Node Swelling Research Articles

Molecular Epidemiology and Characterization of Theileria in Goats

The study was carried out to determine the prevalence and associated risk factors of theileriosis in goats of Chattogram district, Bangladesh. Molecular characterization of circulating Theileria in this area was also undertaken. A total of 400 samples were collected from goats of different breeds, ages and sex with relevant information of rearing and management. The prevalence of theileriosis was 8.50% (34/400) by polymerase chain reaction though all of those samples were test-negative by microscopic examination. Among different risk factors season, breed and tick infestation were found to be significantly (p ≤ 0.05) associated with the prevalence of theileriosis in goats. Serous nasal discharge and swollen lymph nodes were determined to be significant clinical signs. The Theileria spp. detected in the present study closely resemble isolates which were previously detected in Myanmar and China. Further large scale epidemiological studies are required to identify the circulating species and responsible vectors, which would facilitate control measures for this disease in Bangladesh.

Radiologist observations of computed tomography (CT) images predict treatment outcome in TB Portals, a real-world database of tuberculosis (TB) cases

The TB Portals program provides a publicly accessible repository of TB case data containing multi-modal information such as case clinical characteristics, pathogen genomics, and radiomics. The real-world resource contains over 3400 TB cases, primarily drug resistant cases, and CT images with radiologist annotations are available for many of these cases. The breadth of data collected offers a patient-centric view into the etiology of the disease including the temporal context of the available imaging information. Here, we analyze a cohort of new TB cases with available radiologist observations of CTs taken around the time of initial registration of the case into the database and with available follow up to treatment outcome of cured or died. Follow up ranged from 5 weeks to a little over 2 years consistent with the longest treatment regimens for drug resistant TB and cases were registered within the years 2008 to 2019. The radiologist observations were incorporated into machine learning pipelines to test various class balancing strategies on the performance of predictive models. The modeling results support that the radiologist observations are predictive of treatment outcome. Moreover, inferential statistical analysis identifies markers of TB disease spread as having an association with poor treatment outcome including presence of radiologist observations in both lungs, swollen lymph nodes, multiple cavities, and large cavities. While the initial results are promising, further data collection is needed to incorporate methods to mitigate potential confounding such as including additional model covariates or matching cohorts on covariates of interest (e.g. demographics, BMI, comorbidity, TB subtype, etc.). Nonetheless, the preliminary results highlight the utility of the resource for hypothesis generation and exploration of potential biomarkers of TB disease severity and support these additional data collection efforts.

Acute onset supraclavicular lymphadenopathy coinciding with intramuscular mRNA vaccination against COVID-19 may be related to vaccine injection technique, Spain, January and February 2021

Monitoring adverse reactions following immunisation is essential, particularly for new vaccines such as those against COVID-19. We describe 20 cases of acute onset of a single supraclavicular lymphadenopathy manifesting between 24 h and 9 days after ipsilateral intramuscular administration of an mRNA-based COVID-19 vaccine, referred to our WHO Collaborating Centre for Vaccine Safety. Our results indicate that the swelling of supraclavicular lymph nodes following immunisation may constitute a benign and self-limited condition, related to a higher than recommended injection site.

An elderly-onset neuroblastoma concomitant with minimal change nephrotic syndrome: the first autopsy case report

Neuroblastoma is a well-known embryonal cancer; however, adult-onset neuroblastomas are rare. The systemic symptoms are related to catecholamine excretion or intraabdominal mass effects. Only two cases of neuroblastoma with nephrotic syndrome have previously been reported. We herein present the first autopsy case of neuroblastoma in an older individual associated with minimal change nephrotic syndrome. A 63-year-old man was admitted to our hospital for investigation of general fatigue. His renal function was normal and his urine was negative for protein. A computed tomography scan showed a renal tumor and intraabdominal lymph node swelling. Approximately 4months after admission, he suddenly developed acute renal failure and severe proteinuria, and hemodialysis was instituted. A computed tomography scan revealed an increase in the size of the renal tumor and lymph nodes. He died 1month later and an autopsy was performed. The tumor exhibited diffuse proliferation of tumor cells with scant cytoplasm, namely small blue cell tumor with rosette formation. As a result of immunohistochemical study, a neuroblastoma was diagnosed. Despite the patient's severe renal failure, most glomeruli showed no remarkable changes. The tubular epithelium exhibited detachment and vacuolation. Electron microscopic study of the glomeruli showed diffuse effacement of the foot processes. These features indicate a diagnosis of minimal change nephrotic syndrome with acute tubular injury. Minimal change nephrotic syndrome is the most common renal manifestation associated with lymphoproliferative malignancies. We here present an extremely rare case of adult-onset neuroblastoma with minimal change nephrotic syndrome.

