Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening l...Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening left eye pain, proptosis, tearing, gritty sensation, blurred vision and multiple lymphadenopathy. An axillary lymph node resection showed reactive follicular and interfollicular lymph node hyperplasia, and increased eosinophils and plasma cells(at least 80% of Ig G+ plasma cells were positive for IgG 4). A distinct feature was the presence of multifocal, perifollicular histiocytic granulomas, which formed a wreath around the entire follicles. The human herpes virus 8 was not detected by immunohistochemistry. In addition, an extensive panel of special stains, immunohistochemistry, and flow cytometry was negative for lymphoma, fungal, or mycobacterial infection. The findings were suggestive of IgG 4-related sclerosing disease-associated lymphadenopathy. Further laboratory testing showed a significant increase of serum immunoglobulin E(> 23000 IU/mL) and slight increase of total Ig G, but normal serum Ig G4. Even though perifollicular granuloma is a nonspecific histopathologic feature and can be seen in other diseases, such as nodular lymphocyte predominant Hodgkin lymphoma, Ig G4-related lymphadenopathy should be listed in the differential diagnoses of benign reactive lymph nodes, especially when perifollicular granuloma and plasmacytosis coexist.展开更多
Inflammatory pseudotumor(IPT) has always been considered a diagnostic challenge. Its rarity and resemblance to other more common pathological entities imposes that neither clinical nor radiological characteristics can...Inflammatory pseudotumor(IPT) has always been considered a diagnostic challenge. Its rarity and resemblance to other more common pathological entities imposes that neither clinical nor radiological characteristics can lead to a definitive diagnosis. The surgical excision of the lesion is the ultimate approach for accurate diagnosis and cure. Moreover the true nature of IPT, its origin as a neoplastic entity or an overreactive inflammatory reaction to an unknown trigger, has been a long debated matter. Surgery remains the treatment of choice. IPT is mostly an indolent disease with minimal morbidity and mortality. Local invasion and metastasis predict a poor prognosis. We hereby present a unique case of pulmonary IPT that was surgically excised, but recurred contralaterally, shortly thereafter. Despite no medical or surgical treatment for ten years, the lesion has remained stable in size, with neither symptoms nor extra-pulmonary manifestations.展开更多
INTRODUCTIONInflammatory pseudotumor of the liver ,a rare benign lesion ,is often confused with the malignant tumors .Until 1998,less than 80 cases had been reported in the world [1,2].The accuracy of the pre-surgica...INTRODUCTIONInflammatory pseudotumor of the liver ,a rare benign lesion ,is often confused with the malignant tumors .Until 1998,less than 80 cases had been reported in the world [1,2].The accuracy of the pre-surgical diagnosis was low p[3,4] ,and very few materials on the diagnosis using dynamic MRI were reported [5-7] .We collected thirteen cases of inflammatory pseudotumor of the liver were collected and roved by pathology with MRI studies .Our purpose is to describe and analyze the MRI findings of this lesion and find out the valuable signs suggesting the diagnosis so as to avoid unnecessary operations.展开更多
Here we report the clinical,radiological and neuropathological findings of a patient with tumor-like inflammatory demyelinating diseases of the central nervous system.The patient was a 51-year-old man with a four-mont...Here we report the clinical,radiological and neuropathological findings of a patient with tumor-like inflammatory demyelinating diseases of the central nervous system.The patient was a 51-year-old man with a four-month history of inflammatory pseudotumor and no other significant medical history,who presented to our hospital recurrent relapse numbness and weakness of his right extremities,dysarthria and memory deterioration.Brain magnetic resonance imaging(MRI) showed mass focal lesion in white matter of left parietal lobes.The biopsy showed numerous infiltrating macrophages and lymphocytes within the perivascular.The patient responded clinically to corticosteroid and intravenous immunoglobulin(IVIG) therapy.According to the results of the biopsy and the MRI,a diagnosis of inflammatory pseu-dotumor of the central nervous system was made.The vascular dysfunction may act in the pathogenesis of inflammatory pseudotumor of the central nervous system.展开更多
