• Title/Summary/Keyword: granulomatous lesion

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Pelvic Actinomycosis Mimicking Malignancy of the Uterus: a Case Report

  • Shin, Dahye;Hwang, Jiyoung;Hong, Seong Sook;Lee, Eun Ji;Kim, Yon Hee
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.2
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    • pp.136-141
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    • 2019
  • Pelvic actinomycosis is an uncommon infectious disease. It induces a chronic, suppurative illness characterized by an infiltrative and granulomatous response and, thus, the clinical and radiologic findings may mimic other inflammatory and neoplastic conditions. A 56-year-old female with a long-standing intrauterine device was diagnosed with pelvic actinomycosis manifesting as a large uterine mass with locally infiltrative spread into surrounding tissue that mimicked uterine malignancy. Actinomyces israelii infection was confirmed with a surgical specimen, and the patient was treated with antibiotic medication. Pelvic actinomycosis must be included in the differential diagnoses of patients with an infiltrative pelvic mass extending across tissue planes or in patients with findings of multiple microabscesses, particularly in a patient with an intrauterine device, even the lesion primarily involves the uterus.

Pulmonary Malakoplakia Associated with Peripheral Cysts in an Immunocompetent Patient: A Case Report

  • Correa, Liana Ferreira;Silva, Thiago Krieger Bento da;Camarg, Spencer Marcantonio;Furian, Bianca Canela
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.422-424
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    • 2022
  • Pulmonary malakoplakia is a rare lung lesion more frequently found in immunocompromised patients than in immunocompetent individuals. In this study, we report the challenging case of a young immunocompetent patient with an irregular pulmonary nodule with peripheral cysts who, after undergoing surgery, was diagnosed with malakoplakia. Due to the rarity of the disease and the similarity of this condition to malignant neoplasms, cytopathological or histopathological examinations are necessary for the correct diagnosis. A description of pulmonary malakoplakia with peripheral cysts has not been previously published in the literature.

Immunohistochemical Observation of Plasma Cell Granuloma in Intraoral Chronic Inflammatory Lesions (구강내 만성염증병소에서 보이는 형질세포육아종의 면역조직화학적 관찰)

  • Kim, Yeon-Sook;Lee, Suk-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2011
  • Purpose: Chronic inflammatory gingival lesions occur as pyogenic granulomas or non-specific chronic suppurative lesions. Methods: Of the 59 chronic inflammatory gingival lesions examined, plasma cell granuloma (n=14), which showed an intense antibody-mediated immune reaction with the increased infiltration of plasma cells, was observed as a pseudotumor-like gingival overgrowth and myofibroblastic or fibrohistiocytitc proliferation of stromal cells with a heavy collection of plasma cells. The levels of CD3, CD20, CD31, CD68, RANKL, cathepsin G, cathepsin K, lysozyme, TNF${\alpha}$, MMP-2, and MMP-9 in the 14 cases of gingival plasma cell granuloma with immunohistochemical detection were measured to determine the pathogenetic progresses of the plasma cell granuloma compared to the common pyogenic granuloma (n=45) in the gingiva. Results: The gingival lesions of the plasma cell granuloma could be divided into three histological types, plasma cell predominant type (PPT, n=8), mixed inflammatory cell type (MICT, n=2), and sclerosed fibrosis type (SFT, n=4). The PPT showed a condensed infiltration of plasma cells into the perivascular spaces of the granulomatous lesion with frequent formation of Russel's body in their cytoplasm. The MICT showed the concomitant infiltration of many macrophages together with plasma cells, resulting in the diffuse destruction of stromal fibrous tissue. The SFT showed granulomatous lesions replaced gradually by thick collagenous fibrous tissue, resembling an inflammatory pseudotumor. The SFT expressed strongly the lymphocytic markers, CD3 and CD20, and the macrophage/monocyte markers, CD31 and CD68, but showed reduced expression of common inflammatory markers, TNF${\alpha}$, cathepsin G, lysozyme, MMP-2, and MMP-9, as well as the reduced expression of osteoclastogenic markers, RANKL and cathepsin K. Conclusion: These results suggest that a gingival plasma cell granuloma shows variable gene expression for cell-mediated immunity and stromal tissue degeneration, undergoing sclerotic fibrosis with a persistent inflammatory reaction.

Thoracic Actinomycosis - A Case Report - (흉부 방선균증-1례 보고-)

  • 박찬범;최시영;조덕곤;문석환;조규도;조건현;왕영필;이선희
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.914-916
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    • 2002
  • Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

Actinomycosis of Submandibular Gland (악하선에 발생한 방선균증)

  • Lee Jin-Ho;Park In-Woo;Choi Hang-Moon;Heo Min-Suk;Lee Sam-Sun
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.132-137
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    • 2000
  • Actinomycosis is defined as a chronic, specific, suppurative, granulomatous disease caused mainly by the anaerobic, gram positive organism, Actinomyces israelii. Actinomycosis in the salivary gland is a rare disease that is caused by an inhabitant of the normal flora. We report the case of the actinomycosis of submandibular gland. A 53-year old man presented with the swelling on left submandiblar area. The lesion was not painful but had been increasing for about 10 days. In the CT view, the internal portion of the mass showed homogeneous moderate signal. The mass had continuities with the inferior portion of the left enlarged submandibular gland. In the MRI, there was a mass that showed a buldging pattern inferiorly in the left submandibular gland without bony invasion sign. The biopsy shows the colony of special organism. Many filaments are discovered with clubbed ends diffused from center of colony. We diagnosed this disease as actinomycosis in the submandibular gland by the postoperational biopsy.

