1/34. MR imaging of a hemorrhagic and granulomatous cyst of the ligamentum flavum with pathologic correlation.cysts of the ligamentum flavum are uncommon causes of neurologic signs and symptoms and usually are seen in persons over 50 years of age. We report a case of an epidural cyst located in the ligamentum flavum, which contributed to spinal stenosis in a 30-year-old man. Radiologic features were similar to those of a synovial cyst, but synovium was not identified histologically. The imaging and pathologic features were unusual, including hemorrhage and a fibrohistiocytic reaction with giant cells.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/34. Rare complication of massive hemorrhage in neurofibromatosis with arteriovenous malformation.Neurofibromatosis is rare in the general population. Its clinical manifestations are systemic and variable. The clinical presentation of cutaneous lesions is even more variable. Some patients have giant tumors in the trunk or limbs (so-called "elephant neurofibromatosis"). The pathological findings are diffuse neurofibromatosis of the nerve trunk associated with overgrowth of subcutaneous tissue and skin. The associated vascular malformations make most surgeons hesitant to address them because bleeding to death is possible if the bleeding is not well controlled. According to the authors' experience in treating this complication of neurofibromatosis, they noted that there are three key points to reducing the amount of hemorrhage to a minimal level: (1) hypotensive anesthesia, (2) preliminary sutures around the lesion, (3) ligation of the limited numbers of feeding vessels in the vascular malformation of the neurofibroma. Ligating these pedicles can decrease bleeding during resection of the neurofibroma, as demonstrated in their patient.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/34. A newborn with nodular ulcerated lesion on a giant congenital nevus.The proliferative nodule is a lesion that develops within a congenital nevus. It is usually small (less than 5 mm), sometimes multiple, with a slow growth rate, and has a black or dark brown, smooth, shiny surface. It usually involutes spontaneously. We report a newborn infant who, at birth, had a giant congenital nevus with a nodular, ulcerative, hemorrhagic lesion within it. Physical and neurologic examinations were normal. Radiologic studies at birth and subsequently were normal. A fragment of the lesion was biopsied and histologic findings were compatible with a diagnosis of proliferative nodule in a giant congenital nevus. The rest of the nodule regressed spontaneously after 4 months.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
4/34. Combined choriocarcinoma and adenocarcinoma of the lung occurring in a man: case report and review of the literature.BACKGROUND: Human chorionic gonadotropin (hCG)-producing large or giant cell carcinoma of the lung is not uncommon, but primary pulmonary choriocarcinoma is an extremely rare entity. Even rarer are cases occurring in males; to date the authors have found only 12 reported cases in the English literature. methods: The clinical record of a 61-year-old man who presented with hemoptysis is described. A review of the literature regarding patients with primary pulmonary choriocarcinoma also is reported. RESULTS: Computed tomography scan of the chest demonstrated an expanding thickness of the bullous wall within areas of emphysematous change in the lower lobe of the right lung. Moreover, a new, round tumor near the thickness appeared and rapidly expanded evenly into the surrounding lung tissue. Exploratory thoracotomy revealed the previous tumor to be adenocarcinoma with a small foci of choriocarcinoma, and the new tumor to be a hemorrhage with choriocarcinoma. Because of the pleural dissemination, the patient was treated with chemotherapy. At last follow-up he was alive and well with a gradually increasing serum hCG-beta level in spite of chemotherapy. CONCLUSIONS: Primary pulmonary choriocarcinoma occurring in men is an extremely rare entity with a fatal prognosis. Of the 12 cases reported to date in the English literature, 3 cases of choriocarcinoma with the coexistence of another type of pulmonary carcinoma were reported. To the authors' knowledge the clinical relation between these two types of carcinoma are unknown because all cases to date have been detected at the time of autopsy. Only in the current study case could the clinical course of the disease be followed and pathologic confirmation achieved, although the pathogenesis of the two types of carcinoma could not be determined.