Benign Origin Research Articles

Levels of IL-6 and IL-8 in complicated versus uncomplicated urinary tract infection

Background: Urinary tract infections (UTIs) are one of the world's most frequent infectious diseases, affecting 150 million people each year and resulting in severe morbidity and high medical expenditures. UTIs can be clinically defined as uncomplicated UTIs (uUTIs) or complicated UTIs (cUTIs) to differentiate infections of benign origin from those with a higher risk of recurrence or progression to severe pathology. The aim of this study was to evaluate interleukin-6 (IL-6) and IL-8 as potential biomarkers in differentiating complicated and uncomplicated Methods: Ninety samples of urine were collected. There were 43 samples from healthy controls and 47 samples from UTI patients, those who have been clinically diagnosed with UTIs by the urologist. The serum IL-6 and IL-8 were measured using an enzyme-linked immunosorbent assay and commercially available kits. Results: The levels of both IL-6 and IL-8 were significantly higher in UTI patient then in control subjects (p=0.001, p=0.001). A significant difference was observed in the mean of level IL-6 between culture positive UTI patients and culture negative UTI patients (p=0.014). In addition, the type of bacterial growth, a significant difference was observed in the mean of serum IL-6 and IL-8 level in UTI caused by gram negative bacteria in comparison with UTI caused by gram positive bacteria. Conclusion: High levels of IL-6 are associated with the growth of gram-negative bacteria, and this indicates that gram-negative bacteria could induce stronger inflammatory responses than gram-positive bacteria. IL-8 levels are higher in UTIs caused by gram-negative bacteria. This result further supported the evidence that gram-negative bacteria are potent inducers of inflammatory responses.

Use of autofluorescent stomatoscopy in the diagnostic algorithm for oral mucosal and vermilion border lesions in adolescents

Relevance. There is currently significant interest in studying the prevalence of diseases affecting the oral mucosa and lip vermilion border in adolescents. A promising approach in this field is the use of modern non-invasive optical technologies, which not only offer additional insights into the patient's oral health status but also enhance their compliance.Materials and methods. A total of 71 adolescents (9th to 11th grade students) aged 15 to 17 years (mean age — 16.2 ± 0.8 years) were examined. The oral mucosa and lip vermilion border were assessed for abnormalities under natural light and through endogenous fluorescence using autofluorescent stomatoscopy. Various optical filters were applied, and clinical images were compared with autofluorescent images. A visual analog scale was used to assess the clarity of the diagnostic test results for the participant. Recommendations were provided, and treatment was prescribed according to the established diagnoses.Results. Oral mucosal lesions and lesions of the lip vermilion border were observed in 45% of cases, all of benign origin, without visible changes to the naked eye or pain. The most frequently diagnosed lesions were morsicatio buccarum and chapped lips. Distinct autofluorescent characteristics of the identified lesions were observed and documented. Participant-reported feedback was positive in 100% of cases during autofluorescent stomatoscopy. The mean score for the clarity of diagnostic results, assessed using the visual analog scale, was 9.3±0.12, indicating a high level of diagnostic visibility.Conclusion. Implementing a qualified clinical approach focused on preventing oral diseases in adolescent patients is recommended with the use of autofluorescent stomatoscopy. This technique not only offers real-time insights into the patient’s oral health status but also actively engages young patients, increasing their motivation to maintain good oral health.

Evaluation of PD-1 and interleukin-10-receptor expression by T lymphocytes in malignant and benign pleural effusions