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Cholesterol Granuloma of Frontal Bone - A Case Report - (전두골에 발생한 콜레스테롤 육아종 1례 - 증례보고 -)

  • Lee, Sang Weon;Cha, Seung Heon;Park, Dong June;Song, Geun Sung;Choi, Chang Hwa;Lee, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.777-780
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    • 2001
  • Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.

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TUBERCULOUS OSTEOMYELITIS SIMULTANEOUSLY OCCURED ON THE MAXILLA AND MANDIBLE (상악골과 하악골 동시에 발생한 결핵성 골수염)

  • Kim, Il-Kyu;Ryu, Mun-Kwang;Kim, Dong-Soo;Ku, Je-Hoon;Choi, Jin-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.164-169
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    • 2005
  • Tuberculosis is a systemic disease with a world-wide distribution, and its occurance in the oral cavity is well documented in the literature. Disease of oral cavity and jaw caused by Mycobacterium tuberculosis is very rare, so it is often difficult to diagnose tuberculosis in the oral cavity. When granulomatous and ulcerative lesion persists in the oral cavity for a long time, it may be considered a tuberculosis. When differential diagnosis is needed, the most reliable indicators of mycobacterial infection are careful clinical evaluation, skin test, acid-fast staining, biopsy and culture. We report a case of tuberculous osteomyelitis which simultaneously occurred on the maxilla and mandible in a 85 years old man that proved diagnosis difficult, but which responded very well to surgical treatment and chemotherapy.

A Case with Single Cavitary Nodule in Right Upper Lung (우상부의 공동성 폐 병변)

  • Choi, Jin-Won;Park, Ik-Soo;Choi, Wan-Young;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Jeon, Suck-Chul;Park, Moon-Hyang;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.2
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    • pp.199-204
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    • 1992
  • A 46 years old male showed radiologically a single cavitary nodular lesion in right upper lung, which extended to the regional chest wall. This finding has to be made into differential diagnosis of numerous pulmonary diseases including infections such as mycobacterial, fungal or bacterial, granulomatous diseases, and neoplasms. For the definite diagnosis, fine needle aspiration biopsy guided by biplane fluoroscopy was performed. The aspirates contained several sulfur granules, in the center of which many gram positive, filamentous organisms were compactly intermingled. Such a findings was compatible with pulmonary actinomycosis. Now the lesions is cleared out by medical treatment with amoxicillin for 3 months.

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Fine Needle Aspiration Cytologic Features of Follicular Lymphoma (여포성 림프종의 세침흡인 세포학적 소견)

  • Chung, Jin-Haeug;Ha, Hwa-Jeong;Park, Sun-Hoo;Koh, Jae-Soo;Kim, Min-Suk;Lee, Seung-Sook;Cho, Kyung-Ja
    • The Korean Journal of Cytopathology
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    • v.13 no.2
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    • pp.60-65
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    • 2002
  • The accuracy of fine needle aspiration cytology (FNAC) for the diagnosis of follicular lymphoma was investigated by a review of 13 FNAC specimens from 10 patients. All patients Included in this study were confirmed by surgical biopsy preceded by FNAC. Three aspirates were unsatisfactory because of scanty cellularity. Among the remaining 10 cases, 5(50%) were diagnosed as lymphoma, 3(30%) as reactive hyperplasia, one (10%) as metastatic small cell carcinoma, and one (10%) as granulomatous inflammation. Cytologic distinction between follicular lymphoma and reactive hyperplasia is very difficult with cytomorphology alone. Compared to reactive hyperplasia, the characteristic cytologic features such as relatively homogeneous cellular constituent, paucity of tingible body macrophages and lymphohistiocytic aggregates, and less mitotic activity in follicular lymphoma are important findings to prevent false negative diagnosis. In addition, lymphoglandular bodies are useful in distinguishing malignant epithelial tumor from lymphoid lesion.

IMMUNOHISTOPATHOLOGIC STUDY OF PERIAPICAL LESIONS (치근단(齒根端) 병소(病巢)의 면역병리조직학적(免疫病理組織學的) 연구(硏究))

  • Cho, Hyo-Sun
    • Restorative Dentistry and Endodontics
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    • v.8 no.1
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    • pp.19-30
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    • 1982
  • This study was performed to elucidate the histopathologic distribution of immunoglobulins, particularly IgA, IgG and IgM in the periapical lesions, including 22 periapical granulomas and 18 periapical cysts. The immunoperoxidase staining method using reagents manufactured and supplied by Danish DAKO company was employed in this study. In comparison with the immunohistochemical methods, this method was proved to be reliable and convinient one to detect immunoglobulins in the tissue. The following results were obtained: 1. In the 22 periapical granulomas, IgG was found in 20 cases (90.9%), IgA in 16 cases (72.7%) and IgM in 19 cases (86.3%). 2. In the 18 periapical cysts, IgG was found in 16 cases (88.8%), IgA in 13 cases (72.2%) and IgM in 15 cases (83.3%). 3. The distribution of immunoglobulins both in periapical granulomas and periapical cysts was in great diversity according to the lesion and area. 4. More immunoglobulins were found in the exudative area with moderate or severe infiltrations of plasma cells and lymphocytes and less concentration of immunoglobulins were seen in the area with leukocytes infiltration and tissue destruction. 5. The area with collagenolysis and reparative activity contained more abundant IgG and IgM than IgA in periapical granulomas. 6. IgG was dominant in the granulomatous connective tissue and immunoglobulins were not easily found in the fibrous capsule in periapical cysts.

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