ABSTRACT
A sarcoidose caracteriza-se como doença granulomatosa que acomete diferentes órgãos humanos, especialmente os pulmões, sendo sua patogênese pouco conhecida. No caso em questão, a paciente iniciou com sintomas inespecíficos, como fraqueza, perda ponderal e tosse seca esporádica, sendo internada para extensão da propedêutica. Sugeriu-se como hipótese diagnóstica inicial possível quadro de mieloma múltiplo, tendo em vista a anemia, a disfunção renal, a hipercalcemia e, sobretudo, as lesões osteolíticas apresentadas pela paciente. Todavia, o diagnóstico de sarcoidose foi selado a partir das biópsias de medula óssea e de linfonodo inguinal, que evidenciaram mielite e linfadenite granulomatosas, respectivamente. A terapêutica instituída baseou-se na administração de corticosteroides e em medidas de redução da calcemia. A paciente recebeu alta, com melhora do quadro clínico, para acompanhamento ambulatorial da doença. Conclui-se que a sarcoidose não possui tratamento curativo, mas a terapêutica imunossupressora é eficaz no controle da progressão da enfermidade, fazendo com que o paciente tenha um prognóstico favorável.
Sarcoidosis is characterized as a granulomatous disease that affects different human organs, especially the lungs, and its pathogenesis is little known. In this case, the patient started with nonspecific symptoms, such as weakness, weight loss, and sporadic dry cough, being hospitalized for extension of the propaedeutics. The initial diagnostic hypothesis suggested was a possible case of multiple myeloma, based on the anemia, renal dysfunction, hypercalcemia and, above all, the osteolytic lesions presented by the patient. However, the diagnosis of sarcoidosis was made after bone marrow and inguinal lymph node biopsies that showed granulomatous myelitis and lymphadenitis, respectively. The therapy instituted was based on the administration of corticosteroids and on measures to reduce the level of calcium. The patient was discharged, with clinical improvement, for outpatient follow-up of the disease. It is concluded that sarcoidosis has no curative treatment, but immunosuppressive therapy is effective in controlling the progression of the disease, giving the patient a favorable prognosis.
Subject(s)
Humans , Female , Aged , Sarcoidosis/diagnostic imaging , Rare Diseases/diagnostic imaging , Multiple Myeloma/diagnostic imaging , Sarcoidosis/drug therapy , X-Rays , Biopsy , Blood Protein Electrophoresis , Bone Marrow/pathology , Prednisone/therapeutic use , Tomography, X-Ray Computed , Adrenal Cortex Hormones/therapeutic use , Creatinine/blood , Diagnosis, Differential , Acute Kidney Injury/diagnosis , Hypercalcemia , Anemia , Lymph Nodes/pathology , Lymphadenitis/diagnosis , Myelitis/diagnosisABSTRACT
Background: Inflammatory pseudo tumor, a rare non-neoplastic lesion, commonlypresents as slow growing solid lesion in the lung, but many extra-pulmonary locations havebeen described. Case characteristics: A 4-year-old girl who presented with respiratorydistress due to massive pleural effusion. Computed tomography revealed large hypodensenon-enhancing lesion in the left hemi thorax. Surgical exploration revealed large semisolidpleural collection filled with gelatinous material with normal underlying lung. Outcome:Histopathology revealed spindle shaped cells with abundant myxoid stroma. Childrecovered after surgery and was asymptomatic at 5 years follow-up. Message: Primarypleural inflammatory pseudotumor may be a rare cause of pleural effusion in a child
ABSTRACT
Plasma cell granuloma is a rare non-neoplastic lesion that occurs most often in the lungs, but it is not commonly seen in the maxillofacial region. Its etiology, biological behavior, ideal treatment and prognosis are still unclear and rather controversial. Very few cases of intraoral plasma cell granulomas have been reported in the past. Hence, we present an unusual case of plasma cell granuloma in a 60year-old female which was presented clinically as ill-defined swelling over left upper buccal vestibule region extending to the midpalate. Histological examination revealed fibro-cellular connective tissue stroma with inflammatory cell infiltrate containing plasma cells and lymphocytes. The plasma cells are abundant varying in size and shape, with very few large and binucleated plasma cells. Both clinically and histopathologically, it may be misinterpreted as various pathological entities thus proper evaluation of patient and histopathological examination of the tissue to rule out other lesions is mandatory.
