Red Nodules Research Articles

Tubular apocrine adenoma with uncertain malignant findings: report of a case and review of the literature

Introduction: Tubular apocrine adenoma (TAA) is a rare sweat gland tumor, usually presenting as a well-defined, red to brown nodule on the scalp. Generally, TAA is considered as benign tumor; however, it may be difficult to differentiate TAA from metastatic or primary carcinoma. Case presentation: A woman in her 90s presented with a pale red nodule on her right posterior auricle for 3 years. Histology showed several tubular structures contained two layers in the dermis. These showed decapitation secretion. At the periphery of the lesion, squamoid tumor cells formed nest-like patterns. Some squamoid tumor cells exhibited multinucleation. From the histopathological findings, we diagnosed the tumor as tubular apocrine adenoma with uncertain malignant findings. Conclusion: TAA is a rare sweat gland neoplasm. Although TAA is generally benign, it can exhibit aggressive features, making thorough pathological evaluation crucial to rule out malignancy.

Red nodule on the face of a middle-aged woman

Red nodule on the face of a middle-aged woman

A 4-year-old Boy with a Red Nodule on His Hand: A Quiz.

A 4-year-old Boy with a Red Nodule on His Hand: A Quiz.

Aspergillosis in 41 wild bird species in the eastern United States: a 22-year retrospective review.

Aspergillosis is the most commonly and widely reported fungal infection in birds. Disease development is often secondary to stressors that cause immunocompromise, and it is typically regarded as a disease of captivity. We retrospectively evaluated data from 133 birds diagnosed with aspergillosis at the Southeastern Cooperative Wildlife Disease Study from 2001-2023 to assess diversity and relative frequency across avian taxa, gross and histologic lesion patterns, and comorbidities. Of 10 taxonomic orders represented, Charadriiformes (shorebirds; n = 35) and Accipitriformes (raptors; n = 32) were most common. Among them, the laughing gull (Leucophaeus atricilla; n = 20) and bald eagle (Haliaeetus leucocephalus; n = 14) were infected most commonly. Gross lesions were most frequent in lung (n = 80), air sac (n = 71), or celomic cavity lining (n = 42). Four distinct gross lesion patterns were identified: 1) tan caseous plaques (n = 106), 2) hollow masses lined with mold (n = 26), 3) red pulmonary nodules (n = 15), and 4) necrotic brown plaques (n = 3). Histologically, fungal hyphae were most common in lung (n = 107) and air sac (n = 49). Comorbidities were diagnosed in 67 birds with a spectrum of viral (n = 19), bacterial (n = 11), parasitic (n = 6), other fungal (n = 4), and non-infectious (n = 50) causes. Six birds each were diagnosed with highly pathogenic avian influenza or salmonellosis. Twenty-two birds were emaciated. Free-ranging birds are susceptible to myriad stressors that can predispose them to the development of aspergillosis.

Characterization of different clinical presentation of Merkel cell carcinomas and their potential prognostic implications.

Recent studies analyzed the impact of Merkel cell polyomavirus (MCPyV) on the prognosis of Merkel cell carcinoma (MCC) patients. No data on specific morphological clinical differences of MCPyV+ or MCPyV- are currently available neither on the possible prognostic implication of different clinical presentation of MCC. 1) to describe clinicopathological characteristics of MCC patients and the prevalence of MCPyV infection in an Italian cohort of patients; 2) to define possible differences in clinicopathological and prognostic features among MCPyV+ and MCPyV- MCCs. Retrospective, multicenter, cohort study conducted in two Italian tertiary referral centers. MCPyV presence was detected by immunohistochemistry (IHC) and PCR with two different primers amplifying VP1 (VP1-PCR) and LT viral region (LT-PCR). Clinicopathological features were compared between MCPyV+ and MCPyV- tumors and between red exophytic nodules and subcutaneous cyst-like MCCs. 62 MCCs were included, presenting as red exophytic nodules (69.3%) or with a subcutaneous cyst-like appearance (19.3%); MCPyV was detected in 40.3% of cases by IHC, 56.4% by VP1-PCR and 79% by LT-PCR. No correlation was found between clinical morphology and viral status. Mortality rate was 40.8% for MCPyV- and 23.1% for MCPyV+ (p-value 0.239) and 69.8% for red nodules and 25% for cyst-like lesions (p-value 0.005). By multivariable analysis, age at diagnosis, ki67 and treatment with surgery/radiotherapy remained the only factors significantly affecting the OS. This study highlights the potential impact of clinical morphology of MCCs on prognosis. Subcutaneous cyst-like morphology may provide a survival benefit to the patients, regardless the presence of MCPyV.

