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Subicz I, Sztanó B, Krasznai G, Vörös A, Tiszlavicz L, Borkó R, Rovó L. Diagnostic Difficulties in Evaluation of Neck Masses - Idiopathic Lymph Node Infarction. J Med Life 2019; 11:269-273. [PMID: 30894881 PMCID: PMC6418319 DOI: 10.25122/jml-2018-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Palpable neck masses are often the only signs of patients visiting their ENT specialists. Lymphadenopathy may be a primary or secondary manifestation of numerous benign and malignant disorders. The medical history, physical examination, imaging and pathological examination may help to set the appropriate diagnosis. Lymph node infarction is a very rare entity among the various pathologies involving the lymph nodes. We hereby present three cases, in which infarction was the only symptom, no associated condition occurred.
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Affiliation(s)
- Imre Subicz
- Department of Oto-Rhino-Laryngology, Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary
| | - Balázs Sztanó
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, University of Szeged, Hungary
| | - Géza Krasznai
- Department of Pathology, Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary
| | - András Vörös
- Department of Pathology, University of Szeged, Hungary
| | | | - Rezsö Borkó
- Department of Oto-Rhino-Laryngology, Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary
| | - László Rovó
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, University of Szeged, Hungary
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Okuni M, Yakushijin K, Sakai Y, Suto H, Ichikawa H, Sakai R, Kakiuchi S, Kurata K, Mizutani Y, Kitao A, Miyata Y, Saito Y, Kawamoto S, Yamamoto K, Ito M, Matsuoka H, Minami H. A Case of Classical Hodgkin Lymphoma with Total Lymph Node Infarction. J Clin Exp Hematop 2018; 58:24-26. [PMID: 29415974 DOI: 10.3960/jslrt.17026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Lymph node infarction is very rare, and is frequently associated with neoplasms, such as malignant lymphoma and non-neoplastic disease, or interventions such as fine-needle aspiration (FNA). A 76-year-old-man presented with cervical lymph node swelling. Although FNA was performed, the findings were insufficient for a definitive diagnosis. Consequently, surgical biopsy of the cervical lymph node was performed, which revealed total infarction; a diagnosis of classical Hodgkin lymphoma was made later. Both lymphoma itself and FNA may cause total lymph node infarction, which makes diagnosis confusing. Therefore, it is important to repeat the biopsy rather than repeat FNA to correctly diagnose malignant lymphoma, including Hodgkin lymphoma.
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Affiliation(s)
- Marika Okuni
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Kimikazu Yakushijin
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Yasuhiro Sakai
- Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan
| | - Hirotaka Suto
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Hiroya Ichikawa
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Rina Sakai
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Seiji Kakiuchi
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Keiji Kurata
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Yu Mizutani
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Akihito Kitao
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Yoshiharu Miyata
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Kawamoto
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Katsuya Yamamoto
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Mitsuhiro Ito
- Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hiroshi Matsuoka
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
| | - Hironobu Minami
- The Division of Medical Oncology and Hematology, the Department of Medicine, Kobe University Hospital, Kobe, Japan
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Kalaivani S, Saranya GD, Kar R, Basu D. Role of Immunohistochemistry in Acute Leukemias with Myelonecrosis. Indian J Hematol Blood Transfus 2018; 34:643-647. [PMID: 30369734 DOI: 10.1007/s12288-018-0918-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
Myelonecrosisis a rare antemortem finding most commonly seen in haematopoeitic neoplasms, especially in acute leukemia. When myelonecrosis occurs at the time of presentation, it imposes certain diagnostic issues in sub categorization of leukemias which is necessary for therapeutic as well as prognostic purposes. Flow cytometry, though is a powerful modality, has its own limitations especially when the cells are not fresh and viable; and when the specimen is not of adequate cellularity which is usual in cases of myelonecrosis. In such situations, immunocytochemistry (ICC) or immunohistochemistry (IHC) may play a major role in lineage specification in leukemias as the necrosed marrow with the ghost cells can still retain the antigenicity for certain immunomarkers. Four such interesting cases of common B acute lymphoblastic leukemia (ALL) where IHC was used for diagnosis were included. ICC and IHC done on the necrosed marrow contributed to the diagnosis of ALL in all the four cases and contributed to subsequent management. ICC and IHC if contributory can play a major role in identifying the primary cause of myelonecrosis as the ghost cells can retain the antigenicity despite being morphologically non-viable.
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Affiliation(s)
- Subramanian Kalaivani
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Gurusamy Dharma Saranya
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Rakhee Kar
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
| | - Debdatta Basu
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006 India
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