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Parotid pilomatrixoma: Diagnostic trap and management dilemma 腮腺毛瘤:诊断陷阱和治疗困境
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.1.12
A. Bhardwaj, Sumeet Angral, S. Chandra, M. Malhotra, M. Priya, S. Varshney, Arpana Singh, Ritu Raj
Introduction. Pilomatrixoma is a benign cutaneous adnexal neoplasm originating from the matrix cells of the hair follicles. Usually a slow growing and painless lesion, it must be considered in differential diagnosis of a preauricular swelling. Rapidly progressive lesion with skin fixity and missed subtle cytological features may lead to a misdiagnosis of parotid neoplasm resulting in management dilemma. Aim. This report emphasizes consideration of pilomatrixoma as a differential diagnosis in a similar clinical scenario, the role of frozen section during surgery and fascia lata interposition to prevent Frey’s syndrome. A brief review of literature is presented. Description of the case. We present a similar dilemmatic case of a 19 years old male with preauricular swelling. Based on cytology and image findings, a diagnosis of parotid neoplasm with possible malignancy was made. Surgical exploration revealed primarily a subcutaneous lesion with partial attachment to superficial surface of parotid. Lesion was excised with a cuff of normal parotid tissue. Frozen section confirmed it to be a nonmalignant lesion with possibility of pilomatrixoma. Fascia lata was interposed between parotid and thin skin flap to avoid gustatory sweating. Patient is on follow up for 6 months without recurrence or any complication. Conclusion. Pilomatrixomas can be misdiagnosed in case of lesions in subcutaneous plane in parotid region. In such cases, the differential diagnosis should include tumor and non-tumor lesions of skin and parotid gland. Importance of frozen section should also be kept in mind and the pathologist should be engaged at the time of surgical excision of the tumor. Interposition of soft tissue between parotid and thin skin flap helps prevent gustatory sweating in such cases. A high index of suspicion is needed for proper diagnosis and management of these lesions.
介绍。毛囊基质瘤是一种起源于毛囊基质细胞的良性皮肤附件肿瘤。通常是一种生长缓慢且无痛的病变,在耳前肿胀的鉴别诊断中必须加以考虑。快速进展的病变伴皮肤固定和遗漏细微的细胞学特征可能导致腮腺肿瘤的误诊,从而导致治疗困境。的目标。本报告强调,在类似的临床情况下,应考虑将毛基质瘤作为鉴别诊断,手术中冷冻切片和阔筋膜介入预防Frey综合征的作用。简要回顾一下相关文献。案件描述。我们提出一个类似的困境的情况下,一个19岁的男性耳前肿胀。根据细胞学和影像学检查,诊断为腮腺肿瘤,可能为恶性肿瘤。手术探查主要发现一皮下病变,部分附着于腮腺浅表。病变切除与正常腮腺组织袖口。冷冻切片证实为非恶性病变,有可能为毛基质瘤。在腮腺和薄皮瓣之间插入阔筋膜,以避免味觉出汗。随访6个月,无复发及并发症。结论。在腮腺区皮下平面病变容易被误诊。在这种情况下,鉴别诊断应包括皮肤和腮腺的肿瘤和非肿瘤病变。冷冻切片的重要性也应铭记在心,病理学家应在手术切除肿瘤时参与。在这种情况下,在腮腺和薄皮瓣之间放置软组织有助于防止味觉出汗。对这些病变的正确诊断和处理需要高度的怀疑指数。
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引用次数: 0
Evaluation of the dose-response for electrostimulation with Aussie current in the core strength 澳洲电流电刺激对核心强度的剂量反应评估
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.2.1
Andressa Bonito Lopes, Dhebora Espindola Amboni, Marilis Macedo Schmidel, Miriélly Junges Maciel, A. R. de Carvalho, G. Bertolini
Introduction. Muscle strengthening to improve joint stability is widely used in the rehabilitation process, and the use of neuromuscular electrical stimulation is a useful tool, but the use of Aussie current still has little documentation about its effectiveness. Aim. To verify if there is a dose-response effect to Aussie current, both in the strength and in the static and dynamic stability of the deep pelvic lumbar muscles. Material and methods. 39 volunteers divided into four groups, one control and three electrostimulation with intensity variation, one with intensity at the contraction threshold (GT), another with intensity maintained at 20% more (G20), and another with intensity maintained at 30% more (G30) than the intensity at the contraction threshold. The intervention lasted four weeks, with three weekly sessions lasting 15 minutes. Initially and after the intervention period, the strength and stability of the deep muscles of the pelvic lumbar region were measured in a static and dynamic manner by a biofeedback pressure unit. Results. There was a significant increase of pressure under the lordoses in the pre- and post-evaluation moments, there were no differences in the evaluation of indirect force (dynamic stability), but there was an increase in the time for GT. The effect sizes presented advantages for the electrostimulated groups in static stability. Conclusion. The doses used did not promote significant statistical differences, but the effects were positive for the electrostimulated groups, especially with respect to static stability.