PD-1 (programmed cell death protein-1)/PD-L1 (programmed cell death ligand 1) as well as IL-10 (interleukin-10)/IL-10R (interleukin-10 receptor) interactions play a major role in tumor immune evasion in various malignancies. Several studies investigated the expression of PD-1 on T lymphocytes in pleural effusions (PE) in patients with malignant diseases. However, results in malignant pleural effusions (MPE) compared to benign PE (BPE) are underreported. In this prospective study, 51 patients (median age 66 years, IQR 54–78, 47% male) with PE of malignant or benign origin at the Medical University of Vienna between March 2021 and November 2022 were enrolled and divided into three groups according to the cytological results (group 1: MPE [n = 24, 47%]; group 2: BPE in malignant disease [n = 22, 43%]; group 3: BPE in benign disease [n = 5, 10%]). In the cytological samples, T cells were analyzed for the expression of PD-1 and IL-10R via flow cytometry. In MPE, the proportion of PD-1+ T lymphocytes on CD4+ cells was significantly lower than in BPE (40.1 vs. 56.3 in group 1 vs. 3, p = 0.019). Moreover, a significantly lower expression of PD-1+ IL-10R+ CD8+ (9.6 vs. 35.2 in group 1 vs. 2, p = 0.016; 9.6 vs. 25.0 in group 1 vs. 3, p = 0.032) and a significantly higher expression of PD-1-IL-10R-CD8+ T lymphocytes (43.7 vs. 14.0 in group1 vs. 2, p = 0.045; 43.7 vs. 23.3 in group 1 vs. 3, p = 0.032) were observed in MPE when compared to BPE. The frequency of T cells expressing PD-1 and IL-10R on CD8+ T cells is significantly lower in MPE compared to BPE regardless of the underlying disease indicating a different microenvironment in PE driven by the presence of tumor cells. Our observation spotlights the possible involvement of PD-1 and IL-10R in MPE.

Pathophysiological features of acute liver failure caused by cholestasis [

Acute liver failure is a syndrome that occurs in 20-59% of patients with liver pathology and is one of the main causes of death in 40% of patients with mechanical jaundice of benign origin and in more than 70% of cases of tumor obstruction of the biliary tract and cancer of caput pancreas. In most cases, the syndrome is a consequence of acute liver damage (viral or drug-induced). Still, it can occur with longterm obstructive jaundice, be the first manifestation of Wilson’s disease, autoimmune chronic hepatitis, or superinfection of the hepatitis D virus against the background of chronic hepatitis B. The aim of the work was to study the pathophysiological features of the development of acute liver failure in patients with bile outflow disorders. The pathogenesis of acute liver failure caused by cholestasis is based on the damage and death of hepatocytes due to impaired blood circulation in the liver, as well as the toxic effect on the parenchyma of both the etiological factors themselves and their metabolites. The first week from the onset of symptoms is very important and usually accompanied by a systemic inflammatory response syndrome with significant consequences. At the same time, the main factors influencing the results of treatment of patients at different points in time are the combination of the critical functional reserve of the liver and the nature and severity of liver damage. In the case of the development of a systemic inflammatory response syndrome, there is a further increase in inflammation, which has a systemic nature and leads to the failure of other organs. Under these circumstances, understanding the pathophysiological features of the course of acute liver failure makes it possible to carry out the necessary diagnostic measures on time and offer appropriate therapy.

Levels of IL-6 and IL-8 in Complicated versus Uncomplicated Urinary Tract Infection

Urinary tract infections (UTIs) are one of the world's most frequent infectious diseases, affecting 150 million people each year and resulting in severe morbidity and high medical expenditures. UTIs can be clinically defined as uncomplicated UTIs (uUTIs) or complicated UTIs (cUTIs) to differentiate infections of benign origin from those with a higher risk of recurrence or progression to severe pathology. The aim of this study was to evaluate interleukin-6 (IL-6) and IL-8 as potential biomarkers in differentiating complicated and uncomplicated. Ninety samples of urine were collected. There were 43 samples from healthy controls and 47 samples from UTI patients—those who have been clinically diagnosed with UTIs by the urologist. The serum IL-6 and IL-8 were measured using an enzyme-linked immunosorbent assay and commercially available kits. The levels of both IL-6 and IL-8 were significantly higher in UTI patient then in control subjects (p=0.001, p=0.001). A significant difference was observed in the mean of level IL-6 between culture positive UTI patients and culture negative UTI patients (p=0.014). In addition, the type of bacterial growth, a significant difference was observed in the mean of serum IL-6 and IL-8 level in UTI caused by gram negative bacteria in comparison with UTI caused by gram positive bacteria. High levels of IL-6 are associated with the growth of gram-negative bacteria, and this indicates that gram-negative bacteria could induce stronger inflammatory responses than gram-positive bacteria. IL-8 levels are higher in UTIs caused by gram-negative bacteria. This result further supported the evidence that gram-negative bacteria are potent inducers of inflammatory responses.