ABSTRACT
Plasma cell granuloma is a rare benign tumor lesion that is classified and described under the pseudo inflammatory tumor category. Its occurrence in the oral cavity is rare, making diagnosis and treatment really difficult, as it bears some clinical similarity with malignant tumor diseases. Proper diagnosis and treatment of PCG requires performing biopsy and a histopathological/immunohistochemicalstudy to rule out possible plasma and neoplastic cell dyscrasias. Consequently, the use of these auxiliary diagnostic devices will enable us to provide the appropriate treatment for the patient. In this study, we present the case of a 63-year-old female patient with a tumor/ulcerative lesion of the left buccal mucosa of a month of evolution and a tumor/ulcerative lesion on the right buccal mucosa of 15 days of evolution after the onset of the first lesion. The patient was treated successfully for a period of one year with immunosuppressive drugs, and to date the disease is inactive. The purpose of this paper is to show one of the most unusual locations in the oral cavity affected by this pathological entity, its clinical and histological features, and establish the differential diagnosis correctly with other malignant or benign disease entities, suggesting the most suitable treatment for this type of condition...
El Granuloma de Células Plasmáticas es una rara lesión tumoral benigna descrita dentro de la clasificación de tumores pseudoinflamatorios, es rara su aparición dentro de la cavidad oral, haciendo realmente complicado su diagnóstico y tratamiento, ya que presenta similitud clínica con patologías tumorales malignas. Para el adecuado diagnóstico y tratamiento del GCP, se requiere de la realización de biopsia y estudio histopatológico/inmunohistoquímico, para descartar posibles discrasias de las células plasmáticas y neoplásicas, de tal forma que el uso de estos auxiliares de diagnóstico nos permitirá sustentar de manera adecuada el tratamiento otorgado al paciente. Se presenta el caso de paciente femenino de 63 años de edad, con una lesión tumoral/ulcerativa de la mucosa yugal izquierda de un mes de evolución y lesión tumoral/ulcerativa de la mucosa yugal derecha de 15 días de evolución posterior a la aparición de la primera lesión, tratada por un periodo de un año con inmunosupresores de forma exitosa ya que a la fecha la paciente presenta inactiva la enfermedad. El propósito de este manuscrito es mostrar una de las localizaciones más extrañas de esta entidad patológica en la cavidad oral, sus características clínicas e histológicas, establecer de forma correcta el diagnóstico diferencial con otras entidades patológicas malignas ó benignas y así emplear el tratamiento requerido para la forma en que se presente la misma...
Subject(s)
Humans , Female , Middle Aged , Mouth Diseases/pathology , Mouth Diseases/drug therapy , Granuloma, Plasma Cell/pathology , Granuloma, Plasma Cell/drug therapy , Biopsy , Diagnosis, Differential , Immunosuppressive Agents/therapeutic useABSTRACT
Loosening is a well-known complication of total hip arthroplasty. The accumulation of detritus resulting from mechanical wear forms inflammatory cells that have the function of phagocytizing this debris. Over the long term, these cells may give rise to a local granulomatous reaction. Here, we present a report on a case of pelvic pseudotumor subsequent to total hip arthroplasty, which is considered rare in the literature. The patient was a 48-year-old black man who started to be followed up medically eight months earlier because of uncharacteristic abdominal pains, dysuria and pollakiuria. He had undergone left total hip arthroplasty 17 years previously. Through clinical investigation and complementary examinations, an extra-articular granulomatous mass was diagnosed, constituting a pelvic pseudotumor...
