Histopathological Evaluation of Solitary Nodules of Thyroid

Introduction: Solitary Thyroid nodules (STNs) can be ofboth non-neoplastic or neoplastic in nature and it is difficultto assess whether an STN is neoplastic or non-neoplasticby clinical examination alone. Imaging technique mayhelp in differentiating them preoperatively but histologicalexamination offers the final diagnosis. This study was aimedat studying the incidence rates of various types of STNs as itvaries from one geographical area to another.Material and methods: A total of 58 cases of STNsreceived over the period of 18 months were studied andhistopathological features were analysed.Results: In this study, non-neoplastic STNs were 32 (55.17%)and neoplastic were 26 (44.82%), the former being morecommon. There was a female preponderance in both nonneoplastic and neoplastic STNs with an incidence of 90.62%and 84.61% respectively. Mean age of presentation of STNswas 42.09 years. Non-neoplastic lesions of thyroid were; 18cases of colloid nodules, 10 cases of hyperplastic nodulargoitre, 04 cases of Hashimoto Thyroiditis and the neoplasticlesions were; 05 cases of follicular adenoma, 11 cases oftypical/conventional papillary carcinoma of thyroid (PTC),6 cases of papillary carcinoma thyroid variants, 01 case offollicular carcinoma 01 case of Undifferentiated carcinoma,01 case of Squamous cell carcinoma and 01 case of medullarycarcinoma.Conclusion: STNs are not so uncommon and comprise of agamut of both non-neoplastic and neoplastic lesions. Colloidnodule and PTC are the most common of non-neoplastic andneoplastic STNs respectively.

Histopathological Study Of Non-neoplastic Lesions Of Nose, Paransal Sinuses And Nasopharynx

Background: The various lesions of the nose, paranasal sinuses and nasopharynx were subjected to histopathological evaluation over a period of 5 years (2010 to 2015) at the Department of Pathology, in a rural based hospital. Total 84 specimens were studied over the time of 5 years. Methodology: The formalin fixed specimens were received with complete clinical and radiological features. Routine gross examination and required number of sections were taken and stained with hematoxylin and eosin. Result: In the study, 84 cases were of Inflammatory and Non neoplastic le-sions. Nasal polyps were the most common lesions with 77 (91.67%) cases. Among the all Nasal polyps, 77 cases, 20 (25.97%) cases were of Allergic polyp, 50 (64.93%) cases were of inflammatory polyp, while 7 (9.09%) cases were of Antrochoanal polyp. 2 cases (2.38%) each of Sinusitis and Intradermal naevus. Rhinosporidiosis, Mucocele and Na-solabial cyst comprised of 1 (0.77%) case each respectively. Conclusion: In our study, most common lesions were Nasal Polyps. Most of the cases were presented in 2ndand3rddecade of life with Male preponderance. Nasal obstruction was the most common clinical presentation in the present study.

Imaging features and differential diagnosis of obstructive jaundice caused from non-neoplastic diseases / 中华消化外科杂志