Long-term disease control of metastatic type 2 papillary renal cell carcinoma using local treatment and molecular targeted therapy: A case report.

A 46-year-old man underwent right partial nephrectomy for type 2 papillary renal cell carcinoma (PRCC) in 2011. Lung metastasis and lymph node (LN) metastases around the inferior vena cave appeared in 2012. A right radical nephrectomy and extensive LN dissection was performed and the resection of lung metastasis was performed one month after the nephrectomy. Mediastinal LN metastases occurred in 2013, and resection of the affected LNs was performed. Sunitinib and zoledronic acid was started in 2014 because mediastinal LN swelling and multiple bone metastases appeared. Sunitinib treatment was stopped soon after due to adverse events and axitinib treatment was started. Axitinib was effective and the patient had stable disease for 30 months. Adverse events were successfully controlled by dose reduction and periodic drug withdrawal schedules (for example, 5 days on, 2 days off). Axitinib was further continued for 19 months as the metastatic lesions had progressed slowly. Temsirolimus treatment was started in 2019, but it was stopped after three cycles due to interstitial pneumonia. The patient died 80 months after the initial recurrence. Using multidisciplinary treatment, durable disease control was achieved in a patient with metastatic type 2 PRCC.

Radiological and morphological parallels in the course of respiratory sarcoidosis

The objective of the study: to study the radiological and morphological parallels in respiratory sarcoidosis (RS). Subjects and methods . 121 patients with respiratory sarcoidosis were enrolled in the study, their ages varied from 21 to 66 years, they all were examined in 2007-2019. The analysis of radiological manifestations of sarcoidosis was assessed according to the main parameters (symmetry of the lesions, the size of the intrathoracic lymph nodes, the presence of dissemination, pneumofibrosis). The extended morphological testing of biopsy specimens was carried including evaluation of the quantitative and qualitative composition of granulomas. Results . The chest computed tomography revealed a discrepancy between the radiation signs in respiratory sarcoidosis and the staging theory by Wurm. Changes in the lung parenchyma and swelling of the mediastinal lymph nodes were found in all patients at stages I-III. The components of the cellular elements of the inflammatory infiltrate did not differ at different stages of respiratory sarcoidosis. However, as the radiological changes progress, the number of granulomas increased and there was a direct correlation between the number of granulomas in the biopsy specimen and the X-ray staging by Wurm (r = 0.24; p <0.05), while the frequency of granulomas with necrosis also increased (r = 0.39 ; p < 0.05).

Clinical Impact of Organ-Preserving Surgery for Pancreatic Neuroendocrine Neoplasms: A Single-Center Experience.

Organ-preserving surgery (OPS) has been accepted for pancreatic neuroendocrine neoplasms, particularly for the management of small tumors. This study aimed to analyze the surgical outcome following this treatment at our institute, focusing on the perioperative factors and postoperative locoregional recurrence. We analyzed 71 consecutive patients with no synchronous liver metastasis. These patients were classified into 1 of 2 groups: the standard operation group (SOG, 41 patients) with prophylactic regional lymph node dissection and the organ-preserving surgery group (OPG, 30 patients). We performed OPS based on size criteria (tumor size <1.5 cm in nonfunctional pancreatic neuroendocrine neoplasms and <2 cm in insulinoma with no evident bulky lymph node swelling on preoperative imaging). The median follow-up periods were 37 months. The OPG included enucleation, partial resection, proximal parenchymal pancreatectomy, central pancreatectomy, spleen-preserving distal pancreatectomy, and Warshaw operation. The SOG included pancreatoduodenectomy and distal pancreatectomy, showing no statistically significant differences between the 2 groups in terms of operation time, hospitalization duration, and postoperative complications. Ten patients showed lymph node metastasis (25%) only in the SOG. There were no locoregional recurrent cases in the OPG. In selected patients, OPS may be effective based on the appropriate tumor size criteria.

