Appearance Of Nodules Research Articles

Clinical and dermoscopic correlation of reactive perforating collagenosis

The acquired perforating dermatosis is constituted by a group of diseases whose main characteristic is the transepithelial elimination of altered dermal material. It has the clinical appearance of crateriform papules or nodules, with central keratotic plug, which may suggest some kind of transepithelial purging; nevertheless the final diagnosis is histologic. The dermoscopic examination is a useful tool that helps to exclude similar dermatoses, such as nodular prurigo and hypertrophic lichen planus. The present article discusses the clinical and dermoscopic correlation of this dermatosis.

Surface Microstructure of Nanoaluminized CoCrAlY Coating Irradiated by HCPEB

A thermal sprayed CoCrAlY coating was prepared by air plasma spray on the surface of Ni-based superalloy GH4169; then, a nanoscale aluminum film was deposited with electron beam vacuum deposition on it. The coatings irradiated by high-current pulsed electron beam were investigated. After HCPEB treatment, the Al film was remelted into the bond coat. XRD result shows that Al and Al2O3phase were recorded in the irradiated and aluminized coatings, while Co-based oxides which originally existed in the initial samples disappeared. Microstructure observations reveal that the original coating with porosity, cavities, and inclusions was significantly changed after HCPEB treatment as compact appearance of interconnected bulged nodules. Moreover, the grains on the irradiated coating were very refined and homogeneously dispersed on the surface, which could effectively inhibit the corrosive gases and improve the coating oxidation resistance.

Laryngeal involvement with fatal outcome in progressive nodular histiocytosis: A rare case report

Progressive nodular histiocytosis (PNH) represents a very rare type of non-Langerhans cell histiocytosis. It is characterized by progressive appearance of papules and nodules without spontaneous resolution. We report a 60-year-old patient with novel clinical features in the form of extensive noduloulcerative lesions, ichthyotic patches, and laryngeal involvement culminating in fatal outcome prior to therapeutic intervention. Although the presenting features were baffling, histopathology and immunohistochemistry clinched the diagnosis of PNH.

Redox system of the bottom sediments of the western Kara Sea

The geochemical characteristics of bottom sediments from the western Kara Sea, including the estuary of the Ob River and regions outside the zone strongly affected by the river discharge (west of the Yamal Peninsula, Novaya Zemlya Trough, and St. Anna Trough) were considered in the context of reduction–oxidation (redox) processes in seawater, bottom sediments, and pore water. The content of organic matter controls the mechanism and scale of diagenesis, which results in the redistribution of Mn, Fe, and other elements along the sedimentary profile forming redox stratification in the regions of interest. The most significant manifestation of diagenesis in the bottom sediments is the dissolution of reactive Mn and Fe compounds, diffusion in pore water, and formation of an oxidized surface layer varying in thickness from one millimeter to 0.5 m. The appearance of ferromanganese nodules was observed in the oxidized sediments. An ochre-colored oxidized layer often observed in the sedimentary sequence was formed owing to oxygen input by benthic organisms and horizontal water inflow along aquifers connected to the surface or represents a rudimentary unit resulting from nonuniform sedimentation in the past periods. Most of the Kara Sea sediments are reduced and contain iron sulfides, which give gray and black colors to the sediments, and methane, often in cavities. Even the Kara Sea regions farthest from the Ob and Yenisei estuaries exhibit the influence of river discharge on the lithological properties of sediments, OM supply, and biological production. The geological transect from the mouth of the Ob River to the St. Anna Trough is characterized by a zoning typical of the river–sea mixing region in the south and relatively isolated conditions in the north.

Apoptosis in Hemocytes Induces a Shift in Effector Mechanisms in the Drosophila Immune System and Leads to a Pro-Inflammatory State.

