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Isolated Intracranial Rosai-Dorfman Disease: A Case Report of F ollow- Up MRI Showing Dynamic Changes of the Lesion 孤立性颅内Rosai-Dorfman病:MRI随访显示病灶动态变化1例
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001099
Jie-ming Jiang, D. Han, Yuanming Jiang, Zhen-Guang Zhang, Fenglin Xue, B. He
Rosai-dorfman disease (RDD) is a histiocytic proliferative disorder and considered to be extremely rare in the CNS. In this paper, we reported a patient confirmed as isolated intracranial RDD in a 58-year-old woman. MRI imaging without contrast enhancement two years ago found nothing at the onset of the symptoms. Follow-up CT and MRI imaging one year later showed dynamic changes of the lesion from scratch. This report suggests that the symptoms of RRD are earlier than imaging findings. Moreover, we made a systematic literature review on the disease to better understand it.
Rosai-dorfman病(RDD)是一种组织细胞增殖性疾病,在中枢神经系统极为罕见。在本文中,我们报告了一例确诊为孤立性颅内RDD的58岁女性患者。两年前没有增强对比的核磁共振成像没有发现任何症状。1年后随访CT和MRI显示病灶从头开始发生动态变化。本报告提示RRD的症状早于影像学发现。此外,我们对该疾病进行了系统的文献综述,以更好地了解它。
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引用次数: 0
A Case of Precursor B-cell Acute Lymphoblastic Leukemia Occurre d with Rapid Hip Bone Destruction and Femoral Neck Fracture 前体b细胞急性淋巴细胞白血病伴快速髋部骨破坏及股骨颈骨折1例
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001098
Yutaka Suzuki, T. Asano, D. Takahashi, T. Irie, Ryuta Arai, Yuko Cho, A. Iguchi, M. Terkawi, N. Iwasaki
Background: Precursor B-cell lymphoblastic lymphoma is a rare subtype of acute lymphoblastic lymphoma and sometimes presents as lytic bone lesions. Diagnosis and treatment of lytic bone lesions are always challenging. This is a rare case of delayed leukemic change of precursor B-cell acute lymphoblastic lymphoma presented with a rapid hip bone destruction. Case presentation: A 12-year-old Japanese girl presented with progressive left hip pain, and bone destruction of her left hip two months after the onset of symptoms. She had no past medical or family history of malignancy and had no genetic abnormality. Radiograph and MRI examination showed bone destruction and osteolytic lesions in her left femoral neck and pelvis. Blast cells were not found in our initial examination of the peripheral blood and aspirated bone marrow cells. The case was finally diagnosed as Precursor B-cell lymphoblastic lymphoma as the results of bone biopsy, and blast cells were then detected after preforming multiple bone marrow aspirations. She also had pathological femoral neck fracture, but after treatment regimen by chemotherapy, her osteolytic lesions cured with obtainment of femoral neck fusion. She could walk at the final period. Conclusion: This case highlights the importance of early diagnosis of this disease for greater curing rates. Diagnosis of Precursor B-cell lymphoblastic lymphoma was finally made based on the results of biopsy of tissues because of the delayed appearance of leukemic changes. Orthopaedic surgeons should be aware of Precursor B-cell lymphoblastic lymphoma, when making diagnosis of patients exhibiting a rapid hip bone destruction.
