Miles Prince
Keyword(s):  
Young Woman ◽  
Inflammatory Markers ◽  
Inflammatory Pseudotumor ◽  
Unknown Etiology ◽  
Diagnostic Challenge ◽  
Inflammatory Lesions ◽  
Splenic Mass ◽  
Clinical Presentations ◽  
Inflammatory Pseudotumors

Isolated splenic inflammatory pseudotumors (IPT) are extremely rare, typically benign, inflammatory lesions with varied clinical presentations that pose a diagnostic challenge to clinicians due to their similarity in appearance to neoplasms. We present the case of a young woman diagnosed with a splenic IPT following investigation for persistent anemia, raised inflammatory markers, and polyclonal hyper-gammaglobulinemia, whose symptoms resolved completely following splenectomy. This case highlights the need to consider this diagnosis when evaluating patients with a splenic mass of unknown etiology.

scholarly journals Diagnosis, treatment, and rehabilitation of a patient with inflammatory pseudotumor

2018 ◽  
Vol 12 (03) ◽  
pp. 454-458
Author(s):  
Flávio Tendolo Fayad ◽  
Matheus Cavalcante Tomaz Bezerra ◽  
Marina Rolo Pinheiro da Rosa ◽  
Tiago Novaes Pinheiro
Keyword(s):  
Surgical Resection ◽  
Clinical Features ◽  
Inflammatory Pseudotumor ◽  
Multidisciplinary Treatment ◽  
Unknown Etiology ◽  
Functional Rehabilitation ◽  
Multiple Biopsies ◽  
Complete Surgical Resection ◽  
Inflammatory Pseudotumors ◽  
Maxillary Region

ABSTRACTInflammatory pseudotumors are a group of lesions of unknown etiology that mimic clinically and radiographically neoplasms. In the maxilla, inflammatory pseudotumors are presented with bone alterations of erosion, remodeling, and sclerosis. The diagnosis is of exclusion, where multiple biopsies are required. The present study aims to report the case of a male patient who presented with increased volume in the left maxillary region, with diagnosis after total left maxillectomy being inflammatory pseudotumor. The patient did not present recurrences with 3 years of preservation and underwent by multidisciplinary treatment with esthetic and functional rehabilitation with the preparation of a bucomaxilo prosthesis. Despite presenting some suggestive clinical features, the inflammatory pseudotumor has a difficult and of exclusion diagnosis, where multiple biopsies are required. They are lesions that simulate clinically and radiographically neoplasms. If it is surgically accessible, the treatment of choice is complete surgical resection.

scholarly journals Inflammatory pseudotumor of the spleen

2006 ◽  
Vol 63 (8) ◽  
pp. 757-760 ◽  
Author(s):  
Natasa Colovic ◽  
Radoje Colovic ◽  
Nikica Grubor ◽  
Marijan Micev ◽  
Vladimir Radak ◽  
...  
Keyword(s):  
World Literature ◽  
Lymphoproliferative Disorder ◽  
Epstein Barr Virus ◽  
Inflammatory Pseudotumor ◽  
Unknown Etiology ◽  
Left Shoulder ◽  
Exact Nature ◽  
Barr Virus ◽  
Inflammatory Pseudotumors ◽  
Epstein Barr

Background. Inflammatory pseudotumors are benign tumor lesions of an unknown etiology that can appear almost at any organ, sometimes along with infectious agens, like Epstein-Barr virus. They are extremely rare in the spleen, with less than 80 cases described in the world literature. It is a single, very rarely multinodal lesion. Middle aged patients are mostly affected. Symptoms are either absent or uncharacteristic, so that the tumors are discovered by chance or during investigations of other diseases. Case report. We presented a 56-year-old woman in whom a nodal lesion of 2 cm in diameter had been discovered in the spleen during a routine check-up after a mild traffic accident. The lesion had grown up to 6 cm in diameter during a 5-year follow-up causing a mild pain over the upper left abdomen and left shoulder. Fine needle biopsy failed to show the exact nature of the lesion. Splenectomy was performed due to a suspected lymphoproliferative disorder. Histology and immunohistochemistry of the lesion of the upper pole of the spleen showed inflammatory pseudotumor. Epstein-Barr virus was not present. The patient developed postsplenectomy thrombocytosis (up to 850 ? 109/l) which settled down within 10 weeks. Conclusion. Inflammatory pseudotumors of the spleen are extremely rare. The exact diagnosis can be established only by histology and/or immunohistochemistry of the spleen removed for a suspected lymphoproliferative disorder, most frequently lymphoma. The patient was cured with splenectomy.

