ABSTRACT
Eosinophilic gastroenteritis (EoGE) is a group of infrequent conditions that arise from the accumulation of eosinophils in the gastrointestinal (GI) tract without any secondary causes of eosinophilia. Most cases of EoGE cases show involvement of different parts of the GI tract. Herein, we report a case of EoGE with the sole involvement of Jejunum. A 57-year-old male patient presented to our center with a chief complaint of acute abdominal pain. The patient had experienced chronic abdominal pain and intermittent diarrhea for several years, but he presented to the emergency department with severe acute flank pain. The patient was first diagnosed with renal stone and treated accordingly. However, the computed tomography (CT) scan also showed other incidental findings related to his chronic abdominal pain from several years ago, including mesenteric infiltration which shows fluid appearance in some areas, mild wall thickening, and mucosal edema of the duodenum and jejunal loops with normal appearance of the ileum. Complete blood count (CBC) showed increased eosinophil (15.5%) and decreased lymphocytes (13.1%) percent. Pathological examination of enteroscopy samples of jejunum showed a mild increase in the number of eosinophils in lamina propria. Neither parasites nor granuloma was detected. However, no such changes were found in other parts of the GI tracts. Based on pathological examination, the patient was diagnosed with eosinophilic enteritis of the jejunum. EoGE does not typically involve a specific part of the GI and generally affects both the stomach and intestine. This study reported the first case of EoGE where only the jejunal part of the intestine was involved and other parts of the GI tract were spared.
ABSTRACT
Proliferative myositis (PM) is a benign intramuscular tumor that might mimic a malignant one due to its unusual pseudosarcomatous inflammatory nature. In this report, we describe a patient who developed PM after vaccination with Sinopharm coronavirus disease (COVID-19) vaccine. A 73 years old man was admitted due to rapidly-growing painful mass in his left thigh from a few days ago, curtailing his walking. He received a recent COVID-19 vaccination (Sinopharm COVID-19 vaccine) about 5 days before the beginning of symptoms. No history of trauma was present. On physical exam, a round firm mass was found in lateral side of mid portion of left thigh within the muscle with tenderness on palpation. An oval-shaped well-defined intramuscular mass measured 15 × 41 mm was noted in vastus lateralis muscle in ultrasonography. Left thigh magnetic resonance imaging (MRI) showed a well-defined intramuscular mass with a definite margin of 19 × 39 mm. Finally, ultrasound (US)-guided core needle biopsy showed muscular tissue with a loose mass composed of plump fibroblasts and myofibroblasts and large ganglion-like cell with abundant amphophilic to basophilic cytoplasm, vesicular nuclei and prominent nucleoli. Pathology report showed a very rare case identified as proliferative myositis. It should be noted that we cannot make a direct link between these 2 events. PM is an extremely rare entity; however, its relation with COVID-19 vaccination might be a coincidence.
ABSTRACT
BACKGROUND: Hepatoblastoma is the most common primary malignancy of hepatic origin in children, with an estimated incidence of 0.5-1.5 per million children. Hepatoblastoma classically has an intraparenchymal location, and pedunculated hepatoblastoma is a relatively rare entity. Accurate diagnosis can be challenging due to its extrahepatic location and possibly its thin peduncle, which is not easily identified in imaging. CASE PRESENTATION: Here, we report a case of asymptomatic giant palpable hepatoblastoma in the LUQ of a four-month-old male infant, initially suspected of neuroblastoma based on abdominal ultrasound findings. The final diagnosis of giant pedunculated hepatoblastoma was made based on the abdominal CT scan and the diagnosis was confirmed by percutaneous biopsy. Due to the size of the tumor, complete removal of the tumor was not initially possible. Therefore, the patient was treated with several courses of chemotherapy. The tumor was shrunk and then completely removed. The patient was treated, and no complications were found in the 6-month follow-up. CONCLUSION: Pedunculated hepatoblastoma is rare but should be considered as a possibility in the case of a perihepatic mass in a pediatric patient that can be confused with other upper abdominal masses such as an adrenal mass. Therefore, in such cases, we must look for the vascular pedicle in the imaging and keep the AFP check in mind.
