101
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Milnerowicz H, Chmarek M, Rabczyński J, Milnerowicz S, Nabzdyk S, Knast W. Immunohistochemical localization of metallothionein in chronic pancreatitis. Pancreas 2004; 29:28-32. [PMID: 15211108 DOI: 10.1097/00006676-200407000-00052] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Metallothionein (MT) is a low-molecular weight intracellular protein, rich in sulfhydryl residues, and able to bind bivalent metals. MT, like Zn, is a component of the diversified elements of antioxidant system. Recent studies have shown that reactive oxygen species play a role in the pathogenesis and development of chronic pancreatitis. The aim of the study was to identify immunohistochemically (LSAB2-HRP; DAKOCytomation) the localization of metallothionein and to determine MT expression in 9 patients with chronic pancreatitis. Our studies confirm that MT is present in exocrine and endocrine cells of patients with chronic pancreatitis and chronic pancreatitis with concomitant diabetes. They also indicate increased expression of MT, particularly in acinar cells of the pancreas. This suggests that MT is greatly involved in homeostasis of the pancreas and synthesis of pancreatic hormones.
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102
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Schneider G, Fries P, Samaras P, Remberger K, Uder M, Kramann B. Inflammatory pseudotumor of the liver in a patient with congenital granulocytopenia and HCV infection. Eur J Radiol 2004; 48:293-8. [PMID: 14652149 DOI: 10.1016/s0720-048x(03)00047-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Inflammatory pseudotumor (IPT) of the liver is a rare pathologic lesion. Although IPTs within the liver shows spontaneous regression, these lesions are frequently misdiagnosed as malignant on the basis of the clinical manifestation and the results of diagnostic imaging. With special regard to magnetic resonance imaging (MRI), differential diagnosis such as hepatocellular or cholangiocellular carcinoma (HCC/CCC) as well as regenerative liver lesions are discussed in a case of IPT with concomitant hepatitis C virus (HCV) infection and congenital granulocytopenia.
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103
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Lo OS, Poon RT, Lam CM, Fan ST. Inflammatory pseudotumor of the liver in association with a gastrointestinal stromal tumor: A case report. World J Gastroenterol 2004; 10:1841-3. [PMID: 15188521 PMCID: PMC4572284 DOI: 10.3748/wjg.v10.i12.1841] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Inflammatory pseudotumor of the liver is a rare benign lesion that can mimic a malignant liver neoplasm. A case of inflammatory pseudotumor of the liver found in association with a malignant gastrointestinal stromal tumor (GIST) of the small bowel was reported. The inflammatory pseudotumor was misdiagnosed as a metastasis from the GIST by frozen section. A correct diagnosis was made only after histopathological examination of the paraffin section of the resected specimen. This case is particularly interesting because of the association of the two rare pathological entities and the diagnostic dilemma that arose from the similarity of their histological appearances. To our knowledge, this association has not been reported in the literature.
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104
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Shenoy SN, Raja A. Intracranial plasma cell granuloma. Neurol India 2004; 52:262-4. [PMID: 15269490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We report two rare cases of primary intracranial plasma cell granuloma. The tumors probably arose from the dura and involved the cerebral parenchyma. These patients presented with clinical features of raised intracranial pressure and there was focal neurological deficit. The management issues are discussed.
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105
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Cho AH, Lee BH, Kwak KW, Kang JK. Inflammatory pseudotumor of temporal bone with pachymeningitis, cranial neuropathies and uveitis. Eur Neurol 2004; 51:238-40. [PMID: 15159608 DOI: 10.1159/000078550] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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106
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Fritzsch J, Richter M, Edelmann C, Lange R, Tannapfel A. [35-year old male with fever and round mass of the liver]. Internist (Berl) 2004; 45:713-6. [PMID: 15133612 DOI: 10.1007/s00108-004-1195-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 35 year old male suffered from fever till 39 degrees C and malaise since 6 months; infectious or neoplastic causes have been ruled out. Ultrasonography revealed a hypoechoic lesion of 75 mm diameter in the liver. The histologic examination of the needle biopsy showed an inflammatory process, and the final diagnosis was inflammatory pseudotumor. EBV specific LMP-1 protein was detected within the tumor immunohistochemically. A liver segment resection was performed, and the patient has been well and without fever since then for 18 months. Inflammatory pseudotumor is a rare but important differential diagnosis in cases of hypoechoic liver lesions associated by fever, if there is no abscess or malignancy. The diagnosis must be confirmed histologically, because imaging techniques cannot reliably classify the lesion.
