• Title/Summary/Keyword: Differential Diagnosis

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A Clinically, Radiologically Malignant, but Histopathologically Benign Lesion in Oral Cavity (구강내 발생한 임상적, 방사선학적 악성 및 조직병리학적 양성 병소)

  • Oh, Hyun Jun;Jeon, Jae-ho;Myoung, Hoon
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.6
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    • pp.199-204
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    • 2018
  • Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.

Apathy syndrome in a patient previously treated with selective serotonin reuptake inhibitors for depression

  • Kim, Hye-Geum;Koo, Bon-Hoon;Lee, Seung Woo;Cheon, Eun-Jin
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.249-253
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    • 2019
  • There is considerable overlap in the clinical presentations of apathy and depression. However, differential diagnosis between apathy and other psychiatric conditions, including depression and dementia, is important. In this report, we present the case of a 67-year-old woman with a history of receiving selective serotonin reuptake inhibitor (SSRI) treatment for depression. Differential diagnosis between treatment-resistant depression and SSRI-induced apathy syndrome was required. The symptoms of her apathy syndrome were relieved after the discontinuation of SSRIs and the addition of olanzapine, methylphenidate, and modafinil. Furthermore, we briefly review related literature in this article.

Masticator Space Tumor Mimicking Temporomandibular Disorder Presenting Facial Swelling and Trismus: A Case Report

  • Jeong, Koo-Hyun;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • v.44 no.2
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    • pp.65-68
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    • 2019
  • Temporomandibular disorders (TMD), involving the masticator system of temporomandibular joint (TMJ) and masticator muscle, can be characterized with the cardinal signs and symptoms of jaw pain, noises and limitation of mandibular range of motion. However, TMD requires differential diagnosis due to its heterogeneous characteristics with various causes despite the similar clinical profiles. Oral cancer involving TMJ and the masticator system, although infrequent, can be one of these causes and should be considered one of the most life-threatening disease mimicking TMDs. This report introduces a case of masticator space tumor originally diagnosed as TMD in a 73-year-old Korean female with previous history of brain tumor. The clinical signs and symptoms closely mimic that of TMD which may have disrupted differential diagnosis. We discuss here key points for suspecting TMDs of secondary origin, namely, that of cancer and the implications it has on dental clinicians.

Oculocardiac reflex in an adult with a trapdoor orbital floor fracture: case report, literature review, and differential diagnosis

  • Brasileiro, Bernardo Ferreira;Sickels, Joseph E. Van;Cunningham, Larry L. Jr.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.428-434
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    • 2020
  • Orbital floor blowout fractures can result in a variety of signs and symptoms depending on the severity of the bone defect. Large defects often result in enophthalmos and restriction of ocular movement; yet the timing of surgery can be delayed up to two weeks with good functional outcomes. In contrast, an orbital trapdoor defect with entrapment of the inferior rectus muscle usually elicits pain with marked restriction of the upward gaze and activation of the oculocardiac reflex without significant dystopia or enophthalmos. When autonomic cardiac derangement is diagnosed along with an orbital floor fracture, it has been suggested that the fracture should be treated immediately. Otherwise, it will result in continued hemodynamic instability and muscular injury and may require a second surgery. This article reports the management of an unusual presentation of a trapdoor blowout orbital floor fracture surgery with oculocardiac response in an adult, with emphasis on its pathophysiology, management, and differential diagnosis.

Management of Ameloblastic Fibro-odontoma Associated with Impacted Tooth in the Posterior Mandible: Case Reports

  • Gahui, Jeong;Nanyoung, Lee;Myeongkwan, Jih;Hyewon, Shin
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.172-180
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    • 2022
  • Ameloblastic fibro-odontoma (AFO) is a rare odontogenic tumor, which occurs in young children before the age of 20 years. Radiologically, it is a well-defined radiolucent lesion containing radiopaque masses. Histopathologically, AFO is composed of odontogenic epithelium in a primitive-appearing connective tissue and hard tissue consisting of enamel and dentin. It is commonly found in the mandibular posterior region. AFO may be asymptomatic and is often associated with delayed tooth eruption. As it shows similar characteristics clinically and radiologically to odontoma, differential diagnosis through histopathological examination is important. Treatment of AFO is conservative enucleation, and teeth enclosed or associated with the lesion may require extraction. In this report, 2 young patients who visited our clinic with a chief complaint of delayed eruption were diagnosed as AFO with radiological and histopathological examination. After the surgery, the healing status was found to be favorable, and no evidence of recurrence was observed.