Objective To investigate the imaging features and differential diagnosis of obstructive jaundice caused from non-neoplastic diseases.Methods The retrospective descriptive study was conducted.The clinical data of 62 patients with obstructive jaundice caused from non-neoplastic diseases who were admitted to the Peking University People's Hospital between August 2014 and August 2016 were collected,including 13 with immunoglobulin G4 associated cholangitis (IAC),2 with primary sclerosing cholangitis (PSC),21 with recurrent purulent cholangitis (RPC),2 with Mirizzi syndrome,4 with groove pancreatitis (GP) and 20 with Lemmel syndrome.All the patients underwent plain and enhanced scans of computed tomnography (CT) and magnetic resonance imaging (MRI) and magnetic resonanced cholangio-pancreatography (MRCP).Film reading were respectively done by 2 imaging doctors,and then was analyzed again by senior doctors when there is disagreement.Observation indicators:(1) situations of imaging exanination and imaging features;(2) treatment and follow-up.Patients received laboratory and related examinations and then underwent corresponding treatment after diagnosis.Follow-up using outpatient examination and telephone interview was performed once every 6 months to detect patients' prognosis up to November 2016.Results (1) Situations of imaging examination and imaging features:of 62 patients,21 underwent plain and enhanced CT scans,7 underwent plain and enhanced MRI scans,4 underwent MRCP,15 underwent plain and enhanced CT scans and MRCP,1 underwent plain and enhanced CT scans and plain and enhanced MRI scans,3 underwent plain and enhanced MRI scans and MRCP and 11 underwent plain and enhanced CT scans,plain and enhanced MRI scans and MRCP.Imaging features of 13 patients with IAC:MRI scans showed that diffuse and symmetrical bile duct walls were thickened,with delayed enhancement.The narrowed lumen of bile duct was mainly occurred in common bile duct,without occlusion.Of 13 patients with IAC,9 were combined with IgG4 associated pancreatitis and 7 with bilateral nephropathy.Imaging features of 2 patients with PSC:MRI scans showed that bile duct wall was multiple localized thickening and persistent enhancement,that was imaging feature of liver cirrhosis.MRCP examination showed that intra-and extra-hepatic bile ducts had multifocality stricture and beading-like and/or dry twig-like dilatation,and branches of intrahepatic peripheral bile duct were reduced.Imaging features of 21 patients with RPC:MRI and CT scans and MRCP examination showed that there was thickening bile duct wall and delayed enhancement.The first and second level of intrahepatic bile duct were segmental dilatation,distal bile duct dramatically narrowed and branches of intrahepatic bile duct were reduced.Most of extrahepatic bile duct was dilatation and a few were narrow-like changes.There were stones of intrahepatic bile duct and pneumobilia.Liver parenchymal atrophy with cholangiectasis occurred most frequently in left lobe or right posterior lobe of liver.There were secondary liver abscess and cholangiocarcinoma.Imaging features of 2 patients with Mirizzi syndrome:MRI scans showed that there was common hepatic duct stricture caused by stones in the junction between neck of gallbladder and common hepatic duct,and intra-and extra-hepatic bile ducts dilatation in proximal end of stones and normal bile duct in distal end of stones.There were gallbladder and biliary fistulas,irregular gallbladder wall thickening and inflammation around the gallbladder.Imaging features of 4 patients with GP:MRI scans showed that no clear mass was detected in duodenal loop and head of pancreas,with heterogeneous and slightly irregular enhancement.Cyst formation occurred in intramural wall of duodenum and head of pancreas.Enhanced MRI scans showed that common bile duct wall was thickened and slightly irregular stricture,pancreatic duct was normal or mild expansion,and thickened duodenal wall had varying degrees of stenosis of lumen.Imaging features of 20 patients with Lemmel syndrome:MRI scans showed that pouch-like structure was detected inside of the descending duodenum,with thin cyst wall and liquid in cyst wall.MRCP examination showed dilatations of common bile duct and intra-and extra-hepatic bile ducts.(2) Treatment and follow-up:of all the 62 patients,30 underwent corresponding surgeries,including 2 with IAC,1 with PSC,7 with RPC,2 with Mirizzi syndrome,3 with GP and 15 with Lemmel syndrome,and the other 32 without surgery received corresponding medical treatment.Sixty of 62 patients were followed up for 3-17 months.During follow-up,28 patients undergoing surgery received definitive diagnosis and good recovery,2 were lost after definitive diagnosis and 32 undergoing medical treatment were in stable condition.Conclusion Non-neoplastic diseases can cause obstructive jaundice,with a higher misdiagnosis rate,imaging findings of which can be conducive to diagnose diseases and provide clinical treatment.

