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BACKGROUND: Gout and seronegative rheumatoid arthritis (SNRA) are two distinct inflammatory joint diseases whose co-occurrence is relatively infrequently reported. Limited information is available regarding the clinical management and prognosis of these combined diseases. CASE SUMMARY: A 57-year-old woman with a 20-year history of joint swelling, tenderness, and morning stiffness who was negative for rheumatoid factor and had a normal uric acid level was diagnosed with SNRA. The initial regimen of methotrexate, leflunomide, and celecoxib alleviated her symptoms, except for those associated with the knee. After symptom recurrence after medication cessation, her regimen was updated to include iguratimod, methotrexate, methylprednisolone, and folic acid, but her knee issues persisted. Minimally invasive needle-knife scope therapy revealed proliferating pannus and needle-shaped crystals in the knee, indicating coexistent SNRA and atypical knee gout. After postarthroscopic surgery to remove the synovium and urate crystals, and following a tailored regimen of methotrexate, leflunomide, celecoxib, benzbromarone, and allopurinol, her knee symptoms were significantly alleviated with no recurrence observed over a period of more than one year, indicating successful management of both conditions. CONCLUSION: This study reports the case of a patient concurrently afflicted with atypical gout of the knee and SNRA and underscores the significance of minimally invasive joint techniques as effective diagnostic and therapeutic tools in the field of rheumatology and immunology.
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Gamma-delta (γδ) T-cell acute lymphoblastic leukemia/lymphoma (T-ALL) is not commonly observed in adult patients. We report three adult cases and describe their immunophenotypes. Two of these cases were diagnosed as γδ T-ALL; one was diagnosed as a mixture of T-ALL and T-cell non-Hodgkin lymphoma (T-NHL). We also discussed the differential diagnoses.
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Glial choristoma of the tongue is an extremely rare developmental malformation. The authors report a case of a 5-month-old male baby with a congenital glial choristoma located on the posterior part of midline of the left dorsal tongue. Histological examination of the resected specimen revealed a poorly demarcated submucosal mass containing neuroglial tissue, scattered neuron, choroids plexus and ependyma. In addition to neuroglial tissue, a sheet of leptomeningeal tissue was observed more rarely in the case. The clinical and pathological characteristics of previous cases and their probable embryogenesis were also reviewed.