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107
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Abstract
Intracranial pseudotumour has rarely been reported in haemophilia. We present the fourth case describing this complication.
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108
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Wright DA. Case 39-2003: a woman with gross hematuria. N Engl J Med 2004; 350:1687-8; author reply 1687-8. [PMID: 15088325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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109
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Lirón Ruiz R, Torralba Martínez JA, Morales Cuenca G, Martín Lorenzo JG, Aguayo Albasini JL. [A 48 year old man with recurrent abdominal pain for 8 months, anemia and weight loss]. Rev Clin Esp 2004; 204:25-6. [PMID: 14746757 DOI: 10.1157/13056788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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110
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Esposito I, Bergmann F, Penzel R, di Mola FF, Shrikhande S, Büchler MW, Friess H, Otto HF. Oligoclonal T-cell populations in an inflammatory pseudotumor of the pancreas possibly related to autoimmune pancreatitis: an immunohistochemical and molecular analysis. Virchows Arch 2004; 444:119-26. [PMID: 14722765 DOI: 10.1007/s00428-003-0949-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2003] [Accepted: 11/26/2003] [Indexed: 12/31/2022]
Abstract
Inflammatory pseudotumors (IPT), also known as inflammatory myofibroblastic tumors (IMT), are benign inflammatory processes that may have an infectious etiology and are very rare in the pancreatico-biliary region. Recent studies suggest a biological distinction between IPT and IMT, the latter being a true neoplastic process. We describe a case of pancreatic IPT, originally diagnosed as malignancy, which presumably recurred 4 months after the operation. Histologically, the tumor consisted of a smooth muscle actin and CD68-positive spindle cell population and a more abundant mononuclear inflammatory cell population, primarily composed of macrophages and T-lymphocytes. Inflammatory cells were the source of connective tissue growth factor and transforming growth factor-beta1 and tended to accumulate around nerves and blood vessels, as well as around residual pancreatic parenchymal elements, where an intense angiogenetic response was detected. Comparative genomic hybridization analysis of the tumor showed no chromosomal imbalances. Polymerase chain reaction-based analysis of T-cell receptor gamma gene rearrangement revealed an oligoclonal pattern. These findings suggest that the pathogenesis of aggressive cases of IPT could be related to the development of an intense and self-maintaining immune response, with the emergence of clonal populations of T-lymphocytes. The relation of the pancreatic IPT to autoimmune pancreatitis is emphasized.
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111
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Martín-Lorenzo JG, Torralba-Martinez A, Lirón-Ruiz R, Flores-Pastor B, Miguel-Perelló J, Aguilar-Jimenez J, Aguayo-Albasini JL. Intestinal invagination in adults: preoperative diagnosis and management. Int J Colorectal Dis 2004; 19:68-72. [PMID: 12838363 DOI: 10.1007/s00384-003-0514-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2003] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Intestinal invagination in adults is an uncommon but potentially serious condition that is usually diagnosed during surgery by the presence of a mechanical obstructive syndrome. We report a series of adults with intestinal invagination and discuss preoperative diagnosis and surgical procedures. PATIENTS AND METHODS We analyzed the files of all the seven patients aged over 18 years with a postoperative diagnosis of intestinal invagination and treated at our center between 1996 and 2000. RESULTS Preoperative causal diagnosis was established in six cases by ultrasonography and computed tomography. All the patients received surgery, three as emergency and four programmed. The lesions causing the invagination were: three benign (Meckel's diverticulum, inflammatory pseudotumor, fibroid polyp) and one malignant (degenerative villous adenoma polyp) located in the terminal ileum, two malignant lesions in the cecum (both adenocarcinomas over a polyp), and in the remaining case a double lymphoma of the jejunum and ileum. The intussusceptions were ileoileal in three cases and ileocolic in four. We performed intestinal resection in six cases and one excision of Meckel's diverticulum. CONCLUSION Preoperative diagnosis of intussusception was possible in most cases. Sonography and computed tomography proved the most effective and useful preoperative diagnostic methods. In adults colonic invagination is almost always malignant while small bowel is almost always benign. Invagination in adults must be clarified by surgery, and intestinal resection is the procedure of choice.