A Rare Presentation of Type 2 Lepra Reaction: Necrotizing Erythema Nodosum Leprosum with Extensive Ulceration

Background: Leprosy, primarily caused by Mycobacterium leprae, is a chronic infectious disease that mainly affects the skin and peripheral nerves. Type 2 leprosy reaction (ENL) is an immune complex-mediated complication characterized by inflammation of the skin, nerves, and other organs. A less common manifestation of ENL is necrotizing ENL, which presents with extensive skin necrosis and ulceration. This case report describes a rare presentation of necrotizing ENL with extensive ulceration in a young woman with borderline lepromatous leprosy. Case presentation: A 20-year-old female presented with multiple, progressively enlarging, painless ulcers on her right leg and painful reddish nodules on her left arm and left leg. She had a history of borderline lepromatous leprosy. Dermatological examination revealed madarosis, infiltration, nodules, hyperpigmentation macules, ulcers, and blackish crusts. Sensory testing showed hypoesthesia in the abdomen and back, and anesthesia in both lower arms and legs. Histopathological examination confirmed the diagnosis of necrotizing ENL. Conclusion: Necrotizing ENL is a rare and severe complication of leprosy. This case highlights the importance of early diagnosis and appropriate management with multi-drug therapy and corticosteroids to prevent significant morbidity and disability.

Canine corneoconjunctival hemangiosarcoma: case report from Costa Rica

A 10-year-old, 8-month-old indoor, outdoor male mixed breed dog had a dark red nodule on the left cornea. Treatment included surgical removal of tissues from the temporal corneoconjunctival area, cryotherapy, and graft placement. The dog was diagnosed with hemangiosarcoma by histopathology. One year and two months after surgery, the eye is functional and shows no signs of tumor regrowth.

Primary Umbilical Endometriosis Fine Needle Aspiration Cytology Diagnosis: Case Report and Literature Review

Introduction Umbilical endometriosis is a rare form of endometriosis accounting for 0.5-1% of total cases of endometriosis. It may occur in the setting of prior abdominopelvic surgical procedures or spontaneously, where the latter is more common. The classic clinical presentation is red or black painful nodule with cyclical nature of pain. Initial diagnosis is usually made clinically but histopathologic confirmation is required. Fine needle aspiration cytology is also diagnostic for endometriosis. This case report is aimed to highlight the role of Fine needle aspiration cytology in diagnosing endometriosis, and discus the clinical presentation, pathogenesis and diagnosis of primary umbilical endometriosis with review of previously published case reports. Presentation of Case A 24 years old nulliparous woman presented with slowly growing umbilical swelling and pain of 02 years duration. The pain worsens with menses. She had no history of previous surgical procedure. On physical examination there was well defined, non-tender, firm mobile subcutaneous mass with overlying skin hyperpigmentation measuring, 23mm*19mm. Fine needle aspiration cytology was done from the nodule and the findings were consistent with endometriosis. Subsequent histopathologic examination also confirmed the diagnosis of endometriosis. Conclusion Even though it is rare, primary umbilical endometriosis should be considered in a women of reproductive age group presenting with painful umbilical mass. With favorable clinical setting, fine needle aspiration cytology is cost effective, fast and accurate diagnostic modality in diagnosing umbilical endometriosis.

