RESUMEN
Primary malignant myelomatous pleural effusion (PMMPE) occurs in less than 1% of patients with multiple myeloma and is diagnosed either by visualization of plasma cells on cytology or by positive flow cytometry. The presence of immature plasma cells characterized by high nucleus to cytoplasm ratio, visible nucleolus and presence of Mott cells and Russell bodies are independent poor prognostic factors. The clinician should differentiate PMMPE from secondary pleural effusion as it is associated with a significantly worse prognosis and poor overall survival.
RESUMEN
Endocarditis is a rare presentation for cytomegalovirus (CMV) infection. We present the case of a 49-year-old man who underwent mitral and tricuspid valve replacement for valvular CMV endocarditis. The patient's past medical history was significant for human immunodeficiency virus, intravenous drug abuse, and chronic hepatitis B. During his clinical course, he was found to have tricuspid and mitral valve vegetations. After progressive valvular destruction despite antibiotic therapy, he underwent successful mitral and tricuspid valve replacement. Pathologic analysis of the culture-negative valve specimens were found to contain inclusion bodies consistent with CMV, and quantitative serum polymerase chain reaction returned a highly elevated CMV DNA count.
Asunto(s)
Infecciones por Citomegalovirus/diagnóstico , Endocarditis/cirugía , Endocarditis/virología , Implantación de Prótesis de Válvulas Cardíacas/métodos , Válvula Mitral/cirugía , Válvula Tricúspide/cirugía , Biopsia con Aguja , Infecciones por Citomegalovirus/complicaciones , Ecocardiografía Transesofágica/métodos , Endocarditis/diagnóstico por imagen , Estudios de Seguimiento , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Enfermedades de las Válvulas Cardíacas/cirugía , Enfermedades de las Válvulas Cardíacas/virología , Prótesis Valvulares Cardíacas , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Válvula Mitral/patología , Válvula Mitral/virología , Medición de Riesgo , Resultado del Tratamiento , Válvula Tricúspide/patología , Válvula Tricúspide/virologíaRESUMEN
Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.
Asunto(s)
Infecciones por Bacterias Grampositivas/microbiología , Sarcina , Gastropatías/microbiología , Femenino , Infecciones por Bacterias Grampositivas/patología , Humanos , Persona de Mediana Edad , Gastropatías/patologíaRESUMEN
Angiomyolipoma is a mesenchymal neoplasm characterized by the coexpression of melanocytic and smooth muscle markers. Sarcoidosis is a multisystem disorder of unknown etiology, which presents with characteristic nonnecrotizing granulomas and rarely involves the kidney. The coexistence of renal sarcoidosis with renal neoplasms is exceedingly rare and was reported only with renal cell carcinoma. Renal sarcoidosis associated with a nonepithelial renal neoplasm, such as an angiomyolipoma has never been reported. We present the first reported case of sarcoid granulomas in a renal angiomyolipoma, including morphologic and immunohistochemical features.
