Giant Cell Granulomatous Reaction Research Articles

Multifocal splenic lesions in primary AL amyloidosis secondary to amyloidosis with giant cell granulomatous reaction.

Multifocal splenic lesions in primary AL amyloidosis secondary to amyloidosis with giant cell granulomatous reaction.

51. Oxidised cellulose (Surgicel) granuloma radiologically mimicking recurrent renal cell carcinoma: An example of iatrogenic pathology demonstrable by histochemical staining

Background Local haemostatic materials such as oxidised cellulose (Surgicel) are widely used to achieve intraoperative haemostasis. Oxidised cellulose (Surgicel) is typically completely resorbed within weeks of its use. However; a Surgicel granuloma can rarely persist for months to years and can therefore mimic a recurrent neoplasm on imaging studies. Method We present a case of a 64-year-old man who previously underwent open nephron-sparing surgery for a stage 1a clear cell renal cell carcinoma involving the posterior upper pole of the kidney with negative margins. A post-operative surgical haematoma was noted which was treated conservatively. Twelve months later, imaging studies showed a complex mass immediately anterior to pelvi-uereteric junction in the same kidney. The mass was unable to be dissected from the kidney, and a radical nephrectomy was therefore performed. Results Macroscopically, a well circumscribed lesion was present within the perinephric fat adjacent to the pelvi-ureteric junction with associated ectasia of the pelvicalyceal system. Microscopically, there was a giant cell granulomatous reaction to scattered islands of a non-refractile weakly eosinophilic foreign material associated with fat necrosis, chronic inflammation and haemosiderin deposition. Histochemical staining for Masson Trichrome stained the foreign material intensely red which was consistent with cellulose matter. No residual clear cell carcinoma was present. Conclusion Persistent Surgicel granuloma has been previously described in various sites as isolated case reports, all with radiological concern of recurrent neoplasm. Clinicopathological correlation is very useful in such cases. Furthermore, retained Surgicel can be demonstrated with use of histochemical staining (Masson Trichrome). To our knowledge, this characteristic histochemical property of cellulose has not been documented in prior case reports of Surgicel granulomata.

Omental Mass Caused by Pericolic Vegetable Granuloma: A Rare Case Report

Introduction Foreign materials typically produce a reaction by multinucleated giant cells. Foreign bodies (such as vegetable cells in food material) in the omentum have not been reported to produce an omental mass. Vegetable cells surrounded by foreign body giant cells called vegetable granuloma/pulse granuloma by the previous literature are a peculiar type of granuloma caused by vegetable plant cells. Case Presentation Here in we present our experience with an old age lady who was operated with the impression of gastric mass. During the surgery no gastric mass was found but several omental masses were detected. Pathological study of the resected masses showed only vegetable cells in the omentum surrounded by an extensive foreign body giant cell granulomatous reaction, some of which were hyalinized. To the best of our knowledge such situation has not been reported in the English literature thus far. Conclusions In a patient with several omental granuloma, both in surgery and pathological examination, foreign body granuloma should be considered as a possible differential diagnosis.

SCROTAL CALCINOSIS - RARE CASE REPORTS OF TWO CASES

AbstractScrotal calcinosis is a benign disease characterized by multiple calcified scrotal nodules. The nodules develop slowly over many years and patients usually do not seek for treatment, until they grow to large size. Histopathological examination shows deposition of basophilic amorphous material surrounded by giant cell granulomatous reaction. We report two cases of scrotal calcinosis occurring in 27 year and 45 year old males who presented with multiple scrotal swellings. Clinical diagnosis was multiple sebaceous cysts. On histopathology, excised swellings showed deposition of calcium with giant cell reaction. On regular follow up both are doing fine without any recurrence.

Soft Tissue Amyloidoma of the Extremities

Amyloidoma (tumoral amyloidosis) is defined as a solitary localized tumorlike deposit of amyloid, in the absence of systemic amyloidosis. Amyloidoma is the least common presentation of tissue amyloid deposition and may be of AL-type or AA-type. It has been reported in many anatomic sites including the respiratory, genitourinary, and gastrointestinal tracts, as well as internal viscera, the central nervous system, skin, breast, and soft tissues. Amyloidoma of soft tissues is extremely rare and occurs mainly in the mediastinum and abdomen. Soft tissue amyloidoma of the extremities is even more uncommon and, when strictly defined, only 11 such cases are reported in the English language to date. Most have been of AA-type and have occurred on the leg. Some have been associated with local trauma, surgery, infection, or peripheral vascular disease, and a few patients have been diabetic. We report the case of a soft tissue amyloidoma on the leg of an 85-year-old woman. Clinically, it was a subcutaneous nodule on the left shin, of approximately 4 years duration. Traumatic fat necrosis was suspected. On excision a firm gray/tan, lobulated, soft tissue mass, measuring 2.3 cm in greatest dimension, was observed. At the microscopic level, it was seen to consist mainly of amyloid, associated with a giant cell granulomatous reaction, a patchy lymphocytic infiltrate, and focal microcalcification. The features were those of a soft tissue amyloidoma of the extremity. Persistence of congophilia after pretreatment with permanganate in this case suggested the presence of AL amyloid.