背景:前体B细胞淋巴细胞淋巴瘤是一种罕见的急性淋巴细胞淋巴瘤亚型,有时表现为溶解性骨病变。溶解性骨病变的诊断和治疗总是具有挑战性的。这是一个罕见的前体B细胞急性淋巴细胞淋巴瘤的延迟性白血病改变,表现为髋骨快速破坏。病例介绍:一名12岁的日本女孩在出现症状两个月后出现进行性左髋疼痛和左髋骨破坏。她没有恶性肿瘤病史或家族史,也没有遗传异常。射线照片和核磁共振检查显示她的左股骨颈和骨盆有骨质破坏和溶骨性病变。在我们对外周血和吸入骨髓细胞的初步检查中没有发现Blast细胞。根据骨活检结果,该病例最终被诊断为前体B细胞淋巴母细胞淋巴瘤,然后在预形成多个骨髓愿望后检测到母细胞。她也有病理性股骨颈骨折,但经过化疗方案,她的溶骨性病变通过股骨颈融合术治愈。她可以在最后阶段走路。结论:该病例强调了早期诊断该疾病对提高治愈率的重要性。由于白血病改变的延迟出现,最终根据组织活检结果诊断为前体B细胞淋巴细胞淋巴瘤。骨科医生在诊断髋关节骨快速破坏的患者时,应注意前体B细胞淋巴母细胞淋巴瘤。
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引用次数: 1
Bone Undifferentiated Pleomorphic Sarcoma – A Case Report 骨未分化多形性肉瘤一例报告
Pub Date : 2018-04-23 DOI: 10.4172/2165-7920.10001095
André Costa, B. Santos, C. Mateus, L. Fardilha, Gomes, I. Silva, Pedro Varanda, N. Sevivas
Bone sarcomas are a rare group of tumors arising mostly in the extremities, being the undifferentiated pleomorphic sarcoma (UPS), also known as malignant fibrous histiocytoma, the most common. UPS exhibits a wide spectrum of clinical behavior and a diagnosis challenge. We report a clinical case of a proximal humeral UPS that presented with a non-recognized pathological fracture, initially treated with open reduction and internal fixation. Suboptimal postoperative management of the patient, leading to a diagnosis delay, occurred related to its hematoid transformation, a variant of aggressive high-grade sarcoma associated with a worse prognosis. Pulmonary embolic complication, external axillary vein compression, rapidly tumor growth and diffuse metastization were some characteristics. Abrupt disease development makes important to recognize the clinical features of those tumors, so better outcomes can be obtained.
骨肉瘤是一组罕见的肿瘤,主要发生在四肢,是未分化多形性肉瘤(UPS),也称为恶性纤维组织细胞瘤,最常见。UPS表现出广泛的临床行为和诊断挑战。我们报告了一例肱骨近端UPS的临床病例,该病例表现为未识别的病理性骨折,最初采用切开复位和内固定治疗。该患者的亚最佳术后处理导致诊断延迟,其发生与血细胞转化有关,血细胞转化是侵袭性高级别肉瘤的一种变体,预后较差。肺栓塞并发症、腋窝外静脉压迫、肿瘤快速生长和弥漫性转移是一些特征。疾病的突然发展使得识别这些肿瘤的临床特征变得重要,从而可以获得更好的结果。
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引用次数: 0
Remote Primary Intraventricular Haemorrhage in Case of a Ruptur ed MCA Aneurysm Ruptured MCA动脉瘤的远端原发性脑室内出血
Pub Date : 2018-04-23 DOI: 10.4172/2165-7920.10001093
Redmond Jg, Pattavilakom Sa
This is the first documented case report of a simultaneous middle cerebral artery (MCA) aneurysmal subarachnoid hemorrhage (aSAH) and remote third ventricular clot. The occurrence of simultaneous subarachnoid hemorrhage and remote hypertensive intracerebral hemorrhage (ICH) is a rare occurrence and has only been reported three previous times in the literature. Intraventricular hemorrhage (IVH) post aneurysmal subarachnoid hemorrhage is common, where peri-ventricular intracerebral clot has ruptured the ependymal lining. However primary intraventricular hemorrhage (PIVH) without associated parenchymal clot is rare. Migration of blood via outlet foramina of the fourth ventricle through CSF pulsation and flow is thought to be the mechanism for this occurrence and would account for small volumes in the subacute setting. Here, we present a case of a 52-year-old woman with a CT demonstrated spontaneous middle cerebral artery (MCA) bifurcation aneurysmal subarachnoid hemorrhage and a large acute third ventricular clot spanning the foramen Monroe.