基金Supported by Department of Pathology,the University of Texas Health Science Center at Houston,United States
文摘Perifollicular granuloma is a unique histologic feature and whether it is associated with immunoglobulin G4(IgG 4)-related disease is controversial. We report a case of a 38-year-old man who presented with worsening left eye pain, proptosis, tearing, gritty sensation, blurred vision and multiple lymphadenopathy. An axillary lymph node resection showed reactive follicular and interfollicular lymph node hyperplasia, and increased eosinophils and plasma cells(at least 80% of Ig G+ plasma cells were positive for IgG 4). A distinct feature was the presence of multifocal, perifollicular histiocytic granulomas, which formed a wreath around the entire follicles. The human herpes virus 8 was not detected by immunohistochemistry. In addition, an extensive panel of special stains, immunohistochemistry, and flow cytometry was negative for lymphoma, fungal, or mycobacterial infection. The findings were suggestive of IgG 4-related sclerosing disease-associated lymphadenopathy. Further laboratory testing showed a significant increase of serum immunoglobulin E(> 23000 IU/mL) and slight increase of total Ig G, but normal serum Ig G4. Even though perifollicular granuloma is a nonspecific histopathologic feature and can be seen in other diseases, such as nodular lymphocyte predominant Hodgkin lymphoma, Ig G4-related lymphadenopathy should be listed in the differential diagnoses of benign reactive lymph nodes, especially when perifollicular granuloma and plasmacytosis coexist.
文摘Inflammatory pseudotumor(IPT) has always been considered a diagnostic challenge. Its rarity and resemblance to other more common pathological entities imposes that neither clinical nor radiological characteristics can lead to a definitive diagnosis. The surgical excision of the lesion is the ultimate approach for accurate diagnosis and cure. Moreover the true nature of IPT, its origin as a neoplastic entity or an overreactive inflammatory reaction to an unknown trigger, has been a long debated matter. Surgery remains the treatment of choice. IPT is mostly an indolent disease with minimal morbidity and mortality. Local invasion and metastasis predict a poor prognosis. We hereby present a unique case of pulmonary IPT that was surgically excised, but recurred contralaterally, shortly thereafter. Despite no medical or surgical treatment for ten years, the lesion has remained stable in size, with neither symptoms nor extra-pulmonary manifestations.
文摘INTRODUCTIONInflammatory pseudotumor of the liver ,a rare benign lesion ,is often confused with the malignant tumors .Until 1998,less than 80 cases had been reported in the world [1,2].The accuracy of the pre-surgical diagnosis was low p[3,4] ,and very few materials on the diagnosis using dynamic MRI were reported [5-7] .We collected thirteen cases of inflammatory pseudotumor of the liver were collected and roved by pathology with MRI studies .Our purpose is to describe and analyze the MRI findings of this lesion and find out the valuable signs suggesting the diagnosis so as to avoid unnecessary operations.
文摘Here we report the clinical,radiological and neuropathological findings of a patient with tumor-like inflammatory demyelinating diseases of the central nervous system.The patient was a 51-year-old man with a four-month history of inflammatory pseudotumor and no other significant medical history,who presented to our hospital recurrent relapse numbness and weakness of his right extremities,dysarthria and memory deterioration.Brain magnetic resonance imaging(MRI) showed mass focal lesion in white matter of left parietal lobes.The biopsy showed numerous infiltrating macrophages and lymphocytes within the perivascular.The patient responded clinically to corticosteroid and intravenous immunoglobulin(IVIG) therapy.According to the results of the biopsy and the MRI,a diagnosis of inflammatory pseu-dotumor of the central nervous system was made.The vascular dysfunction may act in the pathogenesis of inflammatory pseudotumor of the central nervous system.