Analysis of non-neoplastic hepatic lesions in SD rats at different age / 中国职业医学

OBJECTIVE: To explore the non-neoplastic hepatic lesions in SD rats at different ages. METHODS: The specificpathogen free SD rats were collected from the blank control groups used in subacute toxicity tests,subchronic toxicity tests and chronic toxicity combined with carcinogenic tests for safety evaluation. At the end of each experiment,i. e. week 10,19,56 and 108(assigned into four groups: 10,19,56 and 108 weeks,each contained 100 rats with each sex),rats were executed. The liver organ coefficient was calculated,the pathological examination was performed,and the non-tumorous lesions in the liver were analyzed. RESULTS: The liver organ coefficients at the age of 19,56,108 weeks were lower than that of 10 weeks(P < 0. 05); those at the age of 56 and 108 weeks were lower than that of 19 weeks(P < 0. 05),and that of 108 weeks was greater than of 56 weeks(P < 0. 05). Among the 10-week-old,19-week-old,56-week-old and 108-week-old groups,the types of non-neoplastic hepatic lesions detected in the female rats were 6,6,13 and 15 respectively,meanwhile those in the male rats were 6,6,13 and 15 respectively. Both male and female rats,the incidences of hepatocyte fatty degeneration,edema and hepatic infiltration of inflammatory cells were significantly increased with the increase of age in each group(P < 0. 05). The incidences of intrahepatic bile duct proliferation and intrahepatic bile duct fibrosis in rats at the age of 56 and 108 weeks were higher than those at the age of 10 and 19 weeks(P < 0. 008).Moreover,the frequency of hepatic sinus expansion lesions in rats at the age of 108 weeks was higher than those of 19 weeks(P < 0. 008). CONCLUSION: Spontaneous non-neoplastic lesions in the liver of SD rats were common,primarily demonstrated as hepatocyte fatty degeneration,edema and infiltration of inflammatory cells. The incidences of lesions increased with the increase of age.

Differential Diagnosis between Neoplastic and Non-Neoplastic Brain Lesions in Radiology / Diagnóstico diferencial entre lesões cerebrais neoplásicas e não neoplásicas em radiologia

Introduction The observation of multiple lesions in a skull computed tomography (CT) scan is always cause for concern because of the frequent possibility of neoplastic etiology, although granulomatous, infectious, vascular, iatrogenic, demielinating, trauma, parasitic diseases, and strokes can produce a similar aspect on radiology. A wide range of non-neoplastic conditions can mimic a brain tumor, both clinically and radiologically, representing a potential pitfall for physicians involved in patient care. The study's goal is to alert specialists to the possibility of other neoplastic and nonneoplastic etiologies in the differential diagnosis of hypodense lesions in non-contrast. Methods We performed a literature review using PubMed, Medline, Science Direct, Embase, Clinical Trials, Ebsco, and Scielo. Articles were selected in the period of 1986 to 2015. Discussion Knowledge of various etiologies when with multiple lesions appear on computed tomography allows specialists to guide the diagnosis to appropriate treatment, avoiding the irradiation of non-neoplastic lesions and unnecessary surgeries. The most common lesions were the neoplasm (74% to 86%), especially gliomas, followed by infections (8% to 15%), and infarcts (0.6% to 6%), which represent nonneoplastic lesions. Conclusion Given the relatively high percentage of wrong neuroradiology diagnoses, most cases may require histological diagnosis, because even magnetic resonance imaging (MRI) renders difculties in distinguishing such lesions.

Introdução Observação de múltiplas lesões na tomograa computadorizada de crânio (TC) é sempre motivo de preocupação por causa da possibilidade frequente de etiologia neoplásica, embora as doenças granulomatosas, infecciosas, vascular, iatrogênica, desmielinizante, trauma, e parasitárias podem produzir aspecto semelhante na radiologia. Uma ampla gama de condições não neoplásicas pode mimetizar um tumor cerebral, tanto clínica, quanto radiologicamente, representando uma armadilha potencial para os médicos envolvidos no cuidado ao paciente. O objetivo do estudo é alertar a possibilidade de outras etiologias neoplásicas e não neoplásicas no diagnóstico diferencial de lesões hipodensas em TC sem contraste. Métodos Revisão da literatura utilizando PubMed, MEDLINE, Google Scholar, Ensaios Clínicos, EBSCO, Scielo, Tópicos em radiologia. Foram selecionados por período 1986- 2015. Discussão O conhecimento de várias etiologias, quando confrontado com múltiplas lesões na tomograa computadorizada permite o direcionamento do diagnóstico para o tratamento adequado, evitando a irradiação de lesões não neoplásicas e cirurgias desnecessárias. As lesões mais frequentes são neoplasias (74% a 86%), especialmente gliomas, seguido de infecções (8% a 15%) e infartos (0,6% a 6%), que representam lesões não neoplásicas. Conclusão Como um possível resultado da percentagem relativamente elevada de diagnósticos errados neurorradiológicos, o diagnóstico histológico faz necessário, porque mesmo Ressonância pode ser difícil na diferenciação de tais lesões.

