1/75. Sclerosing mesenteritis seen clinically as pancreatic pseudotumor: two cases and a review.Sclerosing mesenteritis is an uncommon nonneoplastic inflammatory process in the mesentery that is seen as a pseudotumor, usually involving the small bowel mesentery, the mesenteric fat, and less commonly, the mesentery of the large bowel. We report two cases of sclerosing mesenteritis and review the literature on this rare disease. Both patients had pain, profound weight loss, and a mass on computed tomography (CT) scan of the abdomen. The provisional diagnosis was pancreatic neoplasm on the basis of clinical presentation and imaging studies. The diagnosis of sclerosing mesenteritis was established by histologic findings in biopsy material obtained at laparotomy in both cases. Interval histologic studies in one patient who had a high CA 19-9 level, progressive biliary ductal and partial duodenal compression, revealed a transitional histologic pattern from predominant inflammation and fat necrosis to predominant fibrosis. This may explain the varied descriptive terms used in the literature to describe this entity.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
2/75. Postoperative alveolar hydatid disease with cutaneous-subcutaneous involvement.The first Japanese case of alveolar hydatid disease with cutaneous-subcutaneous lesions is reported. The patient, a 58-year-old man who developed an indurated subcutaneous tumor on the right side of the abdomen, had had partial hepatectomy of the right lobe for echinococcosis thirteen years earlier. Clinically, the tumor was adherent with a fistulosis communication to deeper structures. Histopathologically, multiple PAS-positive cuticular layers with foreign body granulomas and fibrosis were observed between the dermis and subcutaneous fatty tissue. Surgical excision of the swelling provided the patient with temporary relief. To our knowledge, only eight cases of subcutaneous alveolar hydatid disease have been reported throughout the world. Ours, the ninth case, highlights the importance and difficulty of treating of alveolar hydatid disease.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
3/75. Low-intensity laser therapy for benign fibrotic lumps in the breast following reduction mammaplasty.BACKGROUND AND PURPOSE: Fibrotic masses in the breast secondary to fat necrosis or hematoma are a complication of breast reduction mammaplasty. The treatment commonly recommended for this condition is early surgical debridement of necrotic tissue from the entire area, which causes scarring. This case report describes the use of low-intensity laser therapy for fibrotic lumps following reduction mammaplasty. CASE DESCRIPTION: The patient was a 46-year-old woman who had breast reduction surgery 80 days prior to referral for physical therapy. At the time of referral, the largest mass was 8.0 cm in diameter. The patient reported pain and said she was distressed about the breast disfigurement. Laser irradiation was initiated at an energy density (ED) of 20 J/cm2 and a pulse repetition rate of 5,000 pulses per second. The laser settings were adjusted during the 8-month treatment period. The final ED was 50 J/cm2. OUTCOMES: The mass was 33% of its original size after 3 treatments over the initial 11-day period. Pain relief was immediate. The rate of resolution decreased after the initial period. The patient had some tissue thickening at the time of discharge after 6 months of treatment. DISCUSSION: This case demonstrates the potential use of laser therapy as a treatment for benign breast lumps following mammaplasty.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
4/75. Sclerosing mesenteritis involving the pancreas: two cases of a rare cause of abdominal mass mimicking malignancy.Two patients presented with abdominal pain and weight loss and each was found to have an abdominal mass involving the pancreas and small bowel mesentery. In both cases a malignant process was suspected clinically, radiologically and surgically. Multiple biopsy specimens in both patients showed dense fibrosis, chronic inflammation and fat necrosis with pancreatic infiltration. Histological opinions included the differential diagnosis of retroperitoneal fibrosis but, with the knowledge of the presence of localized masses, these cases were eventually considered to be due to sclerosing mesenteritis. Direct involvement of the pancreas has not previously been highlighted and led to diagnostic difficulty. Both patients have responded to treatment with corticosteroids. Interestingly, one of the patients subsequently developed a tubulo-interstitial nephritis, which has not previously been reported as associated with sclerosing mesenteritis. This has also responded to corticosteroid treatment.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