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112
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Heney NM, Young RH. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 39-2003. A 33-year-old woman with gross hematuria. N Engl J Med 2003; 349:2442-7. [PMID: 14681511 DOI: 10.1056/nejmcpc030029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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113
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Allanore Y, Pham XV, Clerc DA, Menkès CJ, Kahan A. Sacral inflammatory pseudotumor revealed by paraneoplastic syndrome. Rheumatol Int 2003; 24:166-8. [PMID: 14652690 DOI: 10.1007/s00296-003-0365-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2003] [Accepted: 06/04/2003] [Indexed: 10/26/2022]
Abstract
There is still debate on whether inflammatory pseudotumor should be considered benign or malignant. This lesion has only been reported twice in bone, apart from cases complicating foreign body reaction to joint replacement arthroplasty. We report here a third case, localized at the sacrum. A 31-year-old man had inflammatory dorsalgia and polyarthralgia without synovitis but with fever, asthenia, and erythema nodosa. Biological tests and X-rays were not informative, but technetium scintigraphy revealed a high level of left sacroiliac tracer binding. Several nonsteroidal anti-inflammatory drugs and sulfasalazine treatment were given over 3 months but ineffective. Pelvic magnetic resonance imaging showed an osteolytic tumor of the sacrum. Biopsy suggested a malignant fibrosarcoma, but complete evaluation after surgical resection demonstrated an inflammatory pseudotumor. All clinical symptoms disappeared within a few days after surgery, which is suggestive of a paraneoplastic syndrome. No relapse has occurred after 4 years.
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114
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Büyükyavuz I, Karnak I, Haliloglu M, Senocak ME. Inflammatory myofibroblastic tumour of the extrahepatic bile ducts: an unusual cause of obstructive jaundice in children. Eur J Pediatr Surg 2003; 13:421-4. [PMID: 14743334 DOI: 10.1055/s-2003-44736] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Inflammatory myofibroblastic tumour is a rare entity in children with few reported series. The extrahepatic bile duct is an unusual location for this tumour. The authors report here the case of an 8-year-old girl presenting with obstructive jaundice due to inflammatory myofibroblastic tumour of the extrahepatic bile ducts with differential diagnosis of obstructive jaundice in children.
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115
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Ueda M, Yukihide Y, Ogawa K, Haga H, Ogura Y, Ito T, Tanaka K. A case of inflammatory pseudotumor of the liver hilum successfully treated with aggressive hepatectomy. J Pediatr Surg 2003; 38:E9-11. [PMID: 14614735 DOI: 10.1016/j.jpedsurg.2003.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Inflammatory pseudotumor (IPT) of the liver is a rare, benign tumor. When the tumor involves the hepatic hilum, however, the clinical course of the patient becomes problematic because of obstructive jaundice and portal hypertension. Complete removal of the tumor sometimes is difficult when the hepatic hilum is extensively involved, and liver transplantation becomes necessary for such an unresectable tumor. This report concerns a 7-year-old boy who presented with obstructive jaundice and portal hypertension owing to an inflammatory pseudotumor of the hepatic hilum and was treated successfully with aggressive hepatectomy, vascular reconstructions of both the portal vein and the hepatic artery, and biliary reconstruction. The patient was discharged after 39 days of hospitalization. Eight months later, portal vein obstruction was detected and treated successfully with percutaneous transhepatic balloon dilatation of the obstructed site. The liver has continued to function well for 11 months after the tumor resection.
