Spontaneous Resolution Of Lesions Research Articles

Primary Central Nervous System Vasculitis Mimicking Susac Syndrome and Multiple Sclerosis With Long-Term Remission and Spontaneous Resolution of Lesions: A Case Report

Primary Central Nervous System Vasculitis Mimicking Susac Syndrome and Multiple Sclerosis With Long-Term Remission and Spontaneous Resolution of Lesions: A Case Report

10020-ML-1 SENTINEL LESION PRECEDING PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA

Abstract It has been reported that there are rare cases of spontaneous resolution, which are referred to as sentinel lesions in the early stages of primary malignant lymphoma of the central nervous system (PCNSL). In this study, we examined cases of PCNSL that presented with a sentinel lesion. Of the 43 PCNSL cases biopsied at our institution between 2011 and 2022, three cases were difficult to diagnose on initial biopsy. No preoperative steroids were used in all patients, and postoperative CT or MRI confirmed that the lesions were appropriately sampled from the targeted lesions. Since the diagnosis was not confirmed by the initial biopsy and symptoms were stable, the patients were followed up without chemotherapy, but symptoms worsened around 6 months later, and MRI showed recurrent large lesions. Another biopsy was performed in all patients, and a definitive diagnosis of diffuse large B-cell lymphoma (DLBCL) was finally obtained. It has been reported that sentinel lesions in PCNSL are characterized by demyelination or nonspecific inflammation on initial pathology and spontaneous resolution of lesions, which are estimated to be changes mediated by immunological mechanisms. In the present study, the course of symptoms was characterized by a relatively slow progression, and diffusion-weighted images at the initial onset did not show as high a signal as in usual PCNSL. Multiple biopsies are required to make a definitive diagnosis, and careful follow-up of symptoms and images and determination of the appropriate timing of biopsy are important.

Clinical and microbiologic investigation of an expedited peri-implantitis dog model: an animal study

BackgroundAnimal studies are pivotal in allowing experimentation to identify efficacious treatment protocols for resolution of peri-implantitis. The purpose of this investigation was to characterize an expedited dog peri-implantitis model clinically, radiographically, and microbiologically.MethodsEight hound dogs underwent extractions (week 0) and implant (3.3 × 8.5 mm) placement with simultaneous surgical defect creation and ligature placement for induction of peri-implantitis (week 10). Ligatures were replaced at 6 weeks (week 16) and removed after 9 weeks (week 19) when supporting bone loss involved approximately 50% of the peri-implant bone. Microbial samples from the defects and healthy control implant sites collected at week 19 were analyzed utilizing a microarray. Clinical measures of inflammation were obtained and radiographic bone loss was measured from periapical radiographs. Radiographic depth and width measurements of bony defect were repeated at weeks 10 (baseline), 16, and 19. Canonical analysis of principal coordinates was used to visualize overall differences in microbial abundance between peri-implantitis and healthy implants.ResultsThis accelerated disease protocol led to intrabony defect creation with a mean depth and width of 4.3 mm and 3.5 mm, respectively after 9 weeks of ligature placement. Microbial identification revealed 59 total bacteria in peri-implant sites, 21 of which were only present in peri-implant sites as compared to healthy controls. Overall microbial beta diversity (microbial between-sample compositional diversity) differed between peri-implantitis and healthy implants (p = 0.009).ConclusionsWithin the limitations of this study, this protocol led to expedited generation of peri-implant defects with a microbial profile indicative of a shift to disease and defect patterns conducive to regenerative treatment. However, the possibility of potential spontaneous resolution of lesions due to the lack of a chronicity interval as compared to chronic disease models need to be further clarified and considered during preclinical peri-implantitis model selection.

Granuloma anular generalizado: un reto terapéutico. Nuestra experiencia en 12 pacientes

IntroductionGranuloma annulare is a benign skin disease characterized by the presence of umbilicated papules or annular plaques, which most frequently affects young people and is typically located on the extremities. The generalized form, with later onset, represents 15% of the total. Although spontaneous resolution of lesions is described in up to 80% of cases within 2 years, recurrence is highly frequent, occurring in up to 40% of cases. Materials and methodsWe conducted a retrospective descriptive study of cases of generalized granuloma annulare evaluated at our center between January 1, 2007 and February 28, 2010. ResultsWe identified a total of 12 patients, 11 adults aged between 22 and 65 years, and a boy of 10 years. Most were women (10 out of 12). None of our patients had associated diseases such as diabetes mellitus, thyroid disease, hepatitis, or immunosuppression, and there were only two patients with dyslipidemia. The location of the lesions was most frequently the lower extremities, followed by the lower limbs and trunk. In all patients, the lesions were annular plaques. Most were asymptomatic, except in cases related to pruritus. In all patients, skin biopsy was compatible with granuloma annulare. The most common histological type was interstitial (10 out of 12), and granulomas were found in the remaining two patients. Of all the treatment regimens (topical and oral corticosteroids, phototherapy, antimalarial drugs and potassium iodide), only PUVA (ultraviolet A associated with psoralen) was useful. This treatment improved the lesions in five patients but four of them relapsed after treatment discontinuation. In two patients there was spontaneous remission. DiscussionThe course of generalized granuloma annulare is unpredictable, and spontaneous remission may occur at any time. The therapeutic arsenal used in the treatment of this condition is very broad, but very few treatments have scientifically proven effectiveness. In our series, the most effective treatment was PUVA, but most patients relapsed after this treatment was discontinued.

