Cases reported "Melanosis"

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1/34. The uptake of gallium 67 in colonic macrophages.

    A case is presented in which a patient with a well-differentiated adenocarcinoma showed high gallium concentration in the segment with melanosis coli proximal to the obstruction. Although in this case the gallium was associated with an increased number of faecal pigment containing macrophages it is unlikely that macrophages are the main factor in tumour uptake of gallium compounds.
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2/34. Oral mucosal hyperpigmentation secondary to antimalarial drug therapy.

    A case of oral mucosal hyperpigmentation resulting from antimalarial drug therapy is presented. The patient reported a history of long-term quinacrine therapy and exhibited diffuse blue-gray pigmentation of the nail beds and the skin of the nasal ala. Microscopic examination of the involved mucosa showed macrophages, containing both melanin and ferric iron, scattered within the connective tissue adjacent to the epithelium. The clinical, historical, and microscopic features of antimalarial-induced pigmentation are discussed. Other causes of diffuse or multifocal oral pigmentation are also addressed.
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3/34. Pseudomelanosis duodeni: case report.

    Pseudomelanosis duodeni is a rare benign condition. It manifests endoscopically as discrete, flat, small brown-black spots in the duodenal mucosa. It produces no symptoms and may be reversible. The cause and natural history of the pigmentation have not been clarified, although it is associated with a variety of systemic illnesses and medications. With electron microscopy and electron-probe energy dispersive X-ray analysis, the pigment corresponds principally to an accumulation of ferrous sulfide (FeS) in macrophages within the lamina propria. We report the case of a 56-year-old female patient with a past history of diabetes mellitus and hypertension. She was admitted because of nausea, vomiting, and diarrhea and underwent esophagogastroduodenoscopy because of stool occult blood test results of 3 . endoscopy revealed diffusely scattered black spots in the bulb and second portion of the duodenum. Histological examination showed numerous pigment-laden macrophages in the lamina propria of mucosal villi. The diagnosis requires further confirmation by electron microscopy and electron-probe energy dispersive X-ray microanalysis. No special therapy is indicated for this rare lesion.
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4/34. Peritoneal "melanosis" associated with a ruptured ovarian dermoid cyst: report of a case with electron-probe energy dispersive X-ray analysis.

    A case of peritoneal "melanosis" due to a ruptured left ovarian dermoid cyst is described. histology showed that the dermoid contained gastric mucosa associated with ulceration, necrosis, and hemorrhage. The areas of pigmentation within the dermoid, omentum, and peritoneal cavity were due to collections of heavily pigment-laden macrophages. The pigment lacked the histochemical features of either melanin or hemosiderin, but electron-probe energy dispersive x-ray analysis showed that the pigment contained a high concentration of iron. It is postulated that peptic ulceration with hemorrhage is the most likely source of the pigment and that the peritoneal pigmentation is secondary to spillage of the contents of the dermoid cyst.
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5/34. A variant of junctional naevus of epithelioid and spindle cell type rich in melanophages.

    We describe a form of junctional melanocytic neoplasm with a massive production of melanin accumulated in the dermis. The pigment is stored in macrophages, which are by far the most numerous cellular component of the lesion. Another peculiar aspect is the occasional presence of a few melanocytes scattered in a pagetoid pattern above the dermo-epidermal junction in the spinous layer. The histological picture of this lesion is similar to a form of "tumoral melanosis" induced by a regressed malignant melanoma. The lesion had a worrisome clinical picture, its dark colour constituting a clinico-pathological diagnostic problem. The main clinical clues to the benign nature of this entity are the small lateral diameter, the uniform distribution of the pigment and the stability of the lesion over time; moreover, the patients are alive and well after a considerable length of time. Although a regressed dysplastic or malignant lesion cannot be totally excluded from a scientific point of view, we conclude that there is no sound morphological or clinical evidence that the lesion is other than biologically benign. The lesion is most likely another peculiar variant of epithelioid and spindle cell naevus.
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6/34. The congenital lingual melanotic macule.

    BACKGROUND: Circumscribed oral melanotic macules in adults are a well-defined entity. Congenital oral melanotic macules, however, are rare and not well characterized. We report 5 cases of congenital lingual melanotic lesions with consistent clinical and histologic features. OBSERVATIONS: Congenital lingual melanotic macules presented in all cases at birth, followed by proportional growth. Clinical findings were well-circumscribed, brown, single or multiple macules on the tongue, 2 to 5 mm in size, without history of bleeding, ulceration, or trauma. family history was negative for similar pigmented lesions. A literature review showed only 2 previous clinical case reports with similar features. Histopathologic examination showed increased melanin pigmentation in the basal epidermal layer with varying degrees of overlying hyperkeratosis and subepidermal pigment-laden macrophages. No appreciable increase in melanocyte number, junctional nests of melanocytes, or cell atypia was noted. Two retrospective histopathology reviews mention 4 corresponding cases but report no clinical data. CONCLUSION: The congenital lingual melanotic macule represents a clinically distinct, benign, pigmented oral melanotic lesion, and may be more common than the literature suggests.
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7/34. Diffuse melanosis after chemotherapy-induced tumor lysis syndrome in a patient with metastatic melanoma.