5/75. Fibrosing cholestatic hepatitis: a report of three cases.Fibrosing cholestatic hepatitis is an aggressive and usually fatal form of viral hepatitis in immunosuppressed patients. We report three cases of fibrosing cholestatic hepatitis in various clinical situations. Case 1 was a 50-year-old man who underwent a liver transplant for hepatitis b virus (HBV)-associated liver cirrhosis. Two and a half years after the transplant, he complained of fever and jaundice, and liver enzymes were slightly elevated. serum HBsAg was positive. Case 2 was a 30-year-old man in an immunosuppressed state after chemotherapy for acute lymphoblastic leukemia. He was a HBV carrier. Liver enzymes and total bilirubin were markedly elevated. Case 3 was a 50-year-old man who underwent renal transplantation as a known HBV carrier. One year after the transplant, jaundice developed abruptly, but liver enzymes were not significantly elevated. Microscopically lobules were markedly disarrayed, showing ballooning degeneration of hepatocytes, prominent pericellular fibrosis, and marked canalicular or intracytoplasmic cholestasis. Portal inflammation was mild, but interphase activity was definite and cholangiolar proliferation was prominent. hepatocytes were diffusely positive for HBsAg and HBcAg in various patterns. patients died of liver failure within 1 to 3 months after liver biopsy in spite of anti-viral treatment.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
6/75. Stress-related primary intracerebral hemorrhage: autopsy clues to underlying mechanism.BACKGROUND: research into the causes of small-vessel stroke has been hindered by technical constraints. Cases of intracerebral hemorrhage occurring in unusual clinical contexts suggest a causal role for sudden increases in blood pressure and/or cerebral blood flow. CASE DESCRIPTION: We describe a fatal primary thalamic/brain stem hemorrhage occurring in the context of sudden emotional upset. At autopsy, the brain harbored several perforating artery fibrinoid lesions adjacent to and remote from the hematoma as well as old lacunar infarcts and healed destructive small-vessel lesions. CONCLUSIONS: We postulate that the emotional upset caused a sudden rise in blood pressure/cerebral blood flow, mediating small-vessel fibrinoid necrosis and rupture. This or a related mechanism may underlie many small-vessel strokes.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
7/75. Hyperostotic macrodactyly and lipofibromatous hamartoma of the median nerve associated with carpal tunnel syndrome.A new case with 14-year follow-up of an extremely rare variety of congenital hand macrodactyly is presented. The disease characteristically presents a diffuse proliferation of fibrofatty tissue, but in this special type, osteocartilaginous deposits around the joints can also be found. The case presented included the troublesome feature of a lipofibromatous hamartoma in the median nerve at the wrist and its branches producing carpal tunnel syndrome. The patient obtained benefit from carpal tunnel release and epineurolysis. The hyperostotic development was managed with conservative resection of the periarticular osteochondromas. The literature reviewed suggests that the hyperostotic cases of macrodactyly do not differ from general cases of this congenital condition, except for the osteochondral deposits. These tumours develop during adulthood or after previous trauma, before epiphyseal closure.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
8/75. angiomyolipoma arising in the thigh.A 41-year-old man presented with an asymptomatic mass in the right medial thigh. magnetic resonance imaging (MRI) revealed a well-demarcated, 10-cm mass in the right adductor muscles. The margins of the mass exhibited high signal intensity and the rest showed low or iso signal intensity on T1-weighted MR images. However, the high signal intensity was decreased on T2-weighted images with fat suppression. The central part of the tumor was of inhomogeneous high signal intensity on T2-weighted images; after Gd-DTPA injection it enhanced in homogeneously on T1-weighted images with fat suppression. On dynamic computed tomography (CT) in the arterial phase, there were strongly enhancing spotty areas in the tumor. At surgery, a yellow-whitish tumor was resected and a pathological diagnosis of angiomyolipoma (AML) in the thigh was made.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
9/75. temporomandibular joint involvement in a patient with centronuclear myopathy.We describe here the temporomandibular joint and masticatory muscle abnormalities disclosed by computed tomography and magnetic resonance imaging in a 25-year-old man with centronuclear myopathy (a congenital myopathy) who presented with marked limitation of jaw movements. We found an intense and general fatty replacement of the masticatory muscles, and magnetic resonance imaging signals indicated articular fibrosis. We conclude that in centronuclear myopathy, the presence of weakness and hypomotility of the masticatory muscles can induce chronic abnormalities of the temporomandibular joint.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
10/75. Clinical application of in vitro radiohypersensitivity testing.The cases of two patients who suffered severe late effects of radiotherapy are reported; each tested positive for elevated in vitro radiohypersensitivity (RHS) but negative for the ataxia-telangiectasia mutation. The first patient underwent surgery and postoperative radiotherapy for lung cancer and subsequently developed fatal myelopathy. The second patient underwent triple-modality therapy for cervical cancer and suffered highly symptomatic pelvic fibrosis. The value of the testing was that it increased the confidence in the diagnosis of radiation effects and enabled suitable treatment to proceed. An increasing role for clinical RHS testing is anticipated.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
| | Next -> |