Overview of Tuberculosis among Children of Madurese Ethnicity in East Java, Indonesia

ABSTRACT This study aimed to find the characteristics of tuberculosis (TB) in children among the Madurese ethnicity in Indonesia. A descriptive study with a cross-sectional approach was used. The study used Indonesian TB scoring on 23 Madurese children consisting of 16 children with active TB and 7 healthy control children. Data was analysed with SPSS software and Pearson’s test. The findings showed that children who contacted adults with TB active associated with the incident of active TB (OR=64 (3.83-2623.17)). A positive result of the tuberculin test was experienced in active TB participants (OR=136 (5.58-20266.2)). While weight or nutritional status has a good category (OR=0.31 (0.03-3.07) and children with TB active indicated the symptom of cough more than 3 weeks (OR=7 (0.60-185.21)). Those who had swollen lymph nodes were in an active TB group (OR=128 (5.22-19130.8)), as well as had a chest X-ray suggestive of TB (OR= 0.02 (0-0.26)).

Recurrence after ESD curative resection for early gastric cancer

BackgroundEndoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-up with endoscopy is recommended, but follow-up with abdominal ultrasonography or computed tomography (CT) for surveillance of metastases is not recommended after the eCuraA resection. However, we experienced a case of lymph node recurrence following ESD resulting in eCuraA.Case presentationA 76-year-old female received ESD for EGC in a previous hospital 4 years ago. Pathological findings were tub1, 30 mm, T1a (M), UL0, Ly0, V0, pHM-, pVM- (eCuraA) according to the 15th edition of Japanese Classification of Gastric Carcinoma. Follow-up esophagogastroduodenoscopy revealed submucosal tumor, which was suspected as a swollen lymph node by CT and endoscopic ultrasound fine-needle aspiration revealed the recurrence of gastric cancer. We performed total gastrectomy with D2 lymph node dissection. Postoperative pathological examination revealed no local recurrent tumor at the ESD site in the stomach. Swollen lymph node was diagnosed as metastasis and lymph node metastasis was limited near the cardia.ConclusionThis case provides valuable information about tumor with a minimum poorly differentiated adenocarcinoma component may develop lymph node metastasis even satisfying the guidelines criteria for curative resection.

OROPHARYNGEAL SQUAMOUS CELL CARCINOMA TREATED CONCURRENTLY WITH CETUXIMAB: A CASE REPORT OF INTOLERANCE TO CISPLATIN IN YOUNG AGE

Squamous cell carcinoma of the oropharynx is a common case of head and neck cancer related to human papillomavirus. We present a case of moderately (G2) differentiated squamous cell carcinoma, which responded well to concurrent radiotherapy with cetuximab after intolerance of cisplatin. A 37-year-old woman referred to our hospital for a locally advanced cancer of the base of tongue. Physical examination revealed an ulcerative tumor with spread to the supraglottic structures, and swelling of the right side cervical lymph node at group IIA. The histological diagnosis from a biopsy specimen was moderately differentiated p16 positive squamous cell carcinoma. The patient underwent cisplatin-based concurrent chemoradiotherapy. Two – three weeks after receiving an intravenous cisplatin dose 100 mg/m 2 for the first day of chemorradiation, the patient presented with profound bilateral sensorineural hearing loss. The cisplatin-based chemotherapy had changed to alternative agent. The patient continuously underwent concurrently radiation with cetuximab without the break of radical radiotherapy course. The patient experienced partial recovery of hearing after radical treatment of cancer. Complete clinical and radiological response of oropharyngeal squamous carcinoma was achieved. Conclusions. Toxicity with only one standard dose of cisplatin can be profound also in young age. This risk should be addressed when counseling patient prior to initiation of treatment. In case of platinum ineligibility, replacing cisplatin with less toxic agent cetuximab may be taken into consideration for p16 positive carcinoma of the oropharynx.