这是第一例同时发生大脑中动脉(MCA)动脉瘤性蛛网膜下腔出血(aSAH)和远端第三脑室血栓的病例报告。同时发生蛛网膜下腔出血和远处高血压性脑出血(ICH)是一种罕见的情况,以前在文献中只报道过三次。动脉瘤性蛛网膜下腔出血后的脑室内出血(IVH)很常见,脑室周围的脑内凝块使室管膜衬里破裂。然而,没有相关实质凝块的原发性脑室内出血(PIVH)是罕见的。血液通过第四脑室出口孔通过CSF搏动和流动的迁移被认为是这种情况发生的机制,并且在亚急性情况下会导致小体积。在这里,我们介绍了一个52岁的女性的病例,她的CT表现为自发性大脑中动脉(MCA)分叉动脉瘤性蛛网膜下腔出血和横跨门罗孔的大的急性第三脑室凝块。
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引用次数: 0
Systemic Steroids, Clarithromycin and Metronidazole in the Trea tment of Rosacea during Pregnancy 全身性类固醇、克拉霉素和甲硝唑治疗妊娠期酒渣鼻
Pub Date : 2018-04-23 DOI: 10.4172/2165-7920.10001100
B. Clanner-Engelshofen, H. Schwaiger, G. Plewig, H. Wolff, T. Ruzicka, M. Reinholz
Rosacea is a common skin disease with a predilection for the face. Patients suffer from symptoms like flushing, redness of the face, telangiectasia, pustules, or papules. A more acute form is rosacea fulminans that occurs preferentially in women. Hormonal fluctuations as during a pregnancy can aggravate existent rosacea. The case of a female patient is presented, who was in the 26th week of her pregnancy. She discontinued her usual rosacea medication when she became pregnant. The patient developed rosacea fulminans, which was treated with systemic corticosteroids as recommended. She responded well to clarithromycin 250 mg for three times a week in combination with topical treatment using metronidazole 0.75% creme, continuing this regimen until a stable result was obtained. Based on the observations in this case study the therapy of rosacea fulminans with clarithromycin can help to reduce the symptoms, especially since treatment with systemic isotretinoin and doxycycline is contraindicated during pregnancy.
酒渣鼻是一种常见于面部的皮肤病。患者会出现脸红、脸发红、毛细血管扩张、脓疱或丘疹等症状。更为急性的形式是暴发性酒渣鼻,多发于女性。怀孕期间的荷尔蒙波动会加重酒渣鼻。病例的女病人是提出,谁是在她的怀孕26周。当她怀孕时,她停止了常用的酒渣鼻药物。患者发展为暴发性酒渣鼻,经推荐全身性皮质类固醇治疗。患者对克拉霉素250 mg,每周3次,联合使用0.75%甲硝唑乳膏进行局部治疗,反应良好,并继续该方案,直到获得稳定的结果。根据本病例研究的观察,用克拉霉素治疗暴痤疮可以帮助减轻症状,特别是因为在怀孕期间使用全身异维甲酸和强力霉素治疗是禁忌。
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引用次数: 0
Cardiac Tumor in a 15-Year-Old Patient 一名15岁患者的心脏肿瘤
Pub Date : 2018-04-13 DOI: 10.4172/2165-7920.10001102
S. Milouchi, A. Sghaier, H. Ajmi, K. Ali, Ferjani Souad
Tumors of the heart are a very rare disease in cardiology practice. They are more frequently benign. Neonatal diagnosis is possible, but the accidental late discovery of a cardiac mass remains the most common situation. We report a case of a cardiac tumor in a 15-year-old patient symptomatic of palpitations. The belonging of the tissue to the cardiac muscle was confirmed on echocardiography and on other radiological findings. Regular monitoring was chosen at first then surgical resection was decided as an increase in the tumor’s size was noted on the echocardiographic control.