Sebaceous Adenoma in a Geriatric Poodle Dog: A Case Report

A 14-year-old black male Poodle was brought to the Animal Teaching Hospital, Udayana University by its owner with clinical signs of frequent licking of its left front paw. Upon examination, red bumps were observed on the left front leg, accompanied by small, round black spots scattered on the dorsal side of the body. Additionally, black nodules were present on the lower eyelids and hind limbs. Surgical intervention was undertaken to excise the tumor mass, with the animal under anesthesia induced by ketamine at 5 mg/kg BW intravenously. The reddish nodule was excised by performing an elliptical incision at the base of tumor. Postoperatively, the animal received an antibacterial injection comprising ceftriaxone and tazobactam at 25 mg/kg BW intramuscularly and antiseptic wound dressing for supportive care. Microscopic examination revealed neoplastic cells arranged into lobules of varying sizes and shapes within the tumor mass. These lobules consisted of differentiated sebocytes and basaloid cells. At the periphery of the neoplastic lobules, the basaloid cells displayed several layers and exhibited invasion with moderate anisocytosis. The mitotic index was no more than ten cells in one field of view. Based on these histopathological features, the tumor was confirmed to be a sebaceous adenoma. After a 10-month follow-up period, there were no signs of tumor recurrence observed.

A patient with Behcet’s disease and IgA nephropathy in China

BackgroundBehcet’s disease (BD) is an inflammatory disorder of unknown cause that is characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. Local vasculitis can cause damage to the visceral system, but it is rare in kidney patients, especially those with IgA nephropathy (IgAN). In China, a small number of related cases have been reported. Here we present a case of co-occurrence of BD and IgAN.Case presentation: An 18-year-old female who presented with a history of recurrent oral ulcers was found ten years ago. Four years later, the patient presented with reddish nodules on the skin of both lower limbs and then presented with vulvar ulcers. This patient was clinically diagnosed with Behcet’s disease after left calf skin biopsy and presented severe proteinuria and hematuria during this period. IgAN was diagnosed after percutaneous renal biopsy. The patient was treated with hormonal, anti-inflammatory, immunomodulatory, kidney protective, and protein-lowering urine agents. After 3 years of follow-up, the patient reappears oral ulcers, reddish nodules on the skin of both lower limbs and renal dysfunction.ConclusionsBD is less common in China and is clinically prone to missed diagnosis and misdiagnosis. BD with IgAN is rarer. We should regularly pay attention to the routine urine and renal function of BD patients for early detection and treatment and to prevent further progression of the disease.

Giant mucinous liposarcoma of the abdominal cavity: A case report.

Mucinous liposarcoma myxoid liposarcoma is a malignant mucoid soft tissue tumor derived from undifferentiated stromal cells in perivascular, subbody cavity and intermuscular space, and composed of cells at different stages of differentiation from preadipocytes to mature cells. In rare cases, it may change from lipoma malignancy. The main manifestations is painless mass, relatively slow growth, the course can last decades, the prevalence of liposarcoma in the population is 14% to 18%, mainly in adults, male prevalence is higher than women, but not significant. The main good hair part is the thigh, have mucinous sex, high differentiation type, dedifferentiation type, polymorphic type. Clinical diagnosis is difficult, and there are no obvious symptoms in the early stage, so the diagnosis should be combined with B ultrasound, MRI, CT, and other auxiliary examinations. The gold standard is pathological examination. In December 2023, our department admitted a patient with a mucinous abdominal mass. The report is as follows. Does liposarcoma metastasize? Is any chemotherapy required after surgery? Will it ever relapse in the future? What is the survival period after surgery? Mucinous liposarcoma. Surgical resection of the sarcoma. The nodule sample was 33 * 28 * 13 cm, with complete capsule, gray and yellow sections, fine texture, soft, gray, red, grayish, and yellow mucoid nodules in some areas, and the maximum diameter of the nodules was 21cm. Immunohistochemistry was: CD34 (+), CDK 4 (+), CK (-), Desmin (weak +), Ki67 (index 5%), MDM 2 (-), p16 (weak +), S-100P (+), Vimentin (+), BCL-2 (+). He was also sent to the Department of Pathology of Peking Union Medical College Hospital for consultation with Professor Lu Zhaohui, whose consultation opinion was in line with myxoliposarcoma. Retroperitoneal liposarcoma is a common retroperitoneal tumor, but it is relatively rare in clinical practice; the overall morbidity is low, mainly manifested as abdominal pain and abdominal distension, abdominal distension, and a long course of disease; it is not sensitive to radiotherapy and chemotherapy, and should be closely follow up by CT examination to understand the recurrence and metastasis.