Apart from their role in cellular immunity via phagocytosis and encapsulation, Drosophila hemocytes release soluble factors such as antimicrobial peptides, and cytokines to induce humoral responses. In addition, they participate in coagulation and wounding, and in development. To assess their role during infection with entomopathogenic nematodes, we depleted plasmatocytes and crystal cells, the two classes of hemocytes present in naïve larvae by expressing proapoptotic proteins in order to produce hemocyte-free (Hml-apo, originally called Hemoless) larvae. Surprisingly, we found that Hml-apo larvae are still resistant to nematode infections. When further elucidating the immune status of Hml-apo larvae, we observe a shift in immune effector pathways including massive lamellocyte differentiation and induction of Toll- as well as repression of imd signaling. This leads to a pro-inflammatory state, characterized by the appearance of melanotic nodules in the hemolymph and to strong developmental defects including pupal lethality and leg defects in escapers. Further analysis suggests that most of the phenotypes we observe in Hml-apo larvae are alleviated by administration of antibiotics and by changing the food source indicating that they are mediated through the microbiota. Biochemical evidence identifies nitric oxide as a key phylogenetically conserved regulator in this process. Finally we show that the nitric oxide donor L-arginine similarly modifies the response against an early stage of tumor development in fly larvae.

Management of subsolid pulmonary nodules in CT lung cancer screening.

The distinct appearance and behavior of subsolid pulmonary nodules (SSNs) has resulted in separate recommendations for the management of solitary SSNs, both for incidentally detected as well as for screen detected nodules. However, these guidelines have been based primarily on expert opinion. Recently two studies were published regarding SSNs detected in low-dose computed tomography (LDCT) lung cancer screening, including management advices.

Lipoatrophie annulaire des chevilles traitée par autogreffe de tissu graisseux : à propos d’un cas et revue de la littérature

Annular lipoatrophy of the ankles is a rare disease. Eleven cases are described in the literature. We report the case of a 10-year-old girl having an annular lipoatrophy of the ankles. The clinical history begins with the appearance of inflammatory infiltrated nodules at the two legs, which have evolved in a few months to a circumferential lipoatrophy of the ankles. Laboratory studies showed a very high antistreptolysin O titer, concluding streptococcal origin of this hypodermitis. After two years of stable lesions, the patient received two sessions of fat injection. A satisfactory outcome of the adipocyte graft was observed with reconstitution of shapely legs, stable over time. Eleven cases described in the literature are found. It is a pediatric pathology seen predominantly in female children. The evolution towards lipoatrophy is systematic with or without treatment initiated at the inflammatory phase. We first discuss the management of aesthetic sequelae of this disease. Fat grafting appears to be a good indication for the treatment of the cosmetic sequelae seen in annular lipoatrophy of the ankles.

Gastric xanthalesmas: Report of five cases and review of the literature

Xanthalesmas are incidental lesions that are rarely encountered during upper gastrointestinal (GI) endoscopy. The most frequent location of xanthelasma in the upper GI tract is the stomach. The reported incidence of gastric xanthelasma is quite variable: it rangs from 0.018% to 0.8%. Upper GI xanthelasmas have a typical endoscopic appearance of yellow-white well-demarcated single or multiple nodules or plaques, with a size varying from 1 to 10 mm in diameter. Xanthelasmas are composed of large foamy cells containing lipids. In this report; five patients who attended hospital with nonspesific symptoms and xanthelasma-like lesions were incidentally found on their endoscopic examination.

Multiple cutaneous, oropharyngeal and pulmonary nodules

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis defined by heterogeneous multiorgan involvement. Due to the rarity of this disease strong evidence-based therapies have yet to be established and prognosis has previously been considered to be poor, with more than half of patients dying within 3years of initial presentation. We describe an 86-year-old woman with a 34-year history of extensive cutaneous and internal nodules with typical pathological and immunophenotypical (CD68(+) /CD1a(-) ) features of ECD without evidence of the BRAF V600E mutation. The cosmetic appearance of cutaneous nodules and hoarse voice caused by vocal cord nodules has been managed surgically. More aggressive therapies reported for ECD were trialled for this patient, such as radiotherapy and interferon-α, with no response. This case demonstrates a relatively good prognosis in ECD that has been managed conservatively.