介绍。肌肉强化以提高关节稳定性在康复过程中被广泛使用,神经肌肉电刺激是一种有用的工具,但使用澳氏电流仍然很少有关于其有效性的文献。的目标。为了验证澳大利亚电流是否存在剂量反应效应,无论是在强度方面还是在骨盆深腰肌的静态和动态稳定性方面。材料和方法。39名志愿者被分为四组,一组为对照组,三组为强度变化电刺激组,一组为收缩阈值强度(GT),另一组为比收缩阈值强度高20% (G20),另一组为比收缩阈值强度高30% (G30)。干预持续四周,每周三次,每次15分钟。干预期开始和结束后,通过生物反馈压力装置以静态和动态方式测量骨盆腰椎区深部肌肉的强度和稳定性。结果。在评估前后,电刺激组的压力显著增加,间接力(动态稳定性)的评估没有差异,但GT的评估时间有所增加。在静态稳定性方面,效应量表现出电刺激组的优势。结论。使用的剂量并没有促进显著的统计学差异,但对电刺激组的影响是积极的,特别是在静态稳定性方面。
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引用次数: 0
A concurrent outbreak of COVID-19 and methanol poisoning in Iran: Is this the time to make amendments to alcohol drinking laws? 伊朗同时爆发COVID-19和甲醇中毒:现在是修改饮酒法的时候了吗?
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.3.17
Ali Banagozar Mohammadi, M. Vahabzadeh
Received: 13.06.2020 | Accepted: 5.08.2020 Publication date: September 2020 Participation of co-authors: A – Author of the concept and objectives of paper; B – collection of data; C – implementation of research; D – elaborate, analysis and interpretation of data; E – statistical analysis; F – preparation of a manuscript; G – working out the literature; H – obtaining funds © Wydawnictwo UR 2020 ISSN 2544-1361 (online); ISSN 2544-2406 doi: 10.15584/ejcem.2020.3.17
收稿日期:13.06.2020 |收稿日期:5.08.2020发表日期:2020年9月共同作者参与:A -论文的概念和目标作者;B -数据收集;C -实施研究;D -阐述、分析和解释数据;E -统计分析;F -准备手稿;G -整理文献;H -获取资金©Wydawnictwo UR 2020 ISSN 2544-1361 (online);ISSN 2544-2406 doi: 10.15584/ ejem .2020.3.17
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引用次数: 3
Pelvic Exenteration: An Updated Mini-Review from 1948 to 2020 盆腔切除:从1948年到2020年的更新迷你回顾
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2019.4.10
E. Unal, A. Yıldız, S. Yuksekdag, A. Firat
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引用次数: 1
Memory of Professor Antoni Leśniowski 1867–1940
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.2.12
M. Osuchowski, D. Aebisher
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引用次数: 0
Imaging studies of kidney cancer 肾癌的影像学研究
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2019.4.8
Piotr Przyczyna, D. Aebisher, Joanna Gustalik, Sabina Galiniak, D. Bartusik-Aebisher, E. Kaznowska
Dorota Bartusik-Aebisher acknowledges support from the National Center of Science NCN (New drug delivery systems-MRI study, Grant OPUS-13 number 2017/25/B/ST4/02481).
