1/18. Ano-genital granulomatosis: the counterpart of oro-facial granulomatosis.Ano-genital granulomatosis encompasses the previously recognized clinical entities of vulvitis granulomatosa, posthitis granulomatosa, and ano-perineitis granulomatosa. We report three patients with ano-genital granulomatosis. The pathological features of the disease are lymphoedema and the presence of non-caseating giant cell granulomas. These granulomas are histologically indistinguishable from those found in both Crohn's disease and sarcoidosis, therefore, patients with ano-genital granulomatosis with accompanying gastro-intestinal or pulmonary symptoms should be investigated for the presence of Crohn's disease or sarcoidosis, respectively. The value of ano-genital granulomatosis as a unifying clinicopathologic concept is to provide a label for the affliction as well as to stimulate a careful search for possibly underlying systemic disorders, thus also permitting a more specific approach to therapy.- - - - - - - - - - ranking = 1keywords = granuloma (Clic here for more details about this article) |
2/18. Unusual presentation of angiocentric T-cell lymphoma mimicking perianal abscess.BACKGROUND: Subcutaneous angiocentric T cell is a common form of cutaneous lymphoma localized within subcutis mimicking lobular panniculitis. It is rarely manifested as perianal skin lesion. OBJECTIVE: To suggest that perianal T-cell lymphoma is a rare entity that should be included in the differential diagnosis of perianal infiltrate mimicking perianal abscess. methods AND RESULTS: A 65-year-old woman presented with painful perianal infiltrate mimicking a perianal abscess. The pain lasted seven days and there was no evidence of fever. Bacterial examination of tissue of the infiltrate discovered staphylococcus aureus. Angiocentric T-cell lymphoma was demonstrated on biopsy. CONCLUSION: Our case represented sequela of subcutaneous angiocentric T-cell malignant lymphoma with a complication of a secondary infection mimicking perianal abscess. In patients presenting with a perianal infiltrate without abscess, a malignant condition should be considered a differential diagnosis and a biopsy should be performed.- - - - - - - - - - ranking = 0.078180067614374keywords = lymphoma (Clic here for more details about this article) |
3/18. Unusual presentation of early lymphogranuloma venereum in an hiv-1 infected patient: effective treatment with 1 g azithromycin.The incidence of lymphogranuloma venereum (LGV) is low in the western world. Early LGV is characterised by bubonic disease following a painless papule or small ulcer. We report a white bisexual male who presented with a painful perianal ulcer, inguinal lymphadenitis, and concomitant infection with human immunodeficiency virus 1 (hiv-1). chlamydia trachomatis serovar L2 was identified as the cause after polymerase chain reaction and genotyping the major outer membrane protein by restricted fragment length polymorphism. Treatment with a single dose of 1 g azithromycin was effective. This case illustrates that early LGV may mimic other genital ulcer diseases, such as genital herpes or chancroid, especially in HIV infected patients. In the western world, LGV must still be included in the differential diagnosis of bubonic disease with or without sexually acquired ulcers.- - - - - - - - - - ranking = 260.04360643486keywords = lymphogranuloma, granuloma (Clic here for more details about this article) |
4/18. Perianal mass and recurrent cellulitis due to enterobius vermicularis.A unique case of enterobiasis presenting as recurrent cellulitis and a perianal mass in a six-year-old girl is reported. Complicated perianal lesions due to enterobius are unusual. Only 10 previous cases are known, with unclear pathogenesis in most of them, although mucosal breaches and perianal crypt or gland entry have been postulated. The association of the mass in this case with a deep crypt, and the histopathologic finding of squamous epithelium focally surrounding the granulomatous reaction to the enterobius eggs suggest that the worm entered the perianal tissues via a crypt. Local secondary bacterial infection can cause significant morbidity. Surgical excision of such granulomatous mass lesions is necessary in symptomatic or complicated cases.- - - - - - - - - - ranking = 0.11764705882353keywords = granuloma (Clic here for more details about this article) |
