ABSTRACT
Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. Cholesterol granuloma is histologically characterized as fibrous granulation tissue containing cholesterol crystals within surrounding giant cells. Cases of cholesterol granuloma of the pancreas are very rare. We report a case of a 47-year old male who had a cholesterol granuloma of the pancreas. Abdominal CT showed 24 mm-sized cyst in the pancreas and peri-pancreatic regional mass infiltrating to the stomach. PET-CT revealed increased 18F-FDG uptake at the cyst and peri-pancreatic mass. Thus, Whipple's operation was done. The disease was confirmed by surgical pathologic examination of the tissue. Pathologic examination of resected specimen showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells. We report on this case and give a brief review of the literature.
Subject(s)
Humans , Male , Middle Aged , Cholesterol , Diagnosis, Differential , Fluorodeoxyglucose F18/chemistry , Granuloma, Foreign-Body/pathology , Pancreas/pathology , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
Much attention has been paid to the insertion of central venous catheter(CVC) but their removal is a subject discussed rarely. After removal of a central venous catheter, rare but potentially life-threatening, transient cardiopulmonary collapse or neurological dysfunction had developed. The failure to appreciate these complications may be a significant factor in their high mortality. Early recognition and treatment may be made possible by a high index of suspicion. In this report, the clinical courses of two patients with central venous catheter removal distress syndrome are reviewed. Also guidelines for safe removal of CVC are formulated. An awareness of potential CVC removal complications is most important for their prevention and timely treatment. CVCs should be removed with the same degree of meticulous attention to detail that accompanies their insertion. Medical personnel should be reminded that removal of the catheter is an integral component of CVC management.
Subject(s)
Humans , Catheters , Central Venous Catheters , MortalityABSTRACT
Sjogren's syndrome is a chronic,slowly progressive,autoimmune disease in which the exocrine glands are damaged by lymphocytic infiltration,resulting in xerostomia and xerophthalmia.Fever in patients with Sjogren's syndrome is rarely manifested with the exception of cases with complicated illness such as lymphoma.We experienced a 70-year-old male patient with Sjogren's syndrome who was presented with fever of unknown origin.Despite of thorough investigation,other diseases to cause fever could not be found.Fever and other clinical features were improved with empirical steroid therapy.
Subject(s)
Aged , Humans , Male , Exocrine Glands , Fever of Unknown Origin , Fever , Sjogren's Syndrome , XerostomiaABSTRACT
Aspergilloma and Allergic Bronchopulmonary Aspergillosis (ABPA) are different types of spectrum of pulmonary aspergillosis. ABPA results from hypersensitivity reaction to Aspergillus species and is known to be usually associated with bronchial asthma and cystic fibrosis. Aspergilloma results from simple colonization of this fungus within cavitary lung lesion or bronchiectasis. But rarely some patients can present together with ABPA and aspergilloma. We experienced a case of ABPA associated with aspergilloma in a 38 year-old male. The diagnosis was confirmed by asthma, immediate cutaneous reactivity to A. fumigatus, IgG antibody to A. fumigatus, elevated total and specific IgE antibodies to A. fumigatus, central bronchiectasis and peripheral eosinophilia coincident with radiographic infiltrates. During follow-up management with steroid, left pneumonectomy was done because of spontaneous pneumothorax with persistent air-leak and multidrug resistance pulmonary tuberculosis in association with aspergilloma. His respiratory symptoms and ABPA activity was much more improved after removal of aspergilloma. These findings suggest that surgical resection of aspergilloma can be considered to reduce antigenic source of colonized fungi in ABPA patients when associated with aspergilloma.
Subject(s)
Adult , Humans , Male , Antibodies , Aspergillosis, Allergic Bronchopulmonary , Aspergillus , Asthma , Bronchiectasis , Colon , Cystic Fibrosis , Diagnosis , Drug Resistance, Multiple , Eosinophilia , Follow-Up Studies , Fungi , Hypersensitivity , Immunoglobulin E , Immunoglobulin G , Lung , Pneumonectomy , Pneumothorax , Pulmonary Aspergillosis , Tuberculosis , Tuberculosis, PulmonaryABSTRACT
A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.
Subject(s)
Humans , Male , Aneurysm , Aneurysm, False , Arteries , Bronchial Arteries , Embolization, Therapeutic , Hemoptysis , Hemorrhage , Respiratory Insufficiency , Thorax , Tomography, Spiral Computed , Tuberculosis, PulmonaryABSTRACT
Sulindac is a commonly used nonsteroidal anti-inflammatory drug (NSAID). It is relatively economical and seems to be less nephrotoxic due to its property of minimal renal prostaglandin inhibition. Although hepatic injury has been infrequently reported for nearly all NSAIDs currently on the market, sulindac has more commonly been associated with hepatotoxicity. In addition, it has been known that sulindac is the agent to have a definite association with pancreatitis. We describe a 37-year-old woman who developed cholestatic hepatitis and acute pancreatitis in association with sulindac. This patient met the diagnostic criteria of both mixed connective tissue disease and systemic sclerosis, in which the disease classification needs to be clarified. While being treated with sulindac, close observation and periodic liver function test seem to play an important role.
Subject(s)
Adult , Female , Humans , Anti-Inflammatory Agents, Non-Steroidal , Classification , Hepatitis , Liver Function Tests , Mixed Connective Tissue Disease , Pancreatitis , Scleroderma, Systemic , SulindacABSTRACT
Spontaneous rupture of the kidney is uncommon. Since the first description by Wunderlich in 1865, about 300 cases have been reported in the English literatures. In Korea, 5 cases have been reported. Its presumptive symptoms were hematuria, excruciating pain and palpable mass. Nephrectomy was performed immediately because of the present failure of the conservative treatment. Herein we report a case and review the urological literature related to it.