RESUMO
Mycobacterium marinum is a ubiquitous water-borne non-tuberculous mycobacterial (NTM) pathogen. In humans, M. marinum infections are acquired through direct inoculation of skin wounds and are almost exclusively localized to skin and soft tissues. Pulmonary infection with M. marinum is extremely rare, and to our knowledge, invasive endobronchial disease has not been reported. Here, we present a case of a 71-year-old immunocompetent male surfer with invasive endotracheal M. marinum granulomatous disease. The patient was successfully cured with a regimen of azithromycin 250 mg daily, ethambutol 900 mg (15 mg/kg) daily and rifampicin 600 mg daily for 12 months following culture conversion. This case highlights several important concepts: Firstly, M. marinum infection, including invasive endobronchial infection, should be considered a rare cause of NTM pulmonary disease. Secondly, endotracheal infection can be successfully eradicated with this selected therapeutic regimen. Finally, the absence of M. marinum skin or soft-tissue infection in this patient, raises the possibility that human disease might also be acquired via inhalation of M. marinum contaminated water in rare circumstances.
RESUMO
Four patients with synchronous breast cancer and lymphoma are described. In all cases, the lymphoma was an unexpected finding in the histopathology of the axillary lymph-node dissection. The diagnosis of synchronous malignancies poses challenges for both the diagnosing pathologist and the treating clinician.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Linfoma não Hodgkin/patologia , Neoplasias Primárias Múltiplas/patologia , Axila , Carcinoma Ductal de Mama/secundário , Feminino , Humanos , Excisão de Linfonodo , Metástase LinfáticaAssuntos
Septo Interatrial/patologia , Cardiopatias/diagnóstico , Lipomatose/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Átrios do Coração/patologia , Cardiopatias/patologia , Neoplasias Cardíacas/diagnóstico , Humanos , Hipertrofia , Lipoma/diagnóstico , Lipomatose/patologia , Lipossarcoma/diagnósticoRESUMO
Granulocytic sarcoma is a rare manifestation of myeloid leukemia and is even rarer as a primary presentation. Granulocytic sarcoma may affect any organ and has many modes of presentation. Diagnosis by cytology is possible as long as the diagnosis is considered. Diagnosis by cytology of body cavity effusion fluid has rarely been described. We present an unusual case of granulocytic sarcoma in which pleural effusion was a part of the initial presentation. Cytologic examination of the pleural effusion was able to make the definitive diagnosis of granulocytic sarcoma.