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Oyamatsu H, Fujimura T, Okagawa T, Niimi S. Sclerosing thymoma with numerous coarse calcifications. Respirol Case Rep 2024; 12:e01295. [PMID: 38328629 PMCID: PMC10848278 DOI: 10.1002/rcr2.1295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024] Open
Abstract
This patient is the youngest among the previously reported sclerosing thymoma cases, and the resected mass contained numerous coarse calcifications due to dystrophic calcification. This is an unprecedented and extremely rare case.
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Affiliation(s)
| | - Takaki Fujimura
- Department of Thoracic SurgeryOkazaki City HospitalOkazakiJapan
| | | | - Seijirou Niimi
- Department of Thoracic SurgeryOkazaki City HospitalOkazakiJapan
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2
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Maia A, Saraiva M, Costa L, Carvalho AC, Freitas C, Amaral C, Coelho A, Carvalho R. Leg dystrophic calcification as a consequence of chronic diabetic foot infection: a case report. J Wound Care 2024; 33:66-71. [PMID: 38197282 DOI: 10.12968/jowc.2024.33.1.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Foot ulceration and infection is associated with a substantial increase in morbidity and mortality in patients with diabetes. We present a clinical case of recurrent diabetic foot infection with an atypical clinical evolution. A 58-year-old male patient with type 1 diabetes and a history of bilateral Charcot foot neuroarthropathy was followed at our Diabetic Foot Clinic for an unhealed plantar foot ulcer for >1.5 years with recurrent episodes of infection. He was admitted to hospital due to foot ulcer reinfection with sepsis and ipsilateral lower limb cellulitis. The foot infection was found to be associated with an underlying abscess in the anterior compartment of the leg, with a cutaneous fistulous course with extensive alterations of an inflammatory nature. Exudate from the lesion was drained and tissue biopsied, revealing Serratia marcescens and Klebsiella oxytoca with dystrophic calcification (DC). Surgical excision of dystrophic tissue with debridement of the fistulous tracts was performed. The excised material corroborated the presence of fibroadipose connective tissue with marked DC, as well as areas of mixed inflammation compatible with a chronic infectious aetiology. Targeted long-term antibiotic therapy was implemented, for a total of six weeks, with a favourable clinical evolution and complete closure of the lesion at the final follow-up. DC results from calcium deposition in degenerated tissues without evidence of systemic mineral imbalance and is a potential cause of non-healing ulcers. Few cases of DC have been reported in diabetic foot patients and its treatment remains challenging and controversial. A longer follow-up period is necessary to verify the effectiveness of our approach.
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Affiliation(s)
- Ariana Maia
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Saraiva
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Costa
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Orthopedics and Traumatology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - André Couto Carvalho
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Cláudia Freitas
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Cláudia Amaral
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - André Coelho
- Division of Pathological Anatomy, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Rui Carvalho
- Diabetic Foot Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto, Porto, Portugal
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3
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Hernández-Reséndiz R, Villanueva-Castro E, Mateo-Nouel EDJ, Gómez-Apo E, Peñafiel-Salgado C, Salinas-Lara C, Tena-Suck ML. Calcified Pilocytic Astrocytomas and Calcifying Pseudoneoplasms of the Neuraxis: A Diagnostic Challenge. Cureus 2024; 16:e51765. [PMID: 38322074 PMCID: PMC10844034 DOI: 10.7759/cureus.51765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/08/2024] Open
Abstract
Pilocytic astrocytoma (PA), recognized as the most prevalent central nervous system (CNS) tumor, has long been associated with calcifications, a characteristic often attributed to benign or indolent growth patterns. In this study, we explored the calcified attributes in these tumors that beckon a deeper understanding. This is a retrospective study, on a set of seven cases, with a histopathological diagnosis of pilocytic astrocytoma with calcifications and psammoma bodies (PB). Despite an encouraging overall survival outcome, the recurrence in four cases cast some doubt on the conventional classification. The histological study of these cases revealed a spectrum of calcifications, varying in size and morphology, all of which exhibited positive reactivity to glial fibrillary acidic protein (GFAP), osteoconduction, and osteopontin. Notably, the immunohistochemistry showed hyaline bodies displaying an atypical immune profile, strikingly negative for vimentin and GFAP, and a robust positivity for epidermal growth factor receptors (EGFR), tumor necrosis factor-alpha (TNF-α), and interleukin 1 beta (IL-1β). These results stimulated speculation that the identity of these calcified tumors may have extended and potentially embraced the realm of calcifying pseudoneoplasms of the neuraxis (CAPNON), underscored by intense pilot gliosis. This study transcends mere anatomical exploration; it delves into the intricacies of calcified tumors, casting a spotlight on the dynamic interplay between PA and CAPNON. As we traverse the frontiers of neuro-oncology, these findings pave the way for innovative avenues in the diagnostics and therapeutics of these tumors.
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Affiliation(s)
| | - Eliezer Villanueva-Castro
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | - Edgardo de Jesus Mateo-Nouel
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | - Erick Gómez-Apo
- Department of Pathology, Hospital General de México, Mexico City, MEX
| | - Carlos Peñafiel-Salgado
- Department of Neuropathology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | - Citlaltepetl Salinas-Lara
- Department of Neuropathology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | - Martha Lilia Tena-Suck
- Department of Neuropathology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
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4
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Jones E, Valiga A, Solowey M. Distinguishing dystrophic calcification from calciphylaxis. JAAD Case Rep 2023; 40:19-22. [PMID: 37675067 PMCID: PMC10477728 DOI: 10.1016/j.jdcr.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Affiliation(s)
- Elizabeth Jones
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Alexander Valiga
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Miriam Solowey
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Kato T, Yamada M, Watanabe T, Nakao K. A rare case of a branchial cyst with calcification: A case report. Exp Ther Med 2023; 26:366. [PMID: 37408860 PMCID: PMC10318597 DOI: 10.3892/etm.2023.12065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/24/2023] [Indexed: 07/07/2023] Open
Abstract
Branchial cysts are relatively rare lesions with lymphoid tissue in the underlying epithelium of the cyst wall. The present study describes the case of a branchial cyst with keratinization and calcification that occurred in the right submandibular region, along with a review of the literature. A 49-year-old female patient presented with a complaint of swelling in the right submandibular region. Computed tomography revealed a well-defined, cystic lesion located anterior to the sternocleidomastoid muscle, outside the hyoid bone, and in front of the submandibular gland. The cystic cavity presented an opaque image suggestive of calcification. Magnetic resonance imaging showed high-intensity lesions on both T2-weighted and short-τ inversion recovery images on the anterior margin of the right sternocleidomastoid muscle, just below the platysma muscle, with a clear demarcation from the surrounding tissue, and posterior compression and flattening of the submandibular gland. Cystectomy was performed under general anesthesia, and histopathological examination confirmed the diagnosis of branchial cyst with keratinized and calcified substances. The patient recovered well and had no complications or recurrence at ~2-year follow-up. This case highlights the rare occurrence of a branchial cyst containing calcification in the cystic cavity and provides a literature review of the factors contributing to the calcification.