Metaphyso-Diaphyseal Chondroblastoma of the Humerus: About Two Cases

Chondroblastoma accounts for less than 2% of all bone tumors, it is a tumor of benign cartilage origin, it is typically located at the level of the epiphysis or process of a long bone. Most often located in the proximal humerus, the distal femur, the proximal tibia, it more rarely affects the tarsal bones or the pelvis. We report 2 cases of young patients (aged 14 years and 15 years) with metaphysodiaphyseal chondroblastoma of the right humerus which was revealed by painful shoulder swelling and joint limitation. Our goal is to discuss the diagnostic difficulties and evolutionary aspects of this rare tumor as well as its treatment.

Chest pain in pediatric patients in the emergency department- Presentation, risk factors and outcomes-A systematic review and meta-analysis.

This study aimed to assess and determine the presentation, risk factors, and outcomes of pediatric patients who were admitted for cardiac-related chest pain. Although chest pain is common in children, most cases are due to non-cardiac etiology. The risk of misdiagnosis and the pressure of potentially adverse outcomes can lead to unnecessary diagnostic testing and overall poorer patient experiences. Additionally, this can lead to a depletion of resources that could be better allocated towards patients who are truly suffering from cardiac-related pathology. This review was conducted per PRISMA guidelines. This systematic review used several databases including MEDLINE, Embase, Scopus, and Web of Science to obtain its articles for review. A total of 6,520 articles were identified, and 11 articles were included in the study. 2.5% of our study population was found to have cardiac-related chest pain (prevalence = 0.025, 95% CI [0.013, 0.038]). The most commonly reported location of pain was retrosternal chest pain. 97.5% of the study population had a non-cardiac cause of chest pain, with musculoskeletal pain being identified as the most common cause (prevalence = 0.357, 95% CI [0.202, 0.512]), followed by idiopathic (prevalence = 0.352, 95% CI [0.258, 0.446]) and then gastrointestinal causes (prevalence = 0.053, 95% CI [0.039, 0.067]). The overwhelming majority of pediatric chest pain cases stem from benign origins. This comprehensive analysis found musculoskeletal pain as the predominant culprit behind chest discomfort in children. Scrutinizing our study cohort revealed that retrosternal chest pain stands as the unequivocal epicenter of this affliction. Thorough evaluation of pediatric patients manifesting with chest pain is paramount for the delivery of unparalleled care, especially in the context of potential cardiac risks in the emergency department.

Contrast-enhanced Chest Ultrasound – Modern Achievements of Pulmonology in Bulgaria

Contrast-enhanced ultrasound (CEUS) is an innovative imaging method in pulmonology based on the intravenous administration of a contrast medium in the form of microspheres, and the subsequent detailed representation of the perfusion characteristics of the target tissues. The method allows the distinction between malignant and benign origin of a given pathological lesion. The purpose of the current article is to introduce to the scientific society the modern achievements of contrast-enhanced ultrasound of the thorax in pulmonology in Bulgaria. We present twenty-seven clinical cases from the period 2017--2020, in which CEUS was applied at different stages of the diagnostic process. The results are compared with a previous survey conducted in Bulgaria in 2011.

Giant Cervical Lymphangioma Extending from Skull Base to Clavicle- A Rare Case.

Lymphangiomas are congenital benign lesions commonly seen in pediatric age group with a rare occurrence in the region of head and neck, commonly presenting as asymptomatic masses. Cervical lymphangioma is a rare entity among adults, and giant sized lymphangiomas in this region have sparse mention in literature. This case report describes the rare presentation of a giant cervical lymphangioma and the challenges involved to treat such masses in the region of head and neck. We encountered a rare case of a 52 year old female who presented with a 10 × 5cm swelling in the right posterior triangle of neck swelling since 6 months extending from skull base up till clavicle. Pathological and radiological entities confirmed the lesion as a "giant cervical lymphangioma". Head and neck lymphangiomas are congenital lesions of benign origin. Lymphangiomas have been classified as macrocystic if larger than 2cm, and microcystic if less than 2cm. Our description of a macrocystic 10 × 6 cm lesion is hence definitely one of the largest cervical lymphangiomas encountered till date. It's a problematic and arduous plan of treatment for such masses in head and neck with a high chance of recurrence if incompletely removed.

