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Case Studies
Primary Necrobiotic Xanthogranulomatous Sialadenitis with Submandibular Gland Localization without Skin Involvement
Myunghee Kang, Na Rae Kim, Dong Hae Chung, Jae Yeon Seok, Dong Young Kim
J Pathol Transl Med. 2019;53(4):261-265.   Published online January 16, 2019
DOI: https://doi.org/10.4132/jptm.2019.01.08
  • 5,663 View
  • 158 Download
  • 1 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Necrobiotic xanthogranulomatous reaction is a multiorgan, non-Langerhans cell histiocytosis with an unknown etiology. Occurrence in the salivary gland is extremely rare. We recently identified a case of necrobiotic xanthogranulomatous sialadenitis in a 73-year-old Korean woman who presented with a painless palpable lesion in the chin. There was no accompanying cutaneous lesion. Partial resection and subsequent wide excision with neck dissection were performed. Pathological examination showed a severe inflammatory lesion that included foamy macrophages centrally admixed with neutrophils, eosinophils, lymphocytes, plasma cells, and scattered giant cells, as well as necrobiosis. During the 12-month postoperative period, no grossly remarkable change in size was noted. Necrobiotic xanthogranulomatous inflammation may be preceded by or combined with hematologic malignancy. Although rare, clinicians and radiologists should be aware that an adhesive necrobiotic xanthogranuloma in the salivary gland may present with a mass-like lesion. Further evaluation for hematologic disease and close follow-up are needed when a pathologic diagnosis is made.

Citations

Citations to this article as recorded by  
  • Five Cases of Xanthogranulomatous Sialadenitis
    Satoshi Kiyama, Hiroyuki Iuchi, Kotoko Ito, Kengo Nishimoto, Tsutomu Matsuzaki, Masaru Yamashita
    Practica Oto-Rhino-Laryngologica.2022; 115(4): 315.     CrossRef
  • Xanthogranulomatous change in a pleomorphic adenoma: An extremely rare variant/degenerative change. Is it fine needle aspiration induced?
    Mukta Pujani, Dipti Sidam, Kanika Singh, Aparna Khandelwal, Khushbu Katarya
    Diagnostic Cytopathology.2021;[Epub]     CrossRef
  • A Case of Xanthogranulomatous Sialadenitis with Facial Palsy Mimicking Malignancy
    Sang Hyun Kim, Sun Woo Kim, Sang Hyuk Lee
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2021; 64(6): 422.     CrossRef
  • Xanthogranulomatous Sialadenitis, an Uncommon Reactive Change is Often Associated with Warthin’s Tumor
    Lihong Bu, Hui Zhu, Emilian Racila, Sobia Khaja, David Hamlar, Faqian Li
    Head and Neck Pathology.2020; 14(2): 525.     CrossRef
  • A Case of Xanthogranulomatous Sialadenitis of the Sublingual Gland:A Review of Literature
    Naoya KITAMURA, Seiji OHNO, Tetsuya YAMAMOTO
    Journal of Japanese Society of Oral Medicine.2019; 25(1): 20.     CrossRef
Bile Granuloma Mimicking Peritoneal Seeding: A Case Report
Hasong Jeong, Hye Won Lee, Hye Ra Jung, Ilseon Hwang, Sun Young Kwon, Yu Na Kang, Sang Pyo Kim, Misun Choe
J Pathol Transl Med. 2018;52(5):339-343.   Published online July 16, 2018
DOI: https://doi.org/10.4132/jptm.2018.06.02
  • 5,488 View
  • 99 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Laparoscopic cholecystectomy is a widely used treatment method for most cholelithiasis and is a relatively safe procedure. Foreign body granulomatous reaction to bile or gallstone spillage during laparoscopic cholecystectomy has rarely been reported. We report a case of bile granuloma after laparoscopic cholecystectomy, which mimicked peritoneal seeding. A 59-year-old Korean man presented with right upper quadrant pain. He underwent laparoscopic cholecystectomy for acute cholecystitis with cholelithiasis. Pathologic examination revealed an incidental adenocarcinoma invading the lamina propria with acute cholecystitis and cholelithiasis. After 3 months, follow-up abdominal computed tomography revealed a subhepatic nodule, which showed hypermetabolism on positron emission tomography–computed tomography. Suspecting localized peritoneal seeding, wedge resection of the liver, wedge resection of the transverse colon, and omentectomy were performed. Pathologic examination of the resected specimens revealed multiple bile granulomas. Awareness of bile granuloma mimicking malignancy is noteworthy for patient management to reduce unnecessary procedure during postoperative surveillance.