DRESS sindrom bez eozinofilije uzrokovan karbamazepinom - prikaz slučaja

Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare, severe, systemic, drug-induced hypersensitivity syndrome, the most frequently associated with anticonvulsants. Case Report: A 35-years-old woman with a history of depression and hypothyroidism developed fever 39.5°C, enlarged, painful neck and axillary lymph nodes, slight facial edema around the mouth, confluent maculopapular rash, and laboratory signs of hepatocellular injury, leukocytosis and lymphopenia, but with normal eosinophil count. The syndrome was evident two weeks after starting carbamazepine, and gradually decreased after withdrawal of this drug and introduction of corticosteroid therapy. Conclusion: If a patient is taking carbamazepine and develops skin rash as well as fever and swollen lymph nodes, the physician should always check for internal organ damage and possible DRESS syndrome.

Prevalence and Clinicopathological Studies of Theileriosis in Goats

The present study was conducted to study the clinical profile, hemato-biochemical, post-mortem and histopathological changes of theileriosis in goat cases reported from areas in and around of Udgir city of Maharashtra state during the period from January to December 2020. Out of 107 suspected cases, 41 goats were found positive for theileriosis indicating an overall prevalence of 38.32%. The important clinical signs observed in theileriosis affected goats were fever, pale mucous membranes, swollen lymph nodes, respiratory distress and tick infestation. The hemato-biochemical abnormalities of theileriosis in goats were marked granulocytic leukocytosis, anemia, elevated levels of serum ALT, AST, BUN, creatinine and total bilirubin. The blood and lymph node aspiration smears revealed presence of pleomorphic intra-erythrocytic piroplasms and lymphoblastoid cells or macrophages with intra-cytoplasmic schizonts of Theileria spp. respectively. The characteristic post-mortem lesions of theileriosis in goats were pale or papery white mucous membranes, swollen oedematous or haemorrhagic lymph nodes, splenomegaly, punched out ulcers in abomasum and hepatomegaly with icteric discoloration. The histopathological lesions observed includes multiple haemorrhagic ulcerations and necrosis of mucosal epithelium of abomasum, proliferative changes in lymph nodes, hepatocellular degeneration and interstitial pneumonia. In conclusion, goat population in and around of Udgir city of Maharashtra state had overall prevalence of 38.32% of theileriosis by blood and lymph node aspiration smear examination.

Infektivna mononukleoza i autoimuni hepatitis

Introduction: The case report shows a sick nine-year-old girl whose disease initially manifested as infectious mononucleosis. Encountering infectious mononucleosis in pediatrics is quite common and it is estimated that as much as 50% of children are infected with the Epstein-Barr virus before the age of 5. Suspicion of mononucleosis emerges every time there is a patient with swollen neck lymph nodes, fever, painful and difficult swallowing. However, the laboratory findings in the second month of the onset of the disease raised suspicion for autoimmune disease. Case report: Based on the clinical manifestations, the patient underwent a series of examinations such as biochemical analyses, blood count, and Epstein-Barr virus serology, as well as abdominal ultrasound and testing of ceruloplasmin and Alpha-1 antitrypsin values. The autoimmune disorder was confirmed after detecting elevated IgG levels, the presence of anti-LKM antibodies, and interface hepatitis as a pathoanatomic substrate of liver bioptates. Conclusion: The case report presents the Epstein-Barr virus as a direct trigger of autoimmune hepatitis. This DNA virus known for its cytopathic effect on B lymphocytes induced the swelling of lymph nodes, liver, and spleen. Its overall impact on B lymphocytes and the liver led to producing specific autoantibodies and infiltrating hepatic nodes with lymphocytes.

Kimura's disease: A challenge to the cytologist

Kimura's disease is a rare idiopathic chronic inflammatory disease which usually presents as deep-seated subcutaneous swelling in the head and neck region. Accompanied by lymphadenopathy, peripheral eosinophilia, and elevated immunoglobulin E levels, it is more prevalent among young Asian males. Here, I report the case of a 20-year-old male presenting with left posterior cervical lymph node swelling. Based on proper clinical setting and characteristic cytological features, a cytological diagnosis of Kimura's disease was rendered which was later confirmed by histopathological examination.

Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease.

Objective:To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD).Methods:Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated.Results:After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04).Conclusion:HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced.

A Case of Paraaortic Lymph Node Swelling Diagnosed as Metastasis from Intrahepatic Bile Duct Cancer following Laparoscopic Retroperitoneal Resection

A Case of Paraaortic Lymph Node Swelling Diagnosed as Metastasis from Intrahepatic Bile Duct Cancer following Laparoscopic Retroperitoneal Resection

Histological conversion of seminoma of testis to metastatic choriocarcinoma in left cervical lymph node: An unusual phenomenon

Germ cell tumors (GCT) of more than one histological subtype (although very rare) can be present in the same patient. We present a 29-year-old male who presented with a cervical lymph node swelling. The tissue received was a globular mass with a thick cystic wall and necrotic areas. A histopathological examination revealed the presence of residual lymphoid tissue in the form of lymphoid follicles, areas of hemorrhage and necrosis, tumor nests, and perivascular distribution of tumor cells. The neoplastic cells were arranged in a vague glandular pattern and also showed squamoid-like morphology on the basis of which a diagnosis of metastatic adenosquamous carcinoma was made. The patient was subjected to a whole-body positron emission tomography (PET) scan to look for primary on which a testicular mass was discovered; seminoma on histology. The sections of the cervical mass were revisited and trophoblastic cells were identified; they were also positive for β- human chorionic gonadotropin (hCG) on Immunohistochemistry. Therefore, a diagnosis of metastatic choriocarcinoma from seminoma testis was made. The direct derivative of germ cell neoplasia in situ/intratubular germ cell neoplasia being seminoma; it has the capacity for histological conversion to more differentiated forms (choriocarcinoma in this case).

Case report of a patient with recurrence after endoscopic submucosal dissection for superficial esophageal cancer, diagnosed with mediastinal lymph node endoscopic ultrasound-fine needle aspiration based on the symptom of hoarseness

The patient was an 81-year-old man who presented with a complaint of hoarseness. When he was 80 years old, he had developed superficial esophageal cancer and had undergone endoscopic submucosal dissection (ESD) at our hospital. Two months after the ESD, he developed hoarseness. Computed tomography (CT) scan showed no abnormal findings at that time;therefore, he was diagnosed with idiopathic vocal cord paralysis, and followed up with symptom treatment in the Gastroenterology and Otolaryngology Departments. Ten months after the ESD, a CT scan revealed mediastinal lymph node swelling. He was admitted to our hospital for histopathological examination of the lymph node using endoscopic ultrasound-fine needle aspiration (EUS-FNA). The histopathological examination revealed squamous cell carcinoma of the lymph node, similar to the primary esophageal tumor. This result suggests that laryngeal nerve paralysis involving hoarseness is caused by lymph node metastasis of superficial esophageal cancer. We report that histopathological examination with EUS-FNA helps in determining the cause of hoarseness that develops after ESD.

Cervical Cystic Hygroma in an Older Adult: A case study

Cystic hygromas are very uncommon malformations in adults. In most of the cases, they present as a painless, fluctuant swelling, usually located in the neck region. They tend to grow extensively if not removed. Cystic hygromas can range from 1 mm to several centimeters in size and are filled with clear- to straw-colored fluid. Surgical treatment remains the gold-standard treatment for these tumors. In some cases they can be misdiagnosed with branchial cysts, swollen lymph nodes or other pathologies. When this malformation is present in the prevertebral fascia its surgical treatment is challenging, and some Authors advise its conservative treatment, which is in a great risk of its reoccurence. Because of potential malignant transformation in some percentage of branchial cyst cases, a similar situation was suspected. The present report describes a case of cystic hygroma of the left side of the neck in a 92-year-old female adult and its clinical, radiologic and operative features.

Characteristic MR Imaging Findings of the Temporomandibular Joint in Diabetes Mellitus: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle and Lymph Node Swelling in the Parotid Glands

Characteristic MR Imaging Findings of the Temporomandibular Joint in Diabetes Mellitus: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle and Lymph Node Swelling in the Parotid Glands