    Diffuse melanosis is a rare event associated with advanced metastatic malignant melanoma. A 35-year-old woman with stage IV melanoma is presented, who developed slate bluish-gray to brown discoloration of her skin after chemotherapy-induced tumor lysis syndrome. A number of studies were performed to re-evaluate possible mechanisms of melanosis. skin tissue was examined on routine hematoxylin-and-eosin-stained sections, Fontana stains, immunohistochemical studies with antibodies for Melan-A, gp100, tyrosinase, FXIIIa, and CD68, and by electron microscopy. The main cell types found to contain melanin pigment were histiocytes and dendritic cells. In the dermis, they were distributed mainly around venules. In the subcutaneous fat, they were scattered throughout the fat lobule. Melanin pigment was not only seen within cells but also extracellularly. No melanoma cells were seen in the skin. No increase in melanin pigment or number of melanocytes was seen in the epidermis. A bone marrow biopsy contained melanophages but no melanoma cells. Ultrastructural examination of the patient's serum revealed the presence of melanosomes. sequence analysis of the tumor's cDNA failed to identify any mutations in the tyrosinase gene, and no tyrosinase protein was detected in non-melanocytic cells, indicating that it was unlikely that a mutation had resulted in a secretory form of the protein. These findings document that diffuse melanosis may result from tumor lysis, with release of melanosomes into the bloodstream.
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ranking = 6.5065121737763E-6
keywords = bone
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8/34. melanosis coli involving pericolonic lymph nodes associated with the herbal laxative Swiss Kriss: a rare and incidental finding in a patient with colonic adenocarcinoma.

    melanosis coli is a well-known condition in which macrophages filled with a lipofuscin-like pigment are found in the colonic lamina propria. The condition has been associated with the ingestion of anthracene laxatives and is believed to be caused by increased epithelial apoptosis. Although melanosis coli is a frequent finding in colonic biopsies and resection specimens, to our knowledge the presence of identical pigment in macrophages of pericolonic lymph nodes has been reported in only 4 other patients in the English literature. We report the case of a patient who underwent a left hemicolectomy for colonic adenocarcinoma and was found incidentally to have melanosis coli associated with long-term use of the herbal laxative Swiss Kriss, not only in his colonic mucosa, but also in the colonic submucosa and in his pericolonic lymph nodes.
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9/34. Oral mucosal pigmentation secondary to minocycline therapy: report of two cases and a review of the literature.

    minocycline is a semisynthetic broad-spectrum antimicrobial agent that was first introduced into clinical practice in 1967. The most common use of minocycline is for the long-term treatment of acne vulgaris. A well-recognized side effect of minocycline treatment is pigmentation, which has been reported in multiple tissues and fluids including thyroid, skin, nail beds, sclera, bone, and teeth. While there have been several reports of oral pigmentation following minocycline therapy, these have been, for the most part, pigmentation of the underlying bone with the overlying oral mucosa only appearing pigmented. We report two cases of actual pigmented oral mucosal lesions on the hard palate secondary to minocycline therapy with the accompanying histopathology, followed by a discussion of minocycline-induced oral pigmentation and a differential diagnosis of these lesions.
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ranking = 1.3013024347553E-5
keywords = bone
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10/34. Leukomelanoderma following acute cutaneous graft-versus-host disease.

    Acute graft versus host disease (GVHD) is characterized by a selective epithelial inflammation that can affect the skin, digestive tract, and liver. Development of pigmentary abnormalities can be observed in sites where acute cutaneous GVHD has occurred, and usually consists of hyperpigmented spots. We observed atypical pigmetary changes consisting of a combination of hyper- and hypopigmentation, so called leukomelanoderma, in a young allogeneic bone marrow recipient who suffered repetitive acute GVHD. The histopathological examinations showed features of a post-inflammatory process. Because keratinocytes produce inflammatory cytokines including tumor necrosis factor (TNF)-alpha and interleukin (IL)-1alpha, which may be implicated in the inflammatory phenomena seen in acute GVHD, we studied whether these inflammatory cytokines might be implicated in these pigmentary changes. The cytokines tested were IL-1alpha, IL-2, TNF-alpha and IL-10. The expression of TNF-alpha increased in the hyperpigmented skin relative to normal and hypopigmented skin. While TNF-alpha was variably distributed in proportion to different degrees of pigmentation, other molecules were detected at minimal levels in all samples. This observation may indicate that the production of TNF-alpha by epidermal microenvironment may be involved in postinflammatory pigmentary changes.
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ranking = 6.5065121737763E-6
keywords = bone
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