RESUMO
Kimura's disease, which occurs endemically in the Far East and sporadically in the West, has so far eluded efforts to determine its exact pathogenesis. It presents as solitary or multiple benign swellings of the skin, has a predilection for the periauricular and scalp regions, and often is associated with regional lymphadenopathy. Morphologically, the lesions are characterized by proliferating blood vessels with rich eosinophilic infiltrate. Peripheral blood eosinophilia and raised serum IgE levels are signature features of the condition. The overall prognosis is good. When surgery is not possible, conservative treatment with either corticosteroids or radiation often can produce a favorable response. Complete surgical excision whenever feasible is the preferred treatment despite a high recurrence rate. Based on a recent case of Kimura's disease in a 55-year-old black woman, we discuss the pitfalls in the diagnosis of this chronic inflammatory disorder.
Assuntos
Hiperplasia Angiolinfoide com Eosinofilia/patologia , Hiperplasia Angiolinfoide com Eosinofilia/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Couro Cabeludo/patologiaRESUMO
Even in this age of effective medical treatment for peptic ulcers, their complications remain the same. Many require prompt surgical intervention. We present an unusual case of postbulbar duodenal ulcer complicated by intramural perforation and abscess formation. Such complications have a high mortality rate because of frequent delays in diagnosis and treatment caused by a lack of peritoneal signs or other specific clinical findings.
Assuntos
Abscesso/etiologia , Candidíase/etiologia , Duodenopatias/etiologia , Úlcera Duodenal/complicações , Úlcera Péptica Perfurada/complicações , Infecções por Acinetobacter/etiologia , Adulto , Doença Crônica , Esofagite/etiologia , Gastrite/etiologia , Humanos , Masculino , Pancreatite/etiologiaRESUMO
Sarcoidosis is an uncommon disorder characterized by a multi-systemic granulomatous disease of undetermined etiology and pathogenesis. The diagnosis is established by the presence of a compatible clinical illness and by histologic demonstration of noncaseating epithelioid cell granulomas in the affected organs. Accurate diagnosis requires a thorough evaluation to exclude infectious and neoplastic diseases that can mimic sarcoidosis. Although all organs and systems can be affected, the lungs and intrathoracic lymph glands are the most common sites of involvement. We describe an unusual case of extrapulmonary sarcoidosis presenting as obstructive jaundice.