Citations

Citations to this article as recorded by  
  • A mimic of peritoneal metastatic disease, multifocal intraabdominal foreign body granulomas secondary to feculent peritonitis
    Damien Gibson, Christo Joseph, Diarmid P. Foulis, Christophe R. Berney
    ANZ Journal of Surgery.2024;[Epub]     CrossRef
  • Practices and Attitudes of Surgeons With Regard to Spilled Gallstones During Laparoscopic Cholecystectomy: A Cross-Sectional Study From Saudi Arabia
    Mohammed Alfehaid, Moath Aljohani, Sajad A Salati , Shoug Alaodah, Wejdan Alresheedi, Raghad Almarshud
    Cureus.2024;[Epub]     CrossRef
  • Spilled gallstone mimicking intra-abdominal seeding of gallbladder adenocarcinoma: A case report
    Cheng-Ken Huang, Ruey-Hwa Lu, Chien-Cheng Chen, Po-Chun Chen, Wen-Chang Hsu, Meng-Jui Tsai, Chin-Tsung Ting
    World Journal of Gastrointestinal Surgery.2024; 16(2): 622.     CrossRef
  • Biliary Granulomatous Peritoneal Reaction as Consequence of Cholecystectomy: Case Report and Literature Review
    Giuseppe Tarantino, Denise Menghini, Maria Eva Argenziano, Miriam Palmieri, Alessandra Mandolesi, Enrico Dalla Bona, Antonio Benedetti, Mario Guerrieri, Maria Giovanna Danieli
    SN Comprehensive Clinical Medicine.2023;[Epub]     CrossRef
  • Foreign body reaction mimicking local recurrence from polyactide adhesion barrier film after laparoscopic colorectal cancer surgery
    Tien-Chan Hsieh, Chao-Wen Hsu
    Medicine.2022; 101(5): e28692.     CrossRef
  • Spilled gallstones after laparoscopic cholecystectomy: a systematic review
    Sajad Ahmad Salati, Mohammed Alfehaid, Saleh Alsuwaydani, Lamees AlSulaim
    Polish Journal of Surgery.2022; 94(4): 1.     CrossRef
  • Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation: A case report
    Shinpei Ogino, Tatsuya Matsumoto, Yosuke Kamada, Noriaki Koizumi, Hiroshi Fujiki, Kenji Nakamura, Takeshi Yamano, Chouhei Sakakura
    World Journal of Clinical Oncology.2021; 12(11): 1083.     CrossRef
Clear Cell Renal Cell Carcinoma with Intratumoral Granulomatous Reaction: A Case Report and Review of the Literature
Hayeon Kim, Jong Wook Kim, Aeree Kim, Hyeyoon Chang
J Pathol Transl Med. 2017;51(3):325-328.   Published online March 14, 2017
DOI: https://doi.org/10.4132/jptm.2016.09.08
  • 7,851 View
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AbstractAbstract PDF
Granulomatous reaction associated with clear cell renal cell carcinoma (CCRCC) is a rare finding, and only a few cases have been described in the literature. It is postulated to occur due to cancer- related antigenic factors such as cancer cells themselves or soluble tumor antigens shed into the blood. Herein, we describe a case of a 56-year-old male patient diagnosed with CCRCC with intratumoral granulomatous inflammation.
IgG4-Related Disease Presented as a Mural Mass in the Stomach
Chang Gok Woo, Jeong Hwan Yook, Ah Young Kim, Jihun Kim
J Pathol Transl Med. 2016;50(1):67-70.   Published online September 30, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.28
  • 8,104 View
  • 84 Download
  • 21 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Isolated gastric IgG4-related disease (IgG4-RD) is a very rare tumefactive inflammatory condition, with only a few cases reported to date. A 48-year-old woman was incidentally found to have a subepithelial tumor in the stomach. Given a presumptive diagnosis of gastrointestinal stromal tumor or neuroendocrine tumor, she underwent wedge resection. The lesion was vaguely nodular and mainly involved the submucosa and proper muscle layer. Microscopically, all classical features of type I autoimmune pancreatitis including lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and numerous IgG4-positive plasma cells were seen. She had no evidence of IgG4-RD in other organs. Although very rare, IgG4-RD should be considered one of the differential diagnoses in the setting of gastric wall thickening or subepithelial mass-like lesion. Deep biopsy with awareness of this entity might avoid unnecessary surgical intervention.