Intracranial extension of inflammatory pseudotumor of the orbit

1984 ◽  
Vol 60 (3) ◽  
pp. 625-629 ◽  
Author(s):  
Andrew H. Kaye ◽  
Joseph F. Hahn ◽  
Atanase Craciun ◽  
Maurice Hanson ◽  
A. Jan Berlin ◽  
...  
Keyword(s):  
Case Report ◽  
Inflammatory Pseudotumor ◽  
The Other ◽  
Intracranial Extension ◽  
Unknown Etiology ◽  
Content Type ◽  
Inflammatory Lesions ◽  
Orbital Neoplasm ◽  
The Subject ◽  
Fine Print

✓ Orbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. Involvement of the other orbit is uncommon, and extension into the paranasal sinus rare. Intracranial extension of pseudotumor of the orbit is previously unreported. This is a case report of a patient with pseudotumor of the orbit with intracranial extension. The literature of the subject is reviewed.

Extra-nodal Rosai-Dorfman Disease Confined to Breast

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S41-S42
Author(s):  
E Ozluk ◽  
R Shackelford
Keyword(s):  
Plasma Cells ◽  
African American Woman ◽  
American Woman ◽  
Lymphocytic Infiltration ◽  
Needle Aspiration ◽  
Left Breast ◽  
Unknown Etiology ◽  
Diagnostic Challenge ◽  
Ductal Cells ◽  
Rosai Dorfman Disease

Abstract Introduction/Objective First described by Rosai and Dorfman in 1969, Rosai-Dorfman Disease (RDD) is an uncommon, idiopathic, reactive lymph node process with an unknown etiology. It may involve extra-nodal organs including the skin, bone, soft tissue, and eyes. However, breast involvement is rare and RDD confined to breast without nodal involvement is extremely uncommon. Methods Here we present a case of RDD confined to breast. The patient was a 51-year-old African American woman who was found to have an irregular, solid left breast mass on routine mammogram, which had speculated irregular margins and measured of 37.0 x 32.0 x 32.0 mm. She did not have any symptoms, nor any palpable lymph nodes. The clinician stated that the lesion was highly suspicious for a breast malignancy and requested a fine needle aspiration (FNA) of the mass, followed by total excision. Results An FNA was interpreted as atypical histiocytic cells in a mixed lymphoid background. Histopathologic examination revealed an ill-defined mass with sheets of histiocytes, plasma cells, and a mixed lymphocytic population, with occasional germinal centers. Some of the histiocytes were spindle shaped and associated with storiform collagen deposition. The histiocytes had single and multiple nuclei and exhibited occasional emperipolesis. Immunohistochemical staining with S100 diffusely highlighted the histiocytes, whereas CD1a was negative. CD3 and CD20 immunostains were positive for mixed-type lymphocytic infiltration. Cytokeratin staining was performed and reassuringly stained only the benign ductal cells. A diagnosis of RDD of the breast was made, based on these histopathologic findings. Conclusion We report an example of an extra-nodal RDD involving the mammary gland that was initially suspected to be breast carcinoma. RDD may still be a diagnostic challenge, especially in a patient with suspected carcinoma. It is the pathologist’s role to lead the clinician to the proper diagnosis and render a correct histopathologic diagnosis.

scholarly journals Fetal death: an extreme manifestation of maternal anti-fetal rejection

2017 ◽  
Vol 45 (7) ◽  
Author(s):  
Kia Lannaman ◽  
Roberto Romero ◽  
Tinnakorn Chaiworapongsa ◽  
Yeon Mee Kim ◽  
Steven J. Korzeniewski ◽  
...  
Keyword(s):  
Cohort Study ◽  
Amniotic Fluid ◽  
Study Design ◽  
Fetal Death ◽  
Unknown Etiology ◽  
Amniotic Cavity ◽  
Inflammatory Lesions ◽  
Esi Ms ◽  
Chemokine Ligand ◽  
Placental Inflammation

AbstractObjective:The aim of this study was to determine the association between chronic placental inflammation and amniotic fluid (AF) markers of maternal anti-fetal rejection as well as the presence of microorganisms in the AF fluid of patients with fetal death.Study Design:This cohort study included 40 patients with fetal death whose placentas were examined for chronic inflammatory lesions and whose AF chemokine ligand (CXCL)10 and interleukin (IL)-6 concentrations were determined by immunoassays. AF was processed for bacteria, mycoplasmas and viruses using cultivation and molecular microbiologic techniques (i.e. PCR-ESI/MS).Results:(1) The most prevalent placental findings were maternal vascular underperfusion (63.2%, 24/38), followed by chronic inflammatory lesions (57.9%, 22/38); (2) chronic chorioamnionitis (18/38) was three times more frequent than villitis of unknown etiology (6/38); (3) an elevated AF CXCL10 concentration (above the 95Conclusion:In women with unexplained fetal death, there is an association between elevated AF CXCL10 and chronic placental inflammatory lesions. Therefore, we conclude that a subset of patients with fetal death may have endured a breakdown of maternal-fetal tolerance, which cannot be attributed to microorganisms in the amniotic cavity.

scholarly journals Inflammatory Pseudotumor of the Maxillary Sinus

2009 ◽  
Vol 24 (2) ◽  
pp. 38-39
Author(s):  
Johann F. Castañeda ◽  
Jeffrey S. Concepcion ◽  
Ricardo L. Ramirez ◽  
Kirt Areis Delovino
Keyword(s):  
Soft Tissue ◽  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Inflammatory Pseudotumor ◽  
Soft Tissue Mass ◽  
The Body ◽  
Medical Attention ◽  
Tissue Mass ◽  
Inflammatory Pseudotumors ◽  
Left Maxillary Sinus

Inflammatory pseudotumor (IPT) is a rarely occurring lesion with no identifiable local or systemic cause. First described in 1905 by Birch-Hirschfield,1 it remains somewhat of an enigmatic disease entity despite multiple otolaryngologic, radiologic, and pathologic reports. The term “pseudotumor” was used because these lesions mimic invasive malignant tumors, both clinically and radiologically. IPT most commonly involves the lung and orbit, but has also been reported to occur at sites that make biopsy or excision difficult or potentially disfiguring.2 Its diagnosis and prompt recognition may help avoid radical surgery for this benign lesion.     CASE               A 27-year-old male was seen at our outpatient department due to a progressively enlarging left infraorbital mass. Two years prior, the patient noted a swelling over his left infraorbital area. The swelling was somewhat painful and rapidly grew in size so that it measured almost 2.5x2.5cm after a week. Still tender, it became firm and violaceous in color. He sought medical attention at a local hospital after one more week of persistent swelling and increasing cheek pain, but denied excessive lacrimation, blurring of vision, orbital pain, eye discharge or numbness.               Incision and drainage of the left infraorbital mass drained purulent material with resolution of the swelling and associated symptoms, but a pea-sized mass was still palpable over the post operative site.  Over the months that followed, the mass gradually increased in size, with occasional serosanguinous discharge from the incision site. There was no pain, numbness or blurring of vision.  He self-medicated with Cefalexin, taken irregularly for 8 months without any improvement, before finally consulting again.               An orbital CT scan requested by the referring Ophthalmology service showed an expansile, mildly enhancing soft tissue mass with few peripheral foci of calcifications measuring 8.2 x 4.4 x 6.4 cm (Figures 1 A, B) completely occupying the left maxillary sinus and extending up to the infero-lateral aspect of the left orbital cavity. There was erosion of the lateral portion of the left orbital floor and disruption of the frontal process of the left zygomatic bone with obliteration and effacement of the left pterygopalatine fossa.   Our physical examination revealed a firm, fixed, nontender 4x4cm left inferior orbital mass with serosanguinous discharge, and a bulging lateral nasal wall. Epiphora from the left eye suggested nasolacrimal duct obstruction, but vision and extraocular movements were intact.               Caldwell-Luc biopsy surprisingly yielded only necrotic and inflammatory tissues despite generous samples from multiple sections of the maxillary portion, and inflammatory polyps from the intranasal component.  At surgery after a few weeks, the mass still occupied the entire left maxillary sinus despite the previous biopsy which had removed a significant amount of tumor. Furthermore, the mass now extended beyond the maxillary sinus into the left upper gingivobuccal area thru the previous maxillary window. The entire clinically aggressive maxillary sinus mass was removed under endoscopic guidance, but the final histopathology report was still similar to the previous findings of necrotic and inflammatory tissues.               A month after surgery, the patient was seen at the Emergency room for left infraorbital swelling and discharge. Contrast-enhanced MRI of the nasopharynx showed a large expansile left maxillary sinus lesion bulging into the nasal cavity, extending into adjacent lateral orbital soft tissue and extending into the buccal space through an apparently disrupted left inferolateral maxillary wall. Intravenous antibiotics and a high-dose steroid trial resulted in complete disappearance of the left infraorbital mass and discharge within a week, and the patient was discharged on a tapering steroid dose.     DISCUSSION               Inflammatory pseudotumor is a quasi-neoplastic lesion that has been reported to occur in nearly every site in the body, most commonly involving the lung and the orbit, and rarely the maxillary sinus1. Its diagnosis is usually by exemption since clinical and histopathologic findings are sometimes vague and inconsistent. The exact etiology of these lesions is not clear. It has been postulated that they might be the result of a post-inflammatory repair process, a metabolic disturbance, or an antigen-antibody interaction with an agent that was no longer identifiable in aspiration or biopsy material.3 The clinical findings in a patient with an inflammatory pseudotumor are variable, depending on the growth rate of the lesion and the specific structures that have been affected. Inflammatory pseudotumors have been reported to cause chronic cough (as a result of endobronchial growth), dry cough, fever, pleuritic pain, right upper quadrant or epigastric pain,  and several constitutional symptoms, such as malaise, weight loss, fatigue, and syncope. Inflammatory pseudotumors have been found incidentally during imaging examinations for other reasons.3 Extraorbital inflammatory pseudotumor of head and neck can occur in the nasal cavity, nasopharynx, maxillary sinus, larynx and trachea. Perineural spread along maxillary, mandibular and hypoglossal nerves had been described. Sinonasal inflammatory psuedotumors do not affect a particular age group and cause no systemic symptoms.  However, they have a more aggressive appearance than those of the orbit, with bony changes such as erosion, remodelling and sclerosis usually seen on radiographic studies.4 On CAT scans, a moderately enhancing soft tissue mass is usually seen, accompanied by bony changes common among malignant processes.5 On cut sections, inflammatory cells dominate as well as necrotic tissues. In some patients, laboratory findings are normal; in others, there might be an elevated erythrocyte sedimentation rate and C-reactive protein level and sometimes a high white blood cell count3. However, none of the published reports on inflammatory pseudotumor have mentioned any presence of positive tumor markers. Complete surgical resection if possible is the treatment of choice for sinonasal inflammatory pseudotumors, followed by corticosteroids in cases of incomplete excision.  Response to steroids is often unpredictable, but these drugs are the primary treatment method for orbital inflammatory pseudotumor. The only cases in which radiation therapy is indicated are those patients for whom surgery or corticosteroid therapy is unsuccessful or contraindicated.6

