1/18. Genital tuberculosis with peritonitis mimicking Meigs' syndrome: a case report.A 19-year-old girl presented with genital tuberculosis (TB) complicated with peritonitis and pleural effusion. In addition to oligomenorrhea, her initial presentation included symptoms of intermittent high fever, exertional dyspnea, productive cough and body weight loss. Acid-fast bacilli were identified by sputum culture. She continued to suffer from persistent abdominal discomfort and body weight loss after eight months of anti-TB treatment. Finally, exploratory laparotomy was performed under the suspicion of Meigs' syndrome or TB peritonitis. Operative findings included diffusely granulomatous change over the peritoneum, ovaries, endometrium, intestine and liver. Histologic examination of the ovaries and endometrium showed caseous necrosis associated with Langhan's giant cells and epithelial cells. Acid-fast stain revealed numerous acid-fast bacilli. She was discharged after two months of anti-TB treatment. Anti-TB therapy was continued for one year after discharge. During 3 years of post-discharge follow up, she was free of abdominal discomfort and had given birth to two healthy children.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/18. Transudative right pleural effusion due to compression of the brachiocephalic vein caused by an intrathoracic goitre.The case presented in this report is of a female patient who suffered recurrent transudative right pleural effusions, due to a giant benign intrathoracic goitre. The latter caused compression of the brachiocephalic vein, which is a very rare cause of pleural fluid accumulation. magnetic resonance imaging played a crucial diagnostic role.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/18. teratoma masquerading as catamenial pleural effusion.pleural effusion is a common clinical entity in medical practice. We report a case wherein extensive investigations failed to yield a diagnosis and medical management including repeated thoracocentesis left the effusion refractory. The patient, a 26 years lady, gave a definite history of catamenial dry cough and wheeze. The mystery was unraveled following exploratory thoracotomy when a giant mediastinal teratomatous cyst with luteinized ovarian tissue was discovered and removed, leading to eventual cure for the patient.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/18. pleural effusion in temporal arteritis.A 73-year-old woman was admitted to hospital with a one-month history of temporal headache, low-grade fever, fatigue, nocturnal sweats and pleural pain. On the fifth day after admission she developed chest pain at the left site of the thorax, productive cough and progressive dyspnea. A pleural effusion was revealed on physical examination, as well as a bilateral temporal artery thickening. An erythrocyte sedimentation rate of 135 mm in the 1st hour was found. Chest X-ray showed left pleural effusion. Thoracocentesis revealed serous fluid exudate. A percutaneous pleural biopsy showed only minimal inflammatory changes. Temporal artery biopsy showed giant cell arteritis. The patient received prednisone 60 mg/daily with a dramatic clinical response. pleural effusion is a rare manifestation of temporal arteritis; only seven cases have been reported worldwide. We present a new case of temporal arteritis with pleurisy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/18. Hyalinizing spindle cell tumor with giant rosettes with pulmonary metastasis after a long hiatus: a case report.Hyalinizing spindle cell tumor with giant rosettes (HSCTGR) is a recently described tumor, which is regarded as an unusual variant of low-grade fibromyxoid sarcoma. Proof of a metastatic potential was lacking. The patient in the report was a 35-yr-old woman who showed multiple bilateral pulmonary nodules with massive pleural effusion in the right side. She had a history of a mass excision in the right thigh 11 yrs ago at another hospital, which was reported as a "leiomyoma". Two years before this presentation, the patient received a routine chest radiograph which demonstrated bilateral multiple pulmonary nodules. A lobectomy of the left upper lung was performed. The histological findings revealed a well-circumscribed nodule that was characterized by a spindle-shaped fibrous to hyalinized stroma with criss-crossing short fascicles and giant collagen rosettes surrounded by a rim of spindle-shaped cells. Electron microscopy confirmed the fibroblastic nature of the tumor. This case, in addition to at least two other cases reported in the literature, demonstrates that the HSCTGR is a malignant neoplasm with the capacity to metastasize after a long hiatus.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
6/18. Persistent pleural effusion after open heart surgery: giant hydatid cyst of the liver and its demonstrative images. A case report.BACKGROUND: Approximately in 50% of the patients who have undergone coronary artery bypass surgery (CABG), pleural fluid collection occurs at the early postoperative period and resolves spontaneously. CASE REPORT: CABG was performed on a 54-year-old male. In the early postoperative period, the chest roentgenogram revealed right pleural collection. The preoperative and the postoperative hepatic function tests were nor-mal. MR scanning revealed a giant hydatid cyst at the apex of the liver. The cyst was excised through thoracotomy transphrenically and primary capitonage was applied. CONCLUSIONS: In the persistent right pleural effusion that occurs after open heart surgery hydatid cyst of the liver should be remembered, especially in the endemic regions.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/18. Primary tuberculous liver abscess: a case report and review of the literature.A 48-year-old diabetic man was admitted to our hospital with abdominal pain in the right upper quadrant, weight loss, night sweats, fatigue, and anorexia. ultrasonography, computed tomography, and magnetic resonance imaging of the abdomen revealed multiple hemangiomas and a hypodense mass lesion in the posterior segment of the right hepatic lobe. Histopathologic examination of the specimens obtained by ultrasonography-guided percutaneous needle biopsy revealed caseating granulomas with epithelioid histiocytes and giant cells. Systemic antituberculous therapy led to improvement of the lesion in the liver without necessitating surgery or percutaneous drainage. tuberculosis should be considered in the differential diagnosis of hepatic mass lesions, especially in the presence of immune-compromised states. Ruling out tuberculosis may avoid delay in initiation of specific therapy in some cases. A greater awareness of this rare clinical entity may prevent needless surgical interventions.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/18. giant lymph node hyperplasia of the lung (Castleman's disease) associated with recurrent pleural effusion.A case of giant lymph node hyperplasia (Castleman's disease) of the lung presented with pleural effusion (which was recurrent), an unusual complication. The patient was treated with pneumonectomy and has survived for three years without relapse. This is the first report of the disease from black africa.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/18. Spinal anaesthesia in a child with Job's syndrome, pneumatoceles and empyema.We present a case of acute bowel obstruction in an immunocompromised child, who also had lobar pneumonia and a giant unilateral pneumatocele. She was successfully managed with subarachnoid anaesthesia for exploratory laparotomy to relieve a colonic obstruction. This proved to be a safe alternative to general anaesthesia with tracheal intubation in this patient and should be considered in infants and children in selected cases whenever a contraindication to general anaesthesia exists.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/18. yellow nail syndrome.The case of a patient with yellow nail syndrome (YNS), an infiltrating duct carcinoma of the breast, and giant cell interstitial pneumonitis (GIP) is presented. YNS has not been previously described in association with GIP. There was improvement of the yellow fingernails following surgery and chemotherapy for the breast cancer. The possible pathogenesis of the yellow nails in this case and its management are presented. A wide variety of conditions are associated with YNS, which has been reported to respond to various treatment modalities. The most likely cause in our case is impaired lymphatic drainage. However, treatments that do not affect lymphatic drainage also have been reported to be successful.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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