Citations

Citations to this article as recorded by  
  • Value of High‐Frequency Ultrasonography in the Qualitative and Semi‐Quantitative Assessment of Immunoglobulin G4‐Related Submandibular Sialadenitis
    Lei Chen, Lin Nong, Jumei Liu, Luzeng Chen, Yuhong Shao, Xiuming Sun
    Journal of Ultrasound in Medicine.2023; 42(10): 2235.     CrossRef
  • IgG4-related pseudotumours: a series of 12 cases and a review of the literature
    Andrea Maccagno, Bianca Grosser, László Füzesi, Björn Konukiewitz, Dmytro Vlasenko, Dorothea Weckermann, Stephan Raab, Johannes Zenk, Abbas Agaimy, Bruno Märkl
    Pathology.2022; 54(5): 563.     CrossRef
  • IgG4-Related Disease With Gastrointestinal Involvement: Case Reports and Literature Review
    Xinhe Zhang, Xing Jin, Lin Guan, Xuyong Lin, Xuedan Li, Yiling Li
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review
    Haruki Sawada, Torrey Czech, Krixie Silangcruz, Landon Kozai, Adham Obeidat, Eric Andrew Wien, Midori Filiz Nishimura, Asami Nishikori, Yasuharu Sato, Yoshito Nishimura
    Journal of Gastroenterology and Hepatology.2022; 37(10): 1865.     CrossRef
  • Utility of gastric biopsy in diagnosing IgG4‐related gastrointestinal disease
    Kaori Uchino, Kenji Notohara, Takeshi Uehara, Yasuhiro Kuraishi, Junya Itakura, Akihiro Matsukawa
    Pathology International.2021; 71(2): 124.     CrossRef
  • A reappraisal of sclerosing nodular and/or polypoid lesions of the gastrointestinal tract rich in IgG4‐positive plasma cells
    Runjan Chetty
    Histopathology.2020; 76(6): 832.     CrossRef
  • Gastric IgG4-related disease presenting as a mass lesion and masquerading as a gastrointestinal stromal tumor
    Banumathi Ramakrishna, Rohan Yewale, Kavita Vijayakumar, Patta Radhakrishna, Balakrishnan Siddartha Ramakrishna
    Journal of Pathology and Translational Medicine.2020; 54(3): 258.     CrossRef
  • IgG4-related Sclerosing Disease Forming a Gastric Submucosal Tumor Diagnosed after Laparoscopic Endoscopic Cooperative Surgery—Report of a Case—
    Tatsuki ISHIKAWA, Katsunori NAKANO, Masafumi OSAKA, Yayoi KADOTANI, Kaori OKUGAWA, Kiyokazu AKIOKA, Kenta SHIGEMORI, Yohei HOSOKAWA
    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2020; 81(2): 254.     CrossRef
  • Calcifying fibrous tumor of the gastrointestinal tract: A clinicopathologic review and update
    Donald Turbiville, Xu-Chen Zhang
    World Journal of Gastroenterology.2020; 26(37): 5597.     CrossRef
  • A Suspected Case of IgG4-Related Appendiceal Pseudotumor
    Yudai Hojo, Yoshiharu Shirakata, Ai Izumi, Jun Matsui, Tokuyuki Yamashita, Hikaru Aoki, Makoto Kurimoto, Masaaki Hirata, Naoki Goda, Hiroaki Ito, Jun Tamura
    The Japanese Journal of Gastroenterological Surgery.2020; 53(12): 976.     CrossRef
  • Immunoglobulin G4-related gastric pseudotumor – An impostor: Case report
    Manuel Santiago Mosquera, Andrea Suarez Gómez, Hugo Herrera, Karen Moreno-Medina, Alejandro González-Orozco, Carlos J-Perez Rivera
    International Journal of Surgery Case Reports.2020; 75: 333.     CrossRef
  • Imaging and pathological features of gastric lesion of immunoglobulin G4-related disease: A case report and review of the recent literature
    Dai Inoue, Norihide Yoneda, Kotaro Yoshida, Hiromi Nuka, Jun Kinoshita, Sachio Fushida, Fumihito Toshima, Tetsuya Minami, Masayuki Takahira, Shoko Hamaoka, Hiroko Ikeda, Toshifumi Gabata, Mitsuhiro Kawano
    Modern Rheumatology.2019; 29(2): 377.     CrossRef
  • Immunoglobulin G4-Related Gastric Ulcer Mimicking Advanced Stomach Cancer in a Patient with Type I Autoimmune Pancreatitis