A Case of Caseous Calcification in the Left Ventricular Outflow Tract with Loss of Consciousness / 日本心臓血管外科学会雑誌

<p>A 61-year-old woman presented with loss of consciousness. Echocardiography revealed a hypoechoic, round mass of 12×13 mm with a smooth border in the left ventricular outflow tract, leading to a diagnosis of loss of consciousness caused by left ventricular outflow tract obstruction, and surgical excision of the mass was performed. The mass, with a smooth, elastic soft surface and filled with yellow, creamy contents, was observed within a range from the subannular region of the left coronary cusp to the anterior mitral leaflet. Pathological examination showed central degeneration and liquefaction, as well as cystic, coarse-granular calcium deposition surrounded by inflammatory cell infiltration and fibroblast proliferation. No tumor cells were seen. Abscess was excluded by preoperative clinical presentations, hematologic data, and culture testing, and thus the mass was considered as caseous calcification of the mitral annulus. Here, we report a case of caseous calcification of the mitral annulus, a rare nonneoplastic lesion thought to be a variant of mitral annular calcification, with literature review.</p>

Non-neoplastic lesions of the ovary - A review.

Ovary is an important organ as it is concerned with the production of progeny. Ovary is the commonest site of neoplastic and non-neoplastic lesion, can present in childhood to postmenopausal age group and accounts for the most prevalent cause of hospital admissions. non-neoplastic ovarian lesions are classified as inflammatory (infectious and non infection ), non-inflammatory (cystic and non-cystic) and pregnancy related disorders.

Non-neoplastic Lesions in Temporal Lobe Epilepsy: A Pathologic Review of 64 cases

Temporal lobe epilepsy is characterized by complex partial seizures with either primary intracranial neoplasms or other non-neoplastic lesions. We reviewed 64 cases of surgically resected temporal lobes and amygdalo-hippocampal regions for temporal lobe epilepsy ansed by non-neoplastic lesions to elucidate the incidence and histologic features of each histologic group for a period of 2 years. The patient's age ranged from 12 to 49 years and the ratio of male to female was 42:22. There were 37 cases(57.8%) with single pathology and an additional 20 cases(31.3%) with dual pathology. The emaining 7 cases(10.9%) had no structural alternations. The most common temporal lobe pathology was hippocampal sclerosis in 41 cases(64.1%), diagnosed alone in 21 cases and as dual lesions in 20 cases. The hippocampal neuron loss was most pro,omemt in CA1, followed by CA4, CA3, and CA2. Amygdaloid sclerosis was present in 28 cases(43.8%), lases had 13 dual lesions, 25 cases also had hippocampal sclerosis. The 20 dual lesions showed that 6 cortical dysplasia, 10 microdysgenesis, 1 chronic non-specific inflammatory lesion, and 3 cysticercosis were associated with the various degree of mesial temporal sclerosis. Neuronoglial malformative lesions were identified in 21 cases(32.8%) including 16 dual lesion cases, which composed of 15 microdysgenesis and 6 cortical dysplasia. Neurofilament immunostain for cortical dysplasia revealed abnormally beaded disarray of axons in dysplastic pyramidal cells. The remaining pathologic lesions observed were 1 cysticercosis, 1 chronic non-specific inflammatory lesion, 3 arteriovenous malformation, 2 fibrous nodule, and 1 fibrous adhesions of the arachnoid.