RESUMEN
Solitary fibrous tumor (SFT) is a mesenchymal tumor accounting for less than 2% of soft tissue tumors and has variable clinical behavior. It can arise in many anatomical locations of the body and in rare occasions in the oral cavity mostly in buccal mucosa and tongue. To date, a handful of such cases have been reported in the hard palate. We present a case of SFT in the hard palate of a 32-year-old man and describe the tissue morphology, immunohistochemistry workup, and follow-up together with literature review.
Asunto(s)
Paladar Duro , Tumores Fibrosos Solitarios , Masculino , Humanos , Adulto , Paladar Duro/patología , Tumores Fibrosos Solitarios/diagnóstico por imagen , Tumores Fibrosos Solitarios/cirugía , Lengua/patología , InmunohistoquímicaRESUMEN
The present study reports on a 72-year-old female initially treated as a presumed chronic obstructive pulmonary disease (COPD) exacerbation, but she was ultimately discovered to have Aspergillus tracheobronchitis. Bronchoscopic findings were characteristic, revealing diffuse plaque-like inflammatory lesions extending from midtrachea into the mainstem bronchi. Evidence suggests that the rise in cases is attributable to the growing number of individuals who are immunocompromised secondary to underlying disease, combined with the expanding number of patients receiving glucocorticoids and immunomodulating medications to treat chronic, nonmalignant disorders. The present observations emphasize the importance of including Aspergillus tracheobronchitis in the differential diagnosis for patients receiving medications with immunosuppressive potential that present with dyspnea, cough, or fever and who fail to improve with empiric antimicrobial therapy.
Asunto(s)
Aspergillus fumigatus/aislamiento & purificación , Huésped Inmunocomprometido , Aspergilosis Pulmonar/complicaciones , Aspergilosis Pulmonar/inmunología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , Líquido del Lavado Bronquioalveolar/microbiología , Femenino , Humanos , Inmunosupresores/efectos adversos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológicoRESUMEN
Mucormycosis is an invasive fungal infection commonly seen in diabetics and immunocompromised patients. We report a case of disseminated mucormycosis in a 47-year-old diabetic male who underwent deceased donor renal allograft transplantation about 5 weeks prior to presentation. Our patient presented with increasing fatigue, diarrhea and oligoanuria and was found to have significant acute kidney injury. Doppler ultrasound of the allograft revealed segmental decreased renal perfusion in the upper pole of the allograft with moderate hydronephrosis. Nephrostomy tube placement yielded minimal urine output. An allograft biopsy showed diffuse C4d-positive staining and fungal hyphae suggestive of Mucor infection. Computed tomography (CT) imaging revealed a right upper lobe mass, a small hypodensity in the liver and normal findings in the head. Despite prompt management including discontinuation of immunosuppression, amphotericin B and allograft nephrectomy, the patient had a rapid decompensation, developed respiratory failure requiring intubation, hypotension and supraventricular tachycardia with multiple new areas of hypoattenuation on head CT - all of which ultimately resulted in his death. A review of the literature revealed that mucormycosis is a relatively rare disease with a cumulative 12-month incidence rate of 0.07% in solid organ transplant recipients. Disseminated disease was found in about 23% of cases, with a mortality rate of 96%.