Cholesterol granuloma (CG) is a histologic description of foreign body giant cell formation toward cholesterol crystals. The majority of temporal bone CG is unilateral and most common in the petrous apex. Middle ear CG is usually the result of underlying ear diseases. Primary middle ear CG is very rare. Most reported CG has not been associated with familial hypercholesterolemia (FH). FH, an autosomal dominant disorder, manifests as high levels of serum cholesterol and low density lipoprotein (LDL) cholesterol. We report a rare case of FH and bilateral aggressive primary middle ear CG. This publication has been approved by the IRB, Hospital Alor Setar.
Most invasive fungal sinusitis occurs in immunocompromised adult patients. We present the case study of a 12-year-old boy diagnosed with acute myeloblastic leukemia undergoing chemotherapy. He developed a progressive darkening discoloration over the dorsum of the nose that turned into an eschar. Nasal endoscopy revealed extensive necrotic tissue in the nasal cavity mucosa, inferior and middle turbinates, and septal cartilage that extended to the eschar of the skin over the nasal dorsum. Histopathology showed aspergillus invasive fungal rhinosinusitis.
Congenital bilateral dacryocystocele with concomitant congenital nasal pyriform aperture stenosis is a very rare case we seen in the paediatric age group. We report a case referred by the paediatric department to rule out choanal stenosis. The referring department had difficulty to insert a feeding tube to the patient. Nose and throat examination showed reduce misting on cold spatula test and unable to introduce nasoendoscope into both nostrils, which indicates obstruction. Radiological investigation revealed as congenital dacryocystocele with nasal pyriform aperture stenosis. The patient was managed surgically with good recovery.
CHs in patients under the age of 20 years are different from those of adults in origin and clinical characteristics. 1,3 The incidence of CHs in the paediatric age group is higher between 0-2 and 13-16 years. In paediatric patients, CH symptoms in the CNS are mainly present as haemorrhage, seizure or focal neurological deficits. Symptomatic CH is characterised by recurrent haemorrhages with step-wise occurrence of focal neurological deficits because of the cumulative effects of haemorrhages. Seizure is likely the outcome of the interaction among several epileptogenic factors 1 : (i) the cortical site; (ii) the frequent presence of calcification within the surrounding parenchyma, which is marked by gliosis; and (iii) the accumulation of ironcontaining substances produced by silent micro-haemorrhage or by diffusion of pigment derived from the destruction of sequestered erythrocytes. In our case, head enlargement was a unique symptom, which had lasted for 4 years. Kim et al. 4 classified the lesions of intracranial CHs into four types based on MRI signal as a combination of mixed high and low T1 and T2 signals with a surrounding haemosiderin rim-like target. Type I lesions exhibit a hyper-intense core on T1-and T2-weighted MRI and indicate the presence of subacute haemorrhage. Type II lesions are characterised pathologically by loculated areas of Fig. 1 Sagittal gadolinium-enhanced T1-weighted magnetic resonance image demonstrating a giant, intense, enhancing, heterogeneous mass in the left parasellar region, and left frontal and temporal lobe atrophy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.