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116
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Torné Cachot J, de Frutos Echaniz E, Arcega Sáinz R, Martín Plata C. [Cranial inflammatory pseudotumor and giant cell arteritis]. Med Clin (Barc) 2003; 121:518-9. [PMID: 14588197 DOI: 10.1016/s0025-7753(03)74004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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117
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Miras-Parra FJ, Parra-Ruiz J, Gómez-Morales M, Gómez-Jiménez FJ, de la Higuera-Torres-Puchol J. Inflammatory pseudotumor of lymph nodes with focal infiltration in liver and spleen. Dig Dis Sci 2003; 48:2003-4. [PMID: 14627348 DOI: 10.1023/a:1026182607257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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118
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Manganelli P, Fietta P, Martella EM, Quaini F. Clinical and histological coexistence of inflammatory pseudotumour of the lymph nodes and rheumatoid arthritis. Clin Rheumatol 2003; 22:467-71. [PMID: 14677031 DOI: 10.1007/s10067-003-0779-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2002] [Accepted: 06/26/2003] [Indexed: 11/25/2022]
Abstract
Inflammatory pseudotumour (IPT) of the lymph nodes is an uncommon, self-limiting, non-neoplastic proliferation of spindle cells, associated with a polymorphous inflammatory cell infiltrate embedded in a collagen-rich stroma and a variable degree of fibrosis, arising in the nodal parenchyma. Its clinical picture is characterised by site-specific signs and the presence, in most cases, of constitutional symptoms. The pathogenesis of IPT is unknown, but it has been interpreted as an aberrant reactive condition of the nodal connective framework, possibly related to viral infections or chronic inflammatory conditions. Its prognosis is usually favourable. We here report the simultaneous onset of seronegative rheumatoid arthritis (RA) and nodal IPT in a 31-year-old woman. Notably, in the nodal biopsy the coexistence of rheumatoid nodules, as well as histological and immunohistochemical features of IPT, was observed. To our knowledge, such an association has not been previously reported and the hypothesis that IPT could represent an unusual epiphenomenon of an RA-related chronic inflammatory response is suggested.
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119
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Stéphen JL, Yakoubi Y, Cottalorda J. [Fever and neoplasms in the child]. Arch Pediatr 2003; 10 Suppl 1:189s-192s. [PMID: 14509794 DOI: 10.1016/s0929-693x(03)90434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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120
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Despeyroux-Ewers M, Catalaâ I, Collin L, Cognard C, Loubes-Lacroix F, Manelfe C. Inflammatory myofibroblastic tumour of the spinal cord: case report and review of the literature. Neuroradiology 2003; 45:812-7. [PMID: 14517703 DOI: 10.1007/s00234-003-1069-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2002] [Accepted: 05/21/2003] [Indexed: 12/22/2022]
Abstract
Inflammatory myofibroblastic tumours (IMT), also called inflammatory pseudotumours, nodular lymphoid hyperplasia, plasma-cell granuloma and fibrous xanthoma, are rare soft-tissue lesions characterised by inflammatory cells and a fibrous stroma. Clinically and radiologically, they may look like malignant tumours. They rarely affect the central nervous system and are very rare in the spinal cord. We report an IMT of the spinal cord in a 22-year-old woman presenting with spinal cord compression and a cauda equina syndrome. MRI showed a lesion at T9 with extramedullary and intramedullary components giving low signal on T2-weighted images and enhancing homogeneously. Pial lesions on the lumbar enlargement and thoracic spinal were present 11 months after surgery, when the lesion recurred. We present the radiological, operative and pathological findings and review the literature.
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121
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Sobesky R, Chollet JM, Prat F, Karkouche B, Pelletier G, Fritsch J, Choury AD, Allonier C, Bedossa P, Buffet C. Inflammatory pseudotumor of the common bile duct. Endoscopy 2003; 35:698-700. [PMID: 12929069 DOI: 10.1055/s-2003-41522] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An exceptional cause of obstructive jaundice is reported in the present case. A 51-year-old woman progressively developed jaundice with pruritus, and abdominal ultrasonography revealed dilated intra- and extrahepatic bile ducts. Endoscopic retrograde cholangiography and endoscopic ultrasonography showed a tumor in the distal common bile duct, but failed to determine the nature of the lesion, and the patient underwent a pancreaticoduodenectomy. The final diagnosis was an inflammatory pseudotumor of the common bile duct. Inflammatory pseudotumors are uncommon, without evident pathogenesis, and are described in many organs. The localization in the common bile duct is exceptional. The prognosis is good, and a more conservative approach is possible if the diagnosis is certain before surgery.