    Joung Ha Park, Jin Hee Noh, Jang ho Lee, Goeun Lee, Seung-Mo Hong, Kwang Bum Cho, Myung-Hwan Kim
    The Korean Journal of Medicine.2019; 94(3): 287.     CrossRef
  • Review of IgG4-related disease
    Raquel Sánchez-Oro, Elsa María Alonso-Muñoz, Lidia Martí Romero
    Gastroenterología y Hepatología (English Edition).2019; 42(10): 638.     CrossRef
  • Revisión de la enfermedad relacionada con la IgG4
    Raquel Sánchez-Oro, Elsa María Alonso-Muñoz, Lidia Martí Romero
    Gastroenterología y Hepatología.2019; 42(10): 638.     CrossRef
  • Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey
    Kenji Notohara, Terumi Kamisawa, Kazushige Uchida, Yoh Zen, Mitsuhiro Kawano, Satomi Kasashima, Yasuharu Sato, Masahiro Shiokawa, Takeshi Uehara, Hajime Yoshifuji, Hiroko Hayashi, Koichi Inoue, Keisuke Iwasaki, Hiroo Kawano, Hiroyuki Matsubayashi, Yukitos
    Journal of Gastroenterology.2018; 53(7): 845.     CrossRef
  • IgG4-Related Disease Mimicking Crohn’s Disease: A Case Report and Review of Literature
    Fabiana Ciccone, Antonio Ciccone, Mirko Di Ruscio, Filippo Vernia, Gianluca Cipolloni, Gino Coletti, Giuseppe Calvisi, Giuseppe Frieri, Giovanni Latella
    Digestive Diseases and Sciences.2018; 63(4): 1072.     CrossRef
  • IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature
    Ho Seok Seo, Yoon Ju Jung, Cho Hyun Park, Kyo Young Song, Eun Sun Jung
    Journal of Gastric Cancer.2018; 18(1): 99.     CrossRef
  • Multivisceral IgG4-related disease presenting as recurrent massive gastrointestinal bleeding: a case report and literature review
    Xuexue Deng, Ronghua Fang, Jianshu Zhang, Rongqiong Li
    BMC Gastroenterology.2018;[Epub]     CrossRef
  • IgG4-Related Sclerosing Disease Presenting as a Gastric Submucosal Tumor
    Takashi Masuda, Toshifumi Matsumoto, Yushi Kaishakuji, Hirotada Tajiri, Akinori Egashira, Hirofumi Kawanaka
    The Japanese Journal of Gastroenterological Surgery.2018; 51(10): 599.     CrossRef
  • A rare case of IgG4-related disease: a gastric mass, associated with regional lymphadenopathy
    Dimitar Bulanov, Elena Arabadzhieva, Sasho Bonev, Atanas Yonkov, Diana Kyoseva, Tihomir Dikov, Violeta Dimitrova
    BMC Surgery.2016;[Epub]     CrossRef
Paediatric Primary Pachymeningeal Xanthogranuloma with Scattered Foci Displaying Reticulohistiocytoma-like Features
Miguel Fdo. Salazar, María del Rocío Estrada Hernández, Erick Gómez Apo, Laura G. Chávez Macías, Carlos Alfonso Rodríguez Álvarez
J Pathol Transl Med. 2015;49(5):403-408.   Published online June 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.28
  • 8,069 View
  • 44 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a unique case of a 4-year-old girl with an intriguing fibrohistiocytic tumour. Magnetic resonance imaging scans showed a dural mass of variegated intensity compressing the left occipital pole and apparently extending toward the superior sagittal sinus. Grossly, the cut surface of the surgical specimen was yellow, pale, and soft with reddish kernel-like crusts. Histologically, the yellow areas resembled cholesterol granulomas with widespread coagulative necrosis, cholesterol clefts, powdery calcification, foreign body-type giant cells, and foamy macrophages, while the scattered red spots contained numerous multinucleated giant cells of foreign-body and Touton types, the former with amphophilic to slightly eosinophilic cytoplasm. Immunoperoxidase reactions confirmed the expression of histiocytic markers and vimentin. As far as we know, no tumour displaying these peculiar morphological features has yet been described.

