Malignant histiocytosis: a case report of a rare tumour presenting with spontaneous splenic rupture

Malignant histiocytosis is a rare invasive proliferation of neoplastic histiocytes. Cases previously reported as malignant histiocytosis were shown to be lymphomas of T or B lineage, especially anaplastic large-cell lymphomas. A case of malignant histiocytosis is described, in which a patient presenting with symptoms suggestive of pneumonia suddenly deteriorated and died. At autopsy, a large quantity of fresh blood, originating from several ruptured nodules on the enlarged spleen, was seen in the peritoneal cavity. Extensive infiltration by pleomorphic tumour cells and erythrophagocytosis by tumour cells were seen on histological examination of the spleen. Immunohistochemical analysis and staining were carried out. This is the second reported case of malignant histiocytosis presenting with spontaneous splenic rupture.     

Spontaneous rupture of splenic artery aneurysm in pregnancy: a case report

Splenic artery aneurysms (SAA) occur predominantly in women, and the majority of them are asymptomatic until rupture. Over half of those that rupture occur during pregnancy. Spontaneously ruptured SAA during pregnancy is always a life-threatening surgical entity for both the mother and the fetus. We report the case of a 29-year-old woman at 34 weeks' gestation with spontaneous rupture of SAA who underwent emergency exploratory laparotomy and splenectomy. This case illustrates the need to consider ruptured SAA as part of important differential diagnosis in haemodynamically unstable pregnant women.     

Death due to splenic rupture in suppressor cell mycosis fungoides: a case report

A case of mycosis fungoides in which pathologic rupture of the spleen led to intraperitoneal hemorrhage and death is described. To our knowledge, splenic rupture has not been reported previously as a cause of death in mycosis fungoides. Immunologic studies demonstrated that the neoplastic cell was a suppressor/cytotoxic T-cell. In most cases of mycosis fungoides or the Sézary syndrome, the neoplastic cell has been a helper/inducer T-cell. This case was very aggressive clinically with prominent visceral involvement and suggests that mycosis fungoides may be clinically diverse as well as immunologically heterogeneous.     

肝脏上皮样血管内皮瘤一例

患者男,57岁。因上腹部不适6个月,于2004年3月15日入院。彩色超声波检查:肝右叶膈顶部2cm×2cm低回声光团,界清;彩色多普勒:其内未见明显血流,PD测及少量静脉频谱,诊断为实质占位,良性病变可能;CT:病灶低密度,界限稍模糊,动态增强后未见明显强化,门脉期边缘可见轻度强化,周围见轻度水肿带,印象为占位,炎性假瘤可能性大;MRI:类圆形异常信号,T1WI为低信号,界尚清,T2WI中心明显高信号,周边略高信号的靶征,增强后动脉期无明显强化,门脉期及延迟期呈周边明显强化,印象为异常信号灶,考虑为慢性肝脓肿(图1)。手术见肝脏周围轻度粘连,病变位于…     

Atraumatic rupture of the spleen associated with hemophagocytic syndrome and isolated splenic peliosis. Case report

Atraumatic rupture of the spleen is an uncommon condition that may be associated with various etiologies. The hemophagocytic syndrome (HS) and isolated splenic peliosis are two rare conditions, each of which has previously been described in association with splenic rupture. We describe a unique case of atraumatic splenic rupture in which concurrent HS and splenic peliosis were diagnosed following splenectomy. Given that both these rare conditions have probably caused the splenic rupture, a possible association between these entities is discussed.     

Winged scapula caused by rhomboideus and trapezius muscles rupture associated with repetitive minor trauma: a case report

We experienced a rare case of winged scapula that was caused by the rupture of the rhomboideus major and the lower trapezius muscles without any nerve injury in a 12 yr old female after she had carried a heavy backpack. Electrodiagnostic study revealed that the onset latencies, amplitudes and conduction velocities were normal in the long thoracic nerve, the spinal accessory nerve and the dorsal scapular nerve. The needle EMG findings were normal as well. An explorative operation was performed and the rupture of the rhomboideus major and lower trapezius muscles was detected. Direct surgical repair of the ruptured muscle was carried out and the deformity was corrected. The anatomical and functional restoration was satisfactorily accomplished.     

肝脏胆管淋巴上皮瘤样癌一例

患者男,44岁.乙型肝炎病毒携带者,既往体健,于2009年12月2日在当地医院体检时B超发现左肝低回声占位性病变来本院就诊.体检:患者慢性病容,皮肤巩膜无黄染,无肝掌及蜘蛛痣,全身浅表淋巴结未及肿大,腹平软、无压痛,肝脾肋下未及,无肝区叩击痛、无移动性浊音.     