Congenital Disseminated Pyogenic Granuloma: A Case With Numerous Mucocutaneous and Visceral Lesions

Abstract Congenital disseminated pyogenic granuloma (CDPG) is characterized by eruptive disseminated or localized lesions, which may arise spontaneously or secondary to predisposing factors. Even rarer is the occurrence of CDPG with numerous lesions affecting variable organs, which develop during the fetal period. This report describes the case of a 32-week-old fetus presenting with severe hydrocephalus and vascular intracranial and right lung masses on magnetic resonance imaging. Preterm labor occurred at the 32nd week due to preterm premature rupture of membranes, and the newborn died due to cardiac dysfunction within 2 hours postpartum. The subsequent autopsy revealed multiple violaceous to dark red papules, nodules, pedunculated and un-pedunculated mucocutaneous masses, as well as two brain lesions, a lung lesion, a thoracic wall intramuscular mass, and a pyloric mass. Microscopic examination and immunohistochemical evaluation for glucose transporter 1 (GLUT1) confirmed the diagnosis of CDPG. CDPG represents a rare condition with an elusive etiology and limited reports in the literature. Differential diagnosis from multifocal infantile hemangioma, based on GLUT1 negativity of CDPG, is imperative due to differing clinical course and treatment modalities. This report underscores a severe case of CDPG characterized by preterm labor and demise shortly after delivery, notable for its extensive involvement across multiple organs, including the brain, lung, intestine, musculoskeletal system, mucosal, and numerous cutaneous sites.

Merkel cell carcinoma overlapping Bowen’s disease: two cases report and literature review

PurposeMerkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin, which mainly occurs in the sun exposed sites of white patients over 65 years, with a higher recurrence and metastasis rate. Clinically, MCC overlapping Bowen’s disease (BD) is a very rare subtype of MCC. Few cases in the literature have been described and the management is not well defined. We summarize and update the epidemiology, clinical and histopathological features, metastasis characteristics, local recurrence rate and management of it by presenting two cases of MCC overlapping BD and reviewing the literature over the last 11 years.DesignWe consulted databases from PubMed, ResearchGate and Google Scholar by MeSh “Merkel cell carcinoma” and “Bowen’s disease”, “Bowen disease” or “squamous cell carcinoma in situ”, from January 2013 to December 2023 and reviewed the literatures. We reported two additional cases.ResultsTotal 13 cases of MCC overlapping BD were retrospectively analyzed, in whom mainly in elderly women over 70 years, the skin lesions were primarily located on the faces, followed by the extremities and trunk. Most of them were asymptomatic, firm, dark red nodules arising on rapidly growing red or dark brown patches, or presenting as isolated nodules. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. All cases were confirmed by histopathology and immunohistochemistry. The most definitive treatment was extended local excision, but local recurrences were common. Of the 13 cases, 4 cases experienced local or distant metastasis. One suffered from an in-transit recurrence of MCC on the ipsilateral leg after local excision and lymph node dissection, whose metastasis completely subsided after avelumab treatment and without recurrence or metastasis during 6 months of follow-up.ConclusionsMCC overlapping BD is a very rare skin tumor mainly predisposed on the faces, with high misdiagnosis rate and recurrence rate. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. The acronym, AEIOUN, has been proposed to aid in clinical identification. Our reports and the literature review can provide a better awareness and management of it.

Impact of microbial consortium of Rhizobium tropici and Rhizobium mayense on the growth of Phaseolus vulgaris L.

Impact of microbial consortium of Rhizobium tropici and Rhizobium mayense on the growth of Phaseolus vulgaris L.