Citations

Citations to this article as recorded by  
  • Reticulohistiocytoses: a revision of the full spectrum
    A. Bonometti, E. Berti
    Journal of the European Academy of Dermatology and Venereology.2020; 34(8): 1684.     CrossRef
Original Article
Clinicopathologic Features of Q Fever Patients with Acute Hepatitis
Miji Lee, Jae Jeong Jang, Yang Soo Kim, Sang-Oh Lee, Sang-Ho Choi, Sung-Han Kim, Eunsil Yu
Korean J Pathol. 2012;46(1):10-14.   Published online February 23, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.10
  • 8,412 View
  • 62 Download
  • 13 Crossref
AbstractAbstract PDF
Background

Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described.

Methods

Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests.

Results

All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure.

Conclusions

C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.

Citations

Citations to this article as recorded by  
  • (Seltene) infektiöse Hepatitiden als wichtige Differenzialdiagnose der unklaren Hepatopathie
    Michael Wührl, Marc Ringelhan, Ursula Ehmer, Jochen Schneider, Juliane Kager, Tobias Lahmer, Anna Schneider, Wilko Weichert, Carolin Mogler
    Die Pathologie.2023; 44(1): 53.     CrossRef
  • Sero-epidemiological study of zoonotic bacterial abortifacient agents in small ruminants
    Muhammad Abid Zeeshan, Sarmad Ali, Ishtiaq Ahmed, Aziz ur Rehman, Muhammad Kamran Rafique, Amar Nasir, Aman Ullah Khan, Muhammad Kashif, Katja Mertens-Scholz, Muhammad Imran Arshad, Syed Ehtisham-ul-Haque, Heinrich Neubauer
    Frontiers in Veterinary Science.2023;[Epub]     CrossRef
  • The First Case of Coxiella Burnetti Infection Detected Through Bone Marrow Biopsy in Vietnam
    Do Thi Vinh An, Bui Thi Viet Ha, Dao Xuan Co, Vu Minh Tam, Le Thi Diem Tuyet, Vu Van Truong
    Clinical Pathology.2022; 15: 2632010X2210963.     CrossRef
  • Pathological study and molecular detection of zoonotic diseases in small ruminants at slaughter houses in Mymensingh, Bangladesh
    Nazneen Sultana, Munmun Pervin, Sajeda Sultana, Mahmuda Islam, Moutuza Mostaree, Mohammad Abu Hadi Noor Ali Khan
    Veterinary World.2022; : 2119.     CrossRef
  • The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt
    Mohamed A. El-Mokhtar, Ibrahim M. Sayed, Ayat M. Kamel, Ahmed Atef Mesalam, Elsayed A. Elgohary, Khaled Abo bakr Khalaf, Sara Adel, Azza Abo Elfadl, Walaa A. Khalifa, Haidi Karam-Allah Ramadan
    Microorganisms.2022; 10(11): 2168.     CrossRef
  • A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies
    Zampaglione Lucia, Bornand Aurélie , Goossens Nicolas , Ramer Lucas , Magini Giulia , Ongaro Marie , Cerny Andreas , Rubbia-Brandt Laura , Jean-Louis Frossard, Spahr Laurent
    Annals of Clinical Gastroenterology and Hepatology.2022; 6(1): 034.     CrossRef
  • Q-fever associated granulomatous hepatitis
    Nicolas Dauby, Maria Gomez Galdon, Isabel Montesinos, Marjan Van Esbroeck, Thomas Sersté
    International Journal of Infectious Diseases.2020; 95: 113.     CrossRef