5/18. Perianal and vulvar Crohn's disease presenting as suspected abuse.Misdiagnosis of sexual abuse may arise in cases of vulvar and/or perianal diseases such as lichen sclerosus et atrophicus, Behcet's syndrome, bullous diseases, contact dermatitis, or neoplastic lesions. We present the case of a 7-year-old girl who was referred by her general paediatrician to the local hospital for perianal fissures and swelling of the labia majora. A report to the judicial authorities was made, for suspected sexual abuse, and the patient was transferred to the department of paediatric surgery. Here, histopathologic examination of vulvar and rectal biopsies revealed multiple non-caseating and non-confluent epithelioid-gigantocellular granulomas, consistent with a diagnosis of Crohn's disease, with cutaneous involvement of the genitalia. In cases of suspected sexual abuse, examination of children should be performed by a specialist in legal medicine in collaboration with a gynaecologist or paediatric surgeon. If the patient is hospitalised and the question of protection does not arise, physicians should exclude dermatological diseases before reporting to the judicial authorities.- - - - - - - - - - ranking = 0.058823529411765keywords = granuloma (Clic here for more details about this article) |
6/18. Anorectal lymphogranuloma venereum in a Melbourne man.We report the first case of anorectal lymphogranuloma venereum (LGV) in a man who has sex with men (MSM) in australia in the setting of the recent emergence of LGV among MSM in europe and the USA. A 33-year-old man presented with a 2 month history of mild external anal discomfort. He gave a history of unprotected receptive and insertive anal intercourse with one partner in europe during the preceding 6 months. No symptoms suggested proctitis and examination revealed two small anal fissures. An anal swab was positive for chlamydia trachomatis; investigation for other STIs including HIV were negative. On review 6 days later, he was investigated and treated presumptively for LGV. The LGV diagnosis was confirmed by identifying the L2 serovar of C. trachomatis using a genotype test on the original anal specimen. This case is in keeping with the more recent reports of LGV from europe, and has demonstrated the need for a high index of suspicion for asymptomatic or minimally symptomatic anorectal LGV.- - - - - - - - - - ranking = 260.04360643486keywords = lymphogranuloma, granuloma (Clic here for more details about this article) |
7/18. vulvitis granulomatosa and anoperineitis granulomatosa.We present the case of a 77-year-old female with a rare genital and anoperineal granulomatous cutaneous manifestation resembling cheilitis granulomatosa Miescher. The typical histological findings of epithelioid cell granulomas were localized in the vulva and anoperineal region; the latter manifestation has not yet been described. Based on our personal observations and a review of the literature, the clinical and histological features of vulvitis granulomatosa are described.- - - - - - - - - - ranking = 0.70588235294118keywords = granuloma (Clic here for more details about this article) |
8/18. Perianal ulcer: an unusual presentation of Wegener's granulomatosis. Report of a case.A 46-year-old man, without remarkable past medical history, had a perianal ulcer that appeared spontaneously two months before presentation. At admission, the ulcer was painless, measuring 4 to 5 cm in diameter and showing detachment and a slightly papillomatous aspect at the edge but without induration of the base. Microscopic examination revealed cutaneous ulceration with a well-developed inflammatory response, a few small vessels with intraluminal thrombosis or necrotizing walls, and isolated microscopic granulomata. No infectious disease was detected. The diagnosis of Wegener's granulomatosis was made six months later, when the disease was clinically evident in three principal sites: upper airways, lung, and kidney. At that time, serum antineutrophil cytoplasmic autoantibodies were detected with indirect immunofluorescence microscopy. There has been an excellent response to immunosuppressive therapy. review of the literature revealed no similar reports.- - - - - - - - - - ranking = 0.35294117647059keywords = granuloma (Clic here for more details about this article) |
9/18. Computed tomography of rectal lymphoma.We present two human immunodeficiency virus positive patients with rectal lymphoma who on CT both demonstrated similar appearances of the rectal tumour, consisting of concentric thickening of the rectal wall and thickening of the levator ani muscles.- - - - - - - - - - ranking = 0.048862542258984keywords = lymphoma (Clic here for more details about this article) |
10/18. Human immunodeficiency virus-associated large-cell immunoblastic lymphoma presenting as a perianal abscess.We report a case of perianal non-Hodgkin's lymphoma that presented as a perianal abscess in an otherwise asymptomatic intravenous drug abuser who tested positively for human immunodeficiency virus infection. Extranodal lymphoma of the anal canal is a very rare event, which has recently been described in homosexual men with the acquired immunodeficiency syndrome. This is the first report, to our knowledge, of perianal lymphoma occurring in a nonhomosexual patient with the acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 0.068407559162577keywords = lymphoma (Clic here for more details about this article) |
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