Application of Trisootra Chikitsa in the management of Mukhadooshika with special reference to Acne Vulgaris - A Case Report

Mukhadushika, likewise referred to as acne vulgaris, is a prevalent skin condition with significant medical and psychological repercussions, particularly among adolescents. Acne is a widespread skin problem that affects over 85% of teenagers, primarily on the face as well as on the chest and upper back. Due to the changing lifestyle, incompatible food practices and sedentary lifestyle, these types of skin manifestations became more prevalent in the present scenario. In modern cosmetology the treatment of Acne includes topical retinoids, antibiotics etc. which all usually causes adverse effects like skin irritation, peeling, redness and associated with sun sensitivity. A 25-year-old female patient suffering from facial pimples, pain, and related discomfort visited the OPD. Despite prior allopathic treatment, no relief was observed. By the proper analysis of the patient history thereby adopting Trisootra Chikitsa protocol, a substantial improvement in the patient's symptoms, with the absence of reddish nodules and tenderness considerable change in the complexion over the face of patient was achieved. It is observed that adopting Trisootra Chikitsa principles along with suitable Oushadhis is beneficial in the management of Mukhadushika, thereby improving the complexion of the skin.

Liuwei Dihuang Pills Enhance Osteogenic Differentiation in MC3T3-E1 Cells through the Activation of the Wnt/β-Catenin Signaling Pathway.

The therapeutic efficacy and molecular mechanisms of traditional Chinese medicines (TCMs), such as Liuwei Dihuang pills (LWDH pills), in treating osteoporosis (OP) remain an area of active research and interest in modern medicine. This study investigated the mechanistic underpinnings of LWDH pills in the treatment of OP based on network pharmacology, bioinformatics, and in vitro experiments. The active ingredients and targets of LWDH pills were retrieved through the TCMSP database. OP-related targets were identified using the CTD, GeneCards, and DisGeNET databases. The STRING platform was employed to construct a protein-protein interaction (PPI) network, and core targets for LWDH pills in treating OP were identified. The GO functional and KEGG pathway enrichment analyses for potential targets were performed using the R package "clusterProfiler". A "drug-target" network diagram was created using Cytoscape 3.7.1 software. The viability of MC3T3-E1 cells was evaluated using the CCK-8 method after treatment with various concentrations (1.25%, 2.5%, 5%, and 10%) of LWDH pill-medicated serum for 24, 48, and 72 h. Following a 48 h treatment of MC3T3-E1 cells with LWDH pill-medicated serum, the protein levels of collagen Ⅰ, RUNX2, Wnt3, and β-catenin were quantified using the Western blot analysis, and the activity of alkaline phosphatase (ALP) was measured. A total of 197 putative targets for LWDH pills for OP treatment were pinpointed, from which 20 core targets were singled out, including TP53, JUN, TNF, CTNNB1 (β-catenin), and GSK3B. The putative targets were predominantly involved in signaling pathways such as the Wnt signaling pathway, the MAPK signaling pathway, and the PI3K-Akt signaling pathway. The intervention with LWDH pill-medicated serum for 24, 48, and 72 h did not result in any notable alterations in the cell viability of MC3T3-E1 cells relative to the control group (all p > 0.05). Significant upregulation in protein levels of collagen Ⅰ, RUNX2, Wnt3, and β-catenin in MC3T3-E1 cells was observed in response to the treatment with 2.5%, 5%, and 10% of LWDH pill-medicated serum in comparison to that with the 10% rabbit serum group (all p < 0.05). Furthermore, the intervention with LWDH pill-medicated serum resulted in the formation of red calcified nodules in MC3T3-E1 cells, as indicated by ARS staining. LWDH pills may upregulate the Wnt/β-catenin signaling pathway to elevate the expression of osteogenic differentiation proteins, including collagen Ⅰ and RUNX2, and to increase the ALP activity in MC3T3-E1 cells for the treatment of OP.

Oral lymphangioma: A clinicopathological analysis of 40 cases and review of the literature

AbstractObjectiveThis retrospective study aimed to perform a clinicopathological analysis of oral lymphangioma cases diagnosed at a reference service in oral pathology.Materials and MethodsA total of 40 cases with reviewed and confirmed histopathological diagnoses for oral lymphangioma were included in the study.ResultsIt was found that Caucasian women represented most of the sample, with the tongue and lower lip being the most affected sites. The most frequent clinical presentation of the lesions was as an asymptomatic reddish nodule. As for morphological characteristics, there was a slight predominance of simple lymphangioma (55%). Surgical removal was the therapeutic approach adopted in most cases.ConclusionsDespite OL being rare, it is essential that dentists and other professionals recognize variations in the clinical presentation and histopathological aspects of these lesions, differentiating them from other vascular lesions, and implementing correct treatment in each case.