  • Pathologic changes and immune responses against Coxiella burnetii in mice following infection via non-invasive intratracheal inoculation
    Xueyuan Hu, Yonghui Yu, Junxia Feng, Mengjiao Fu, Lupeng Dai, Zhiyu Lu, Wenbo Luo, Jinglin Wang, Dongsheng Zhou, Xiaolu Xiong, Bohai Wen, Baohua Zhao, Jun Jiao, Daniel E. Voth
    PLOS ONE.2019; 14(12): e0225671.     CrossRef
  • Fibrin Ring Granulomas in Checkpoint Inhibitor-induced Hepatitis
    Jamie Everett, Amitabh Srivastava, Joseph Misdraji
    American Journal of Surgical Pathology.2017; 41(1): 134.     CrossRef
  • Clinical and Genetic Features ofCoxiella burnetiiin a Patient with an Acute Febrile Illness in Korea
    Seung Hun Lee, Jung Yeon Heo, Hae Kyung Lee, Yeong Seon Lee, Hye Won Jeong, Seon Do Hwang
    Journal of Korean Medical Science.2017; 32(6): 1038.     CrossRef
  • Q Fever Presented as a Large Retroperitoneal Pseudotumoral Mass
    Behdokht Nowroozizadeh, Negar Haghighi Mehmandari, Nicolas Gallegos, Mari Perez-Rosendahl, Di Lu
    Case Reports in Pathology.2017; 2017: 1.     CrossRef
  • From Q Fever to Coxiella burnetii Infection: a Paradigm Change
    Carole Eldin, Cléa Mélenotte, Oleg Mediannikov, Eric Ghigo, Matthieu Million, Sophie Edouard, Jean-Louis Mege, Max Maurin, Didier Raoult
    Clinical Microbiology Reviews.2017; 30(1): 115.     CrossRef
  • Prolonged Pyrexia and Hepatitis: Q fever
    Caitlin Dugdale, Brian Chow, Evgeny Yakirevich, Erna Kojic, Bettina Knoll
    The American Journal of Medicine.2014; 127(10): 928.     CrossRef
Case Report
Brucella Prostatitis: A First Case Report Diagnosed in Korea.
Seong Yeol Ryu, Hyun Ah Kim, Jiyoung Park, Misun Choe, Kunyoung Kwon
Korean J Pathol. 2011;45:S66-S69.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S66
  • 3,306 View
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  • 2 Crossref
AbstractAbstract PDF
Brucellosis is a zoonosis caused by several species of Brucella. Brucellosis is usually an acute or sub-acute febrile illness that histologically develops granulomatous inflammation. Brucella prostatitis is a very rare complication and is usually accompanied by epididymo-orchitis. We now report a case of histologically proven granulomatous prostatitis due to Brucella without clinical evidence of epididymo-orchitis. A 61-year-old farmer presented with myalgia, low back pain, and fever. A needle biopsy of the prostate was performed due to symptoms of urinary frequency and high prostate specific antigen levels (17.3 ng/mL). Histologically, the prostate showed granulomatous inflammation without caseous necrosis. Polymerase chain reaction (PCR) studies of blood and prostatic tissue for Brucella were positive, while a PCR study for Mycobacterium tuberculosis was negative. The patient was treated with doxycycline and rifampin. A possibility of Brucella prostatitis should be considered in the differential diagnosis of granulomatous prostatitis or prostatitis of unknown origin associated with or without epididymo-orchitis.

