RESUMO
BACKGROUND: Castleman's disease of the pancreas is a very rare condition that may resemble more common disease entities as well as pancreatic cancer. CASE PRESENTATION: Here we report the case of a 58-year-old African American male with an incidentally discovered lesion in the head of the pancreas. The specimen from his pancreaticoduodectomy contained a protuberant, encapsulated mass, exhibiting microscopic features most consistent with localized/unicentric Castleman's disease. These included florid follicular hyperplasia with mantle/marginal zone hyperplasia along with focal progressive transformation of germinal centers admixed with involuted germinal centers. CONCLUSION: To date, eight cases of Castleman's disease associated with the pancreas have been described in the world literature. We report the first case of unicentric disease situated within the head of the pancreas. In addition, we discuss the diagnostic dilemma Castleman's disease may present to the pancreatic surgeon and review current data on pathogenesis, treatment, and outcome.
Assuntos
Hiperplasia do Linfonodo Gigante/patologia , Pancreatopatias/patologia , Adenocarcinoma/patologia , Hiperplasia do Linfonodo Gigante/etiologia , Hiperplasia do Linfonodo Gigante/terapia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/etiologia , Pancreatopatias/terapia , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios XRESUMO
Iron pill gastritis has been shown to be associated with superficial gastric erosion and deposition of iron in lamina propria and gastric antral glands. However, iron absorption in gastric parietal and chief cells is rare. We present a case of a 62-year-old man with iron deficiency anemia. His past medical history is significant for Billroth II surgery. His medications include ferrous sulphate 325mg. Esophagogastroduodenoscopy showed diffuse circumferential abnormal mucosa at the gastro-jejunal anastomosis. The mucosa was erythematous and violaceous. Biopsy showed reactive gastropathy with iron deposits predominantly in macrophages, parietal cells, and chief cells. These findings were confirmed by iron stain and later by electron micrography of the gastric mucosa that showed iron deposits in mitochondria and cytoplasm of the parietal and chief cells.
Assuntos
Anemia Ferropriva/etiologia , Celulas Principais Gástricas/metabolismo , Gastrite/induzido quimicamente , Gastroenterostomia/efeitos adversos , Ferro/metabolismo , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/metabolismo , Anemia Ferropriva/patologia , Celulas Principais Gástricas/efeitos dos fármacos , Celulas Principais Gástricas/patologia , Mucosa Gástrica/patologia , Humanos , Ferro/administração & dosagem , Ferro/efeitos adversos , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Células Parietais Gástricas/efeitos dos fármacos , Células Parietais Gástricas/metabolismo , Células Parietais Gástricas/patologiaRESUMO
Amyloid-associated protein (AA)-type systemic amyloidosis has been referred to as secondary amyloidosis because it is secondary to an associated inflammatory condition. It is extremely rare in patients with non-Hodgkin's lymphoma (NHL). Here we report an autopsy case of follicular small cleaved cell lymphoma with focal large B-cell lymphoma transformation in association with systemic AA-type amyloidosis. Formalin-fixed, paraffin-embedded tissues from autopsy and the patient's previous surgical specimen were studied by Congo red stain; electron microscopy; and immunostaining with antibodies against AA protein, P component, and kappa and lambda light chains. There was a marked AA amyloid deposition in the glomeruli of both kidneys, the retroperitoneal lymphoma mass, the blood vessels, the adrenal glands, and the adipose tissues. The patient's previous surgical specimens were negative for amyloid. We propose that this patient's systemic AA-type amyloidosis developed along the course of his NHL.
Assuntos
Amiloidose/patologia , Leucemia Linfocítica Crônica de Células B/patologia , Linfoma de Células B/patologia , Proteína Amiloide A Sérica , Amiloidose/complicações , Amiloidose/metabolismo , Transformação Celular Neoplásica , Evolução Fatal , Humanos , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/metabolismo , Linfoma de Células B/complicações , Linfoma de Células B/metabolismo , Masculino , Pessoa de Meia-Idade , Proteína Amiloide A Sérica/metabolismoRESUMO
Paenibacilli are gram-positive, aerobic bacteria that are related to Bacilli but differ in the DNA encoding their 16S rRNA. Until recently, these organisms were not known to cause human disease. There are now several reports of human infection caused by a few members of this genus, most commonly by P. alvei. We report a human infection in a patient with a permacath for chronic hemodialysis who was found to have bacteremia caused by P. thiaminolyticus, which is an environmental bacterium that has never been found to cause human disease. We identified this bacterium by biochemical tests, cloning, sequencing the genomic DNA encoding its 16S rRNA, growth characteristics, and electron microscopic studies. This constitutes the first report of a human infection caused by this organism.