Cutaneous melanocytic tumor with CRTC1::TRIM11 fusion: a case report

BackgroundCutaneous Melanocytic Tumor with CRTC1::TRIM11 Fusion (CMTCT) represents a novel and rare entity in the realm of dermatological oncology, characterized by distinct melanocytic differentiation. This particular tumor type has yet to be officially recognized by the World Health Organization (WHO). CMTCT is generally perceived as a tumor with a relatively indolent nature; however, it is not devoid of metastatic potential. Therefore, ensuring complete surgical excision of the tumor, coupled with rigorous long-term follow-up, is paramount for patient management. In this context, we report the case of an 18-year-old female patient who presented with a dull red nodule on her left leg. Initial surgical intervention led to a pathological diagnosis of CMTCT, but it was determined that the tumor had not been fully excised. Consequently, a second surgical procedure was undertaken to achieve complete removal of the tumor. During a follow-up period of six months post-surgery, the patient showed no signs of local recurrence or metastasis, indicating a successful outcome.Case presentationAn 18-year-old female patient noticed a dull red nodule on her left leg three years ago, which exhibited slow growth over time. She underwent a subcutaneous tumor resection. Histological examination under high-power magnification revealed that the neoplasm consisted of epithelioid cells arranged in nests, fascicles, bundles, or sheets. The tumor cells had round or ovoid nuclei with prominent nucleoli and visible mitotic figures. Notably, areas resembling nevus cell clusters were observed. Immunohistochemical analysis confirmed melanocytic differentiation. Next-generation sequencing (NGS) identified a CRTC1::TRIM11 fusion, and fluorescence in situ hybridization (FISH) for CRTC1 confirmed rearrangement. Consequently, a diagnosis of cutaneous melanocytic tumor with CRTC1::TRIM11 fusion was established.ConclusionsCMTCT is a rare tumor characterized by melanocytic differentiation. In this case, the tumor predominantly comprised epithelioid cells with localized nevus cell clusters. The expression of melanocyte markers could easily lead to a misdiagnosis as cutaneous melanoma. However, several distinguishing features were noted: the tumor was not connected to the epidermis, exhibited low cellular heterogeneity and proliferation index, and showed minimal cellular atypia. Additionally, tests for EWSR1 rearrangement (FISH) and BRAF V600E mutation (PCR-ARMS) were negative.This case underscores the importance of a comprehensive diagnostic approach when clinical, microscopic, immunohistochemical, and molecular findings do not align. The presence of nevus cell clusters morphology in the tumor cells enhances our understanding of this disease’s histological spectrum and aids in avoiding misdiagnosis or missed diagnosis.

Hemangiosarcoma epitelioide intramuscular em um cavalo

ABSTRACT: A 20-year-old, sexually intact male Dutch Warmblood horse was presented with a 5-day history of difficulty moving and non-flexion of the right pelvic limb, followed by subcutaneous swelling and permanent lateral decubitus. Despite attempts at palliative care, the horse was euthanized after clinical worsening and lack of treatment response. The main gross finding was a soft, red-to-black, lobulated mass involving the right semitendinosus, semimembranosus, and biceps femoris muscles. Soft, red nodules were also seen in all pulmonary lobes and adrenal glands. Histology revealed neoplastic proliferation of malignant polygonal cells, occasionally arranged in irregular anastomosing vascular channels filled with erythrocytes. Neoplastic cells were immunoreactive for factor VIII-related antigen, confirming the blood vascular origin. A final diagnosis of epithelioid hemangiosarcoma was made. These findings reinforced the inclusion of hemangiosarcoma as a differential diagnosis of equine muscular lesions and highlighted the histological features of the epithelioid hemangiosarcoma subtype.

Selection of multi-purpose native rhizobia from a new red clover cultivar developed in Brazil

Selection of multi-purpose native rhizobia from a new red clover cultivar developed in Brazil