Citations

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  • An Imported Case of Brucella melitensis Infection in South Korea
    Jee Young Lee, Yongduk Jeon, Mi Young Ahn, Hea Won Ann, In Young Jung, Wooyong Jung, Moo Hyun Kim, Jin Young Ahn, Je Eun Song, Yong Chan Kim, Dong Hyun Oh, Eun Jin Kim, Su Jin Jeong, Nam Su Ku, Hyunsoo Kim, Kyungwon Lee, June Myung Kim, Jun Yong Choi
    Infection & Chemotherapy.2018; 50(2): 149.     CrossRef
  • Brucellosis Prostatitis: A Neglected Diagnosis for a Tropical Disease
    Jing Liu, Bhavika Kaul, Andrea Shioleno, Niraj Mehta, Rojelio Mejia
    Current Tropical Medicine Reports.2016; 3(4): 181.     CrossRef
Original Article
Comparison of Various Detection Methods of Mycobacterium Species in Formalin-Fixed Paraffin-Embedded Tissue with Chronic Granulomatous Inflammation.
Hyun Seung Lee, Hyoungnam Lee, Soyoung Im, Yun Su Lee, Kyo Young Lee, Yeong Jin Choi
Korean J Pathol. 2010;44(3):259-266.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.259
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AbstractAbstract PDF
BACKGROUND
To determine the most effective method for detecting mycobacteria in formalin- fixed paraffin-embedded (FFPE) tissue, we compared the results of Ziehl-Neelsen stain (ZNS) and mycobacterial culture with those of polymerase chain reaction (PCR) and real-time quantitative PCR (RQ-PCR).
METHODS
We analyzed 54 cases diagnosed as chronic granulomatous inflammation. In all cases, ZNS and nested PCR using three different primers, IS6110, Mpb64 and IS6110/Rpobeta were done. RQ-PCR with the IS6110/Rpobeta primer was done in 51 cases.
RESULTS
Mycobacteria were identified by ZNS in 15/54 (27.8%) cases. RQ-PCR had the highest sensitivity (80.0%) compared to PCR with IS6110 (73.3%), Mpb64 (60.0%) and IS6110/Rpobeta (73.3%). Specificity was higher in all PCR experiments (79.5-82.1%) than in RQ-PCR (69.4%) experiments. The false negative rate was lowest for RQ-PCR (20.0%) than for PCR with IS6110 (26.7%), Mpb64 (40.0%) and IS6110/Rpobeta (26.7%). The false positive rate was highest for RQ-PCR (30.6%) compared to PCR with IS6110 (20.5%), Mpb64 (17.9%) and IS6110/Rpobeta (20.5%).
CONCLUSIONS
RQ-PCR had the highest sensitivity, and the lowest false negative rate, but it also had a higher false positive rate than PCR for detection of mycobacteria in FFPE tissues.

