Skeletal involvement in sarcoidosis: a case report

A patient is described in whom sarcoidosis caused a pathological fracture of the middle phalanx of the little finger. A bone scan showed increased uptake. She was treated by resection of the diseased area and bone grafting, which led to bone healing. The bony manifestations of sarcoidosis are reviewed.     

Testicular sarcoidosis: case report and review of the literature

We report a case of clinically evident and histologically proved sarcoidosis of the testicle. Six cases have been reported in the literature. This condition is present most commonly in black patients. Sarcoidosis is known to be associated with malignancy and several cases of coexistent testicular cancer have been reported in the white population. Management should include complete testicular neoplasia diagnostic studies, biopsy of peripheral or mediastinal lymph nodes, and radical orchiectomy in cases of unilateral lesions. Testicular biopsy from the inguinal approach and frozen section evaluation may be considered in bilateral lesions or in the patient with previous orchiectomy for testicular sarcoidosis.     

Aberrant colonic epithelium in the bladder: report of a case

We report autopsy findings of an immature neonate whose bladder included a focus of colonic type epithelium in the posterior wall. The small island of mucosa consisted of columnar epithelium with numerous goblet cells and crypt formation. There appeared to be several signet-ring cells in the transitional epithelium adjacent to this area. No gross congenital abnormalities of the bladder or inflammation of the lamina propria was observed. The island of colonic epithelium was considered to be aberrant enteric mucosal tissue rather than glandular metaplasia of the transitional cell epithelium.     

Hypothalamic-pituitary sarcoidosis. A case report

A 42-year-old woman suffered from sarcoidosis and hypothalamic-pituitary involvement. When she presented initially, an abnormal chest radiograph and abnormal features on histological examination of the lymph nodes, which showed caseating granulomas, suggested a diagnosis of tuberculosis. Failure to respond to antituberculosis therapy and the progressive development of symptoms of both posterior and anterior pituitary deficiency prompted a review of the initial diagnosis. Subsequent dynamic tests of hypothalamic and pituitary function indicated lesions at both the hypothalamic and pituitary levels. Further tests, including the Kveim reaction, favoured a diagnosis of sarcoidosis. This case illustrates the uncommon association of caseating granulomas with sarcoidosis and documents hypopituitarism due to combined hypothalamic and pituitary disease caused by sarcoid infiltration.     

Soft tissue sarcoidosis of the hand: a case report.

A tumour of the hand may be the first manifestation of systemic sarcoidosis. In our patient, this mass involved only the soft tissues; more commonly, there is bone involvement as well.     

CNS sarcoidosis presenting with intracerebral hemorrhage: case report

Sarcoidosis is a systemic, chronic inflammatory disease characterized by non-caseating epithelioid granuloma. It is well known that the central nervous system (CNS) is also involved in about 5% of patients with systemic sarcoidosis. Although CNS sarcoidosis presents with various neurological manifestations, intracerebral bleeding is quite rare. In this report, we describe a case in which a patient suffered from intracerebral hemorrhagic due to CNS sarcoidosis. A 57-year-old male who had been diagnosed as having systemic sarcoidosis was admitted to our hospital due to status epilepticus. Plain CT scan showed a subcortical hematoma in the left marginal gyrus. Serial MR imaging revealed that an enhanced mass in the overlying cortex had gradually increased its size. Subsequently, the enhanced mass and hematoma were totally removed, using a navigation system. Pathological examination revealed typical findings of sarcoidosis. We discuss the mechanism of intracerebral bleeding due to CNS sarcoidosis in this report.     

Adenocarcinoma of the salivary gland metastatic to the pituitary gland: case report

OBJECTIVE AND IMPORTANCE: A case of metastasis to the pituitary gland from a ductal adenocarcinoma of the salivary gland is presented. Metastasis to this site is rare, and a salivary gland source has never previously been described. CLINICAL PRESENTATION: This patient presented with hypopituitarism, including diabetes insipidus. INTERVENTION: A craniotomy was performed to alleviate visual loss. The histological features of the sellar tumor were identical to those of a tumor removed from the parotid gland 18 months earlier. CONCLUSION: Although intrasellar tumors originating from embryonic rests of salivary gland tissue have been reported, metastasis from a malignant neoplasm arising within a true salivary gland is also possible and should not be excluded from consideration for patients in whom a salivary gland-like tumor is discovered in the sella turcica.     

Tuberculosis of the thyroid gland: a case report

Thyroid tuberculosis is a very rare condition even if the incidence of extrapulmonary forms of tuberculosis has increased. We report the case of a 56-year old female patient with tuberculosis of the thyroid gland and tubercular lymphadenitis of the neck mimicking thyroid malignancy. The diagnosis was established on histological examination after surgery in August 2002. Total thyroidectomy and central neck dissection were performed for very hard euthyroid multinodular goiter and paratracheal bilateral lymphadenopathy. There were no evidence of tubercular involvement of the other organs. The patient underwent combination treatment with antitubercular drugs for 6 months. During the three years follow-up period there was no evidence of disease recurrence.     

