Cerebral aspergillosis commonly affects immunocompromised hosts, primarily patients on immunosuppressive therapy and those with acquired or immunodeficient states such as AIDS. We report a case of cerebral aspergillos...Cerebral aspergillosis commonly affects immunocompromised hosts, primarily patients on immunosuppressive therapy and those with acquired or immunodeficient states such as AIDS. We report a case of cerebral aspergillosis in a 39-year-old woman with a history of treated chronic lymphocytic leukemia (CLL). Multiple fragments of fixed tissues with formalin were freshly sent to the laboratory. An extemporaneous examination was performed by spreading. The rest of the sample was embedded in paraffin and studied according to the standard histological method with special stains and an immunohistochemical study. A microscopic observation showed abundant clusters of tangled mycelial filaments, Grocott+. At the edge, a nervous tissue was observed remodeled by an abundant inflammatory infiltrate consisting essentially of small lymphocytes and plasma cells. Additional immunohistochemistry was performed using anti-CD20, anti-CD3, anti-CD5, anti-CD23, anti-Bcl2, anti-Ki67, anti-IgD and anti-Kappa and Lamda antibodies. All taken together there were no further founding in support of a secondary localization of CLL. Cerebral aspergillosis is quite rare and often occurs in a context of immunosuppression. This case indicates the importance of a close collaboration between clinicians and pathologists for optimal patient care.展开更多
Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 ye...Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 years old seem to be more affected. Classically, one opposes the primary or idiopathic forms and the secondary forms. Case Report: We report the case of a 62-year-old female patient with a history of treated peptic ulcers, who presented with episodes of intermittent atypical abdominal pain that worsened abruptly. The physical examination revealed a surgical abdomen with tenderness to palpation. The patient underwent a jejunal resection. The pathological examination showed macroscopically an intestinal fragment with confluent subserosal and intestinal intraparietal bullae. On opening, the portion containing the bullae was thickened, infarcted, congestive, hemorrhagic, and brittle with narrowing of the intestinal lumen. The bullae are tense and leave serosities. On histological examination, the intestinal wall was very congestive with hemorrhagic patches of suffusion. There were optically empty cystic formations that do not communicate with the digestive lumen. The adjacent mucosa is the site of a moderate subacute inflammatory reaction. Conclusion: Pneumatosis cystoides intestinalis is a rare and usually benign pathology. The symptoms, when they exist, are not specific. Its physiopathology is still very much debated. The prognosis is generally good. The knowledge of this pathology is necessary to avoid invasive explorations and heavy treatment without interest for the patient.展开更多
Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right bre...Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right breast for one year. The scan and mammography revealed a long-axis node of 3 × 2 × 1 cm in the upper outer quadrant of the right breast ranked stage IV by the American College of Radiology (ACR), associated with a set of axillary lymph nodes and the largest one measuring 15 × 15 × 20 millimeters (mm). The breast biopsy helped diagnose a Scarff Bloom Richardson (SBR) grade II non-specific invasive carcinoma, modified by Ellis and Elston. A right mastectomy associated with a lymph node dissection was performed. We noticed a not well defined and whitish 5 mm tumor mass associated with 16 lymph nodes removed. The histological examination confirmed the diagnosis of SBR grade II non-specific invasive carcinoma with invasion of 7 lymph nodes (N+ = 7/16). In 3 metastatic lymph nodes, there were epithelioid and gigantocellular granulomas with full central necrosis. The Ziehl Neelsen staining had highlighted acid-fast bacilli. The tumor was oestrogen and progesteron receptor, without an overexpression of the oncoprotein human epidermal growth factor receptor 2 (HER2), which corresponds to a 0 score and the Ki 67 proliferation index assessed at 10%. The patient was given an anti-tuberculosis treatment combining Rifampicin (H), Isoniazid (I), Pyrazinamid (Z), Ethambutol (E) over 2 months and secondly a combination of Rifampicin and Isoniazid over 4 months (2RHZE/4 RH). The anti-tumor chemotherapy used a protocol combining 3 FAC60+ 3 Docetaxel (F = Fluorouracil®A = Adriblastin®, C = Cyclophosphamid). Conclusion: This coexistence is uncommon, of incidental discovery and necessitates a multidisciplinary care.展开更多