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Affiliation(s)
- Tomoki Kato
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Michihiro Yamada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Takuma Watanabe
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Kazumasa Nakao
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
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Banerjee A, Nandini DB, Misra SR, Chakraborty B. Calcifications in oral carcinomas: Depicts diversity of calcium in cancer biology! J Oral Maxillofac Pathol 2023; 27:396-398. [PMID: 37854933 PMCID: PMC10581284 DOI: 10.4103/jomfp.jomfp_313_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 10/20/2023] Open
Abstract
Calcifications in the soft tissues can be accidental findings during diagnostic procedures. Oral squamous cell carcinoma (OSCC) forms the major percentage of oral malignancies; calcifications are rare findings in OSCC. Calcifications are seen as a result of necrosis, chronic inflammations as well as degenerative changes and imbalances of the local calcium and phosphorous environment. The presence of calcifications can be a prognostic marker, hypothesizing that the influx of calcium from hard tissues into the soft tissues, can probably determine the invasive nature and the destructive characteristics of the carcinoma; hence, detecting calcifications can help us in predicting the prognosis and spread of the malignancy.
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Affiliation(s)
- Abhishek Banerjee
- Department of Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | | | - Satya Ranjan Misra
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha, India
| | - Bidyut Chakraborty
- Department of Oral and Maxillofacial Pathology, Burdwan Dental College, Bardhaman, West Bengal, India
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Firl CEM, Halushka M, Fraser N, Masson M, Cuneo BF, Saxena A, Clancy R, Buyon J. Contribution of S100A4-expressing fibroblasts to anti-SSA/Ro-associated atrioventricular nodal calcification and soluble S100A4 as a biomarker of clinical severity. Front Immunol 2023; 14:1114808. [PMID: 37090702 PMCID: PMC10117984 DOI: 10.3389/fimmu.2023.1114808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 04/25/2023] Open
Abstract
Background Fibrosis and dystrophic calcification disrupting conduction tissue architecture are histopathological lesions characterizing cardiac manifestations of neonatal lupus (cardiac-NL) associated with maternal anti-SSA/Ro antibodies. Objectives Increased appreciation of heterogeneity in fibroblasts encourages re-examination of existing models with the consideration of multiple fibroblast subtypes (and their unique functional differences) in mind. This study addressed fibroblast heterogeneity by examining expression of α-Smooth Muscle Actin (myofibroblasts) and of S100 Calcium-Binding Protein A4 (S100A4). Methods Using a previously established model of rheumatic scarring/fibrosis in vitro, supported by the evaluation of cord blood from cardiac-NL neonates and their healthy (anti-SSA/Ro-exposed) counterparts, and autopsy tissue from fetuses dying with cardiac-NL, the current study was initiated to more clearly define and distinguish the S100A4-positive fibroblast in the fetal cardiac environment. Results S100A4 immunostaining was observed in 4 cardiac-NL hearts with positional identity in the conduction system at regions of dystrophic calcification but not fibrotic zones, the latter containing only myofibroblasts. In vitro, fibroblasts cultured with supernatants of macrophages transfected with hY3 (noncoding ssRNA) differentiated into myofibroblasts or S100A4+ fibroblasts. Myofibroblasts expressed collagen while S100A4+ fibroblasts expressed pro-angiogenic cytokines and proteases that degrade collagen. Cord blood levels of S100A4 in anti-SSA/Ro-exposed neonates tracked disease severity and, in discordant twins, distinguished affected from unaffected. Conclusions These findings position the S100A4+ fibroblast alongside the canonical myofibroblast in the pathogenesis of cardiac-NL. Neonatal S100A4 levels support a novel biomarker of poor prognosis.
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Affiliation(s)
- Christina E. M. Firl
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- *Correspondence: Christina E. M. Firl, , Jill Buyon,
| | - Marc Halushka
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Nicola Fraser
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Mala Masson
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Bettina F. Cuneo
- Department of Obstetrics and Gynecology, University of Colorado Anschultz Medical Campus, Aurora, CO, United States
| | - Amit Saxena
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Robert Clancy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Jill Buyon
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- *Correspondence: Christina E. M. Firl, , Jill Buyon,
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Hasegawa N, Zhao J, Greninger DA, Lu J, Yoon MK, Chen Y, McCulley TJ. An orbital calcific cyst following exenteration. Orbit 2022:1-4. [PMID: 36573493 DOI: 10.1080/01676830.2022.2151630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/20/2022] [Indexed: 02/17/2024]
Abstract
A 77-year-old Asian female with a history of left orbit exenteration and lid-sparing reconstruction for recurrent sebaceous carcinoma presented with fluid-like sensation of the left orbit. Magnetic resonance imaging (MRI) demonstrated bright T2 signal and a cyst-like cavity within the exenterated orbit. Decision was made to proceed with surgical exploration and excision. A calcified, bone-like cavity was encountered intraoperatively and removed. Histopathology revealed dense fibrous connective tissue with areas of calcification without osseous metaplasia, suggestive of retained blood in the orbit that underwent dystrophic calcification. This case report illustrates a rare occurrence of a bone-like calcific cyst following exenteration.