Citations

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  • Clinical Usefulness of PCR for Differential Diagnosis of Tuberculosis and Nontuberculous Mycobacterial Infection in Paraffin-Embedded Lung Tissues
    Yo Na Kim, Kyoung Min Kim, Ha Na Choi, Ju Hyung Lee, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Myoung Ja Chung
    The Journal of Molecular Diagnostics.2015; 17(5): 597.     CrossRef
  • Usefulness of PCR to Mycobacterium Tuberculous and Nontuberculous Mycobacteria from Paraffin-embedded Tissues
    Yeon-Il Choi, Hye-Young Kim
    Korean Journal of Clinical Laboratory Science.2014; 46(2): 47.     CrossRef
Case Reports
Granulomatous Mycosis Fungoides: A case report.
Kyung Sin Lee, Young Oak Kim, Kee Suck Suh, Sang Tae Kim, Man Ha Huh
Korean J Pathol. 1995;29(5):694-697.
  • 1,416 View
  • 10 Download
AbstractAbstract
Granulomatous mycosis fungoides is an extremely rare and unusual histologic variant of mycosis fungoides. This form is clinically characterized by spontaneous resolution of ulcerated nodular lesions into poikiloderma. Histologically, a strong granulomatous component can obscure the underlying cutaneous lymphoma, which is frequently mistaken for non-neoplastic dermatitides or cutaneous sarcoidosis. We report a case of granulomatous mycosis fungoides occurring on the left cheek of 34-year-old man confirmed histologically with an aid of immunohistochemistry and clinical course (immediate response to PROMACE-CYTOBAM chemotherapy), with emphasis on differential diagnosis, along with a review of literature. This is the first documented report in the Korean literature.
Granulomatous(Lobular) Mastitis in a Pregnant Woman: A case report.
Kyu Rae Kim, Hee Sung Kim, Yeon Lim Suh, Jung Hyun Yang, Howe Jung Ree
Korean J Pathol. 1996;30(3):261-265.
  • 2,019 View
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AbstractAbstract PDF
Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Original Article
Histopathological Differences between Silicone Granuloma and Paraffinoma.
Yeon Mee Kim, Hye Kyung Lee, Hye Je Cho, Je Geun Cho
Korean J Pathol. 1996;30(5):427-436.
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During the past two decades, silicone (polydimethylsiloxane) has become one of the most extensively applied biomaterials. Although pure silicone is relatively inert and usually causes only minimal tissue reactions, it has been reported to evoke a definite foreign body reaction. We studied five cases of silicone-induced granulomas in various sites; two in the breast, one in the breast and axillary lymph nodes, one in the subcutis of the abdomen, back and extremities and one in the eyeball, to illustrate the salient histopathologic features of reactions to silicone with particular emphasis to its differences from paraffin granuloma. For this, 17 paraffinomas were also studied. Tissue reaction to silicone liquid and gel was characterized by numerous round to oval empty cystic vacuoles, mild to moderate fat necrosis, foreign body reaction, a variable degree of mononuclear inflammatory cell infiltration and mild focal fibrosis. The cystic spaces were relatively uniform and showed a snow-man like appearance. In contrast to the silicone granulomas, the paraffinomas, also refered to as sclerosing lipogranulomas showed diffuse sclerosis and frequent calcification around the cystic vacuoles. The cystic spaces in paraffinomas were swiss cheese-like configuration, and the content of the cystic spaces was dirty and frequently calcified. However, there were certain similarities between these two types of granulomas particularly in the early phases of the reaction, therefore, the history of silicone injection or implant, is sometimes critical to the diagnosis of silicone granuloma. Despite great technologic advances in the manufacturing of prostheses and medical equipment, droplets and/or particles of silicone still escape into the body tissues in a variety of ways; therefores, the pathologist should always wonder whether the histologic reaction observed is due to silicone or to some other foreign material including paraffin.
Case Reports
Syphilitic Granulomatous Pancreatitis: A case report.
Seong Eun Yang, Yoon Ju Kim, Sung Suk Paeng, Duck Hwan Kim, Hee Jin Chang, Jung Il Suh
Korean J Pathol. 1996;30(8):721-725.
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Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Primary Necrotizing Granulomatous Vasculitis of the Stomach.
Myeong Cherl Kook, Sang Yong Song, Yong Il Kim, In Sung Song, Keun Wook Lee
Korean J Pathol. 1997;31(1):68-74.
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A 55-year-old woman suffered from upper abdominal pain for two months and remained refractile against the anti-ulcer regimen. The palliative gastrectomy specimen revealed multiple shallow ulcerations on the thickened mucosal folds mainly in the antrum and body along the greater curvature where multiple, whitish nodules were found in the submucosa. Microscopically, individual submucosal nodules clearly corresponded to the necrotizing granulomatous vasculitis which were featured with diffuse fibrinoid necrosis of arterial walls accompanying granuloma formation and heavy infiltration of neutrophils, eosinophils, histiocytes and giant cells. Similar vasculitic lesions involved venules and arterioles. There were scattered vasculitic changes in the liver biopsy specimens and omentum. There were no clinical presentations or serological support of systemic involvement including systemic lupus erythematosus, Henoch-Schoenlein purpura, cryoglobulinemia or Churg-Strauss granulomatous vasculitis. We conclude that this is a hitherto undescribed primary necrotizing granulomatous vasculitis predominantly involving the stomach.
Crohn's Disease Involving Small Intestine and Colon: 2 cases report.
Shi Nae Lee, Sun Hee Chang, Hee Soo Yoon, Hea Soo Koo, Ok Kyung Kim, Ryung Ah Lee, Eung Beum Park
Korean J Pathol. 1997;31(4):379-382.
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Crohn's disease was originally described as a small bowel disorder and has been known to involve the large bowel in approximately 40% of all cases with or without concomitant ileal component. We describe two cases of Crohn's diseas of small intestine and colon with a summary of differential diagnosis with ulcerative colitis. Both cases were originally diagnosed and treated as ileal tuberculosis. Grossly, there were skip lesions in both cases with prominent pseudopolyps and ulcerations in colon. Also noted were typical serpentine lesions in ileum as well as in colon. Microscopically, transmural inflammation was confirmed and one case showed scattered noncaseating granulomas in the wall. Submucosal edema and fibrosis with thickening of the wall was not prominent in colon. Polymerase chain reaction performed on paraffin block for the demonstration of Mycobacterium tuberculosis in one case showed negative reaction.
Granulomatous Inflammation of Hand following Sea Urchin Sting: 2 cases report.
Jung Ran Kim, Dong Hoon Kim, Tae Jung Jang, Jong Im Lee, Hyun Sul Lim, Hyeon Kyeong Lee, Sung Han Bae
Korean J Pathol. 1998;32(1):68-71.
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Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.

J Pathol Transl Med : Journal of Pathology and Translational Medicine