A soltura é uma complicação bem conhecida nas artroplastias totais do quadril. O acúmulo de detritos resultante do desgaste mecânico forma células inflamatórias que têm a função de fagocitar esses detritos e podem, em longo prazo, gerar uma reação granulomatosa local. A seguir, apresentamos um relato de caso de pseudotumor de pélvis pós-artroplastia total do quadril, considerado raro na literatura consultada. Trata-se de paciente de 48 anos, masculino, negro, que iniciou seguimento médico por dores abdominais incaracterísticas, disúria e polaciúria havia oito meses. Apresentava artroplastia total do quadril esquerdo havia 17 anos. Após investigação clínica e por meio de exames complementares, diagnosticou-se uma massa granulomatosa extra-articular, pseudotumor de pélvis...
Subject(s)
Humans , Male , Adult , Arthroplasty, Replacement, Hip , Granuloma, Plasma Cell , Pelvic NeoplasmsABSTRACT
Inflammatory myofibroblastic tumor of the urinary bladder is a rare mesenchymal tumor with uncertain malignant potential. It often mimics soft tissue sarcomas both clinically and radiologically. Surgical resection in the form of partial cystectomy or transurethral resection remains the mainstay of treatment. Herein we report the case of an inflammatory myofibroblastic tumor in a young girl, which was managed by laparoscopic partial cystectomy. To the best of our knowledge, this is the first reported case of laparoscopic management of an inflammatory myofibroblastic tumor of the urinary bladder.
Subject(s)
Cystectomy , Granuloma, Plasma Cell , Laparoscopy , Myofibroblasts , Sarcoma , Urinary BladderABSTRACT
Plasma cells are medium-sized round-to-oval cells with eccentrically placed nuclei, usually found in the red pulp of the spleen, tonsils, medulla of the lymph nodes, nasal mucosa, upper airway, lamina propria of the gastrointestinal tract, and sites of inflammation. Plasma cell granuloma is a rare reactive tumor-like proliferation composed chiefly of plasmacytic infiltrate. Here, we present a case of plasma cell granuloma of lip in a female patient.
Subject(s)
Biopsy , Diagnosis, Differential , Female , Granuloma, Plasma Cell/diagnosis , Humans , Lip Diseases/diagnosis , Middle Aged , Oral Ulcer/diagnosis , Plasma Cells/pathology , Stomatitis/diagnosisABSTRACT
Subject(s)
Cathepsin G , Cathepsin K , Cathepsins , Collagen , Cytoplasm , Fibrosis , Gene Expression , Gingival Overgrowth , Granuloma, Plasma Cell , Granuloma, Pyogenic , Immunity, Cellular , Macrophages , Muramidase , Myofibroblasts , Plasma , Plasma Cells , Stromal Cells , Tumor Necrosis Factor-alphaABSTRACT
Primary lung tumours in children are rare, the most common lesions seen in clinical practice are metastatic disease. The majority of children who present with a primary or secondary pulmonary malignancy will present coincidentally while seeking attention for another medical problem, or with non-specific abnormalities such as cough with collapse or consolidation on the chest x-ray. Primary malignant tumours of the lung are the most common, this group is made up of carcinoid tumours, bronchogenic carcinoma and pleuropulmonary blastoma. Benign primary pulmonary tumours are inflammatory pseudotumour or plasma cell granuloma and hamartoma. Often, the possibility of a primary or secundary pulmonary tumour is considered only when radiographic abnormalities or symptoms persist or fail to respond to therapy, many children are asymptomatic until they have advanced disease, which delays diagnosis even further. The aim of this article is show our experience of two patients with inflammatory pseudotumour and literature review.
Los tumores pulmonares primarios en niños son muy poco frecuentes, siendo más reportadas las lesiones metátasicas. La mayoría de los pacientes que presentan un tumor pulmonar ya sea primario o secundario, son hallazgos de algún examen generalmente imagenológico, como parte del estudio de otras causas o en presencia de síntomas inespecíficos como tos asociada a atelectasia o condensación. Los tumores pulmonares primarios malignos son los más frecuentes, comprenden el tumor carcinoide, carcinoma broncogénico y blastoma pleuropulmonar. Los tumores pulmonares primarios benignos son el seudotumor inflamatorio (sTi) o granuloma de células plasmáticas y el hamartoma. Se debe tener un alto índice de sospecha en el diagnóstico de tumor pulmonar primario o secundario, frente a la persistencia de síntomas o si presenta una lesión en la radiografía de tórax que no se modifica o invade localmente a otros tejidos adyacentes a pesar del tratamiento. El objetivo de este artículo es mostrar nuestra experiencia de 2 pacientes portadores de sTi y hacer una revisión de la literatura.
Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Lung Diseases/surgery , Lung Diseases/diagnosis , Granuloma, Plasma Cell/surgery , Granuloma, Plasma Cell/diagnosis , Myofibroblasts , Lung Neoplasms/classification , PneumonectomyABSTRACT
Plasma cell granuloma is a rare reactive lesion composed of polyclonal plasma cells. It manifests primarily in the lungs, but may occur in various other anatomic locations like the oral cavity. Intraoral plasma cell granulomas involving the tongue, lip, oral mucosa and gingiva have been reported in the past. This case presents a 54-year-old female with chronic periodontitis and mandibular anterior gingival overgrowth treated by Phase I therapy (scaling and root planing) and excisional biopsy. Histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma. This case highlights the need to biopsy for unusual lesions to rule out potential neoplasms.
Subject(s)
Chronic Periodontitis/diagnosis , Diagnosis, Differential , Female , Gingival Diseases/diagnosis , Gingival Diseases/pathology , Gingival Overgrowth/diagnosis , Granuloma, Plasma Cell/diagnosis , Granuloma, Plasma Cell/pathology , Humans , Immunoglobulin kappa-Chains/analysis , Immunoglobulin lambda-Chains/analysis , Middle AgedABSTRACT
Plasma cell granuloma is a tumor-like disease characterized by non-neoplastic polyclonal proliferation of plasma cells and other mononuclear cells. This disease occurs most frequently in the lung and upper respiratory tract, while the involvement of the central nervous system is very rare. A 44-year-old female patient presented with nausea and progressive visual disturbance. Brain magnetic resonance imaging (MRI) revealed the mass along the right tentorium with low signal intensity in the T2 weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) sequence, and an isosignal intensity in T1 weighted image (T1WI), the latter of which was enhanced after administration of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA). The thickest portion of the tentorium was partially excised via the combined suboccipital and infratentorial approach. The histopathological examination indicated a diagnosis of plasma cell granuloma. Postoperative steroid therapy was administered for remnant tumor control. Although a follow up MRI scan taken 20 months after the operation showed a slight decrease in tumor size, the lesion had extended to the falx and left frontal convexity along with parenchymal edema at 32 months after the operation and the clinical status was aggravated. The mass was removed from the left frontal convexity. Radiation therapy was given, together with steroid administration.
Subject(s)
Adult , Female , Humans , Brain , Central Nervous System , Edema , Follow-Up Studies , Granuloma, Plasma Cell , Lung , Magnetic Resonance Imaging , Nausea , Plasma , Plasma Cells , Respiratory SystemABSTRACT
Plasma cell granuloma, a form of inflammatory pseudotumor, is a rare nonneoplastic lesion that is characterized by cellular proliferation composed predominantly of polyclonal plasma cells with other inflammatory cells in fibrovascular background. We have experienced an unusual case of plasma cell granuloma of skull that developed in a patient with systemic lupus erythematosus (SLE). A 42-year-old female diagnosed with SLE 13 years ago has complained of palpable scalp mass and headache beginning ten days previously. A brain magnetic resonance imaging showed intensely enhanced soft tissue mass with focal bone defect in right parietal bone and whole body positron emission tomography suggested high possibility of malignancy. Surgical tumor removal was performed. Biopsy specimen revealed inflammatory proliferation predominantly with mature plasma cells which were determined to be polyclonal in immunostaining. Currently, 4 months after surgery, the patient are on regular follow-up with oral medications (prednisolone, hydroxychloroquine) for SLE without evidence of recurrence.