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Affiliation(s)
- Naomi Hasegawa
- Department of Ophthalmology, University of Texas at Houston, Houston, Texas, USA
| | - Jiawei Zhao
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Daniel A Greninger
- Department of Ophthalmology, Kaiser Permanente Antioch Medical Center, Antioch, California, USA
| | - Jonathan Lu
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Michael K Yoon
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Ying Chen
- Department of Ophthalmology, University of Texas at Houston, Houston, Texas, USA
| | - Timothy J McCulley
- Department of Ophthalmology, University of Texas at Houston, Houston, Texas, USA
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Leonard AJ, Garg N, Chen TT, Monga M. Case of the Month from UCSD, San Diego, USA: Treatment of giant dystrophic prostatic calcification using MOSES holmium laser. BJU Int 2022; 129:306-308. [PMID: 35297157 DOI: 10.1111/bju.15695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Austin J Leonard
- San Diego School of Medicine, University of California, San Diego, CA, USA
| | - Nishant Garg
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Tony T Chen
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Manoj Monga
- Department of Urology, University of California San Diego, San Diego, CA, USA
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Sanford JA, Strausborger SL, Lewin-Smith MR, Royer MC. Cutaneous Gamna-Gandy Bodies: An Unusual Case of Dystrophic Calcification. J Cutan Pathol 2022; 49:570-574. [PMID: 35020219 DOI: 10.1111/cup.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/07/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
Dystrophic calcification is a common histopathologic finding that can be concomitant with a plethora of diseases, ranging from self-limited infections to insidious malignancies. Gamna-Gandy bodies (GGBs) are a form of dystrophic calcification associated with chronic hemolysis and are typically observed in the spleen. In this report, we present a case of a 92-year-old man who presented with a four-millimeter blue papule that was biopsied given the concern for a blue nevus. The subsequent histopathological examination of the biopsy specimen showed a dermal organizing hematoma adjacent to pale yellow to brown, refractile material within fibrotic collagen consistent with GGBs. Scanning electron microscopy with energy dispersive x-ray analysis (SEM/EDXA) revealed that the structures were composed of carbon (39%), oxygen (32%), iron (16%), phosphorus (7%), calcium (5%), and sodium (1%). Fourier transform infrared spectroscopy (FTIR) identified amorphous calcium phosphate. GGBs have not been previously described in the skin and have been rarely characterized with SEM/EDXA in other sites. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jeffrey A Sanford
- Walter Reed National Military Medical Center, Department of Pathology
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Khurana A, Jain V, Gupta SC, Malik K, Gupta S. A Potentially Dangerous Industrial Projectile Lodged in the Leg of a Steel Factory Worker. Cureus 2021; 13:e17870. [PMID: 34660071 PMCID: PMC8502740 DOI: 10.7759/cureus.17870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/25/2022] Open
Abstract
Penetrating injuries due to fragments energized by an explosive event are life/limb-threatening and are associated with poor clinical and functional outcomes. Penetrating injuries are commonly inflicted in attacks with explosive devices. The extremities, especially the leg, are the most commonly affected body areas, presenting a high risk of infection, slow recovery, and the threat of amputation. This report presents a case of a young factory worker who sustained an injury to the leg with a foreign body lodged near the neuro-vascular bundle. A 44-year-old gentleman sustained a projectile injury while working in a stainless steel factory from the rula (steel rolling) machine with a foreign body getting lodged in the leg in March 2019. He was initially managed with wound care and didn't report any functional impairment. Gradually patient developed numbness and claudication symptoms of the foot over the next couple of years. He was subsequently operated on in 2021 for removal of the stainless steel foreign body encased in dystrophic calcification close to the tibial nerve and posterior tibial vessels. Interestingly the entry point of the foreign body was on the anterolateral aspect of the leg. The foreign body was removed using the postero-lateral approach to the tibia with careful dissection close to the neurovascular bundle. At a follow-up of 3 months, the patient is symptom-free with significant improvement of limb function. The authors propose that the foreign body crossed the interosseous membrane to get lodged close to the posterior tibial neurovascular bundle. In such a scenario, the patient was extremely lucky to have survived an amputation or significant functional injury of the limb. Proper protective equipment is needed not only for the torso but also for extremities to protect industrial workers from such limb-threatening injuries. Moreover, primary care physicians should be sensitised for the proper management of such injuries.
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Affiliation(s)
| | - Vishal Jain
- Orthopaedics, ESI Hospital Rohini, Delhi, IND
| | | | | | - Sudhir Gupta
- Anaesthesiology, ESI Hospital Rohini, Delhi, IND
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Colboc H, Fontaine J, Bazin D, Frochot V, Letavernier E, Daudon M, Laporte N, Rouzière S, Reby M, Galezowski A, Forasassi C, Meaume S. Calcified leg Ulcers in older patients: clinical description, morphology and chemical characterization. J Gerontol A Biol Sci Med Sci 2021; 77:27-32. [PMID: 34331540 DOI: 10.1093/gerona/glab223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Indexed: 11/14/2022] Open
Abstract
Chronic wounds, including leg ulcers, constitute an important medical problem among older patients. Dystrophic calcifications (DC) are associated with a variety of disorders, including leg ulcers. The aim of this study was to report the clinical and biological characteristics of older patients with DC in leg ulcers and to determine the morphology and chemical composition of these calcifications. We conducted a prospective monocentric study in our Geriatric-Wound and Healing ward, Rothschild Hospital, Paris, from January 2018 to December 2019. Patients with leg ulcers were screened for DC by palpation. Patients' clinical, biological and radiological findings were collected. DC morphology was analyzed using field-emission scanning electron microscopy and chemical composition was analyzed using µFourier transform infra-red spectroscopy and X-ray Fluorescence. Ten (7%) of the 143 patients hospitalized for leg ulcers presented DC. Older patients with DC were more likely to have leg ulcers with venous insufficiency (P=0.015), colonized by Pseudomonas aeruginosa (P=0.026), with a longer healing evolution (P=0.0072) and hypercalcemia (P=0.041). Five DC were extracted from ulcers: two presented 500 nm lacunar spheres and intermingled fibrils of about 10 nm in diameter, consistent with bacterial and biofilm imprints. DC were always composed of Calcium-phosphate apatite and associated to the presence of Zinc. Our analyses were consistent with the involvement of microorganisms and inflammatory process in DC formation. Early management of venous insufficiency, treatment of chronic bacterial colonization and use of calcium-solubilizing drugs seem to be rational strategies for calcified leg ulcer management in older patients.