Dorota Bartusik-Aebisher感谢NCN国家科学中心的支持(新药物输送系统- mri研究,批准OPUS-13号2017/25/B/ST4/02481)。
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引用次数: 0
Traumatic “TERSON SYNDROME PLUS”: Pneumocephalocele with optic atrophy 外伤性“TERSON综合征+”:气性脑膨出伴视神经萎缩
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.2.6
S. Chowdhury, M. Srivastava, N. Chowdhury
Introduction. Terson Syndrome is subarachnoid hemorrhage (SAH) with sub retinal hemorrhage flowing through channel. Reduced vision in such fresh case is due to hemorrhage itself, blocking macula/other photo receptors in the long run macular cellophane retinopathy which causes profound visual loss. SAH causes neurological problems which can become a risk factor for evacuating blood from vitreous. Hypertension is commonest cause to cause Terson Syndrome, but trauma is also devastating cause as it can lead to irreversible visual consequences like total loss of perception of light or blindness. Aim. Here we describe a case of Terson Syndrome plus disease features SAH in frontal lobe. Description of the case. When there is traumatic pneumocephalocele, it gives space to blood to imbibe towards bony optic canal and form hematoma around nerve sheath which causes compression around the same and leads to optic atrophy. Optic nerve can be injured by direct traumatic dissection during road traffic accidents (RTA), but even without that blood may accumulate around optic nerve and in turn leads to formation of hematoma and subsequently pressure induced optic atrophy. Moreover, blood can slowly travel to sub hyaloid space/sub retinal space (beneath internal limiting membrane or sub ILM) with probable gliosis covering typical boat shaped blood as seen in this case. This sub ILM hemorrhage or gliosis may have resolved through three injections of Triamcinolone in the orbital floor (OFTA) near apex, but optic atrophy snatches vision. This protocol was followed to treat traumatic compressive (peri optic hematoma) optic neuropathy and traumatic retinopathy associated with sub hyaloid hemorrhage. Conclusion. Diagnosis of Terson syndrome plus disease was established by addressing all features on computed tomography (CT) scan and magnetic resonance imaging (MRI). Plus, features include pneumocephalus, optic nerve sheath hematoma, optic atrophy and gliosis over sub-hyaloid hemorrhage, typical boat shaped. The part of hemorrhage still endured as seen on optical coherence topography, but vision was lost by virtue of optic atrophy. OCT shows clot in sub hyaloid space.
介绍。Terson综合征是一种蛛网膜下腔出血(SAH)伴视网膜下腔出血。这种新病例的视力下降是由于出血本身,长期阻塞黄斑/其他光感受器,导致严重的视力丧失。SAH引起神经系统问题,这可能成为玻璃体出血的危险因素。高血压是导致Terson综合征的最常见原因,但创伤也是毁灭性的原因,因为它可能导致不可逆转的视觉后果,如完全失去对光的感知或失明。的目标。我们在此报告一例Terson综合征合并疾病特征的额叶SAH。案件描述。当有外伤性气脑膨出时,使血液有空间向骨视神经管吸收,在神经鞘周围形成血肿,造成神经鞘周围的压迫,导致视神经萎缩。在道路交通事故(RTA)中,直接创伤性剥离可以损伤视神经,但即使没有这种损伤,血液也可能在视神经周围积聚,从而导致血肿的形成,随后压力引起视神经萎缩。此外,血液可以缓慢地流动到玻璃体下空间/视网膜下空间(在内限制膜或ILM下),如本例所示,可能有胶质细胞增生覆盖典型的船型血液。通过在眶底(OFTA)近顶点处注射三次曲安奈德,可解决视膜下出血或神经胶质瘤,但视神经萎缩夺取视力。该方案被用于治疗外伤性压迫性(视神经周围血肿)视神经病变和外伤性视网膜病变伴玻璃体下出血。结论。Terson综合征合并疾病的诊断是通过处理计算机断层扫描(CT)和磁共振成像(MRI)的所有特征来建立的。此外,还表现为脑气、视神经鞘血肿、视神经萎缩和玻璃体下胶质增生出血,典型的船型。光学相干地形图显示出血部分仍存在,但因视神经萎缩而丧失视力。OCT显示玻璃体下腔有血块。
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引用次数: 0
Stroke masks – a case report 笔画口罩——一份病例报告
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.3.15
B. Chmielewska, Natalia Leksa, D. Aebisher, Sabina Galiniak, Dawid Leksa, Seweryn Bartosz, D. Bartusik-Aebisher
Dorota Bartusik-Aebisher acknowledges support from the National Center of Science NCN (New drug delivery systems-MRI study, Grant OPUS-13 number 2017/25/B/ST4/02481).