Histopathological changes in the human larynx following expanded polytetrafluroethylene (Gore-Tex®) implantation

BackgroundExpanded polytetrafluroethelyne (e PTFE, Gore-Tex®) has been advocated as an implant material for medialization of the vocal fold. Animal studies involving rabbits and a porcine model have demonstrated host tolerance of the implant. There have been no reports describing the histological changes in a human laryngectomy specimen with a Gore-Tex implant.Case presentationThe histological findings in a laryngectomy specimen of a patient previously implanted with e PTFE for medialization of a paralyzed vocal fold following excision of a vagal neurofibroma were studied.Histopathology revealed a mild foreign-body giant cell granulomatous reaction with some associated fibrosis. The granulomatous response was limited to the periphery of the Gore-Tex and although it closely followed the profile of the material it did not encroach into or significantly break up the material. There was no significant neutrophilic or lymphocytic inflammation.ConclusionsOur findings are consistent with the animal models confirming that Gore-Tex implantation does not result in a significant granulomatous reaction in the human larynx over a 13-month period. Moreover, there is no evidence of resorption or infection. Further, the lack of lymphocytes in association with the granulomas indicates that there is no significant immunological hypersensitivity. Histologically, the slight permeation by connective tissue is similar to that seen in Gore-Tex vascular and cardiac implants. The degree of the slight giant cell response appears to be dependent on the profile of the material; a sharp edge incited more of a response than a flat surface.

Investigation of a Bioresorbable Orbital Implant

To analyze a new bioresorbable orbital implant (open-celled polylactic acid, also known as OPLA). The implants were examined macroscopically, with chemical analysis (Fourier transform infrared spectroscopy), and microscopically with scanning electron microscopy. Animal implantation of OPLA implants was carried out in 9 adult male New Zealand albino rabbits. Implant vascularization was evaluated by histopathologic sectioning. The OPLA implant is porous and lightweight but fragile. Histopathologically it stimulated primarily a multinucleated giant cell granulomatous reaction with little fibrovascular ingrowth seen at 4 and 8 weeks. By 20 and 24 weeks, the implant was replaced predominantly by necrotic debris and peripheral giant cells. The OPLA implant is not an acceptable alternative to other currently available orbital implants.

Histopathology of human American cutaneous leishmaniasis before and after treatment.

Chemical therapy for the treatment of leishmaniasis is still inadequate, and a number of drugs and therapeutic programs are being tested. Besides treatment, the ultimate goal is an effective cure, and histopathological analyses of the lesion cicatrices constitute an important measure of treatment success, or otherwise, in this respect. In this paper, we describe histopathological patterns in cases of American cutaneous leishmaniasis in 32 patients from the municipality of Caratinga, Minas Gerais, Brazil, before and after treatment with the following therapeutic methods: 1) leishvacin + glucantime; 2) leishvacin + BCG associated with glucantime; 3) glucantime; 4) leishvacin + BCG. Lesion fragments were collected from all patients by biopsy prior to, and approximately 30 days after, each treatment which resulted in a clinical diagnosis of cure. Following the analysis of slides, the preparations were described from a histopathological point of view and grouped taking into account the prevalence or significance of the characteristic elements. This process resulted in the following classification: 1. exudative reaction (ER); 2. exudative giant cell reaction (EGCR); 3. exudative productive reaction (EPR); 4. exudative productive giant cell reaction (EPGCR); 5. exudative productive necrotic reaction (EPNR); 6. necrotic exudative reaction (NER); 7. productive exudative reaction (PER), 8. productive giant cell reaction (PGCR); 9. productive exudative giant cell reaction (PEGCR); 10. productive exudative giant cell granulomatous reaction (PEGCGR); 11. productive reaction (PR) and 12. productive cicatricial (cure) reaction (PCR). After this analysis, it was noted that clinical cure did not always coincide with histopathological cure.

Histological patterns of the tissue reaction to polymers in orthopaedic surgery

Unless coated with calcium hydroxyapatite, a layer of fibrous tissue, referred to as the interface membrane, separates polymeric devices from bone into or onto which they have been implanted. Though bone may directly contact certain polymers, e.g. polysulfone, the bulk of implanted prostheses is separated from the bony bed by such an interface membrane. Polymers in current use, e.g. polymethylmethacrylate, polyethylene and polyacetal, when subject to micromotion at the interface, release breakdown products, which induce a giant cell granulomatous reaction. An exuberant granulomatous response, accompanied by chronic inflammatory infiltration and cicatrization, characterizes the ‘pathological’ interface membrane, which is the hallmark of the aseptically loosened prosthetic component. Diverse polymers comprising different prostheses excite a stereotyped granulomatous reaction. Expectedly, when implanted into soft tissue, polymeric devices elicit the formation of an essentially similar granulomatous-cicatrizing response.

Pathological Changes in Kidneys of Intensively Bred Brook Trout (Salvelinus fontinalis Mitchill, 1815)

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Endemic disease in dasyurid marsupials

A histological survey was made of a group of 178 dasyurid marsupials which died or were killed. Among the variety of lesions found, infection by a protozoon which morphologically and tinctorially is toxoplasma was particularly common. Despite the presence of an active meningo-encephalitis or myocarditis due to this organism, serological tests for Toxoplasma gondii were negative. Number examinedNumber with ‘toxoplasma'Dasyuroides byrnei8645Dasycercus cristicauda4934Antechinus macdonnellensis157Antechinomys spenceri98Antechinus stuartii90Antechinus apicalis85Sminthopsis larapinta21Total178100(56%) Apart from the widespread distribution of the parasite and occasional lethal infection, the most common upset in function was weakness of the hind limbs due to meningomyelitis with involvement of anterior horn cells. Spontaneous neoplasms, a cerebellar glioma and an intrathoracic fibrosarcoma were found in 2 Dasyuroides byrnei. Sex anomalies were found in 3 <i>Dasyuroides byrnei</i>. One was due to a chromosomal anomaly, another due presumably to extrauterine trauma and a third due to a non-descent of testicles. Calcification of the renal vessels and a giant-cell granulomatous reaction in the retroperitoneal fat were frequent but unexplained findings.