Primary splenic angiosarcoma with fever and anemia: a case report and literature review

Primary splenic angiosarcoma is an extremely rare and aggressive neoplasm. The prognosis of this disease is dismal, and the mean survival is less than 6 months after the diagnosis. This neoplasm typically presents with abdominal pain, splenomegaly, weight loss, and spontaneous splenic rupture. Fever is a very rare presentation of splenic angiosarcoma. Here we report the case of a 64-year-old man who presented with fever and anemia. A laparoscopic splenectomy was performed and revealed splenic angiosarcoma. The postoperative course was uneventful and the patient received 5 cycles of adjuvant chemotherapy with ifosfamide plus epirubicin. He remained disease free at 9 months after surgery. This is the first case of splenic angiosarcoma with fever as the initial presentation that was treated with laparoscopic splenectomy to be reported in the English literature.     

Isolated splenic metastasis from colorectal carcinoma: a case report

Isolated splenic metastasis arising from colorectal carcinoma is very rare and there has been only 6 cases reported in the English literature. A new case is presented, and its possible pathogenesis was considered with previously reported cases. A 65-year-old male patient had received a right hemicolectomy for ascending colon cancer 36 months earlier. He was followed up regularly with serial measurement of serum carcinoembryonic antigen (CEA). Rising serum CEA was discovered from 33 months postoperatively and CT revealed an isolated splenic metastasis. He therefore underwent splenectomy, which was proven to be a metastatic adenocarcinoma with similar histological feature to the original tumor. As all reported cases showed elevated serum CEA at the time of metastasis, isolated splenic metastasis might be associated with CEA in regard to its biological functions of immunosuppression and adhesion.     

Pediatric follicular bronchiolitis with severe atelectasis: a case report

Follicular bronchiolitis is a rare pulmonary disorder characterized by the presence of multiple hyperplastic lymphoid follicles with a peribronchiolar distribution. An 11-year-old girl with total atelectasis of the right middle lobe (RML) and diffuse multiple small nodules at both lung bases presented to our hospital with frequent upper respiratory infections and pneumonia. The disease progressed during a 3-month period of macrolide therapy, and thoracoscopic biopsy with lobectomy of the atelectatic RML was performed. The histopathologic diagnosis was follicular bronchiolitis. The patient’s pulmonary function improved dramatically after oral steroid treatment. It can be difficult to diagnose follicular bronchiolitis based solely on clinical, laboratory, and radiologic findings; the disorder must be confirmed histopathologically. A patient with longstanding irreversible atelectasis and resulting recurrent respiratory infection may require lobectomy for the diagnosis and treatment of follicular bronchiolitis.     

Osteosarcoma associated with acromegaly: a case report.

A case of acromegaly who developed an osteosarcoma is recorded, with persistently raised levels of growth hormone. It is possible that there was some aetiological relationship between the increased rate of bone formation and the development of the osteosarcoma.     

Ischemic stroke and splenic rupture in a case of Streptococcus bovis endocarditis

A 58-year-old man with an acute stroke suffered from splenic rupture. Streptococcus bovis was found in blood cultures, and gram-negative cocci were found in the infarcted spleen. Hemorrhagic transformation of the stroke occurred. Echocardiography showed aortic endocarditis. Cardiac surgery was not performed because of concern about cerebral bleeding. The patient died due to cerebral rehemorrhage after 3 weeks.     

Primary splenic angiosarcoma: case report and literature review

Angiosarcoma of the spleen is a rare neoplasm. We describe the clinical findings of an index case at our institution and the results of a literature review of the topic. Generally, this cancer has a poor prognosis and prompt splenectomy offers the only cure, as the cancer is poorly responsive to adjuvant chemotherapy.     

Separation of a bipartite patella combined with quadriceps tendon rupture: a case report

Separation of a bipartite patella is very rare. We found only seven cases in the literature [Carter SR. Traumatic separation of a bipartite patella. Injury 1989;20:244; Ireland ML, Chang JL. Acute fracture bipartite patella; case report and literature review. Med Sci Sports Exerc 1995; 27:299-302; Ishii M, Yabuno K, Ishikawa T, Tsujino H, Yamaguchi K. A case of bipartite patella separation accompanied by subcutaneous rupture of quadriceps tendon. Seikeigeka (Orthopedic Surgery) 2003;54:1563-5. [In Japanese]; Canizares GH, Selesnick FH. Bipartite patella fracture. Arthroscopy 2003;19:215-7; Okuno H, Sugita T, Kawamata T, Ohnuma M, Yamada N, Yoshizumi Y. Traumatic separation of a type 1 bipartite patella; a report of four knees. Clin Orthop 2004;420:257-60]. Among these cases only one was complicated with quadriceps tendon rupture, and the patient had diabetes as underlying disease [Ishii M, Yabuno K, Ishikawa T, Tsujino H, