睾丸间质细胞瘤3例报告及文献复习

目的：探讨睾丸间质细胞瘤的临床病理特点及诊疗方法。方法：分析并总结3例睾丸间质细胞瘤患者的,J盏床病理资料并文献复习。结果：1例术中冰冻切片诊断为睾丸间质细胞瘤,2例术前细针穿刺病理诊断为睾丸间质细胞瘤,病理组织学表现为瘤细胞呈团、条索或弥漫分布,体积较大,呈多角形胞质丰富嗜酸性,边界清楚。2例患者行单侧睾丸切除,1例行睾丸肿瘤剜除术,术后分别随访24、15、10个月未见复发。结论：睾丸间质细胞瘤发病率低,临床表现缺乏特异性,易误诊,确诊需依赖病理组织学检查,细针穿刺病理可明确诊断并有助于手术的选择及手术范围的确定。     

鞍区颗粒细胞瘤1例的病历分析及相关文献复习

目的：探讨伴有临床症状的鞍区颗粒细胞瘤（granular cell tumour,GCT）的病理组织学起源及其治疗方法。方法：回顾性分析我院收治的1例具有临床症状的GCT患者的治疗状况和病理结果,并结合近20年来关于GCT病理和治疗的相关文献报道,探讨GCT肿瘤病理组织起源和治疗要点。结果：该患者影像学报告怀疑鞍区炎性肉芽肿,给予抗生素治疗后复查MRI显示鞍区占位较前次无改变,增强MRI可见占位明显强化,诊断良性肿瘤,并采取翼点入路手术切除。术后病理证实为神经垂体颗粒细胞瘤。术后患者头痛缓解,尿量、尿比重、垂体内分泌激素等相关指标相继恢复至正常值。结论：GCT很可能起源于神经组织,伴有临床症状的GCT的治疗首选开颅手术,肿瘤残存的患者,术后不必放射治疗,定期复查即可。     

Plasma Cell Granuloma of The Thyroid: Report of Case and Review of Literature

ObjectiveTo report the 12th case of a patient with a plasma cell granuloma of the thyroid, a rare cause of goiter and hypothyroidism.MethodsWe present a case report of a woman with a plasma cell granuloma of the thyroid. The clinical and pathologic features of the lesion are described, the differential diagnosis is discussed, and the relevant literature is reviewed.ResultsPlasma cell granulomas are uncommon benign lesions most typically located in the lung and only rarely identified in other organs. Only 11 cases of plasma cell granuloma of the thyroid gland have been reported previously. We describe the case of a 55-year-old woman with a long history of hypothyroidism and compressive symptoms from an enlarging neck mass. A thyroidectomy was performed. On gross examination, the thyroid had been replaced by firm, white, fibrotic tissue with a multinodular appearance. On microscopy, the infiltrate consisted predominantly of plasma cells that were polyclonal with the expression of both kappa and lambda light chains. A minor component of CD5- and CD20-positive (T and B) lymphocytes was observed. These features were important for establishing the diagnosis of a plasma cell granuloma and distinguishing the lesion from a plasmacytoma.ConclusionThis is the 12th reported case of plasma cell granuloma of the thyroid gland, a very rare cause of either a diffuse or a nodular goiter and hypothyroidism. The presence of a polyclonal plasma cell population with the expression of both kappa and lambda light chains helps to distinguish a plasma cell granuloma from a malignant plasmacytoma of the thyroid gland. (Endocr Pract. 2008; 14:611-617)     

Mycetoma in China: A Case Report and Review of the Literature

Mycopathologia - Mycetoma is a chronic granulomatous infectious disease that can affect the skin, subcutaneous tissue, fascia and bone. It can be caused by filamentous bacteria or fungi and usually...     

Auricular Chromoblastomycosis: A Case Report and Review of Published Literature

Subcutaneous chromoblastomycosis is an infection commonly seen in tropical and subtropical climates, usually caused by trauma with vegetables and often affects the host’s lower limbs. We report a case of auricular chromoblastomycosis in a 67-year-old man and discuss the rarity of this clinical manifestation of chromoblastomycosis in the medical literature. In the present case, the etiologic agent was Fonsecaea pedrosoi, the most common agent found in Brazil.     

Lasiodiplodia theobromae Keratitis: A Case Report and Review of Literature

A case report and review of literature is reported of a rare case of fungal keratitis from eastern India. A 32-year-old woman with a history of vegetative trauma presented with keratitis in left eye. Microbiological examination of corneal scraping showed refractile hyphae with aseptate branching filaments and black pigmented colonies on multiple solid agar medium. Organism was identified from culture using D1/D2 region of LSU (Large Sub Unit: 28S rDNA)-based molecular technique. PCR amplified a band with a sequence that was 100?% homologous with Lasiodiplodia theobromae. The organism was susceptible to amphotericin B and voriconazole and demonstrated resistance to itraconazole and fluconazole. A therapeutic keratoplasty was performed following non-responsiveness to initial topical voriconazole (2?%) therapy. Recurrence in graft was controlled with topical voriconazole and intracameral amphotericin B. However, the graft failed at the end of 3?months. L. theobromae is a rare cause of fungal keratitis. Management of these cases is difficult, often involving surgical procedures.     

肺复合性血管内皮瘤1例报道及文献复习

目的:探讨复合性血管瘤(composite hemangioendothelioma,CHE)的临床病理和生物学特点。方法:结合相关文献对1例肺复合性血管内皮瘤伴皮肤和脑转移的临床资料、组织病理特征及免疫组化结果进行分析。结果:镜检见肿瘤组织由良性、中间型及恶性血管多种成分混合组成:肺组织与头皮的真皮及皮下组织的病变相似,为浸润性生长,病变包括上皮样血管内皮瘤(约占50%)、网状型血管内皮瘤(约占15%)、梭形细胞血管瘤(约占20%)、"血管肉瘤样"区域(约占5%)和良性血管病变(约占10%)。颅内病变可见上皮样血管内皮瘤、梭形细胞肿瘤及动静脉畸形区域。免疫组化标记示FⅧRAg( )、cD34( )。结论:肺复合性血管内皮瘤属交界性/低度恶性肿瘤,确诊依赖于病理形态学,有复发倾向,少见转移。     

慢性髓性白血病患者非血缘供者骨髓移植术后并发甲状腺功能亢进1例并文献复习

目的:分析骨髓移植后引起甲状腺功能亢进的病因、临床特点、治疗及预后.方法:报道l例慢性髓性白血病患者非血缘供者骨髓移植术后并发甲状腺功能亢进随访9年的结果,并复习相关文献.结果:患者男性,21岁,确诊慢性髓性白血病后行非血缘供者骨髓移植,术后+44天,出现持续低热,抗细菌、抗病毒及抗真菌治疗均无效,排除疾病复发,查甲状腺功能提示患者从亚临床甲状腺功能亢进进展为甲状腺功能亢进,给予口服甲巯咪唑治疗2周,患者体温降至正常,血T4、fT4恢复正常,随访9年,慢性髓性白血病无复发,甲状腺功能持续正常.检索文献发现类似报道5例,对其进行归纳分析.结论:骨髓移植术后早期并发甲状腺功能亢进,可能与放化疗预处理及免疫损伤引起的破坏性甲状腺炎相关,有其独特的临床表现,极易被忽视,治疗方面可以尝试应用糖皮质激素及抗甲状腺药物.对于非血缘供者骨髓移植后不明原因发热者,应考虑到甲亢可能.     

Metastatic Urethral Melanoma: Case Report and Review of the Literature

Melanoma is a cancer that originates from melanocytes, is predominant in adults with white skin, represents 4% of skin cancers, and has high possibility of forming metastasis. This review reports on the case of a young man, age 36 years, previously diagnosed with melanoma. The patient complained of obstructive urinary symptoms and, while he was undergoing a cystoscopy, it was discovered that he had a lesion corresponding with metastatic melanoma of the prostatic urethra, which occluded almost the entire urethra and resulted in blocked urinary flow. He underwent a transurethral resection of the prostate, followed by resection of the lesion. After the procedure, he had good urinary flow and is currently on follow-up.Key words: Melanoma, Urethra, Urinary obstruction, Metastasis, Urethral melanomaPrimary malignant melanoma of the urethra is rare, representing < 1% of all melanomas^1,2; it is often misdiagnosed, which leads to delays in treatment.² The lethality is high, but its incidence is low. Prognosis is considered good if it is detected in its early stages.¹ In recent years, there have been great improvements in patient survival rates. In developed countries, the average estimated 5-year survival is 73%, whereas in developing countries, the average survival is 56%. The estimated world average is 69%.¹ Risk factors in order of importance are sensitivity to the sun, light skin, excessive sun exposure, history of skin cancer, family history of melanoma, congenital nevi, maturity, xeroderma pigmentosum, and dysplastic nevi.¹Individual management according to the clinical presentation is based on extrapolation of evidence for other melanoma treatments.² Due to low occurrence rates of urethral melanoma, the optimal therapy has not yet been established, and surgery remains the mainstay of primary therapy; adjuvant locoregional and systemic therapies are needed.² This article reports on the case of a young patient with metastatic melanoma in the urethra which led to urinary obstruction and urinary symptoms.     

Candida glabrata-Induced Refractory Infectious Arthritis: A Case Report and Literature Review

Mycopathologia - The incidence of deep fungal infection due to non-albicans Candida species (especially Candida glabrata) has significantly increased in recent decades. Candida glabrata is an...     

Actinomycosis of the Brain: Case Report and Review of the Literature

The available world literature (since Friedman''s and Levy''s comprehensive report in 1937) regarding actinomycosis of the central nervous system is reviewed. Only cases proved by culture were included in this analysis. A total of 17 cases was collected and an additional patient with this entity is described.The important differences between actinomycosis and nocardiosis are discussed. A definite diagnosis of actinomycosis was possible only when anaerobic cultures of cerebrospinal fluid or material obtained from a brain abscess yielded colonies of typical Actinomyces organisms. The characteristic result of infection of the brain by this fungus was abscess formation, and this occurred in all except one of the cases reviewed. Penicillin appears to be the drug of choice in treatment and, where possible, surgical excision of the cerebral abscess should be undertaken.     

A Pedigree with Pulmonary Alveolar Microlithiasis: A Clinical Case Report and Literature Review

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease characterized by the presence of innumerable calcium phosphate microliths in the alveoli. Clinical-radiological dissociation is an important hallmark of this disease. Most PAM patients are asymptomatic and pulmonary tissue changes are discovered incidentally. PAM is pathologically attributable to the formation and aggregation of calcium phosphate microliths in the alveoli after mutations in the SLC34A2 gene (the type IIb sodium-phosphate cotransporter gene) coding NaPi-IIb. In the clinical work, we discovered an inbred pedigree with PAM, which include four PAM siblings. We performed a sequence analysis of the SLC34A2 gene in all members of this PAM pedigree and found that a homozygous mutation c.575C > A (p.T192 K) in exon 6 was involved. To the best of our knowledge, this study was the first to discover nucleotide mutations in exon 6 in Asians.     

Micafungin for Candida Albicans Pacemaker-Associated Endocarditis: A Case Report and Review of the Literature

We report on the treatment with micafungin of a pacemaker-associated endocarditis due to Candida albicans. Antifungal therapy was able to reduce vegetation size from 5 to 1 cm making possible the transvenous removal of the device without a high risk of pulmonary embolism. Noteworthy, a high micafungin concentration was documented into the lead vegetation (10 μg/g of vegetation tissue) and this may have contributed to the striking size reduction of vegetation.