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Bae H, Yoo KH, Oh MS. Xanthogranulomatous inflammation of the lower jaw bone: a rare case report. J Korean Assoc Oral Maxillofac Surg 2023; 49:360-364. [PMID: 38155090 PMCID: PMC10761317 DOI: 10.5125/jkaoms.2023.49.6.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 12/30/2023] Open
Abstract
Xanthogranulomatous inflammation (XGI) is an uncommon type of chronic inflammation and is histologically characterized by foamy histiocytes and giant cells. The most common sites of occurrence are kidneys and gallbladder. The etiology remains controversial. Involvement of the lower jaw bone is rare. In this study, we report a case of XGI presenting in the lower jaw.
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Affiliation(s)
- Hyesung Bae
- Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon, Korea
| | - Kil-Hwa Yoo
- Department of Oral and Maxillofacial Surgery, Daejeon Sun Hospital, Daejeon, Korea
| | - Min-Seok Oh
- Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon, Korea
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Chaturvedi HT, Chaturvedi C. Branchial cleft cyst associated with xanthogranulomatous inflammation – An unusual case. Ann Maxillofac Surg 2022; 12:79-82. [PMID: 36199456 PMCID: PMC9527843 DOI: 10.4103/ams.ams_225_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 11/04/2022] Open
Abstract
Rationale: Patient Concerns: Diagnosis: Treatment: Outcomes: Take-away Lessons:
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Xanthogranulomatus inflammatory lesion mimicker of malignancy: A clinicopathological study from rural India. North Clin Istanb 2021; 8:485-492. [PMID: 34909587 PMCID: PMC8630717 DOI: 10.14744/nci.2021.04317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/18/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Xanthogranulomatus inflammation is an uncommon variant of chronic inflammation and a well-established pathological entity involving various organs and systems. It may be associated with infection and obstruction, defective lipid transport, immunological disturbances, and often confused as a malignant neoplasm. The confirmative diagnosis is made on histopathology. METHODS This is a retrospective study conducted from January 2008 to April 2020 on histopathologically diagnosed xanthogranulomatus lesions. All the relevant available data regarding age, sex, and organ involvement were collected from histopathology lab records. The macroscopic and microscopic evaluation of cases was also done. This study was aimed to determine the significance of histopathology in the diagnosis of xanthogranulomatus lesions, revealing pathological changes, and clinicopathological correlation. RESULTS In the current study, there were 93 cases of xanthogranulomatus inflammatory lesion. Gall bladder was frequently involved 70 (75.27%), followed by 5 (5.37%) kidney, gastrointestinal Tract 6 (3 [3.23%] cases in colon and 3 [3.23%] in appendix, respectively), and others. The maximum number of cases was in the age group of 31-40 years with 24 (25.80%) cases. The female to male sex ratio was 2.3:1. CONCLUSION Awareness and knowledge of xanthogranulomatus inflammatory lesion is significant to the pathologist and surgeon to prevent extensive surgery. This lesion often mimics as malignancy and confirmatory diagnosis is made on histopathology. Thus, every excised specimen must be examined histopathologically to diagnose and rule out differential.
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Nomura T, Momose S, Takashima M, Kikuchi S. A case of neck xanthogranulomatous inflammation-suspected malignant tumor. Clin Case Rep 2019; 7:1323-1326. [PMID: 31360477 PMCID: PMC6637363 DOI: 10.1002/ccr3.2220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/19/2019] [Accepted: 04/26/2019] [Indexed: 11/11/2022] Open
Abstract
Xanthogranulomatous inflammation (XGI) is an uncommon chronic inflammatory disease. A 59-year-old male presented with a neck mass which had been diagnosed as an undifferentiated carcinoma. From CD68 staining, XGI was confirmed. It is important to consider the possibility of XGI for a neck mass mimicking a malignant tumor.