THU620 Metastatic Adrenocortical Carcinoma Arising From A Testicular Rest Tumor

Abstract Disclosure: L.E. Chozet: None. J.M. Bruder: None. R. Flores: None. S. Hackman: None. K. highes: None. L. Vasquez: None. G. Le: None. T. cortez: None. M.A. Escobar Vasco: None. Background: Congenital adrenal hyperplasia (CAH) involves a range of autosomal recessive disorders characterized by abnormalities in the adrenal biosynthesis pathway. Testicular adrenal rest tumors (TARTs) are a complication mostly seen in male patients with congenital adrenal hyperplasia which can lead to infertility. These tumors are known to have benign characteristics. We present a unique case of a male patient with CAH diagnosed with metastatic adrenocortical carcinoma arising from a TART. Clinical Case: A 40-year-old man with poorly controlled congenital adrenal hyperplasia from 21-hydroxylase deficiency and bilateral testicular adrenal rest tumors presented with syncope and worsening left testicular pain for 2 months. Scrotal ultrasound showed enlarged bilateral scrotal masses (left bigger than right). Initial evaluation for his syncopal event included CTA chest which showed an incidental finding of innumerable bilateral solid pulmonary nodules. 17-hydroxyprogesterone levels were elevated at 5273 ng/dL (normal less than 138 ng/dL). Additional biochemical workup of the testicular mass was unremarkable. The patient underwent left radical orchiectomy with pathology showing high-grade carcinoma with adrenocortical differentiation. A right upper lobe lung biopsy was done which demonstrated metastatic carcinoma with adrenocortical differentiation, morphologically similar to the testicular tumor. The initial patient presentation of progressively worsening left testicular pain in the setting of testicular adrenal rest tumors (TARTs) led to the diagnosis of adrenal carcinoma. Conclusion: This case presents a unique presentation of adrenal carcinoma in a patient with congenital adrenal hyperplasia arising in the setting of testicular adrenal rest tumors (TARTs). This case demonstrates a unique presentation of adrenal carcinoma, as malignant degeneration has not been described in patients with TARTs. It also highlights the importance of close monitoring even if these tumors are thought to be of benign origin. Presentation: Thursday, June 15, 2023

Hemangiomas of gingiva mimicking pericoronitis: A case report

Malformations and vascular tumors can occur anywhere on the body. Hemangiomas, or vascular tumors, are rare at birth, develop quickly during the first six months of life, involute over time, and can occasionally be harmful even though they do not always spread. Uneven vascular networks, known as vascular malformations, are identified by a certain blood vessel type. Hemangiomas is of benign origin and behavioral but, Hemangioma in the oral cavity is of clinical importance. It often mimics other lesions clinically and requires appropriate clinical diagnosis and proper management. Accurate diagnosis of the lesion plays an important role in framing the correct protocols and for delivering the correct treatment. Imaging techniques such as Ultrasound with color doppler may be needed in combination to determine the nature of the blood supply to the lesion either arterial, venous or arteriovenous malformation and can also aid with diagnosis and treatment. It is also beneficial in eliminating non vascular lesions. This paper presents one such interesting case.

Dilated Pore of Winer; What’s That!

The dilated pore of Winer (DPOW) is an adnexal tumour of benign origin arising from the infundibulum of the pilosebaceous unit extending from superficial to deep dermis. Incidence is more common in white males and mostly affects the face, neck and upper trunk. The diagnosis is primarily clinical but dermoscopy and histopathological evaluation are helpful in diagnosis of unusual presentations. Here, we report a case of a 55-year-old female who presented with a giant comedone-like asymptomatic papular lesion over mons pubis. A diagnosis of DPOW was made. The lesion was surgically excised and no recurrence on follow-up was observed.

