1/82. Ki-1 (CD30)-positive anaplastic large cell lymphoma, sarcomatoid variant accompanied by spontaneously regressing lymphadenopathy.Although it has been reported that primary Ki-1 (CD30)-positive anaplastic large cell lymphoma (ALCL) of the skin may undergo spontaneous regression, it is rare for ALCL without cutaneous involvement to have spontaneously regressing lymphadenopathy. We report a case of sarcomatoid variant of ALCL accompanied by spontaneously regressing lymphadenopathy. The patient had gastric and pulmonary involvement of ALCL in addition to systemic lymphadenopathy, but with no cutaneous involvement. The lymphadenopathy spontaneously improved gradually during a period of one month without any treatment. At the same time, multiple small nodules in both lung fields decreased on chest computed tomography and multiple elevated gastric tumors with dimples were endoscopically recognized to have improved. He has since been treated with combination chemotherapy because of recurrence of the lymphadenopathy.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
2/82. Thoracic lymphadenopathy in hiv patients: spectrum of disease and differential diagnosis.To evaluate the etiology and differential features of intrathoracic lymphadenopathy (LAD) in hiv patients, chest computed tomography (CT) records from an 18-month period were reviewed to identify all hiv-positive patients with intrathoracic LAD (nodal size > or = 1 cm). medical records were reviewed for the documentation of specific diseases causing LAD and the CD4 count at the time of imaging. Of 45 hiv-positive patients with LAD, 40 had specific diagnoses including 22 (55%) infections and 17 (43%) tumors; one patient had both (3%). Mycobacterial disease accounted for 78% of infections; five cases were secondary to bacterial pneumonia and sepsis. Of tumors, lymphoma (7 cases, 39%) was most common, followed by lung cancer, germ cell tumors, and Kaposi's sarcoma. Mean CD4 cell count in patients with tumors was much higher than in patients with infections (314 vs. 62, p < .01). patients with tumors were somewhat more likely than patients with infections to demonstrate axillary adenopathy (29 vs. 5%, p = .068). Cavitary disease was only observed in patients with infections (27%, p < .03). CT and clinical findings may help direct the differential diagnosis of LAD in AIDS, and promote expedient definitive diagnosis and therapy.- - - - - - - - - - ranking = 0.2keywords = sarcoma (Clic here for more details about this article) |
3/82. Extensive lymphadenopathy as the first clinical manifestation in systemic lupus erythematosus.Lymphadenopathy (LAP) is a frequent sign of systemic lupus erythematosus (SLE). The lymph nodes are usually soft, nontender, varying in size from 0.5 cm to several centimeters. However, generalized LAP in SLE is extremely rare, while to our knowledge, the presentation of extensive LAP with blocks of retrosternal, mesenteric, and retroperitoneal nodes has not been previously reported as the first clinical manifestation of the disease. In this report we describe a patient with extensive LAP and active SLE and we point out that generalized LAP should be included among the clinical findings indicating disease activity in SLE patients.- - - - - - - - - - ranking = 0.00024032343608011keywords = soft (Clic here for more details about this article) |
4/82. Intranodal hemangioma of the oral soft tissues: a case report of a rare entity with review of the literature.The presentation of a primary vascular tumor in a lymph node is a rare occurrence. Only 16 documented cases have been reported to date, with none described in the oral soft tissues. This case report presents the first occurrence of an intra-nodal hemangioma of the oral soft tissue in an 11-year-old girl. A review of the literature is also presented.- - - - - - - - - - ranking = 0.0014419406164807keywords = soft (Clic here for more details about this article) |
5/82. CD138-positive and Kaposi's sarcoma-associated herpesvirus (KSHV)-negative B-cell lymphoma with serosal spreading of the body cavity and lymphadenopathy: an autopsy case.CD138-positive and Kaposi's sarcoma-associated herpes virus (KSHV)-negative B cell lymphoma with serosal spreading of the body cavity and lymphadenopathy is presented. Our lymphoma cells showed pleomorphic morphology and a clonal immunoglobulin gene rearrangement. Immunophenotypically, they lacked B- and T-cell-associated antigens but expressed strong membranous CD138 antigen along the serosa. Although our case was not conventional primary effusion lymphoma (PEL) because of the absence of KSHV and the presence of lymphadenopathy, its unique phenotype and serosal spreading were consistent with those of PEL. Our case suggests that, irrespective of KSHV infection, some pleomorphic B cell lymphomas with membranous CD138 expression show a peculiar serosal spreading.- - - - - - - - - - ranking = 1keywords = sarcoma (Clic here for more details about this article) |