scholarly journals Head and neck inflammatory pseudotumor: Case series and review of the literature

2016 ◽  
Vol 29 (6) ◽  
pp. 440-446 ◽  
Author(s):  
Sagar Kansara ◽  
Diana Bell ◽  
Jason Johnson ◽  
Mark Zafereo
Keyword(s):  
Head And Neck ◽  
Inflammatory Pseudotumor ◽  
Case Series ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Disease Recurrence ◽  
Neck Mass ◽  
Level Ii ◽  
Oral Corticosteroids ◽  
Inflammatory Pseudotumors

Inflammatory pseudotumor (IP) is an uncommon idiopathic lesion that often imitates malignancy clinically and radiologically. Inflammatory pseudotumors have been found to occur in various sites but rarely in the head and neck. The histopathology, imaging, and treatment of three unique cases of head and neck inflammatory pseudotumors are described in this case series. Patients in Cases 1 and 2 presented with right level II neck mass and left parotid tail mass, respectively. The patient in Case 3 presented with otalgia, jaw pain and trismus, and a left parapharyngeal space mass. The tumors in Cases 1 and 3 significantly decreased in size with tapered courses of oral corticosteroids. The tumor in Case 2 was surgically excised without disease recurrence. Malignancy must be ruled out with incisional or excisional biopsy. Treatment includes surgical excision, oral corticosteroids, or both. The literature shows that radiotherapy and small-molecule inhibitors may be promising alternatives.

scholarly journals Sinonasal Sarcoidosis: A Case Report

2016 ◽  
Vol 15 (4) ◽  
pp. 648-650
Author(s):  
Afroza Khanam ◽  
Gulshan Akhtar ◽  
Nabila Khanduker ◽  
Nurun Nahar Chowdhury ◽  
Mohammad Abdur Rahman ◽  
...  
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Medical Science ◽  
Neck Region ◽  
Pulmonary Involvement ◽  
Unknown Etiology ◽  
Nasal Discharge ◽  
Diagnostic Challenge ◽  
Current Case ◽  
Nasal Blockage