Dorota Bartusik-Aebisher感谢NCN国家科学中心的支持(新药物输送系统- mri研究,批准OPUS-13号2017/25/B/ST4/02481)。
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引用次数: 0
The role of MRI in the central nervous system 核磁共振成像在中枢神经系统中的作用
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.1.6
Natalia Leksa, D. Aebisher, D. Bartusik-Aebisher
Introduction. Magnetic Resonance Imaging (MRI) has modified the practice of radiology. MRI is base on safe interaction between radiowaves at a particular frequency and hydrogen nuclei in the body. Metabolic encephalophaties are by definition those disorder of the central nervous system that are not due primarily to structural abnormalities. Aim. Here we present the 1H MRI and functional MRI (fMRI) method applied to diagnosis of disorders of the central nervous system. Material and methods. Analysis of literature and self-research. Results.We have discussed the major MRI applications in the characteristic of the central nervous system. The relationship beteen the motion of flowing blood and the representation of the blood on images is complex. This work is an introduction to the basic ideas and techniques of fMRI. Therefore, both, 1H MRI and functional MRI, methods are ued in neuroscience. Conclusion. Nonivasive MRI and functional MRI are daily diagnostics methods in neurology.
介绍。磁共振成像(MRI)已经改变了放射学的实践。核磁共振成像是基于特定频率的无线电波与体内氢核之间的安全相互作用。代谢性脑病的定义是中枢神经系统的紊乱,主要不是由于结构异常。的目标。在这里,我们提出1H MRI和功能MRI (fMRI)方法应用于中枢神经系统疾病的诊断。材料和方法。文献分析和自我研究。结果。我们讨论了MRI在中枢神经系统特征方面的主要应用。血液流动的运动和血液在图像上的表现之间的关系是复杂的。本文介绍了功能磁共振成像的基本思想和技术。因此,1H MRI和功能MRI两种方法都被用于神经科学。结论。无创MRI和功能性MRI是神经病学的日常诊断方法。
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引用次数: 0
Atypical extra nasopharyngeal angiofibroma in an unusual location: tonsil posterior pillar (oropharynx) 异位非典型鼻咽外血管纤维瘤:扁桃体后柱(口咽部)
Pub Date : 2020-01-01 DOI: 10.15584/ejcem.2020.1.11
Shweta Mittal, M. Priya, S. Varshney, Sumeet Angral, Joyson Xavier, M. Malhotra, A. Bhardwaj, Amit Kumar, A. Tyagi
Introduction. Angiofibroma is a benign, locally aggressive highly vascular tumor that typically affects young adolescent males and has a pathognomonic epicenter of origin in the nasopharynx. The atypical angiofibromas share the same histological features as that of Juvenile nasopharyngeal angiofibroma, however they differ significantly in their clinical features. Aim. Here we are reporting a very rare case of atypical angiofibroma in an adult male presenting as a non-vascular mass in the oropharynx with posterior pillar as the subsite. Description of the case. A 26-years old male patient presented with chief complaints of foreign body sensation and mass in throat for one and a half months which was gradually progressive in size. Histopathological examination revealed a lesion with an intricate mixture of blood vessels, irregular fibrous stroma with loose edematous and fibrous area along with multinucleated stromal cells which was suggestive of angiofibroma. Conclusion. Oropharyngeal angiofibroma, being an atypical angiofibroma in terms of site and presenting complaints, presents a diagnostic challenge. Though rare, it should always be kept as a differential diagnosis in any oropharyngeal mass irrespective of its vascularity, typical age or sex of the patient.
介绍。血管纤维瘤是一种良性的,局部侵袭性的高度血管性肿瘤,通常影响年轻的青少年男性,其发病中心位于鼻咽部。非典型血管纤维瘤与青少年鼻咽血管纤维瘤具有相同的组织学特征,但其临床特征有显著差异。的目标。我们在此报告一例非常罕见的成人男性非典型血管纤维瘤,表现为口咽部的非血管性肿块,并以后柱为亚位。案件描述。患者男,26岁,主诉为异物感及喉部肿物1个半月,体积逐渐增大。组织病理学检查显示病变内有复杂的血管,不规则的纤维间质,疏松水肿和纤维区,伴有多核间质细胞,提示血管纤维瘤。结论。口咽血管纤维瘤是一种不典型的血管纤维瘤,在部位和主诉方面,提出了诊断的挑战。虽然罕见,但无论其血管分布,患者的典型年龄或性别如何,它都应作为任何口咽肿块的鉴别诊断。
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引用次数: 0
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临床和实验医学杂志
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