Thyroid Nodules

Thyroid nodules frequently are encountered incidentally, and although thyroid nodules are common, the prevalence of thyroid malignancy is relatively low. Considerable overlap exists between the appearance of benign and malignant thyroid nodules. Also, the varying guidelines among scientific associations, regarding when biopsy of a thyroid nodule is recommended, create a growing diagnostic dilemma. The initial approach to differentiate benign from malignant thyroid nodules focused on pattern recognition with a recent shift to individual feature analysis by ultrasound. Ultimately, fine-needle aspiration is required for definitive diagnosis; however, it is unrealistic to biopsy every thyroid nodule. The objective of this article is to emphasize the use of both pattern recognition and individual feature analysis to appropriately select candidates for biopsy and follow-up with a goal of identifying clinically significant thyroid cancer and of avoiding unnecessary workup of benign thyroid nodules.

Mycosis Fungoides Involving the Lungs Detected by 18F-FDG PET/CT

A 72-year-old male patient with a history of cutaneous mycosis fungoides, in clinical remission after treatment, underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for restaging due to the recent appearance of lung nodules on CT. PET/CT images showed multiple areas of increased radiopharmaceutical uptake corresponding to several bilateral pulmonary nodules (Fig. 1A–C). Subsequently, the patient underwent pulmonary nodule biopsy. Histology showed the presence of interstitial infiltration of small to medium sized lymphoid elements with clear cytoplasm. On

Surgical results of strabismus correction in patients with myelomeningocele.

Myelomeningocele is one of the most common birth defects. It is associated with severe neurological deficiencies, and ocular changes, such as strabismus, are very common. The purpose of this study was to describe indications for strabismus surgery in patients with myelomeningocele and to evaluate the results achieved with surgical correction. We retrospectively reviewed records of all patients with myelomeningocele who underwent surgery for strabismus correction in a 5-year period in an institution for disabled children. The main indications for strabismus surgery were esotropia and A-pattern anisotropia. Excellent surgical results were achieved in 60.9% of patients, satisfactory in 12.2%, and unsatisfactory in 26.9%. Patients with myelomeningocele and strabismus had a high incidence of esotropia and A-pattern anisotropia. Strabismus surgery in these patients had an elevated percentage of excellent and satisfactory results, not only for the ocular deviation, but also for improvement of head posture.

Thyroid nodules in an 11-year DanThyr follow-up study.

Limited longitudinal data are available on changes in the thyroid gland structure in a population and how this is influenced by iodine fortification (IF). Our objective was to clarify how IF influenced thyroid gland structure in 2 regions with different iodine intake at baseline (Copenhagen, mild iodine deficiency [ID]; Aalborg, moderate ID). We conducted a longitudinal population-based study (DanThyr) where participants were examined before (1997) and after (2008) the Danish mandatory IF of salt (2000). We examined 2465 adults, and ultrasonography was performed by the same sonographers using the same equipment, after controlling performances. Change in thyroid gland structure was evaluated. The follow-up period saw an increased prevalence of multinodularity (9.8%-13.8 %, P < .001), especially in the previously moderate ID region of Aalborg (9.1%-15.4%, P < .001), whereas no change in prevalence was seen for solitary nodules (5.6%-5.1%, P = .34). In individual participants, changes in thyroid structure and disappearance of thyroid nodules during the 11 years was common with an overall normalization rate of 21.2 (95% confidence interval [CI] = 17.9-24.9) per 1000 person-years. Solitary nodules had a significantly higher normalization rate than multiple nodules (normalization rate ratio 0.47 [95% CI = 0.32-0.67]). A regional difference (Aalborg vs Copenhagen) was seen between normalization rates of multiple nodules (normalization rate ratio 0.29 [95% CI = 0.12-0.64]), but not for solitary nodules (normalization rate ratio 0.81 [95% CI = 0.53-1.21]). Changes in the thyroid gland structure with both appearance and disappearance of thyroid nodules are common after an iodization program.

Cistos epidermais em ovinos

São descritos os aspectos clínico-patológicos de cistos epidermais em quatro ovinos, com idade entre dois e 12 anos, oriundos da região central do Rio Grande do Sul, Brasil. Três desses ovinos apresentavam múltiplos nódulos cutâneos, distribuídos aleatoriamente pelo corpo, e um ovino apresentava nódulo cutâneo solitário na região cervical. O período entre o aparecimento do primeiro nódulo e o surgimento de múltiplos nódulos foi de oito meses, em um caso, e um ano, em dois casos. Os quatro ovinos eram os únicos animais afetados em seus respectivos rebanhos. Os nódulos cutâneos eram redondos ou ovais, salientes, flutuantes, não pruriginosos e recobertos por pele parcialmente alopécica. Esses nódulos variavam de 1,0 a 7,0cm de diâmetro e, ocasionalmente, apresentavam um pequeno orifício central, com 1-2mm de diâmetro, na superfície externa. Ao corte eram císticos, delimitados por uma parede fina e branca, com 0,5-0,8cm de espessura, e preenchidos por material branco ou amarelado e friável. Histologicamente, os cistos eram revestidos por epitélio, contendo todos os estratos de um epitélio escamosos estratificado, sobre uma fina cápsula de tecido conjuntivo fibroso denso. Os cistos eram preenchidos por agregados homogêneos e feixes de ceratina, arranjados de forma concêntrica. Baseado na localização e características macroscópicas e histológicas esses cistos foram diagnosticados como cistos epidermais infundibulares.

CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects.

Computed tomography (CT) and magnetic resonance (MR) imaging play critical roles in the diagnosis and staging of hepatocellular carcinoma (HCC). The first article of this two-part review discusses key concepts of HCC development, growth, and spread, emphasizing those features with imaging correlates and hence most relevant to radiologists; state-of-the-art CT and MR imaging technique with extracellular and hepatobiliary contrast agents; and the imaging appearance of precursor nodules that eventually may transform into overt HCC.

ERITEMA NODOSO PÓS-INFECÇÃO DE VIA AÉREA SUPERIOR - A PROPÓSITO DE DOIS CASOS

Eritema nodoso é uma paniculite caracterizada pelo aparecimento de nódulos subcutâneos eritematosos e dolorosos, geralmente acompanhados por pródromos, que tem evolução benigna, com tendência para uma rápida cura espontânea. O fato de poder acompanhar ou preceder várias doenças o torna um importante desafio clínico e terapêutico. Os autores apresentam dois casos de eritema nodoso cujo surgimento das lesões foi precedido por infecção de via aérea superior que tiveram evolução favorável.

Thirty cases of human subcutaneous dirofilariasis reported in Rostov-on-Don (Southwestern Russian Federation)

IntroductionDifferent species of the genus Dirofilaria, mainly D. immitis and D. repens, are responsible for emergent vector borne transmitted zoonotic diseases in the Old World. Human D. repens infections are characterized by the appearance of benign subcutaneous nodules that mimic skin malignant tumors or due to live worms in the ocular area. MethodsThirty patients presenting superficial or deep nodules were treated at the Rostov Regional Diagnostic Center (Southwestern Russian Federation). Anatomical characteristics of the nodules were studied by non-invasive ultrasound and color and power Doppler techniques. Worms were surgically removed from every nodule and their DNA analyzed by polymerase chain reaction (PCR). ResultsTwenty-four out of the 30 nodules were located in the hypodermis, two in a retro-ocular location and four in scrotal location. Image techniques allowed the identification of the helminthic origin of all nodules, based on their oval and regular shape, peripheral vasculature, and the existence of internal linear winding hyperechoic structures with or without movements, indicating the presence of live or dead worms, respectively. Specific adscription to D. repens was achieved by the PCR analysis. ConclusionThe series described in the present paper confirms the increasing risk of infection by D. repens in humans living in endemic areas of Eastern Europe. The use of non-invasive ultrasounds and Doppler techniques can contribute to an appropriate management of human dirofilariasis. Moreover, awareness of the medical community in the endemic areas influences the report of cases, and consequently the current epidemiological picture of human dirofilariasis.