Technetium and blood extravasation before gammagraphy: a case report

BackgroundAn 80-year-old woman presented with an abrupt onset of asymptomatic black-to-purple discoloration of her right limb that appeared just before a thyroid gammagraphy. No antecedent of trauma was found.Case presentationOn questioning, patient admitted she did not cooperate during intravenous administration of Tc-99m-pertechnetate. Based on the abrupt onset of lesions and the absence of cooperation during intravenous administration of radiotracer, a suspect diagnosis of technetium and blood extravasation was made. This entity was confirmed in basis of evolution, with a spontaneous resolution of lesions within the next 15 days with no complications.ConclusionPatient and physicians must be reassured because of the non-vesicant property of technetium. Recovery of this entity is spontaneous, and no treatment is needed.

Histiocytome congénital : une lésion bénigne

We report on a newborn presenting a solitary congenital skin nodule due to Langerhans cell histiocytosis. This benign lesion is rare and has been described in the literature under a variety of names; there is no consensus regarding treatment. A 28-day-old newborn presented with a solitary congenital blue-brown nodule measuring 1cm on the left iliac fossa. Histological examination of a skin biopsy showed a proliferation of histiocytes throughout the dermis with an immunohistochemical profile of Langerhans cells. The lesion resolved spontaneously, with rapid reduction of the infiltration, and at 16 weeks only a pigmented scar remained. Thirty-eight similar cases have been reported in the literature under a variety of different names. The lesions noted consisted of a solitary brownish nodule measuring 1cm which was congenital in almost all cases, often ulcerated and exhibited no predilection for any particular body site. Histological examination revealed dermal proliferation of Langerhans cells. Electronic microscopy revealed dense intracytoplasmic bodies and Birbeck's granules. Laboratory and radiological tests did not show systemic involvement in any cases. All lesions other than those surgically removed regressed spontaneously within a mean 8 weeks. It appears necessary to differentiate between congenital and other forms of histiocytoma since therapeutic strategies differ. Spontaneous resolution of lesions and lack of systemic involvement militate in favour of simple clinical follow-up, with surgical excision and further tests required only for cases lasting 6 months and beyond.

PRESUMED TRANSIENT REACTIVE ASTROCYTIC HYPERPLASIA IN IMMATURE RETINA

To describe the appearance and clinical course of small, white, endophytic calcific, peripheral lesions in developing retina of premature infants. Retrospective review of all patients evaluated for retinopathy of prematurity (ROP) at a level I neonatal intensive care unit (NICU) in San Jose, CA, between January 1, 2003, and December 31, 2004. Patients were examined either in the NICU or the affiliated outpatient clinic. Clinical examination consisted of dilated fundus examination with 360 degree scleral depression. Lesions were identified if they were white, calcific, peripheral, and transient. Ancillary testing and examination of family members was performed as indicated. A total of 302 unique patients were screened for ROP. Ten lesions were identified in seven eyes. Three eyes had two lesions each. All lesions were unilateral. The size of the lesions was estimated to range between 500 and 700 microm. All lesions were located anterior to the vascularized retina, had minimal elevation on scleral depression, and demonstrated a predilection for the nasal and temporal raphe. Ultrasound findings demonstrated an elevated, hyperechoic mass with orbital shadowing. Computed tomography and magnetic resonance imaging tests did not demonstrate the lesions. Lesions involute slowly over a period of 6 months. There were no systemic findings or familial dispositions. Immature retina in premature infants may predispose to the formation of transient reactive astrocytic hyperplasia. Development of mature retinal vascularization and spontaneous resolution of lesions should alleviate concerns regarding a more malignant diagnosis.

Tratamiento de la neurocisticercosis: Revisión critica

Neurocysticercosis (NCC) is the most common parasitic disease of the central nervous system. Several drugs, such as drugs against tapeworms, praziquantel or albendazole associated to corticosteroids, have been tested for the treatment of this condition. Although some have claimed the reduction or involution of cystic or granulomatous lesions, there is no consensus about the efficacy of these treatments. The natural evolution of the disease is not clear and this hampers the assessment of treatment effects. Moreover, there are no good imaging or clinical indicators that can predict the progression or spontaneous resolution of lesions, specially at the meningeal or ventricular compartment. Therefore, evidence based medicine does not have a definitive answer about the treatment, neither of seizures, the most common manifestation of NCC, or the varied and complex meningeal and ventricular involvement. This review includes experts opinions to give the clinician some clues for decision making in the treatment of NCC.