Subject(s)
Adult , Female , Humans , Biopsy , Brain , Cell Proliferation , Follow-Up Studies , Granuloma, Plasma Cell , Headache , Lupus Erythematosus, Systemic , Magnetic Resonance Imaging , Parietal Bone , Plasma Cells , Plasma , Positron-Emission Tomography , Recurrence , Scalp , SkullABSTRACT
No abstract available.
Subject(s)
Female , Humans , Middle Aged , Granuloma, Plasma Cell/pathology , Liver/pathology , Liver Diseases/pathologyABSTRACT
Inflammatory pseudotumor (plasma cell granuloma) of the lung is an uncommon nonneoplastic tumor of unknown origin. This tumor typically manifests as a solitary, peripheral, and sharply circumscribed mass. Multiple lesions are seen in about 5% of cases. Resection is recommended for both diagnosis and treatment, and this tumor does not generally recur after complete resection. Here, we report a case of recurrent inflammatory pseudotumor after complete resection; the recurrence was detected as a series of bilateral consolidated lesions with an internal air bronchogram. This is an unusual finding with regard to inflammatory pseudotumors.
Subject(s)
Humans , Male , Middle Aged , Biopsy, Needle , Follow-Up Studies , Glucocorticoids/therapeutic use , Plasma Cell Granuloma, Pulmonary/diagnosis , Pneumonectomy , Prednisolone/therapeutic use , Radiography, Thoracic , Recurrence , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Subject(s)
Abdomen , Antigen-Antibody Reactions , Biopsy , Extremities , Gingiva , Gingivectomy , Granuloma, Plasma Cell , Head , Inflammation , Lung , Mouth , Multiple Myeloma , Neck , Plasma Cells , Plasma , Plasmacytoma , Prognosis , RecurrenceABSTRACT
We report a case of intracranial plasma cell granuloma which is a rare intracranial tumor showing plasma cell infiltration. It mimics meningioma or solitary plasmacytoma clinically and radiologically. Clinical presentation and diagnostic investigations are discussed and pertinent literatures are reviewed.
Subject(s)
Granuloma, Plasma Cell , Meningioma , Plasma Cells , Plasma , PlasmacytomaABSTRACT
We report a 35-year old female patient with history of seizure and mass which was confirmed as a plasma cell granuloma, arising in the left parietal area. The mass appeared on magnetic resonance imaging as well circumscribed area of decreased signal that markedly enhanced with administration of the contrast. Pathologically, biopsy showed a mixed cellular population with considerable numbers of plasma cells along with eosinophils and lymphocytes and the tumors was characterized immunohistochemically by polyclonal population of lymphoid cells.
Subject(s)
Adult , Female , Humans , Biopsy , Brain , Eosinophils , Granuloma, Plasma Cell , Lymphocytes , Magnetic Resonance Imaging , Plasma Cells , Plasma , Rabeprazole , SeizuresABSTRACT
Plasma cell Granuloma (PCG) is a form of idiopathic inflammatory pseudotumor (IPT). It is a rare entity character-ized by a nonneoplastic proliferation of inflammatory cells dominated by a polyclonal expansion of the plasma cells. This lesion has been discovered in many parts of the body including the central nervous system. We now report two cases of plasma cell granuloma involving the brain. The first case was a 42-year-old man who presented a right hemi-paresis. He had a lesion in the convexity of the left parietal region. The second case was a 58-year-old woman who was expressed confusion and a frontal-temporal headache. She had a lesion in the convexity of the left temporal region and mastoid bone. The diagnosis of PCG was confirmed by pathological and immunohistochemical studies revealing pre-dominant plasma cells in the affected tissues.
Subject(s)
Adult , Female , Humans , Middle Aged , Brain , Central Nervous System , Diagnosis , Granuloma, Plasma Cell , Headache , Mastoid , Plasma Cells , Plasma , RabeprazoleABSTRACT
A case of plasma cell granuloma in the right lateral ventricle simulating a meningioma of a 24-year-old man which was totally removed is presented. Plasma cell granuloma is a rare nonneoplastic lesion of unknown etiology which exclusively occurs in the lung. However on review of the English literature, only four prior cases of extrapulmonary plasma cell granulomas in the central nervous system have been reported.