Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results.
Pyoderma vegetans (PV) or blastomycosis-like pyoderma (BLP) is a chronic inflammatory disease, by some authors considered a rare variety of pyoderma gangrenosum (PG), and others describe it as a distinct entity. It commonly presents with verrucous plaques with multiple pustules. The etiology of this disease is unknown, but it has been connected with staphylococcal and streptococcal infections, inflammatory bowel disease, hematological diseases, primary immunodeficiency, alcoholism, and nutritional deficit. Here we present a 66-year-old, otherwise healthy female, with a 2-year-long history of well-defined, vegetative livid plaques with multiple pustules on the dorsal side of both hands. Histopathological analysis of the skin biopsy of the hand showed chronic inflammation and microabscesses, ruptured follicular cysts and follicular pseudoepitheliomatous hyperplasia. Treatment with anti-tuberculosis drugs and antibiotics showed to be ineffective, as well as the treatment with systemic corticosteroids, dapsone and cyclosporine. Itraconazole was given for its immunomodulatory effects and findings of Penicillium species in one of the swabs, which led to partial regression of lesions. Since the treatment did not lead to complete resolution, acitretin was indicated 3 months later, but the patient was lost to follow-up.
Adverse drug reactions should be considered in patients with concomitant lung and liver disease. The mainstay of treatment is drug withdrawal and the use of immunosuppressive drugs in severe cases. Consideration should be given to monitor lung and liver function tests during long term nitrofurantoin therapy.
Background/Aim. We designed and conducted this study due to the fact that results of the previous studies about seroreactivity to low-molecular-weight Helicobacter pylori antigens, cytotoxin-associated gene A (CagA), vacuolating cytotoxin A (VacA) in patients with gastric cancer and peptic ulcer were conflicting. Methods. The Western blot test was performed in 123 patients, 31 with gastric cancer, 31 with duodenal ulcer, 31 with gastric ulcer, 30 with gastritis and functional dyspepsia in order to determine IgG antibodies to H. pylori antigens (CagA, VacA, Heat shock protein 60kDa, Urease B 66 kDa, Flagellin 55kDa, 50kDa, 30 kDa, Urease A 26 kDa, 24 kDa). In this study we analyzed: seroreactivity to H. pylori antigens between group with functional dyspepsia and others; between grades of different histopathological parameters of inflammation of antral and corporal mucosa and between antrum-predominant gastritis and corpus-predominant gastritis + pangastritis groups. Results. It was shown that seropositivity to 50 kDa antigen could be used as a biomarker for functional dyspepsia, seropositivity to 30 kDa antigen for antrum
Background/Aim. Although it is well-known the high sensitivity of brush cytology for the diagnosis of colorectal adenocarcinoma, this kind of diagnostics is not routinely used, and for the past years it has even been declining. The purpose of this study was to evaluate the value of brush cytology for the diagnosis of colorectal carcinoma, by comparison the results of brush cytology and biopsy, and then the results of both diagnostic methods with the final patohistological diagnosis of colorectal resection. Methods. This retrospective study included 173 patients with brush cytology of colorectal region during colonoscopy. In 166 patients concomitant biopsy specimens were obtained, and in 116 of them resection of the intestine as well. A total of the 106 patients underwent to all three diagnostic procedures. Results. Out of 166 patients who went through both brush cytology and biopsy, the congruent diagnosis was made in 129 (77.7%) patients: in 109 (65.7%) adenocarcinoma was diagnosed, which was confirmed after the resection of the intestine in 75 of the patients, and in 14 (8.4%) benign lesion, so there was no need for resection of the intestine. In 6 (3.6%) of the patients, both cytology and biopsy were negative, but the resected specimen was malignant. In 10 of the patients with malignant cytology in whom biopsy was not done, resection of the intestine confirmed malignancy. The sensitivity of detecting malignancy by brush cytology and biopsy were 87.9% and 78.3%, respectively (but this difference was not statistically significant, p = 0.083). Both methods had specificity and positive predictive values 100%. Negative predictive values for cytology and biopsy were 50% and 37.8%, respectively. The accuracy of cytology and biopsy was 89.2% and 80.8%, respectively. The combination of the results of brush cytology and biopsy increased the sensitivity of preoperative diagnostics to 94.8% which was significantly higher than sensitivity of biopsy (p < 0.001), but not than sensitivity of cytology (p = 0.102). Conclusion. Brush cytology could be a routine method, along with biopsy, in the diagnosis of colorectal malignancy. Both methods have comparable both sensitivity and accuracy, and its combination increases sensitivity of preoperative diagnostics of colorectal adenocarcinoma, which gives opportunity to better estimation of further diagnostic and therapeutic approach.
Only by complete cyst removal, the definitive, accurate histopathological diagnosis and classification can be made.
Porokeratosis belongs to a group of disorders of keratinization that are characterized by the histopathological feature of the cornoid lamella, a column of tightly fitted parakeratotic cells. The etiology of porokeratosis is still unclear. Different variants of porokeratosis (PK) have been subsequently recognized, each with its own specific properties in terms of morphology, distribution and clinical course. Linear porokeratosis is one of the variants of porokeratosis, a rare disorder of keratinization that may develop into several epidermal malignancies, squamous cell carcinoma being the most frequent among all of them. Thus, a clinical surveillance for malignancy is an imperative. We present a case of a 54-year-old man with non-healing ulcer of the lower leg caused by squamous cell carcinoma arising on long-standing linear porokeratosis. The treatment included wide excision of tumor with the reconstruction of the area. Acitretin was prescribed for linear porokeratosis treatment. The follow-up of our patient so far has shown that he does not have new malignant lesions after surgical excision.
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