ABSTRACT
This report discusses a rare case of a 75-year-old male presenting with a large lipoma of the tongue. It examines the investigations carried out to aid in diagnosing the lesion and the management options. Since oral lipomas rarely cause symptoms, there tends to be a general delay in seeking treatment. This case report aims to help dental practitioners diagnose intra-oral soft tissue lesions and provide appropriate management for their patients.
Subject(s)
Dentists , Lipoma , Male , Humans , Aged , Professional Role , Lipoma/diagnosis , Lipoma/surgery , TongueABSTRACT
Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid in a 46-year-old woman.
Subject(s)
Carcinoma, Mucoepidermoid , Eosinophilia , Thyroid Neoplasms , Carcinoma, Mucoepidermoid/complications , Carcinoma, Mucoepidermoid/diagnostic imaging , Carcinoma, Mucoepidermoid/surgery , Eosinophilia/complications , Female , Humans , Middle Aged , Thyroid Neoplasms/complications , Thyroid Neoplasms/surgeryABSTRACT
BACKGROUND: Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. METHODS: 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies. RESULTS: In 38 patients, treatment of associated causes led to amelioration of cough ('explained') and in 62, there was no association or improvement ('idiopathic'). The latter group had a longer duration of cough, a lower FeNO levels and a more sensitive capsaicin cough response, with an increase in basement membrane thickness with no differences in goblet cell hyperplasia and seromucinous hyperplasia, and in lymphocyte, neutrophil and eosinophil counts. The duration of cough was inversely correlated with the degree of neutrophil infiltration. CONCLUSION: We conclude that pathological examination of bronchial biopsies is unlikely to be useful in the diagnosis of chronic cough in non-smokers.
Subject(s)
Biopsy/methods , Bronchi/pathology , Bronchoscopy/methods , Chronic Disease , Cough/pathology , Gastroesophageal Reflux/complications , Adult , Asthma/complications , Basement Membrane/pathology , Capsaicin/administration & dosage , Capsaicin/adverse effects , Cough/etiology , Cough/metabolism , Cough/physiopathology , Eosinophils/cytology , Eosinophils/pathology , Female , Goblet Cells/pathology , Humans , Lymphocytes/cytology , Lymphocytes/pathology , Male , Middle Aged , Neutrophils/cytology , Neutrophils/pathology , Spirometry/methodsABSTRACT
Methylene blue is a chromophore dye known for its photosensitizing properties. It is also administered intravenously as a tracer in parathyroid surgery to identify abnormal glands. We describe 2 cases of acute methylene blue-induced phototoxicity in patients who underwent parathyroidectomy. Both patients developed an acute vesiculopustular inflammatory rash on the anterior neck corresponding to the site exposed intraoperatively to overhanging surgical lights. One of the patients also developed a bulla on her finger at the site of attachment of the oxygen probe. Biopsies were taken from both patients at different time points. The histological findings included destruction of sebaceous glands and deposition of diastase-periodic acid-Schiff-positive hyaline material around dermal blood vessels. These features are similar to those seen in skin treated with photodynamic therapy and systemic photosensitivity disorders such as the porphyrias. The wavelengths of light emitted by the surgical lights and oxygen probe overlap with the absorption spectrum of methylene blue. This resulted in excitation of the systemically administered methylene blue at exposed sites, with resultant local tissue damage and a phototoxic reaction.