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Affiliation(s)
- Hester Colboc
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | - Juliette Fontaine
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | | | - Vincent Frochot
- Sorbonne Université, Hôpital Tenon, Service des Explorations Fonctionnelles Multidisciplinaires, Paris, France.,UMR_S 1155, Sorbonne Université-UPMC Paris 06, F-75020 Paris, France
| | - Emmanuel Letavernier
- Sorbonne Université, Hôpital Tenon, Service des Explorations Fonctionnelles Multidisciplinaires, Paris, France.,UMR_S 1155, Sorbonne Université-UPMC Paris 06, F-75020 Paris, France
| | - Michel Daudon
- Sorbonne Université, Hôpital Tenon, Service des Explorations Fonctionnelles Multidisciplinaires, Paris, France.,UMR_S 1155, Sorbonne Université-UPMC Paris 06, F-75020 Paris, France
| | - Naomi Laporte
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | - Stéphan Rouzière
- Laboratoire de Physique des Solides, CNRS, Université Paris-Saclay, Orsay, France
| | - Michael Reby
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | - Agnes Galezowski
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | - Christine Forasassi
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
| | - Sylvie Meaume
- Sorbonne Université, Hôpital Rothschild, Service Plaies et Cicatrisation, Paris, France
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Sugiyama K, Miura J, Shimizu M, Takashima A, Matsuda Y, Kayashima H, Okamoto M, Nagashima T, Araki T. Effects of advanced glycation end products on dental pulp calcification. Oral Dis 2021; 28:745-755. [PMID: 33539626 DOI: 10.1111/odi.13792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/26/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The main aim of this study was to elucidate the effects of advanced glycation end products (AGEs) on the calcification of cultured rat dental pulp cells (RDPCs) and to investigate the crystallisation ability of glycated collagen. MATERIALS AND METHODS AGEs were prepared via non-enzymatic glycation of a dish coated with type I collagen using dl-glyceraldehyde. To investigate the effects of AGEs on RDPCs, we performed WST-1 and lactate dehydrogenase assays; alkaline phosphatase, Alizarin Red S and immunohistochemical staining; and real-time quantitative reverse transcription PCR. In addition, we performed crystallisation experiments on glycated collagen. All microstructures were analysed using scanning electron microscopy/energy-dispersive X-ray spectroscopy and transmission electron microscopy/diffraction pattern analysis. RESULTS AGEs did not affect the proliferation or differentiation of RDPCs, but enhanced the calcification rate and cytotoxicity. No major calcification-related genes or proteins were involved in these calcifications, and glycated collagen was found to exhibit a negative polarity and form calcium phosphate crystals. Cytotoxicity due to drastic changes in the concentration of pericellular ions led to dystrophic calcification, assumed to represent an aspect of diabetic pulp calcifications. CONCLUSION Glycated collagen-containing AGEs provide a nurturing environment for crystallisation and have a significant effect on the early calcification of RDPCs.
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Affiliation(s)
- Keita Sugiyama
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Jiro Miura
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Masato Shimizu
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Aoi Takashima
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Yusuke Matsuda
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Hiroki Kayashima
- Department of Fixed Prosthodontics, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Motoki Okamoto
- Department of Restorative Dentistry and Endodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Tadashi Nagashima
- Division for Interdisciplinary Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Tsutomu Araki
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
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Lee DJ, Miguez P, Kwon J, Daniel R, Padilla R, Min S, Zalal R, Ko CC, Shin HW. Decellularized pulp matrix as scaffold for mesenchymal stem cell mediated bone regeneration. J Tissue Eng 2020; 11:2041731420981672. [PMID: 33414903 PMCID: PMC7750895 DOI: 10.1177/2041731420981672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/28/2020] [Indexed: 02/01/2023] Open
Abstract
Scaffolds that are used for bone repair should provide an adequate environment for biomineralization by mesenchymal stem cells (MSCs). Recently, decellularized pulp matrices (DPM) have been utilized in endodontics for their high regenerative potential. Inspired by the dystrophic calcification on the pulp matrix known as pulp stone, we developed acellular pulp bioscaffolds and examined their potential in facilitating MSCs mineralization for bone defect repair. Pulp was decellularized, then retention of its structural integrity was confirmed by histological, mechanical, and biochemical evaluations. MSCs were seeded and proliferation, osteogenic gene expression, and biomineralization were assessed to verify DPM's osteogenic effects in vitro. MicroCT, energy-dispersive X-ray (EDX), and histological analyses were used to confirm that DPM seeded with MSCs result in greater mineralization on rat critical-sized defects than that without MSCs. Overall, our study proves DPM's potential to serve as a scaffolding material for MSC-mediated bone regeneration for future craniofacial bone tissue engineering.