6/82. Intestinal inflammatory pseudotumour with regional lymph node involvement: identification of a new bacterium as the aetiological agent.Inflammatory pseudotumours are the morphological expression of diverse processes such as reactive/reparative, infective, and neoplastic. This paper reports an example of intestinal inflammatory pseudotumour, with identification of a newly characterized bacterium in the lesion. The patient presented with intestinal obstruction. laparotomy revealed a tumour in the terminal ileum causing stricture, and multiple enlarged regional lymph nodes. Histologically, the tumour and lymph nodes were composed of plump spindle cells disposed in a vague storiform pattern, and associated with lymphocytes and plasma cells. Immunohistochemical studies showed that most of the spindle cells were histiocytes (CD68 positive), prompting a search for a bacterial aetiology, akin to mycobacterial spindle cell pseudotumour. All histochemical stains for micro-organisms were unrewarding. Ultrastructural studies, however, revealed abundant bacteria within the spindle histiocytes. polymerase chain reaction, using conserved oligonucleotide primers complementary to the 16S rRNA genes of eubacteria, was employed to amplify 16S rRNA gene fragments directly from the involved lymph node tissue. Phylogenetic analysis of the amplified dna sequences revealed an organism with 99% sequence conformity to pseudomonas veronii, a bacterium which has hitherto not been implicated in human infection. The importance of searching for an infective agent in inflammatory pseudotumour in the appropriate setting is re-emphasized.- - - - - - - - - - ranking = 0.091024029697548keywords = spindle cell, spindle (Clic here for more details about this article) |
7/82. Paradoxical tuberculous reactions in hiv-infected patients.OBJECTIVE: To report the occurrence of paradoxical tuberculous reactions in two patients co-infected with hiv/AIDS, and to review the literature on this subject. patients: Two hiv-infected patients with miliary tuberculosis who developed expansion of tuberculous disease at a new site following initiation of anti-tuberculosis treatment, with or without antiretroviral treatment, and an additional 29 literature cases of hiv infection with paradoxical tuberculous reaction. RESULTS: Index episodes of tuberculosis included pulmonary, nodal, cutaneous and miliary forms. Types of paradoxical reactions included enlargement of lymph nodes or appearance of new lymphadenopathy, radiographic worsening of pulmonary infiltrates or appearance of miliary infiltrates or pleural effusions, peritonitis, tenosynovitis, worsening or development of new soft tissue lesions, and appearance of new contrast-enhancing intracranial tuberculomas. The occurrence of paradoxical reactions appears more temporally related to antiretroviral than to anti-tuberculosis therapy. CONCLUSIONS: It is important for clinicians to recognise paradoxical tuberculous reactions as inflammatory responses to treatment, and to understand that they do not necessarily indicate drug resistance or an inadequate response to therapy. Anti-tuberculosis and antiretroviral drug regimens need not be altered or discontinued, although a short course of corticosteroids may be useful in reducing inflammation.- - - - - - - - - - ranking = 0.00024032343608011keywords = soft (Clic here for more details about this article) |
8/82. leiomyomatosis of mesenteric lymph nodes associated with duodenal adenocarcinoma.leiomyomatosis of lymph nodes is an extremely rare disease. Only a few cases have previously been reported in pelvic lymph nodes. They were related to a benign uterine leiomyoma, a metastasizing uterine leiomyoma, an endometrial adenocarcinoma, and an ovarian endometrioid carcinoma. We report on a case of leiomyomatosis of the mesenteric lymph nodes associated with a duodenal adenocarcinoma with no history of uterine leiomyoma or any gynecological malignancy. The patient, a 56-year-old woman, was found to have an adenocarcinoma of the duodenum. All mesenteric lymph nodes removed showed leiomyomatosis, which was verified by immunohistochemical study showing positive immunostaining for smooth muscle actin, desmin, and vimentin, but negative staining for HMB-45. It is necessary to make a differential diagnosis from other examples of spindle cell proliferation involving lymph nodes such as a hemorrhagic spindle cell tumor with amianthoid fibers (palisade myofibroblastoma), angiomyolipoma, lymphangiomyomatosis, inflammatory pseudotumor, and Kaposi's sarcoma.- - - - - - - - - - ranking = 0.25623804434918keywords = sarcoma, spindle cell, spindle (Clic here for more details about this article) |
9/82. Chronic lymphadenopathies and human herpes virus type 8.Human herpes virus type 8 (HHV-8) is predominantly associated with Kaposi's sarcoma. Nothing is known about its manifestation in primary infection. We report an hiv-negative patient with chronic polyadenitis and lymphocytosis that may have been related to a primary HHV-8 infection.- - - - - - - - - - ranking = 0.2keywords = sarcoma (Clic here for more details about this article) |
10/82. Echocardiographic differentiation of mediastinal tumors from primary cardiac disease.Three cases of mediastinal tumors (thymic cyst, fibrosarcoma, fibrolipoma) mimicking primary cardiac disease were studied by echocardiography. The echocardiographic findings of the thymic cyst are presented and the echocardiograms in the other two patients discussed. Intrinsic cardiac pathology was excluded and discovery of abnormal extracardiac echoes prompted further investigation. In each instance, the echocardiographic interpretation of the nature and position of each extracardiac mass was confirmed by surgery or autopsy. We conclude that echocardiography is a useful noninvasive technique in differentiating between cardiac and extracardiac disease, and should be performed whenever an unusual or enlarged cardiac silhouette is encountered.- - - - - - - - - - ranking = 0.2keywords = sarcoma (Clic here for more details about this article) |
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