Sarcoidosis is a chronic granulomatous disease of unknown etiology which principally affects the lower respiratory tract & lungs. Sarcoidosis in the head & neck region is infrequent. Isolated sino nasal sarcoidosis without pulmonary involvement is rare.Case: An 18 years old male patient presented with the complaints of nasal blockage, purulent nasal discharge which was occasionally blood stained for 6 months, deformity of nose, swelling of face & lips for 4 months & watering of eyes for same duration. Endoscopy of nose revealed intra nasal mucosal thickening which was friable & bleeds on touch. The diagnosis of sino nasal sarcoidosis was made by histopathological examination of nasal biopsy specimen.Conclusion: Sino nasal sarcoidosis is a disease of diagnostic challenge to the clinician as its mimicking clinical features may be misleading & cause delay in definitive diagnosis. In the current case report, we presented a case of sino nasal sarcoidosis presenting as chronic rhino sinusitis.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.648-650

scholarly journals Prognostic Biomarkers of Sarcoidosis: A Comparative Study of Serum Chitotriosidase, ACE, Lysozyme, and KL-6

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Laura Bergantini ◽  
Francesco Bianchi ◽  
Paolo Cameli ◽  
Maria Antonietta Mazzei ◽  
Annalisa Fui ◽  
...  
Keyword(s):  
Steroid Therapy ◽  
Lung Fibrosis ◽  
Clinical Utility ◽  
Clinical Course ◽  
Unknown Etiology ◽  
Serum Concentrations ◽  
Referral Centre ◽  
Clinical Presentations ◽  
Serum Detection

Purpose. Sarcoidosis is a systemic granulomatous disease with unknown etiology. Many clinical presentations have been reported, and acute disease needs to be distinguished from subacute and chronic disease. The unpredictable clinical course of the disease prompted us to evaluate the clinical utility of biomarker serum detection in sarcoidosis follow-up. Methods. Serum concentrations of chitotriosidase, ACE, KL-6, and lysozyme were analyzed by different methods in a population of 74 sarcoidosis patients (46 on steroid therapy at sampling) regularly monitored at Siena Sarcoidosis Regional Referral Centre and in a group of controls with the aim of comparing their contribution to clinical management of sarcoidosis patients. Results. KL-6 concentrations were significantly elevated in sarcoidosis patients with lung fibrosis and were significantly correlated with DLco and CPI score, while chitotriosidase was significantly higher in patients with extrapulmonary localizations. With a cut-off value of 303.5 IU/ml, KL-6 showed the best sensitivity (78%), while chitotriosidase reported the best specificity (85%) among the biomarkers. Conclusions. KL-6 is a reliable biomarker of fibrotic lung involvement in sarcoidosis patients. Among biomarkers, KL-6 showed the best sensitivity and serum chitotriosidase the best specificity, even in patients on chronic steroid therapy, and seemed to correlate with extrapulmonary localizations.

scholarly journals The Diagnostic Challenge of an Infrequent Spectrum of Cryptococcus Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Francisco Barbosa De Araujo Neto ◽  
Camila Corona De Godoy Bueno ◽  
Liege Tambelini Gomes ◽  
Daniela Alejandra Ortiz Navas ◽  
Mark Wanderley ◽  
...  
Keyword(s):  
Fungal Spores ◽  
Unknown Etiology ◽  
Diagnostic Challenge ◽  
Fungal Isolation ◽  
Palpable Mass ◽  
Cryptococcal Infection ◽  
Important Differential Diagnosis ◽  
Chest X Ray ◽  
Malignant Lesions

Cryptococcal infection results from inhalation of fungal spores and usually is confined to the lungs, but may disseminate systemically. Radiologically, cryptococcal infection has multiple forms of presentation. The diagnosis is usually based on fungal isolation from cultured clinical specimens. Long term antifungal therapy is recommended, but surgical procedures may eventually be necessary when large thoracic symptomatic masses are present. We report a case of a 41-year-old male, immunocompetent, investigating a palpable mass in the left supraclavicular region associated with unintentional weight loss over the last three months. He also reported chest pain in this period. Chest X-ray, ultrasonography, and computed tomography were performed, which diagnosed a mediastinal and left supraclavicular mass, interpreted as lymph node conglomerates of unknown etiology. He also underwent a biopsy of the left supraclavicular mass for etiological determination by histopathology, which confirmed cryptococcosis infection. Although very infrequent, mediastinal cryptococcal infection (simulating masses) is a challenging but important differential diagnosis of benign and malignant lesions, since its treatment is usually clinical.

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