Painless Cervical Adenopathy Research Articles

Temporal bone manifestation of primary extranodal Rosai–Dorfman disease: a case report

BackgroundRosai–Dorfman disease is a rare benign histiocytic disorder characterized in most cases by painless cervical adenopathy. Less than 10% of extranodal cases involve bony lesions. Primary bone Rosai–Dorfman disease in the absence of nodal disease is extremely rare.Case presentationA 48 year-old Caucasian male presented with progressive right-sided otalgia, tinnitus, vertigo, and hearing loss. A right temporal bone lytic lesion was detected on diagnostic imaging. Resection of the lesion and histopathological examination revealed Rosai–Dorfman disease.ConclusionsRosai–Dorfman disease primary bone lesions are an atypical presentation of a rare disease. This is the second reported case of Rosai–Dorfman disease arising within the temporal bone. This case study reveals that Rosai–Dorfman disease should be considered for patients presenting with inflammatory/lytic lesions of the temporal bone, in cases where infection and malignancy have been excluded.

Toxoplasmosis in immunocompetent and immunocompromised population of Constanţa, Romania

Abstract We analyzed a total of 412 adult patients diagnosed with toxoplasmosis in the Clinical Infectious Diseases Hospital Constanta between 01Jan 2010 - 01 Jan 2015. Of these patients, 82.03% were from urban area, 74% female, majority aged 30-48 years. 3.15% were diagnosed with HIV infection (13 patients), in four of these patients, toxoplasmosis was the primary clinical manifestation. The most common clinical manifestation in nonHIV infected patients was painless cervical adenopathy (106 patients), 49 patients had associated infection with Toxocara and in HIV infected patients prevailed cerebral toxoplasmosis (toxoplasmic encephalitis, with or without focal CNS lesions). 59 pregnant women (6 with acute infection and 53 with chronic infection) were followed during pregnancy. Reporting the number of cases of toxoplasma infection in Constanta population (254.693 inhabitants), we obtain a prevalence of 161.76 cases/100.000 inhabitants. Most of the patients were female and their supervision is required for possible implications in pregnancy. We believe that Toxoplasma infection is underdiagnosed in our county.

Rosai–Dorfman Disease

Sinus histiocytosis with massive lymphadenopathy or Rosai-Dorfman disease is a rare clinicopathological entity that typically affects young adults, with patients presenting frequently with fever and painless cervical adenopathy. It can mimic lymphoproliferative diseases, and FDG PET/CT typically demonstrates significant FDG avidity in areas of disease. We report a case of a young Chinese woman presenting with pyrexia and painless cervical adenopathy, for which FDG PET/CT performed as part of the diagnostic process demonstrated FDG avid lesions in both nodal and extranodal sites.

Hodgkin's disease in primary care.

Hodgkin's disease is a common hematologic malignancy in young adults. The typical patient is a young adult male presenting with painless cervical adenopathy or a mediastinal mass on chest X-ray. If diagnosed early and aggressively treated, long-term survival rates are excellent. The subtypes of Hodgkin's disease are differentiated by pathologic examination of an affected lymph node. Chemotherapy, with or without adjuvant radiation, is the favored therapeutic regimen for most patients. A comprehensive approach to care, which incorporates psychosocial implications, can improve quality of life for Hodgkin's disease patients.

Nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a tumor that is uncommon in children and adolescents. Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy. The tumor is curable, but late diagnosis makes this possibility much less likely. Diagnosis of this tumor requires a high index of suspicion on the part of clinicians treating the pediatric population.

Necrotizing lymphadenitis

Thirty patients with necrotizing lymph-adenitis, a disorder initially described in Japan and commonly misdiagnosed as malignant lymphoma, have been studied, in addition, stains for immunologic markers were performed. The patients included 21 United States residents and most commonly were young women with a subacute illness characterized by persistent, painless cervical adenopathy with or without fever. The excised lymph nodes were moderately enlarged and typically showed focal, well-circumscribed, paracortical, necrotizing lesions, and abundant karyorrhectic debris, scattered fibrin deposits, aggregates of large mononuclear cells, and a paucity of plasma cells and neutrophils. Immunohistochemical stains on frozen tissue sections were positive for 63D3 and Leu-2a, indicating an admixture of of histiocytes/macrophages and cytotoxic/suppressor T-lymphocytes in the necrotizing lesions. The etiology of necrotizing lymphadenitis and its distinction from other causes of reactive lymphadenitis are discussed. To our knowledge, this disorder has not previously been reported in the United States.

The neurologic manifestations of sinus histiocytosis with massive lymphadenopathy.

Sinus histiocytosis with massive lymphadenopathy is a benign pseudolymphomatous disease with distinctive microscopic features. Painless cervical adenopathy is the most characteristic clinical finding, although other node groups and extranodal sites may be involved. Of 200 patients in a case registry, 8 had neurologic symptoms. The lesions included vertebral canal and intracranial infiltrates and a destructive vertebral body lesion. Two patients had both cord compression and intracranial disease; one of them died after 10 years of disease. Seven patients were alive 1 to 15 years after disease onset.

Sinus Histiocytosis With Massive Lymphadenopathy: Ear, Nose, and Throat Manifestations

Sinus histiocytosis with massive lymphadenopathy (SHML) is a newly recognized, distinct, pseudolymphomatous benign entity with very characteristic microscopic features. Most patients are children or young adults with massive painless cervical adenopathy, although other node groups and extranodal sites often are involved. Sixteen patients with SHML involving the upper respiratory tract and/ or salivary gland are presented. Nine of the patients had ear, nose, and throat (ENT) manifestations at the time of presentation. In most cases the ENT involvement resulted in prominent clinical symptoms. Treatment included surgery, antibiotics, irradiation, chemotherapy, and steroids, frequently in combination, but no consistent pattern of response emerged from the study. These 16 patients were very similar clinically to patients with SHML who did not have ENT disease, indicating that extranodal involvement is not associated with more aggressive disease.