Liposarcoma of the thyroid gland: a case report

Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in the literature. We report a case of a 40-year-old male patient with nodular goitre with the suspicion of malignancy in Fine Needle Aspiration Biopsy. Total thyroidectomy was performed. The histopathological examination revealed a well-differentiated thyroid liposarcoma. The patient recovered uneventfully. Postoperatively, radiotherapy was given to the neck region. During a 2-year follow-up period, no recurrence of the disease occured.     

Myelolipoma of the adrenal gland: a case report

A case of myelolipoma of the adrenal gland is reported. The patient was a 50-year-old male who was obese and robust, and complained of right flank pain. Laboratory investigation of adrenal functions were within normal levels. Excretory urography showed a large radiolucent mass in the right upper quadrant, displacing the right kidney to a lower position. Angiography demonstrated a large hypovascular mass. CT scan showed a large mass with low density in the right retroperitoneal space. The tumor was surgically removed through a lumbar incision, and was 800 gm in weight and well capsulated. A pathological study of the tumor disclosed adrenal myelolipoma consisting of mature fat cells and myeloid elements. Myelolipoma of the adrenal gland is rare and 33 cases of adrenal myelolipoma from the English and Japanese literature including this case were reviewed and analyzed statistically.     

Atypical pleomorphic astrocytoma in the pineal gland: case report

OBJECTIVE AND IMPORTANCE: We report a rare case of pleomorphic astrocytoma in the pineal region that took a benign course despite pleomorphism. CLINICAL PRESENTATION: A 30-year-old woman suddenly developed right hemiparesis followed by loss of consciousness. A computed tomographic scan revealed a mass in the pineal region accompanied by obstructive hydrocephalus. Her symptoms improved after ventriculoperitoneal shunt surgery. INTERVENTION: The tumor was totally removed in an en bloc fashion using the occipital interhemispheric transtentorial route. Light microscopy revealed that the tumor had marked pleomorphism and multinucleated, bizarre giant cells, but neither mitosis nor necrosis was seen. Glial fibrillary acid protein was immunohistochemically positive in a few tumor cells. Retinal soluble antigen was negative. No reticulin network between the tumor cells was observed. A histological diagnosis of atypical pleomorphic astrocytoma was made. CONCLUSION: No signs of recurrence have been observed for 7 years after surgery without adjuvant therapy. Histologically, the tumor resembled pleomorphic xanthoastrocytoma or pleomorphic granular cell astrocytoma, but the immunohistochemical findings were not completely compatible with either diagnosis. This benign astrocytoma in the pineal gland with unique features is the first such case reported.     

Cystic lymphangioma in the adrenal gland: a case report

Cystic lymphangioma of the adrenal gland are rarely encountered tumoural formations with no clinical expression. Pre-operative diagnosis is difficult. Echography and CT scan are essential exploratory techniques, diagnosis is histological. Usually surgical exploration is indicated due to uncertain diagnosis. We report a new case of cystic lymphangioma of the adrenal gland and a review of recent literature.     

Intraoperative ultrasonographically guided biopsy in testicular sarcoidosis: a case report

We present a case of sarcoidosis with involvement of a solitary testis that was discovered incidentally on an ultrasonogram of the scrotum. This appears to be case 8 of sarcoidosis with genitourinary involvement limited to the testis. We believe it is the second report of intraoperative ultrasonography used to locate and perform a biopsy of impalpable testicular lesions. We consider this technique to be useful in instances of solitary gonads or in cases of bilateral lesions.     

Atypical pulmonary sarcoidosis. A case report

The pulmonary manifestations of sarcoidosis are varied. This report describes a patient with rapidly progressive pulmonary sarcoidosis which had several unusual features and presented with acute pneumonia with air bronchograms on chest radiographs. Gallium-67 scanning and serum angiotensin-converting enzyme estimations aided in the diagnosis and in determining the response to steroid therapy.     

MALT-type lymphoma of lacrimal gland: case report

A 72-year-old female presented with a lump in the left superior-lateral eyelid. The magnetic resonance imaging showed a well-delineated mass in the left lacrimal gland. The tumor was isointense on both the T1 and T2 weighted images, and it was homogenously enhanced with Gd-DTPA. Surgery via the trans-cranial approach revealed a pinkish and elastic-hard tumor. Total resection was successfully performed. The hematoxilyn-eosin staining of the surgical specimen showed a dense infiltrate of lymphocytes, which were composed predominantly of small lymphocytes, centrocyte-like cells, monocytoid cells, and occasionally transformed lymphocytes. The immunohistochemical findings for CD20, CD3, UCHL-1, CD23, CD5, cyclinD1, and bcl-2 were compatible with Mucosa Associated Lymphoid Tissue (MALT)-type lymphoma. The patient received local radiation therapy (30 Gy/15 fractions). She remained in complete clinical remission of the disease about one and a half years after treatment.