文摘Cerebral aspergillosis commonly affects immunocompromised hosts, primarily patients on immunosuppressive therapy and those with acquired or immunodeficient states such as AIDS. We report a case of cerebral aspergillosis in a 39-year-old woman with a history of treated chronic lymphocytic leukemia (CLL). Multiple fragments of fixed tissues with formalin were freshly sent to the laboratory. An extemporaneous examination was performed by spreading. The rest of the sample was embedded in paraffin and studied according to the standard histological method with special stains and an immunohistochemical study. A microscopic observation showed abundant clusters of tangled mycelial filaments, Grocott+. At the edge, a nervous tissue was observed remodeled by an abundant inflammatory infiltrate consisting essentially of small lymphocytes and plasma cells. Additional immunohistochemistry was performed using anti-CD20, anti-CD3, anti-CD5, anti-CD23, anti-Bcl2, anti-Ki67, anti-IgD and anti-Kappa and Lamda antibodies. All taken together there were no further founding in support of a secondary localization of CLL. Cerebral aspergillosis is quite rare and often occurs in a context of immunosuppression. This case indicates the importance of a close collaboration between clinicians and pathologists for optimal patient care.
文摘Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 years old seem to be more affected. Classically, one opposes the primary or idiopathic forms and the secondary forms. Case Report: We report the case of a 62-year-old female patient with a history of treated peptic ulcers, who presented with episodes of intermittent atypical abdominal pain that worsened abruptly. The physical examination revealed a surgical abdomen with tenderness to palpation. The patient underwent a jejunal resection. The pathological examination showed macroscopically an intestinal fragment with confluent subserosal and intestinal intraparietal bullae. On opening, the portion containing the bullae was thickened, infarcted, congestive, hemorrhagic, and brittle with narrowing of the intestinal lumen. The bullae are tense and leave serosities. On histological examination, the intestinal wall was very congestive with hemorrhagic patches of suffusion. There were optically empty cystic formations that do not communicate with the digestive lumen. The adjacent mucosa is the site of a moderate subacute inflammatory reaction. Conclusion: Pneumatosis cystoides intestinalis is a rare and usually benign pathology. The symptoms, when they exist, are not specific. Its physiopathology is still very much debated. The prognosis is generally good. The knowledge of this pathology is necessary to avoid invasive explorations and heavy treatment without interest for the patient.
文摘Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right breast for one year. The scan and mammography revealed a long-axis node of 3 × 2 × 1 cm in the upper outer quadrant of the right breast ranked stage IV by the American College of Radiology (ACR), associated with a set of axillary lymph nodes and the largest one measuring 15 × 15 × 20 millimeters (mm). The breast biopsy helped diagnose a Scarff Bloom Richardson (SBR) grade II non-specific invasive carcinoma, modified by Ellis and Elston. A right mastectomy associated with a lymph node dissection was performed. We noticed a not well defined and whitish 5 mm tumor mass associated with 16 lymph nodes removed. The histological examination confirmed the diagnosis of SBR grade II non-specific invasive carcinoma with invasion of 7 lymph nodes (N+ = 7/16). In 3 metastatic lymph nodes, there were epithelioid and gigantocellular granulomas with full central necrosis. The Ziehl Neelsen staining had highlighted acid-fast bacilli. The tumor was oestrogen and progesteron receptor, without an overexpression of the oncoprotein human epidermal growth factor receptor 2 (HER2), which corresponds to a 0 score and the Ki 67 proliferation index assessed at 10%. The patient was given an anti-tuberculosis treatment combining Rifampicin (H), Isoniazid (I), Pyrazinamid (Z), Ethambutol (E) over 2 months and secondly a combination of Rifampicin and Isoniazid over 4 months (2RHZE/4 RH). The anti-tumor chemotherapy used a protocol combining 3 FAC60+ 3 Docetaxel (F = Fluorouracil®A = Adriblastin®, C = Cyclophosphamid). Conclusion: This coexistence is uncommon, of incidental discovery and necessitates a multidisciplinary care.