Dermoid Cyst of Nasal Tip with a Sinus Tract Extending to the Intracranium: A Case Report

  • Lee, Seungjun;Kim, Seong-Ik;Kim, Min-Seo;Kim, Jong-Ho
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.648-651
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    • 2022
  • Nasal dermoid cysts are rare congenital anomalies that affect one in 20,000 to one in 40,000 individuals. Herein, we report a case of an initially misdiagnosed nasal dermoid cyst with intracranial extension. Among nasal dermoids, the lesion of the nasal tip is considered uncommon. Therefore, this should always be considered as a differential diagnosis of midline nasal masses, and a proper diagnostic approach should be taken.

Cytological Features of Low Grade Fibromyxoid Sarcoma -Report of a Case with a Review of the Literature- (저등급 섬유점액육종의 세포소견 -1예 보고-)

  • Kwon, Mi-Seon
    • The Korean Journal of Cytopathology
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    • v.17 no.2
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    • pp.153-158
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    • 2006
  • Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor. There have been only a few prior fine-needle aspiration (FNA) cytological reports. Recognition of this tumor is important because of its potential for metastasis despite its indolent nature and its deceptively bland cytologic appearance. A 60-year-old male presented with a slowly growing mass in the left calf detected 10 years ago. The patient underwent surgical excision. FNA cytology was performed directly on the mass. The smears showed low cellularity composed of hypercellular tissue fragments, hypocellular loose aggregates, and stripped nuclei. The cytoplasm was seen as either collagenous material or very thin fibrillary collagen strands. Tumor cells had spindle, ovoid, or irregular nuclei, fine chromatin, and small nucleoli. Focally slight degree of nuclear pleomorphism is noted. There were no mitotic figures. Blood vessels were frequently seen. Immunocytochemically, tumor cells were negative for S-100 protein, desmin, smooth muscle actin, and CD34. The diagnosis of LGFMS is rarely possible by cytology alone; however, LGFMS should be included in the differential diagnosis of spindle-cell tumors consisting of hypercellular and hypocellular components with some capillary-sized vessels arising in the deep soft tissue of the lower extremities, particularly the thigh. The immunocytochemical findings are of help in the differential diagnosis.

Cytologic Features of Renal Cell Carcinoma: Clear Cell, Granular Cell and Oncocytoma (신세포암의 세침 흡인 세포학적 소견: 투명세포형, 과립세포형 및 호산성 과립세포종)

  • Choi, Yeong-Jin;Lee, Youn-Soo;Kwon, Mi-Seon;Lee, Kyo-Young;Kim, Byung-Kee;Shim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.31-37
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    • 1996
  • It is well known that fine needle aspiration biopsy(FNAB) is very useful and has a high accuracy rate in the diagnosis of renal neoplasms. Although there is some indecision to perform the FNAB for a rare possibility of tumor seeding along the biopsy needle tract, it tends to be used increasingly. As in the cytologic diagnosis of metastatic lesion through-out the body, renal cell carcinoma should nearly always be considered in the differential diagnosis, the precise understanding of cytologic features of renal cell carcinoma with various cell types and architectural patterns is necessarily required. In this report, we present three cases of primary renal cell tumors, two of renal cell carcinomas and one of oncocytoma, preponderantly emphasizing the cytologic differential points in the FNAB specimen.

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Atypical Extraventricular Neurocytoma

  • Choi, Hyun-Ho;Park, Sung-Hye;Kim, Dong-Gyu;Paek, Sun-Ha
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.381-384
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    • 2011
  • The authors report a case of atypical extraventricular neurocytoma (EVN) transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years ago. An 8-year-old boy underwent a surgical resection for a right frontal mass which was initially diagnosed as oligodendroglioma. When the tumor recurred 15 years later, a secondary operation was performed, followed by salvage gamma knife treatment. The recurrent tumor was diagnosed as an atypical EVN. The initial specimen was reviewed and immunohistochemistry revealed a strong positivity for synaptophysin. The diagnosis of the initial tumor was revised as an EVN. The patient maintained a stable disease state for 15 years after the first operation, and was followed up for one year without any complications or disease progression after the second operation. We diagnosed an atypical extraventricular neurocytoma transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years earlier. We emphasize that EVN should be included in the differential diagnosis of oligodendroglioma.

Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

  • Jadhav, Aniket B.;Tadinada, Aditya;Rengasamy, Kandasamy;Fellows, Douglas;Lurie, Alan G.
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.165-169
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    • 2014
  • An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.