ABSTRACT
Wegener's granulomatosis is a multisystem disorder characterized by necrotizing granulomatous inflammation and vasculitis of small vessels and can affect any organ system. The most common sites of involvement are upper and lower respiratory tracts, and kidneys. Breast involvement is unusual and very rare. We report a case of breast Wegener's granulomatosis in a 32-year-old woman who presented with pulmonary lesions and palpable masses in the left breast. Mammography showed multiple, sharply delineated nodules without microcalcifications. Ultrasonography revealed multiple hypoechoic solid lesions, some of them with anechoic areas of necrosis. Computed tomography showed multiple nodules. Histopathology of excision biopsy specimens of breast lesions revealed necrotizing granulomatous material consistent with Wegener's granulomatosis. Twenty reports of breast involvement in this rare disease were found in the literature; however, the respective ultrasonographic and computed tomography findings have not hitherto been described.
Subject(s)
Breast Diseases , Granulomatosis with Polyangiitis , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Adult , Biopsy, Needle , Breast/pathology , Breast Diseases/diagnostic imaging , Breast Diseases/drug therapy , Breast Diseases/pathology , Cyclophosphamide/administration & dosage , Cyclophosphamide/therapeutic use , Female , Follow-Up Studies , Granulomatosis with Polyangiitis/diagnostic imaging , Granulomatosis with Polyangiitis/drug therapy , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Mammography , Radiography, Thoracic , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, MammaryABSTRACT
This is a case report of a patient diagnosed with three distinct primary intrathoracic tumors (mesothelioma, carcinoid and B-cell lymphoma). The patient had previously had mycosis fungoides. The occurrence of multiple neoplasms in a single patient, synchronous or metasynchronous, is not a rare phenomenon; the incidence varies from 1-11% of all neoplasms. They can be hereditary, or connected with some environmental agents or previous therapies. The incidence of multiple neoplasms increases with age. We report an extremely rare case of multiple intrathoracic neoplasms in a 71-year-old man. A left upper lobectomy was performed, followed by 6 courses of chemotherapy and irradiation of the sternum. The patient was stable two years later.
Subject(s)
Carcinoid Tumor/diagnosis , Lymphoma, B-Cell/diagnosis , Mesothelioma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Thoracic Neoplasms/diagnosis , Aged , Carcinoid Tumor/pathology , Humans , Lymphoma, B-Cell/pathology , Male , Mesothelioma/pathology , Neoplasms, Multiple Primary/pathologyABSTRACT
We present a patient with Churg-Strauss syndrome which appeared with asthma, chronic sinuitis, peripheral and tissue oeosinophilia, migratory pulmonary infiltrates and polyneuropathy but without histologically proven granuloma or vasculitis. The patient successfully recovered under corticosteroid therapy. The aim of this presentation is early recognition of Churg-Strauss syndrome in order to timely diagnose and treat these patients.
Subject(s)
Churg-Strauss Syndrome/diagnosis , Churg-Strauss Syndrome/drug therapy , Female , Humans , Middle AgedABSTRACT
Bronchiolitis obliterans organizing pneumonia (BOOP) is increasingly recognized in "Jordanovac" Clinical hospital for lung diseases. The characteristic pathohistologic finding is the granulated tissue plugs within the lumen of small airways which extend into the alveolar ducts and alveoli. Numerous conditions and diseases show such histologic picture but the clinician by means of clinical, radiologic and laboratory findings establishes the final diagnosis. By eliminating the known causes and conditions of this syndrome the diagnosis of idiopathic BOOP is established. Idiopathic BOOP is unequivocal clinicopathologic entity which is in typical cases recognized as a pulmonary infiltrate accompanied by febrile illness of a few weeks' duration that is not responsive to a typical course of antibiotics. Corticosteroid therapy causes the complete disappearance of pulmonary infiltrates in 65% to 85% of cases but relapses are common. The therapy of secondary BOOP is less efficient. The aim of this review is to acquaint the readers with the BOOP so it could be incorporated in the differential diagnosis of febrile noninfective diseases that resemble pneumonia.