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Affiliation(s)
- Dong Joon Lee
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Patricia Miguez
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Department of Periodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Jane Kwon
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Department of Neurology and Neurosurgery, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Renie Daniel
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Ricardo Padilla
- Department of Diagnostic Sciences, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Samuel Min
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Rahim Zalal
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Ching-Chang Ko
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Hae Won Shin
- Department of Neurology and Neurosurgery, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
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15
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Vaishya R, Siddalingeshwara GI, Vaishya A. Calcific Tendonitis of the Elbow in an Adult - A Case Report and Review of the Literature. J Orthop Case Rep 2020; 10:57-60. [PMID: 33312981 PMCID: PMC7706431 DOI: 10.13107/jocr.2020.v10.i05.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Calcific tendonitis occurs most commonly in the shoulder, and it is a rare entity in other parts including the elbow. We report a symptomatic case of calcific tendonitis of common extensor origin of the non-dominant elbow in a young female. Case Presentation: A 39-year-old female (right hand dominant) presented with the left elbow pain for the past 1 year. The diagnosis was achieved by radiography and confirmed by histopathology. Her pain did not respond to conservative treatment of analgesics, physiotherapy, and elbow support and a local steroid injection. She, therefore, underwent surgical exploration of the elbow, under general anesthesia. There was white-colored paste like a collection within the common extensor tendon origin, with dystrophic calcification of the tendon. The histology of the excised tissue revealed focal nodular aggregates of plump fibroblasts and osteoclastic giant cells around microcalcific foci. Large areas of fibrosis and calcific nodular deposits seen suggestive of calcific tendonitis. Conclusion: Calcific tendonitis is not a common condition around elbow joint. The diagnosis may be delayed due to its rarity. Hence, a high degree of suspicion in the absence of trauma, along with relevant investigations, leads to a definitive diagnosis and treatment. A review of literature also becomes important since it is not a day-to-day case.
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Affiliation(s)
- Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
| | | | - Abhishek Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
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16
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Li L, Tuan RS. Mechanism of traumatic heterotopic ossification: In search of injury-induced osteogenic factors. J Cell Mol Med 2020; 24:11046-11055. [PMID: 32853465 PMCID: PMC7576286 DOI: 10.1111/jcmm.15735] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022] Open
Abstract
Heterotopic ossification (HO) is a pathological condition of abnormal bone formation in soft tissue. Three factors have been proposed as required to induce HO: (a) osteogenic precursor cells, (b) osteoinductive agents and (c) an osteoconductive environment. Since Urist's landmark discovery of bone induction in skeletal muscle tissue by demineralized bone matrix, it is generally believed that skeletal muscle itself is a conductive environment for osteogenesis and that resident progenitor cells in skeletal muscle are capable of differentiating into osteoblast to form bone. However, little is known about the naturally occurring osteoinductive agents that triggered this osteogenic response in the first place. This article provides a review of the emerging findings regarding distinct types of HO to summarize the current understanding of HO mechanisms, with special attention to the osteogenic factors that are induced following injury. Specifically, we hypothesize that muscle injury‐induced up‐regulation of local bone morphogenetic protein‐7 (BMP‐7) level, combined with glucocorticoid excess‐induced down‐regulation of circulating transforming growth factor‐β1 (TGF‐β1) level, could be an important causative mechanism of traumatic HO formation.
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Affiliation(s)
- La Li
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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17
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Abstract
Iatrogenic calcinosis cutis occurs when insoluble calcium salts deposit in cutaneous and subcutaneous tissue. Iatrogenic calcinosis cutis is a rare complication from a variety of medical interventions, most commonly due to extravasated intravenous calcium-containing solutions. We present a severe case of iatrogenic calcinosis cutis in a patient with end-stage renal disease and an elevated serum calcium-phosphate product. Iatrogenic calcinosis cutis has a wide range of clinical presentations. Either subclinical or clinically noticeable extravasations may cause mild to severe calcinosis cutis. Patients with increased serum calcium and phosphate may be at increased risk of iatrogenic calcinosis cutis. Treatment options include conservative, pharmacologic, or surgical management.
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Affiliation(s)
- Brad E Rumancik
- Dermatology, Indiana University School of Medicine, Indianapolis, USA
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18
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Shefali, Sethi A, Tandon A, Shetty DC, Juneja S. Staining efficacy assessment of a differential routine and special stains for pathological stromal calcifications in maxillofacial lesions. J Histotechnol 2020; 43:118-124. [PMID: 32156221 DOI: 10.1080/01478885.2020.1739192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Head and neck connective tissue lesions may have diverse calcifications within the fibrous connective tissue stroma. The perplexity involved in the identification and determination of the nature or degree of calcification through routine hematoxylin and eosin (H&E) stains necessitates the usage of a specific, simple, and cost- and time-effective differential staining techniques. The aim of the present study was to develop criteria to distinguish bone formation from bone resorption using methylene blue-acid fuchsin (MB/AF) stain and the role of collagen fibers in the identification of stromal calcifications using polarizing microscopy with picrosirius red stain. Twenty cases with pathological diagnoses for various stromal calcifications in maxillofacial lesions were retrieved from the departmental archives. Decalcified formalin fixed paraffin embedded tissue sections were stained with hematoxylin and eosin, Masson's trichrome (MT), methylene blue-acid fuchsin (MB/AF), and picrosirius red. The stained sections were assessed to identify the calcifications found in the surrounding connective tissue stroma. It was observed that most cases showed maximum staining intensity with MB/AF stain as compared to the other staining methods. Moreover, the results suggested that contrast between calcification and stromal soft tissue was best distinguished with the MB/AF stain except in the case of dystrophic calcifications. Along with this, polarizing microscopy with picrosirius red enables better characterization of stromal components. Although the H&E stain and a connective tissue stain i.e. Masson's trichrome, are employed routinely in histopathology; the use of special stains such as MB-AF and picrosirius red facilitates the identification of calcifications from the stromal tissues.
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Affiliation(s)
- Shefali
- Department of Oral Pathology and Microbiology, I.T.S Centre for Dental Studies and Research , Ghaziabad, India
| | - Aashka Sethi
- Department of Oral Pathology and Microbiology, I.T.S Centre for Dental Studies and Research , Ghaziabad, India
| | - Ankita Tandon
- Department of Oral Pathology and Microbiology, I.T.S Centre for Dental Studies and Research , Ghaziabad, India
| | - Devi Charan Shetty
- Department of Oral Pathology and Microbiology, I.T.S Centre for Dental Studies and Research , Ghaziabad, India
| | - Saurabh Juneja
- Department of Oral Pathology and Microbiology, I.T.S Centre for Dental Studies and Research , Ghaziabad, India
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19
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Abstract
Papillary thyroid carcinoma (PTC) arising in a coexistent struma ovarii (SO) is a rare malignancy. It manifests with abdominal symptoms such as palpable mass, pain, distension, and possibly ascites. It is usually diagnosed postoperatively, and its histopathological diagnostic criteria remain identical to that of papillary carcinoma of the thyroid gland. Due to the relative rarity of the disease, definitive guidelines for its overall management are still undefined. We present a case of a 51-year old female with suspicion of a left ovarian tumor due to her presenting symptoms: raised serum CA-125 levels and abnormal abdominopelvic CT scan findings. She underwent complete surgical debulking of the mass (total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), omentectomy, appendectomy, and pelvic lymphadenectomy). The mass was postoperatively diagnosed by histopathology as PTC in SO (stage IA). Furthermore, our patient did not receive any adjuvant treatment. The patient has been disease-free for 24 months post-surgery and is scheduled for regular biannual follow-ups.
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Affiliation(s)
| | - Ali Akhtar
- Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Noor Ul Falah
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Fahad N Sheikh
- Internal Medicine, Sahiwal Medical College, Sahiwal, PAK
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20
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Key Words
- CREST
- CREST, calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia
- IL, interleukin
- PDE-4, phosphodiesterase 4
- PTH, parathyroid hormone
- RA, rheumatoid arthritis
- apremilast
- cAMP, cyclic adenosine monophosphate
- calcinosis cutis
- dystrophic calcification
- limited scleroderma
- morphea
- persistent
- potential
- therapeutic substance
- treatment
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Affiliation(s)
- Sultan H Qiblawi
- Michigan State University College of Human Medicine, St. Joseph Mercy Health System Dermatology Residency Program, Ann Arbor, Michigan
| | - David P Fivenson
- Michigan State University College of Human Medicine, St. Joseph Mercy Health System Dermatology Residency Program, Ann Arbor, Michigan
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21
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Ghadimi H, Nikdel M, Eshraghi B. Bilateral calcinosis cutis of orbital walls in CREST syndrome. J Scleroderma Relat Disord 2019; 4:NP1-NP4. [PMID: 35382395 DOI: 10.1177/2397198318819383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/24/2018] [Indexed: 11/16/2022]
Abstract
Purpose To describe a patient with systemic sclerosis who presented with subcutaneous yellow-white nodules on her lateral orbital rims. Methods Case report. Results A 53-year-old female was referred for management of subcutaneous firm nodules on her lateral orbital rims. She was known to have CREST (calcification, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, a limited variant of systemic sclerosis. Her drug history included diltiazem, captopril, aspirin, and prednisolone. There were bilateral multiple immobile yellow-white subcutaneous nodules with firm consistency, a few of which were in close proximity of periorbital skin. She was scheduled for surgical resection of the lesions and following tissue dissection, the calcified foci were removed. The incisions healed with some delay but the final postoperative follow-up at third month showed satisfactory appearance. Conclusion Dystrophic calcinosis cutis occurs in approximately one-fourth of patients with systemic sclerosis (scleroderma), particularly in those with the limited variant or CREST syndrome. The most frequently involved sites are the extremities. Occasionally, calcinosis involves the trunk or head, but involvement of bony orbital walls is extremely rare. Surgical excision can be considered for treatment of discrete foci of calcinosis cutis.
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Affiliation(s)
- Hadi Ghadimi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Nikdel
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Eshraghi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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22
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Abstract
RATIONALE Calcific myonecrosis is a very rare late sequela that occurs in patients who have had trauma accompanied by vascular compromise, in which a single muscle or entire muscles in a compartment undergoes necrosis and form a calcified mass. It is mostly a benign entity, but some cases cause bone destruction and form non-healing chronic sinuses. In such cases, wound management becomes difficult and there is a potential risk of secondary infection. PATIENT CONCERNS A 60-year-old male was referred for evaluation of a pain, erythematous changes, and draining sinus of the anterolateral aspect of his left leg. He had an open reduction and internal fixation as well as a stent insertion in the femoral artery owing to a distal femur fracture and femoral artery rupture. DIAGNOSES A thick fluid with a chalk-like material was discharged through the shiny skin via the sinus. The radiographs of the left leg showed a large, fusiform-shaped, radiopaque soft tissue mass in the space between the tibia and fibula. We performed an incisional biopsy to differentiated soft tissue sarcoma and malignant cells were found. Pathologic evaluation revealed acute and chronic inflammation with dystrophic calcification. These findings led to the diagnosis of calcific myonecrosis. INTERVENTIONS We performed an extensive debridement of the anterior and deep posterior compartments to ensure definitive treatment. Upon performing extensive debridement, we inserted a drain tube and performed primary closure. OUTCOMES The fluid continued to be discharged through the drain even after the surgery; delayed wound healing occurred 4 weeks following the surgery, and there was no recurrence at follow-up conducted 2 years later. LESSONS Calcific myonecrosis is mostly a benign entity, but some cases of calcific myonecrosis cause bone destruction and form non-healing chronic sinuses. In such cases, surgical treatment is required, during which the necrotic tissue and calcific material must be extensively debrided and drained.
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23
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Gaddis KJ, Wolfe J, Shin T, Rubin AI. Onycholemmal carcinoma with prominent dystrophic calcification and review of the literature. J Cutan Pathol 2018; 45:643-646. [PMID: 34493027 DOI: 10.1111/cup.13313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/20/2018] [Accepted: 06/25/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Kevin J Gaddis
- Department of Dermatology, Hospital of the University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, Pennsylvania, 19104, USA
| | - Jonathan Wolfe
- Department of Dermatology, Hospital of the University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, Pennsylvania, 19104, USA
| | - Thuzar Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, Pennsylvania, 19104, USA
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, Pennsylvania, 19104, USA
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Abstract
The epiglottis plays an important role in preventing food of different consistencies from entering the airway during swallowing. Calcification of epiglottis can, potentially, alter and limit its movement causing aspiration amongst other swallowing problems. Isolated calcification of the epiglottis and its clinical presentation remains a poorly understood entity for radiologists as well as clinicians. Therefore, it is important to recognize the imaging features of epiglottic calcification, and it's known clinical presentations to help clinicians with early diagnosis and management.
