ABSTRACT
Organising pneumonia after a mild COVID-19 infection has been increasingly reported and poses a diagnostic challenge to physicians especially in immunocompromised patients. We report a patient with a background of lymphoma in remission on rituximab who presented with prolonged and persistent fever after recovering from a mild COVID-19 infection. The initial workup showed bilateral lower zone lung consolidation; however, the infective and autoimmune workup were unremarkable. Subsequently, a bronchoscopy with transbronchial lung biopsy confirmed the diagnosis of organising pneumonia. A tapering glucocorticoid regimen was commenced with prompt resolution of the patient's clinical symptoms, and subsequent resolution of biochemical markers and radiological lung changes 3 months later. This case highlights the importance of early recognition of the diagnosis of organising pneumonia in immunocompromised populations after a mild COVID-19 infection as it shows promising response to glucocorticoid therapy.
Subject(s)
COVID-19 , Organizing Pneumonia , Pneumonia , Humans , COVID-19/pathology , Glucocorticoids/therapeutic use , Pneumonia/drug therapy , Lung/pathology , Immunocompromised HostABSTRACT
There is a paradigm shift in the detection of phaeochromocytomas with more being identified as adrenal 'incidentalomas'. While majority of these individuals are asymptomatic, they are nevertheless at risk of subtle cardiovascular dysfunction and phaeochromocytoma crises. Therefore, early resection of phaeochromocytomas, even if subclinical, is recommended. However, the perioperative management can be challenging as the normotension can limit the initiation and titration of alpha-blockade. We present a man in his 60s with a subclinical phaeochromocytoma, discuss the evaluation of an incidentally discovered adrenal nodule, as well as the practical considerations in the perioperative management.
Subject(s)
Adrenal Gland Neoplasms , Pheochromocytoma , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/surgery , Humans , Incidental Findings , Male , Pheochromocytoma/diagnosis , Pheochromocytoma/surgeryABSTRACT
COVID-19 coagulopathy is a hypercoagulable state which predisposes to venous, arterial and small vessel thrombosis. We describe a patient with COVID-19 who developed an acute superior mesenteric vein thrombosis with acute intestinal obstruction despite adequate anticoagulation.
Subject(s)
Blood Coagulation Disorders/complications , COVID-19/complications , Intestinal Obstruction/complications , Ischemia/complications , Mesenteric Ischemia/complications , Acute Disease , Adult , COVID-19/virology , Humans , Male , SARS-CoV-2/isolation & purificationABSTRACT
Perivascular epithelioid cell (PEC) tumors are rare tumors of mesenchymal origin and can affect many anatomic regions. Although these tumors are usually benign, malignant variants exist. We document for the first time a malignant PEComa arising from the pleura of a 43-year-old Malay woman. The pathology of the tumor as well as differential diagnoses is discussed.
Subject(s)
Perivascular Epithelioid Cell Neoplasms/pathology , Pleural Neoplasms/pathology , Adult , Fatal Outcome , Female , Humans , Perivascular Epithelioid Cell Neoplasms/diagnosis , Pleural Neoplasms/diagnosisABSTRACT
Soft tissue chondromas are rare, benign extra-skeletal tumours of cartilaginous origin, which may rarely occur within the spinal canal. We report a patient who presented with left lumbar radiculopathy, and a peripherally-enhancing dumbbell shaped soft tissue mass involving both the intraspinal and extraspinal compartments on MRI. This was misdiagnosed as a neurogenic tumour and the patient underwent surgical removal. Histological examination revealed cartilaginous tissue. Although rare, soft tissue chondromas should be considered in the differential diagnosis of spinal dumbbell shaped tumours, especially if MRI shows peripheral contrast enhancement.
Subject(s)
Chondroma/diagnosis , Lumbar Vertebrae/pathology , Radiculopathy/diagnosis , Soft Tissue Neoplasms/diagnosis , Chondroma/surgery , Diagnosis, Differential , Female , Humans , Lumbar Vertebrae/surgery , Middle Aged , Radiculopathy/surgery , Soft Tissue Neoplasms/surgerySubject(s)
Blast Injuries , Eye Foreign Bodies/complications , Retinal Detachment/etiology , Retinal Detachment/physiopathology , Adolescent , Adult , Cilia , Eyelashes , Humans , India , MaleABSTRACT
Squamous lesions of the gallbladder are uncommon. We report a case of a pseudoepidermoid cyst in a middle-aged woman arising on a background of chronic cholecystitis and cholelithiasis, which induced exuberant squamous metaplasia of the entire gallbladder mucosa, clinically mimicking a gallbladder tumor. To our knowledge, this is the first such reported case in the English literature.