心脏肿瘤在心脏病学实践中是一种非常罕见的疾病。它们通常是良性的。新生儿诊断是可能的,但意外发现心脏肿块仍然是最常见的情况。我们报告一例心脏肿瘤在一个15岁的病人症状心悸。超声心动图和其他放射学检查证实该组织属于心肌。首先选择定期监测,然后决定手术切除,因为超声心动图控制显示肿瘤大小增加。
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引用次数: 0
Glucose Abnormalities in Hypothyroidism 甲状腺功能减退症的葡萄糖异常
Pub Date : 2018-04-13 DOI: 10.5376/IJCCR.2018.08.0003
S. Azzoug, Souad Chellali, Fatma Zohra Boudissa, E. Koceir, D. Meskine, F. Chentli
It is classically known that thyroid hormones excess or hyperthyroidism induce hyperglycemia. However, thyroid hormone deficiency or hypothyroidism can also induce glucose abnormalities through the development of abdominal obesity and insulin resistance. The aim of our study was to assess the frequency and predictive factors of glucose abnormalities during hypothyroidism. In this retrospective study, we included 425 patients (383 F/42 M) presenting with primary hypothyroidism. We investigated the presence of hyperglycemia, either fasting (≥100 mg/dl) and/or at 2 hours after an oral glucose tolerance test with 75 grams of glucose (≥140 mg/dl). Hyperglycemia was found in 37.6%. Subjects with hyperglycemia were older than those with normoglycemia (54.4±1.08 vs. 45.7±0.8 years), their Body Mass Index (BMI) was higher (31.5±0.53 vs. 28.7±0.37 kg/m 2 ), they had higher blood pressure (54.3% vs. 21.5%) and a family history of diabetes (36.2% vs. 29.8%). We conclude that glucose abnormalities are frequent in hypothyroidism and are developed mostly in patients with risk factors for insulin resistance such as age, high blood pressure and a positive family history of type 2 diabetes.
众所周知,甲状腺激素过量或甲状腺功能亢进会引起高血糖。然而,甲状腺激素缺乏或甲状腺功能减退也可通过腹部肥胖和胰岛素抵抗的发展诱导葡萄糖异常。我们研究的目的是评估甲状腺功能减退期间血糖异常的频率和预测因素。在这项回顾性研究中,我们纳入了425例(383 F/42 M)原发性甲状腺功能减退患者。我们调查了空腹(≥100mg /dl)和/或口服葡萄糖耐量试验后2小时(≥140mg /dl)是否存在高血糖。高血糖患者占37.6%。高血糖患者年龄大于血糖正常者(54.4±1.08∶45.7±0.8岁),体重指数(BMI)较高(31.5±0.53∶28.7±0.37 kg/ m2),血压较高(54.3%∶21.5%),有糖尿病家族史(36.2%∶29.8%)。我们的结论是,葡萄糖异常在甲状腺功能减退症中很常见,并且主要发生在具有胰岛素抵抗危险因素的患者中,如年龄、高血压和2型糖尿病阳性家族史。
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引用次数: 0
Salvage Procedure after Sternochondroplasty for Pectus Excavatu m 胸骨软骨成形术后的抢救方法
Pub Date : 2018-03-31 DOI: 10.4172/2165-7920.10001097
B. Aramini, U. Morandi, G. Santis, A. Baccarani
Vacuum-Assisted Closure (VAC) in association to flap reconstruction is a well-established approach for treating complicated wounds. The authors present a case of soft-tissue breakdown with hardware exposure in a patient treated with modified Ravitch procedure for pectus excavatum. VAC therapy was applied in association to multiple debridement procedures and final flap closure. This was achieved without the need for hardware removal, thus maintaining adequate skeletal fixation. To our knowledge this approach has not yet been described into the literature after sternochondroplasty procedure. Aggressive debridement and VAC therapy before final closure may represent a new, conservative method for managing surgical complications after sternochondroplasty procedures.
真空辅助闭合术(VAC)结合皮瓣重建是治疗复杂伤口的一种公认方法。作者介绍了一例因硬件暴露而导致软组织破裂的患者,该患者接受了改良Ravitch漏斗胸手术。VAC治疗与多次清创术和最终皮瓣闭合相关。这是在不需要移除硬件的情况下实现的,从而保持了足够的骨骼固定。据我们所知,在胸骨软骨成形术后,这种方法尚未在文献中描述。在最终闭合前进行积极的清创术和VAC治疗可能是一种新的、保守的治疗胸骨软骨成形术后手术并发症的方法。
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引用次数: 0
Iron Deficiency Thrombocytopenia: A Case Report and Review of the Literature 缺铁性血小板减少症1例报告及文献复习
Pub Date : 2018-03-30 DOI: 10.4172/2165-7920.10001090
B. J. Hassan, M. Campos
Iron deficiency is a common cause of anemia in premenopausal women. Thrombocytopenia is rarely found in association with iron deficiency anemia (IDA), and its mechanism is not fully understood. Here, we present the case of a 41-year-old African-American woman who was found to have severe asymptomatic thrombocytopenia (platelet count 22,000/μL) in association with more moderate IDA (hemoglobin 8.5 g/dL). Both cytopenias resolved with oral iron replacement therapy in the absence of other therapeutics, such as corticosteroid therapy, and a diagnostic workup revealed no other cause for thrombocytopenia. We conclude that iron deficiency-associated thrombocytopenia should be considered in any case of thrombocytopenia accompanying IDA. Response of both anemia and thrombocytopenia to iron therapy should obviate the need for expensive evaluations and bone marrow examination.
缺铁是绝经前妇女贫血的常见原因。血小板减少症很少与缺铁性贫血(IDA)相关,其机制尚不完全清楚。在这里,我们介绍了一名41岁的非裔美国妇女的病例,她被发现患有严重的无症状血小板减少症(血小板计数22000/μL),并伴有更中度的IDA(血红蛋白8.5 g/dL)。在没有其他治疗方法(如皮质类固醇治疗)的情况下,通过口服铁替代治疗,两种细胞减少症都得到了解决,诊断检查显示没有其他原因导致血小板减少症。我们的结论是,任何伴有IDA的血小板减少症病例都应考虑缺铁性血小板减少症。贫血和血小板减少症对铁治疗的反应应避免昂贵的评估和骨髓检查。
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引用次数: 0
A Case Report of Danon Disease 达侬病1例报告
Pub Date : 2018-03-30 DOI: 10.4172/2165-7920.10001089
Olusanya Aa, Balachandran Kp
We present a case of a 21-year-old gentleman with background history of moderate learning disability, Type 1 Diabetes Mellitus and elevated ALT. Due to incidental finding of a double apical impulse and abnormal ECG was referred for cardiology review. His echocardiogram findings triggered a cascade of other investigations which eventually resulted into genetic testing that confirmed Danon disease. He had a high HCM risk-SCD score and therefore had an ICD implant but unfortunately due to poor diabetic control, he was unlisted from heart transplant list. About 5 years after his formal diagnosis, he developed decompensated and congestive heart failure despite optimal medical therapy. He unfortunately passed away due to end-stage heart failure.
我们报告一位21岁的男性患者,他有中度学习障碍、1型糖尿病和ALT升高的病史。由于偶然发现双尖顶冲动和心电图异常,他被转介进行心脏病学检查。他的超声心动图发现引发了一连串的其他调查,最终导致基因检测证实了达农病。他有较高的HCM风险- scd评分,因此植入了ICD,但不幸的是,由于糖尿病控制不佳,他没有被列入心脏移植名单。在正式诊断后5年左右,尽管进行了最佳的药物治疗,他仍出现代偿性心力衰竭和充血性心力衰竭。不幸的是,他死于晚期心力衰竭。
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引用次数: 0
期刊
Journal of clinical case reports
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