Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology d...Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology diagnosis. Methods: Ret rospective review of all pathology reports from 1910 to 1999 in the files of the Eye Pathology Institute, University of Copenhagen, describing a lesion of the l acrimal drainage system. In addition, a retrospective review of all reports desc ribing a lesion of the lacrimal drainage system from the Danish Pathology Databa se. All specimens were re-evaluated, except in cases with a primary diagnosis o f dacryocystitis. In these cases a sample of 25%was re-evaluated. Results: A t otal of 643 lesions were collected. Dacryocystitis was the most frequent lesion, constituting 508 cases (79%). The remaining cases were diagnosed as dacryolith iasis (62 cases; 7.9%), tumour (29 cases; 4.5%), trauma (19 cases; 3.0%), con genital malformation (nine cases; 1.4%), canaliculitis (eight cases; 1.2%) and granulomatous inflammation (eight cases; 1.2%). Seventeen tumours were maligna nt, of which B-cell lymphoma was the most common (six cases). In 0.6%of cases with a clinical diagnosis of dacryocystitis/lithiasis a non-suspected malignant tumour was diagnosed. Micro-organisms were uncommon in dacryocystitis (9%) bu t frequent in cases of dacryolithiasis (87%). Conclusion: Dacryocystitis was by far the most frequent lesion of the lacrimal drainage system referred for histo pathological evaluation. Dacryolithiasis was often associated with micro-organi sms, especially Gram positive rods. Histopathology is necessary to confirm suspe cted tumours, more than half of which were inflammatory lesions, and to detect t umours that sometimes masquerade as inflammation.展开更多
Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road ...Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine- cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. Case report. A 75 year- old woman fell on her right leg on the side of themain road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow- growing Gram- positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino- sensitive Staphylococcus aureus. The treatment with sulfamethoxazole- trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. Discussion. The revelation of this particular slow- growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations andwe discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective antibiotic drugs.展开更多
文摘Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology diagnosis. Methods: Ret rospective review of all pathology reports from 1910 to 1999 in the files of the Eye Pathology Institute, University of Copenhagen, describing a lesion of the l acrimal drainage system. In addition, a retrospective review of all reports desc ribing a lesion of the lacrimal drainage system from the Danish Pathology Databa se. All specimens were re-evaluated, except in cases with a primary diagnosis o f dacryocystitis. In these cases a sample of 25%was re-evaluated. Results: A t otal of 643 lesions were collected. Dacryocystitis was the most frequent lesion, constituting 508 cases (79%). The remaining cases were diagnosed as dacryolith iasis (62 cases; 7.9%), tumour (29 cases; 4.5%), trauma (19 cases; 3.0%), con genital malformation (nine cases; 1.4%), canaliculitis (eight cases; 1.2%) and granulomatous inflammation (eight cases; 1.2%). Seventeen tumours were maligna nt, of which B-cell lymphoma was the most common (six cases). In 0.6%of cases with a clinical diagnosis of dacryocystitis/lithiasis a non-suspected malignant tumour was diagnosed. Micro-organisms were uncommon in dacryocystitis (9%) bu t frequent in cases of dacryolithiasis (87%). Conclusion: Dacryocystitis was by far the most frequent lesion of the lacrimal drainage system referred for histo pathological evaluation. Dacryolithiasis was often associated with micro-organi sms, especially Gram positive rods. Histopathology is necessary to confirm suspe cted tumours, more than half of which were inflammatory lesions, and to detect t umours that sometimes masquerade as inflammation.
文摘Introduction. Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine- cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. Case report. A 75 year- old woman fell on her right leg on the side of themain road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow- growing Gram- positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino- sensitive Staphylococcus aureus. The treatment with sulfamethoxazole- trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. Discussion. The revelation of this particular slow- growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations andwe discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective antibiotic drugs.