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/34. Giant adrenal myelolipoma presenting with spontaneous hemorrhage. CT, MR and pathology correlation.We report a case of a 56-year old symptomatic patient found to have a giant adrenal myelolipoma with hemorrhage. The characteristic CT and MR features and their aid in the diagnosis are demonstrated. We propose a definition of the often quoted term "giant" adrenal myelolipoma.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/34. bernard-soulier syndrome in a Turkish family.This report describes the first Turkish family to be diagnosed with bernard-soulier syndrome. The family consists of nine members (two parents, three sons and four daughters). The parents were first cousins. The index case, a 22 year-old-man, had a history of haemorrhagic diathesis with thrombocytopenia, giant platelets in the peripheral blood smear and a prolonged bleeding time. Refractory idiopathic thrombocytopenic purpura had been diagnosed elsewhere and a splenectomy had been performed six months previously. ristocetin agglutination of platelets was defective and flow cytometry analysis of platelet membrane glycoprotein showed markedly reduced expression of glycoprotein lb (2.1%). bernard-soulier syndrome was diagnosed. Increased mean platelet volume was found in both parents, one son and three daughters. The other son and daughter were normal.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/34. A giant retrosternal goiter with severe tracheal compression and superior vena cava syndrome: an operative experience.The peculiarities in the operation of a giant retrosternal goiter with severe tracheal compression and superior vena cava syndrome are highlighted in this report of a 53 year-old female with a large anterior neck swelling interfering with normal breathing and swallowing. From the initiation of the neck incision, mobilization of the gland and performing the subtotal excisions there was troublesome bleeding. pneumothorax resulting after delivery of the massive retrosternal portion was managed with an underwater-seal drainage tube.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
8/34. Giant cell reparative granuloma of the temporal bone: MR findings with pathologic correlation.We report MR findings in a case of a giant cell reparative granuloma involving the temporal lobe in a middle-aged man. On MR images, most of the mass was hypointense on T1-weighted images, hypointense on T2-weighted images, and mildly enhanced on postcontrast T1-weighted images. The hypointensity on T2-weighted images corresponded to areas of hemorrhage and hemosiderin deposition on pathologic correlation.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/34. bernard-soulier syndrome with a homozygous 13 base pair deletion in the signal peptide-coding region of the platelet glycoprotein Ib(beta) gene.We report a family with bernard-soulier syndrome with a homozygous mutation within the GPIb(beta) gene. The proband was a 24-year-old Japanese male who has suffered from life-long bleeding tendency. The patient's sister also had severe bleeding episodes. The proband and the affected sister had no apparent complications including organic or skeletal anomaly, or mental disturbance. They had thrombocytopenia [(35-40) x 10(9)/l] with giant platelets. In addition to platelet size, electron microscopic analysis revealed abnormalities in the internal structures of platelets. ristocetin-induced platelet aggregation was defective. Flow cytometric analysis and western blot analysis showed that glycoprotein IX was nearly absent in platelets, whereas GPIb(alpha) and GPV were detectable. Genetic studies revealed a 13 base pair deletion in the signal peptide-coding sequence of GPIb(beta). The deletion would cause a frame-shift, resulting in the appearance of a stop codon following an indifferent polypeptide sequence. Analysis of platelet RNA showed that the mutant GPIb(beta) gene was transcribed. The propositus and his affected sister were homozygous for the deletion, whereas their unaffected father and mother were heterozygotes. The molecular defects of this family would help understand the relevance of GPIb(beta) for complex formation of the glycoprotein Ib/IX/V receptor.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/34. Hemorrhagic cystitis with herpes simplex virus type 2 in the bladder mucosa.A 67-year-old woman who had underlying rheumatoid arthritis and diabetes mellitus had an 8-year history of recurrent hemorrhagic cystitis. During her most recent episode of cystitis, a specimen of urine yielded herpes simplex virus type 2 in culture. A biopsy of the bladder mucosa revealed intranuclear inclusions in multinucleated and mononuclear giant cells that were positive for herpes simplex virus type 2 by immunoperoxidase staining. She had no evidence of infection with herpes simplex virus outside her bladder.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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