1/57. Symptomatic Rathke's cleft cyst coexisting with central diabetes insipidus and hypophysitis: case report.We describe a 48-year-old female with acute onset of central diabetes insipidus followed by mild anterior pituitary dysfunction. magnetic resonance imaging (MRI) revealed enlargement of the hypophysis-infundibulum accompanied by a cystic component. She underwent a transsphenoidal exploration of the sella turcica. Histological examination showed foreign body type xanthogranulomatous inflammation in the neurohypophysis which might have been caused by rupture of a Rathke's cleft cyst. The MRI abnormalities and anterior pituitary dysfunction improved after a short course of corticosteroid administration, but the diabetes insipidus persisted. The histological findings in this case indicated the site of RCC rupture and the direction of the progression of RCC induced neurohypophysitis and adenohypophysitis.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/57. Foreign body reaction to a metal clip causing a benign bile duct stricture 16 years after open cholecystectomy: report of a case.We present herein a case where a benign bile duct stricture developed 16 years after an open cholecystectomy and without any prior symptoms. The patient was thought to have a Klatskin tumor both pre- and intraoperatively and was treated with a resection of the mass and bile duct confluence, while hepaticojejunostomies were also performed to both ducts separately. A pathologic examination of the specimen revealed extensive fibrosis, chronic inflammation, and a nonnecrotizing granulomata. Any hilar mass presenting after upper abdominal surgery should therefore be considered to be potentially a benign bile duct stricture, even with a long symptom-free interval.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
3/57. Metallosis mimicking osteomyelitis from a forearm plate retained for 50 years.A forearm plate retained for 50 years was removed because an acute inflammation mimicked chronic infection. The radiographs were very confusing. During the operation metallosis was obvious. Despite the general opinion that forearm plates should be kept in place, this probably should not apply to old "historical" hardware of uncertain chemical composition.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/57. Pathologic features of uterine leiomyomas following uterine artery embolization.Bilateral uterine artery embolization has recently been employed as an alternative to operational treatment of uterine leiomyomas. The pathologic features induced by uterine artery embolization have not been previously described in detail. Usually patients experience symptomatic improvement with a reduction in size of the leiomyomas. This report describes the pathologic features in a series of 10 uterine leiomyomas where tissue was available for histologic examination following uterine artery embolization. Characteristic histologic features within the leiomyomas included massive necrosis, sometimes with dystrophic calcification, vascular thrombosis, and intravascular foreign material that elicited a histiocytic and foreign-body giant cell reaction. In some cases, intravascular foreign material was present elsewhere in the myometrium, the cervix, or paraovarian region. In occasional cases, there were foci of myometrial necrosis and microabscess formation beyond the confines of the leiomyomas. Foci of extrauterine inflammation were also occasionally identified. Histopathologists should be aware of these findings because the use of uterine artery embolization will possibly become more widespread in the future.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/57. Injuries from palm tree thorn simulating tumoral or pseudotumoral bone lesions.Three cases of bone changes caused by foreign bodies that appeared to be tumoral lesions or pseudotumors, were observed in young male patients who presented with pain, localized inflammation, and radiographic and bone scan findings suggestive of tumoral or pseudotumoral lesions. Accurate diagnosis was made at surgery when the foreign body was retrieved. Following removal of the foreign body, postoperative recovery was satisfactory. The common causative agent in all these cases was a palm tree thorn.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/57. Pediatric eye injury due to Avena fatua (wild oats).OBJECTIVE: We report on florid and unusual ophthalmic physical signs in three children where the trauma was caused by seeds from Avena fatua, a grass common in western north america. DESIGN: Case series and literature review. SETTING: Three local emergency departments (ED) during the fall of 1998. patients OR PARTICIPANTS: Three children reporting to an ED with an acutely painful eye from which the foreign body was identified botanically as Avena fatua. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Symptoms, interventions, duration of problem. RESULTS: Three male children (6, 10, 14 years) presented separately following incidents in which they had sustained direct eye injury. Each child immediately experienced severe pain and profuse watering of the eye. Severe localized edema of the conjunctiva and inflammation was evident with conjunctival vessel injection leading to bleeding, reminiscent of a chemical "burn." Initially, two children appeared to have an eyelash caught behind the lower lid. In both instances, the emergency physicians initially dismissed the possibility of there being a significant foreign body, but because of the severity of the pain, conjunctival vessel injection, and edema, they attempted to remove the "lash." Removal of the foreign body proved difficult in all three cases, requiring far greater traction than anticipated. Intact seedpods had become embedded in the subconjunctival space. Ophthalmic analgesia relieved the pain immediately, but in one child who was treated with topical antibiotic alone, significant pain was experienced for 18 hours, until steroid-antibiotic therapy was instituted. All injuries occurred in late summer when the grass propagates. CONCLUSIONS: The physical signs of scleral vasculitis and conjunctival edema can be mistaken for chemical injury or allergic chemosis, but where a foreign body resembling a hair or eyelash is visible, the presence of a seed-pod retained in the subconjunctival space must be considered, particularly if the patient reports exposure to wild grass. Application of local analgesia, foreign body removal, and steroid-antibiotic treatment is recommended.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
7/57. Foreign body reaction with delayed extrusion of ganciclovir implant in a patient with immune recovery vitritis syndrome.PURPOSE: To report a case of delayed extrusion of primary ganciclovir implants in a patient with immune recovery vitritis syndrome. METHOD: Interventional case report. A 54-year-old hiv positive male patient with immune recovery vitritis syndrome had spontaneous extrusion of bilateral ganciclovir devices 4 years after primary implantation. RESULT: The extruded ganciclovir implants were removed from both eyes, and removal was complicated by vitreous hemorrhage in one eye. Histopathological examination of the extruded implant, LE, showed marked inflammation and evidence of foreign body reaction. CONCLUSION: Excess inflammation in eyes with immune recovery vitritis syndrome may trigger a foreign body reaction that results in a delayed extrusion of primary ganciclovir implants. The site of ganciclovir implants in patients with immune recovery vitritis syndrome should be regularly inspected for eroding struts to prevent secondary endophthalmitis.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
8/57. Surgical staple metalloptysis after apical bullectomy: a reaction to bovine pericardium?Palliation of symptomatic emphysema may include bullous resection to improve function of the remaining lung. Buttressing staple lines with bovine pericardium partially alleviates postoperative air leak, but can promote inflammation and infection. We report a patient expectorating staples and pericardium 5 years after bilateral apical bullectomy. Previous reporting of this complication in lung volume reduction operation also involved both pericardium and staples, and we propose that an ongoing local inflammatory reaction to these materials may facilitate delayed erosion into airways.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/57. Adverse reaction to surgical sutures in thyroid surgery.BACKGROUND: A mild reaction to surgical sutures after thyroid surgery is common and is characterized by local edema and inflammation around the surgical scar. Severe reaction with microabscesses and granulomatous masses is quite rare. methods AND RESULTS: Two cases of severe reaction to silk sutures after thyroid surgery are presented. Meticulous surgical removal of all surgical sutures along with granulomatous masses, granulation tissue, and microabscesses cured both patients. Pathologic examination revealed giant cells and lymphocytes. Intradermal skin tests were positive to silk sutures. The etiology and the treatment options are discussed. CONCLUSIONS: In rare cases, severe reaction to silk sutures may develop after thyroid surgery. Surgical removal of the stitches is the treatment of choice. Intradermal skin test is a good predictor of allergy to sutures.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/57. Arthroscopic treatment of gunshot wounds to the shoulder.Two cases are presented that demonstrate the utility of arthroscopic intervention for the management of gunshot wounds to the shoulder. The first report involves a 24-year-old man with a retained bullet in his glenohumeral joint after a drive-by shooting The intra-articular bullet was retrieved arthroscopically avoiding chondral injury from the mechanical effects of a loose body as well as the potential local and systemic effects of lead toxicity. Irrigation and debridement was performed to evacuate joint debris, which could have served as a nidus for infection or inflammation. The other case describes a 19-year-old man who sustained a gunshot wound to the lateral portion of his upper arm resulting in a proximal humerus fracture along with a retained bullet in his subacromial space. The bullet was successfully removed arthroscopically avoiding a traditional exposure, which would have complicated his fracture care.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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