AB0920 Clinico-Morphological Variants of Pannikulitis: Diagnostic Problems

BackgroundPannikulitis (PN) is a heterogeneous group of inflammatory diseases associated with damage of subcutaneous fat and internal organs. The difficulties of PN diagnosis are due to variety of clinical and...

Concretions in typical chernozem, gleyed chernozem-like, and solonetzic chernozem-like soils of the southern Tambov Lowland

A system for the diagnostics of chernozemic soils of the Tambov Lowland based on concretions is proposed for agricultural and reclamation purposes. The relationships between the structure and composition of the carbonate concretions, the long-term water regime of the soils, and the productivity of the crops have been established. The dense concretions in the typical chernozem testify to the depth of the seasonal wetting; the angular-rounded concretions in the deeply gleyed chernozem-like soil, to the upper boundary of the capillary fringe; and the angular concretions with sharp edges and cavities in the gleyic chernozem-like soils, to the groundwater table. In the chernozem-like soils that were waterlogged with bicarbonate-sodium water, the black angular concretions were formed in the solonetzic horizons, while the weakly compacted light-colored ones, in the zone of the capillary fringe. Humic acids were responsible for the color of the dark neoformations, and fulvic acids predominated in the light-colored ones. The appearance of black fine nodules indicated periodic surface water stagnation. Manganese predominantly accumulates in these nodules. The structure of the Mn-Fe concretions in the plow horizon observed at a magnification of 40–50 times has a diagnostic importance. The short-term (2–3 weeks) water stagnation leads to the formation of fine-stratified concretions, and the long-term (up to 1.5 months) stagnation promotes the formation of uniform porous ones. The solonetzic process induced by the bicarbonate-sodium water results in the appearance of mottled concretions.

Sa1842 In Esophageal Epithelial Cells From Barrett's Patients, Protein Kinase a Phosphorylates SOX9, Enhancing Its Binding to Target Gene Promoters: A Potential Role for SOX9 in Barrett's Pathogenesis

in response to DCA treatment. 14% of the K14-Cdx2 mice treated with DCA developed two nodules each at the SCJ, whereas none of the K14-Cdx2 mice receiving water alone developed nodules. In contrast, 70% of the IL-1β mice, and an equal number of Cdx2/IL1β mice developed nodular disease at the SCJ after DCA treatment. All DCA treatmentassociated nodules were histologically consistent with metaplasia. However overall the double-transgenic mice had half as many nodules as IL-1β mice. Cdx2 did not affect IL-1β mRNA levels in the double transgenic mice, nor was the inflammation associated with IL1β expression reduced in the Cdx2/IL-1β mice compared to IL-1β mice, as determined by CD45R+ cell infiltration in the esophagi and forestomach. Moreover, cell proliferation rates were not altered by Cdx2 expression, as EdU incorporation was not significantly different. Lastly, the morphologic appearance of the nodules in all three lines, K14-Cdx2, L2-IL-1β, and K14-Cdx2/L2-IL-1β mice was similar, with abundant alcian blue expressing goblet cells detected, along with expression of other markers of intestinalization. Further molecular characterization of the metaplastic nodules by cDNA microarray profiling is underway. Conclusion: Ectopic expression of Cdx2 in the IL-1Beta mouse model for BE reduces the nodular intestinal metaplasia disease burden. These studies raise new questions as to the specific role of inflammation and intestinal transcription factors in the development of Barrett's esophagus in humans.