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Affiliation(s)
- Tsutomu Nomura
- Department of Otolaryngology, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Syuji Momose
- Department of Pathology, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Masatoshi Takashima
- Department of Otolaryngology, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Shigeru Kikuchi
- Department of Otolaryngology, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
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Chen TP, Yi WL, Liu CS, Lin YH. Neck xanthogranuloma mimicking malignancy in a patient with diabetes mellitus: A case report and literature review. Medicine (Baltimore) 2018; 97:e12615. [PMID: 30290633 PMCID: PMC6200551 DOI: 10.1097/md.0000000000012615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Xanthogranulomatous inflammation (XGI) is a rare inflammatory process, which mostly affects the kidney and gallbladder. It usually simulates an aggressive neoplastic process. Occurrences in the neck are extremely rare and would usually be associated with a preexisting cyst or glandular tissues. PATIENT CONCERNS A 49-year-old diabetic patient presented with a right painful neck mass for a week. The pretreatment computed tomography (CT) imaging with contrast demonstrated a huge ill-defined heterogeneous-enhanced lesion abutting surrounding musculatures and great vessels. Both fine needle aspiration (FNA) and ultrasound-guided core biopsy of the neck mass showed inflammatory cells only. DIAGNOSES Histologic evaluation found granulation tissue with histiocytes and occasional Touton giant cells confirming the diagnosis of xanthogranuloma. INTERVENTIONS Open excisional biopsy demonstrated a yellowish mass-like lesion with abscess inside. OUTCOMES The patient recovered from the disease without posttreatment comorbidities. LESSONS This case highlights the need for physicians to maintain awareness of this clinical entity and delayed- or overtreatment should be avoided in these patients due to preoperative ambiguous diagnosis.
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Affiliation(s)
- Tzu-Pai Chen
- Medical College of National Cheng Kung University
| | - Wan-Ling Yi
- Medical College of National Cheng Kung University
| | | | - Yu-Hsuan Lin
- Department of Otolaryngology, Head and Neck Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
- Department of Otolaryngology, Head and Neck Surgery, National Defense, Medical Center, Taipei, Taiwan, Republic of China
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Duan K, Asa SL, Winer D, Gelareh Z, Gentili F, Mete O. Xanthomatous Hypophysitis Is Associated with Ruptured Rathke's Cleft Cyst. Endocr Pathol 2017; 28:83-90. [PMID: 28120170 DOI: 10.1007/s12022-017-9471-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Xanthomatous hypophysitis is a rare inflammatory disease of the pituitary gland that can mimic a neoplastic lesion clinically and radiologically. Its pathogenesis remains largely unknown, although recent evidence suggests that pituitary inflammation may occur as a secondary reaction to mucous content released from a ruptured cyst. In a series of 1221 pituitary specimens, we identified seven cases of xanthomatous hypophysitis. Six patients had complete radiological and biochemical workup preoperatively: a cystic-appearing pituitary mass was identified in all six patients (100%) with a mean size of 2.0 cm (range 1.4-2.5 cm) on imaging, and pituitary endocrine dysfunction was noted in five patients (83.3%). In all cases, the pituitary mass was resected through an endoscopic transsphenoidal approach. Pathological examination revealed the presence of foamy macrophages admixed with variable amounts of giant cells and chronic inflammatory cells, confirming the diagnosis of xanthomatous hypophysitis. Additionally, all cases presented with concurrent findings of ruptured Rathke's cleft cyst, with the exception of one patient who had previous surgery for a Rathke's cleft cyst, followed by recurrence and diagnosis of xanthomatous hypophysitis. While accurate distinction of hypophysitis from a pituitary neoplasm can be problematic in the preoperative setting, the identification of a cystic lesion in the sella turcica should raise the possibility of such an entity in the clinical and radiological differential diagnosis. The current series provides further evidence that xanthomatous hypophysitis predominantly occurs as a secondary reaction to a ruptured Rathke's cleft cyst; thus, it is best classified as a secondary (reactive) hypophysitis.
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Affiliation(s)
- Kai Duan
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G 2C4, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Sylvia L Asa
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G 2C4, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Endocrine Oncology Site Group, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Daniel Winer
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G 2C4, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Zadeh Gelareh
- Endocrine Oncology Site Group, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Neurosurgery, University Health Network, Toronto, ON, Canada
| | - Fred Gentili
- Endocrine Oncology Site Group, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Neurosurgery, University Health Network, Toronto, ON, Canada
| | - Ozgur Mete
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G 2C4, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
- Endocrine Oncology Site Group, Princess Margaret Cancer Centre, Toronto, ON, Canada.
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