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Affiliation(s)
- Sunil Jeph
- Department of Radiology, Geisinger Medical Center, Danville, USA
| | - Michael Aidi
- Department of Radiology, Geisinger Medical Center, Danville, USA
| | | | - Thu-Thao Ly
- Department of Radiology, Geisinger Medical Center, Danville, USA
| | - Oleg Bronov
- Department of Radiology, Geisinger Medical Center, Danville, USA
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25
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Kim GA, Jin JX, Taweechaipaisankul A, Lee S, Yoon BI, Cho J, Lee BC. Mineralized deposits in the uterus of a pig without pregnancy loss. J Vet Sci 2017; 18:563-565. [PMID: 28693296 PMCID: PMC5746453 DOI: 10.4142/jvs.2017.18.4.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/18/2017] [Accepted: 05/05/2017] [Indexed: 11/28/2022] Open
Abstract
Herein, we describe a case of uterine calcification in the uterus of a pig without pregnancy loss. The recipient underwent cloned embryo transfer and Cesarean section for safe delivery of cloned piglets. During the Cesarean section, 4 white, star-like, (2 × 2 × 2) cm, calcified structures were found within the endometrial cavity. Despite dystrophic calcification around the placenta, healthy cloned piglets were produced successfully. To our knowledge, this is the first reported case of dystrophic calcification occurring within the uterus in a pregnant pig.
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Affiliation(s)
- Geon A Kim
- Department of Theriogenology and Biotechnology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Jun-Xue Jin
- Department of Theriogenology and Biotechnology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Anukul Taweechaipaisankul
- Department of Theriogenology and Biotechnology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Sanghoon Lee
- Department of Theriogenology and Biotechnology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Byung Il Yoon
- Laboratory of Histology and Molecular Pathogenesis, College of Veterinary Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Jongki Cho
- Laboratory of Theriogenology, College of Veterinary Medicine, Chungnam National University, Daejeon 34134, Korea
| | - Byeong Chun Lee
- Department of Theriogenology and Biotechnology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
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Zumstein V, Betschart P, Müllhaupt G, Jochum W, Schmid HP, Abt D. Recurrent Dystrophic Calcification of the Prostatic Resection Cavity After Transurethral Resection of the Prostate: Clinical Presentation and Endoscopic Management. J Endourol Case Rep 2017; 3:81-83. [PMID: 28736747 PMCID: PMC5515091 DOI: 10.1089/cren.2017.0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Dystrophic calcification (DC) can occur as a reaction to tissue damage and necrosis. So far, this has never been described as a complication after conventional transurethral resection of the prostate (TURP). Case Presentation: We report on a 59-year-old man who underwent uncomplicated monopolar TURP for lower urinary tract symptoms caused by benign prostatic hyperplasia. The patient showed an excellent course up to 5 weeks after the initial operation. Afterward he suffered from a rapid onset of irritative and obstructive voiding symptoms and pain. Complete DC of the prostatic resection cavity was found by cystoscopy and recurred quickly twice after Re-TURP despite anti-inflammatory treatment and normal urinary and metabolic findings. Complete recovery was only achieved by gently scraping off the calcifications avoiding further trauma to the residual prostatic tissue. Conclusion: In rare cases, delayed occurrence of irritative and obstructive voiding symptoms after TURP can be caused by DC of the prostatic resection cavity and might be misinterpreted as post-TURP infection. The pathomechanism of DC and the presented case suggest minimizing tissue trauma by cautious removal of calcifications rather than performing extensive Re-TURP.
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Affiliation(s)
- Valentin Zumstein
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Patrick Betschart
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gautier Müllhaupt
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dominik Abt
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Jakobiec FA, Rai R, Rashid A, Kanoff J, Mukai S. Dystrophic hyaloid artery remnants and other abnormalities in a buphthalmic eye with retinoblastoma. Surv Ophthalmol 2014; 59:636-42. [PMID: 25233827 DOI: 10.1016/j.survophthal.2014.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/07/2014] [Accepted: 05/22/2014] [Indexed: 11/17/2022]
Abstract
Partial persistence of the hyaloid artery unaccompanied by hyperplastic primary vitreous has not been previously reported in association with retinoblastoma. We describe an 18-month-old child with such a finding who had a retinoblastoma that was undifferentiated, extensively necrotic, heavily calcified, and completely filled the eyeball. The enucleated globe harbored a nonperfused, fossilized remnant of the hyaloid artery due to DNA/calcium deposition in the vascular wall. This structure inserted into a lenticular, extracapsular, fibrous plaque corresponding to a Mittendorf dot. The tumor had induced a placoid cataractous lens, obliterated the anterior and posterior chambers, caused glaucoma leading to buphthalmos, and extended into the optic nerve and extraocularly to involve the orbit. We conclude that the retinoblastoma arose early in ocular morphogenesis, at around 4 months gestation, when the programmed involution of the hyaloid artery begins. This process would typically end at 7-8 months gestation, but was aborted by the tumor. The patient died 6 weeks after surgery without receiving further treatment because of the parents' resistance.