Intraoral Hemangioma: An Overview of the Recent Advances

Hemangiomas are common tumors that exhibit a rapid increase in the number of blood vessels when analyzed microscopically. Hemangiomas are frequently seen since the birth of the infant and possibly enlarge with age. They most likely have developmental rather than malignant roots. Oral hemangiomas are still clinically relevant to the specialist dentist and will require proper clinical treatment regardless of their benign origin and behavior. Nowadays, physical examination, auxiliary inspection, and clinical history serve as the main pillars of diagnosis. Priority should be given in hemangioma treatment to functional harm brought on by the treatment, which may lead to a worsening of the patient’s current condition and may pose a threat to the patient’s life. This shows that early diagnosis, identification, and referral to specialists are critical steps in reducing associated problems and improving prognosis. Surgery and other forms of treatment have a greater rate of morbidity, recurrence, and complications and are not always effective. Oral propranolol is still a widely used first-line medication. Oral propranolol is still a widely used first-line medication, nevertheless. Together with a review of related literature, the main focus of this study will be on the recent changes and modifications being made to ensure accurate diagnosis.

Kissing atypical melanocytic nevus of genital type of the labia majora in a young Bulgarian patient. What's the best approach?

Melanocytic lesions, especially in delicate anatomical locations such as the vulva, penis, mons pubis etc, are challenging to diagnose. The patients may delay physical examinations due to anxiety or discomfort from the location of the lesion. In terms of therapy options, the surgical approach is not always the preferred one, but it is the one that could lead to a definitive solution to the problem. A limited number of studies do not exclude that atypical nevi of genital type could be considered as melanoma precursors. Single case reports have identified atypical genital nevi of the labia majora as a risk factor for genital melanoma development. Lesions that occupy a larger area than the labia majora and extend into the areas around them are particularly problematic, because the result of a single biopsy could be misleading. Therefore, careful physical examinations are mandatory. Mechanical irritation in the genital area, and in particular in the labia majora region, is an additional reason for choosing the surgical-reconstructive therapeutic option. We present a 13-year-old female with a progressive kissing divided nevus, located in the area of the vulva and labia majora, extending to the mucosa. A biopsy was taken in order to rule out malignancy. Immunohistochemistry was performed with specific melanocyte markers S-100, HMB-45 and SOX confirming the benign origin of the lesion. A diagnosis of atypical melanocytic nevus of genital type was made. For prevention a surgical excision was advised but later on declined by the patient's parents. Further close observation of the lesion was recommended.

Surgical management of adult supraclavicular hemangioma: a case report

Introduction: Hemangioma is one of the most common vascular anomalies. It is classified into two types: superficial hemangioma, also known as capillary hemangioma, which appears as brilliant red macular masses, and deep hemangioma, which appears as a soft, non-fluctuating, poorly defined, and occasionally bosselated nodule. Surgical excision is recommended for cavernous-type tumors, which are less sure to regress. Despite its benign origin and behavior, it can develop in any body part. However, its size and origin site may vary and make surgical excision more challenging due to the importance of the structures surrounding the mass. Thus, this study aims to explain the surgical management of adult supraclavicular hemangioma. Case Description: We present a case of primary cavernous hemangioma in 36 years-old-woman with no history of health problems that extends to the supraclavicular area and was linked to essential structures. The surgical excision was performed through a double-incision technique to prevent iatrogenic damage to the system. Postoperative evaluations revealed no impairment of motoric and sensory hand functions, and the patient was discharged three days postoperatively. Histopathologic findings were consistent with the diagnosis of hemangioma. Conclusion: The supraclavicular approach in surgery is challenging due to its critical location and closeness to key neurovascular structures. To obtain the best surgical outcome, the essential operating concepts include thorough dissection and a modified method to limit the risk of functional status and mobility impairment.