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122
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Braun B, Cazorla A, Rivas C, Gárgolas M, Fernández-Guerrero M. Inflammatory pseudotumor of the spleen in a patient with human immunodeficiency virus infection: a case report and review of the literature. Ann Hematol 2003; 82:511-514. [PMID: 12845478 DOI: 10.1007/s00277-003-0662-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2002] [Accepted: 04/05/2003] [Indexed: 11/26/2022]
Abstract
Inflammatory pseudotumor of the spleen (IPS) is a rarely described benign tumoral lesion of unknown etiology and pathogenesis. Diagnosis is complex as clinical manifestations and imaging features are indistinguishable from lymphoproliferative disorders and other malignancies of the spleen. Human immunodeficiency virus (HIV) infection is often combined with several malignancies including non-Hodgkin's lymphoma and Kaposi's sarcoma. However, no HIV infection-associated IPS has been reported so far. We report and discuss a case of IPS in an HIV-infected woman who presented with abdominal pain and multiple lesions in the spleen.
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123
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Bertolín Bernades RJ, Ferrando-Marco J, Arilla-Morell MJ, Pallas-Regueira A. [Splenic inflammatory pseudotumor: report of a case with thrombocytopenic manifestations and review of the literature]. ANALES DE MEDICINA INTERNA (MADRID, SPAIN : 1984) 2003; 20:330-2. [PMID: 12848609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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124
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Buccoliero AM, Caldarella A, Santucci M, Ammannati F, Mennonna P, Taddei A, Taddei GL. Plasma cell granuloma--an enigmatic lesion: description of an extensive intracranial case and review of the literature. Arch Pathol Lab Med 2003; 127:e220-3. [PMID: 12683907 DOI: 10.5858/2003-127-e220-pcgel] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We present an unusual case of intracranial plasma cell granuloma in a 70-year-old man with a 6-month history of progressive visual disturbance. The lesion extensively involved the cranial base, extended into the frontal region, and reached the floor of the third ventricle in the suprasellar area. Microscopic examination of multiple diagnostic transsphenoidal biopsies showed an inflammatory proliferation with a predominance of cells that were immunohistochemically determined to be polyclonal plasma cells. Ultrastructural analysis confirmed the presence of numerous mature plasma cells in a mixed inflammatory proliferation. In situ hybridization for Epstein-Barr viral RNA revealed no evidence of viral expression. The patient was treated with steroid therapy and radiotherapy, without any appreciable reduction of the lesion's size. He is alive with persistent severe visual disturbance 14 months after the diagnosis. We discuss the etiopathogenetic, diagnostic, and therapeutic issues related to this entity, and review the literature.
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125
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Bigal ME, Rapoport AM, Camel M. Cluster headache as a manifestation of intracranial inflammatory myofibroblastic tumour: a case report with pathophysiological considerations. Cephalalgia 2003; 23:124-8. [PMID: 12603369 DOI: 10.1046/j.1468-2982.2003.00508.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a patient with a secondary form of chronic cluster headache, caused by an intracranial presentation of inflammatory myofibroblastic pseudotumour located in the posterior fossa, with total remission of the pain after resection. The headaches were resistant to many of the usual treatments for cluster headache. The patient had two normal computed tomography scans and one normal magnetic resonance imaging of the head before the additional diagnosis of brain tumour was made. This is an unusual cause of cluster headache with intracranial mass, with an unexpected clinical presentation, a rare triggering manoeuvre, unusual pathology and successful treatment. This patient probably had the hypothalamic biological predisposition to cluster headache and, when a small mass disturbed pain-sensitive structures in the posterior fossa, it excited the trigeminovascular system via posterior fossa trigeminal and upper cervical afferents, and triggered the pathophysiological processes that resulted in a secondary form of chronic cluster headache.
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