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Affiliation(s)
- Frederick A Jakobiec
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
| | - Ruju Rai
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Alia Rashid
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Justin Kanoff
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Shizuo Mukai
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Boyde A, Davis GR, Mills D, Zikmund T, Cox TM, Adams VL, Niker A, Wilson PJ, Dillon JP, Ranganath LR, Jeffery N, Jarvis JC, Gallagher JA. On fragmenting, densely mineralised acellular protrusions into articular cartilage and their possible role in osteoarthritis. J Anat 2014; 225:436-46. [PMID: 25132002 DOI: 10.1111/joa.12226] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2014] [Indexed: 12/11/2022] Open
Abstract
High density mineralised protrusions (HDMP) from the tidemark mineralising front into hyaline articular cartilage (HAC) were first described in Thoroughbred racehorse fetlock joints and later in Icelandic horse hock joints. We now report them in human material. Whole femoral heads removed at operation for joint replacement or from dissection room cadavers were imaged using magnetic resonance imaging (MRI) dual echo steady state at 0.23 mm resolution, then 26-μm resolution high contrast X-ray microtomography, sectioned and embedded in polymethylmethacrylate, blocks cut and polished and re-imaged with 6-μm resolution X-ray microtomography. Tissue mineralisation density was imaged using backscattered electron SEM (BSE SEM) at 20 kV with uncoated samples. HAC histology was studied by BSE SEM after staining block faces with ammonium triiodide solution. HDMP arise via the extrusion of an unknown mineralisable matrix into clefts in HAC, a process of acellular dystrophic calcification. Their formation may be an extension of a crack self-healing mechanism found in bone and articular calcified cartilage. Mineral concentration exceeds that of articular calcified cartilage and is not uniform. It is probable that they have not been reported previously because they are removed by decalcification with standard protocols. Mineral phase morphology frequently shows the agglomeration of many fine particles into larger concretions. HDMP are surrounded by HAC, are brittle, and show fault lines within them. Dense fragments found within damaged HAC could make a significant contribution to joint destruction. At least larger HDMP can be detected with the best MRI imaging ex vivo.
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Affiliation(s)
- A Boyde
- Biophysics, Oral Growth and Development, Barts and The London School of Medicine and Dentistry, QMUL, London, UK
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Abstract
Autologous fat injection is widely used procedure for various functional and aesthetic purposes. However, it could result in many immediate or delayed complications including dystrophic calcifications. Almost all of the case reports about dystrophic calcification after autologous fat injection were result from the iatrogenic tissue trauma of breast augmentation. This is a report of a 30-year-old patient who developed pathologically proven multiple dystrophic calcifications on the face after autologous fat injection.
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Affiliation(s)
- Dai Hyun Kim
- Department of Dermatology, Korea University College of Medicine , Seoul , Republic of Korea
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Hunt CH, McKenzie GA, Diehn FE, Morris JM, Wood CP. "The flipping bullet" with associated intramedullary dystrophic calcification: an unusual cause for migratory myelopathy and radiculopathy. Open Neuroimag J 2012; 6:75-7. [PMID: 22942925 PMCID: PMC3431563 DOI: 10.2174/1874440001206010075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/07/2012] [Accepted: 08/09/2012] [Indexed: 12/05/2022] Open
Abstract
We report the case of a 24 year old male who had a retained bullet within his thoracic spine from a gunshot
wound resulting in paraplegia. After 7 months he began experiencing painful dysesthesias at his sensory level. Repeat
imaging demonstrated migration of the bullet as well as the development of intramedullary dystrophic calcification
associated with the bullet. This case demonstrates not only the ability for retained bullets to migrate within the spinal
canal but also demonstrates they can lead to remote symptoms due to the development of dystrophic calcification.
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Abstract
Dystrophic calcification is deposition of calcium salt in degenerated tissues in the presence of normal calcium and phosphorous metabolism. It usually occurs in injured tissues. The condition may be associated with a variety of systemic disorders. The pathophysiology is still unclear. The case of a 17-year-old boy with dystrophic calcifications over the right masseter muscle is presented here with review of literature. Calcified nodules were surgically excised via an intraoral approach.
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Affiliation(s)
- Syed Ahmed Mohiuddin
- Department of Oral and Maxillofacial Surgery, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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Zhao Y, Urganus AL, Spevak L, Shrestha S, Doty SB, Boskey AL, Pachman LM. Characterization of dystrophic calcification induced in mice by cardiotoxin. Calcif Tissue Int 2009; 85:267-75. [PMID: 19690791 PMCID: PMC2830143 DOI: 10.1007/s00223-009-9271-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 06/17/2009] [Indexed: 01/18/2023]
Abstract
Dystrophic calcifications often occur after injury, infection, or onset of certain rheumatic diseases. Treatment has been limited to surgical removal following failure of medical therapy. In an attempt to establish a reproducible animal model for dystrophic calcification that permitted the screening of potential interventions, we evaluated cardiotoxin (injury)-induced calcifications in three murine strains at both the cellular and ultrastructural levels. All osteopontin null mice and tumor necrosis factor receptor null mice on a C57B6 background had calcifications at days 3 and 7 after injury compared to 75% of wild-type C57B6 mice. There was no difference in mineral content among calcifications from the three mouse strains. Osteogenesis was suggested by the expression of osteocalcin, osterix, and alkaline phosphatase in calcified murine muscle tissue. Osteoclast-like cells facilitated the removal of transient dystrophic deposits (<28 days) in all models. However, none of the models showed an association of mineral crystals with collagen, suggesting that the deposits were not bone-like. The dystrophic mechanism was validated as cell death, and mitochondrial calcifications occurred soon after skeletal muscle injury in the three murine strains.
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Affiliation(s)
- Yongdong Zhao
- Center of Excellence in Clinical Immunology, Children's Memorial Research Center, 2300 Children's Plaza, Box 212, Chicago, IL 60614, USA, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annette L. Urganus
- Center of Excellence in Clinical Immunology, Children's Memorial Research Center, 2300 Children's Plaza, Box 212, Chicago, IL 60614, USA
| | - Lyudmila Spevak
- Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Sheela Shrestha
- Center of Excellence in Clinical Immunology, Children's Memorial Research Center, 2300 Children's Plaza, Box 212, Chicago, IL 60614, USA
| | - Stephen B. Doty
- Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Adele L. Boskey
- Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Lauren M. Pachman
- Center of Excellence in Clinical Immunology, Children's Memorial Research Center, 2300 Children's Plaza, Box 212, Chicago, IL 60614, USA, Department of Pediatrics, Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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