Birth-related soft tissue injury due to transverse malpresentation at delivery: a case report

Abstract Objectives Birth-related mechanical trauma to the newborn is an important issue and may be underestimated [Chaturvedi A, Chaturvedi A, Stanescu AL, Blickman JG, Meyers SP. Mechanical birth-related trauma to the neonate: an imaging perspective. Insights Imag 2018;9:103–18]. Risk factors for birth-related injuries include vacuum or forceps delivery, large size for gestational age and abnormal presentation before delivery [Gupta R, Cabacungan ET. Neonatal birth trauma: analysis of yearly trends, risk factors, and outcomes. J Pediatr 2021;238:174–80]. When a newborn has a soft tissue mass, there is a wide range of potential diagnoses, ranging from benign traumatic origins to aggressive phenotypes of malignant tumors [Thacker M. Benign soft tissue tumors in children. Orthop Clin N Am 2014;44:433–44]. Diagnosing a congenital tumor in a newborn creates uncertainty for parents and health care providers. Accurate imaging is crucial for distinguishing soft tissue mass origins. Case presentation A 32 weeks 6 days pregnant Caucasian woman was admitted after premature prelabor rupture of membranes (PPROM). Fetal ultrasound showed no abnormalities, the infant was born by a caesarean section. The delivery was complicated by the infant’s transverse position. A female infant was born with a large left-sided dorsal soft tissue mass at the thoracic level with elastic consistency, and multiple skin lacerations. A broad differential diagnosis was made. Additional imaging was suggestive for a posttraumatic swelling due to transverse position during birth. The mass decreased and disappeared over three days. Conclusions The diagnosis of a soft tissue mass in a newborn can be challenging. A birth-related trauma affecting the soft tissue should be considered, especially if prenatal ultrasound findings were normal. Malpresentation during birth is a significant risk factor. Accurate diagnostic imaging is important to do before conducting further diagnostic examinations. The time course of the mass, before and after birth, can aid in determining its origin.

MANAGEMENT OF A HUGE PARAPHARYNGEAL MASS : A SURGICAL NOVELTY

Parapharyngeal space(PPS) tumors are very uncommon. Though majority of these tumors are of benign origin, the most common among them is a pleomorphic adenoma. Surgical removal is mainstay for the treatment of these tumors for which a strategic preoperative evaluation of each patient and knowledge of different surgical approaches to PPS are essential. Here we report a rare but typical case of a 35 years old female presented to OPD with a mass in right the parapharyngeal space. The mass was excised successfully using mandibular swing approach and the post operative histopathology report suggested it to be “pleomorphic adenoma”.

Occipital Condyle Syndrome, A Late Complication of Malignant Insulinoma

Occipital Condyle Syndrome (OCS) is a rare clinical syndrome caused by lesions at the base of the skull affecting the hypoglossal nerve. It is associated with various etiologies of tumoral and benign origin. Neurological symptoms associated with insulinomas have been only reported to hypoglycemia. Malignant insulinoma, defined by the presence of metastases, is rare.

Giant fibroadenoma of the breast, case report and literature review

The breasts are made up of skin, fat, epithelial structures and mesenchymal connective tissue, so it is common for different tumors of benign or malignant origin to appear in them. The literature indicates that approximately 85 % of all lumps are benign, especially in patients under 40 years of age. A rapid and exaggerated growth of the breast is attributed to this entity, causing remarkable asymmetry, aesthetic deformity and doubts as to the clinical and cytohistological diagnosis. The singularity of this type of entity justified the development of the present clinical case in order to deepen the knowledge and treatment of this subject. The present study dealt with a 32-year-old nulliparous patient, who presented asymmetric breast growth on the right side of 5 months of evolution, without treatment. She went to the clinic where a fibroadenoma of about 15 x 10cm was evidenced, after a benign histopathological diagnosis, a procedure was scheduled. During the surgical procedure these findings were confirmed and fibroadenoma was removed, procedure without complications. After 5 days of hospitalization the patient was discharged in good condition. In conclusions, a timely clinical, ultrasound and histopathological diagnosis will indicate the initial guidelines for prognosis and resolution of this pathology

Abrikossoff's tumor of the penis: a case report

BackgroundGranular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitals. We report in this article the case report of a purely cutaneous case of rare clinical presentation at the level of the penis.Case presentationWe report the case of a man, aged 54, with no history, consulted for a nodular lesion on the penis evolving for a year. a nodular cutaneous plate, indurated 3 cm in large diameter, painless and mobile in relation to the deep plane. The lymph node areas were free, and the remainder of the skin examination was without abnormalities.ConclusionsGranular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitalia, the diagnosis is based on anatomopathology study completed by immunohistochemistry, and treatment consists of complete surgical excision of the tumor.