Granulomatous Peritonitis Secondary to Primary Sclerosing Cholangitis.

Primary sclerosing cholangitis (PSC) is a rare, chronic, and progressive disease of the liver characterized by cholestasis due to multifocal bile duct strictures. PSC can lead to liver fibrosis, and in 10-20% of cases, it leads to cholangiocarcinoma and end-stage liver disease. However, the pathogenesis of the disease is not clearly understood. For the diagnosis of PSC, both imaging and liver biopsy can be used. No medical treatment has managed to prevent the progression of the disease. Consequently, in the case of late-stage disease, liver transplantation is considered the best treatment option. PSC may lead to different complications including bacterial cholangitis, cholangiocarcinoma, and cirrhosis. Nevertheless, to our knowledge, there are no reports of granulomatous peritonitis secondary to PSC. Granulomatous peritonitis may be a result of infectious, malignant, and idiopathic inflammatory diseases. It is also considered a rare postoperative complication, due to cornstarch from surgical glove powder, in laparoscopic procedures. Here, we report the case of a 39-year-old male patient with PSC, in which cholangiocarcinoma and peritoneal carcinomatosis were clinically suspected. Despite that, histological findings and staining methods of the surgically removed peritoneal masses demonstrated granulomatous peritonitis.

A rare ossifying trichilemmal cyst in a young female patient: a case report and literature review.

Trichilemmal cysts (TCs) constitute the second most common cutaneous cysts and are mostly presented on the scalp of middleaged women. Therefore, it is unusual for a young person to have a TC and it is extremely rare for a TC to be ossified. In the literature, only 8 cases of TCs with concomitant ossification have been described. We report the case of a 22-year-old female who presented with a scalp nodule and was treated via surgical excision of the lesion. The pathology examination of the surgical specimen revealed a lesion consisting of a multilayered squamous epithelium of slightly eosinophilic maturing keratinocytes. There was no granular layer, whereas the core of the lesion was occupied by mature bone tissue with calcium deposits. The definite diagnosis of the pathology report was ossifying TC. The aim of this report is, to enlighten clinicians about this rare pathological entity.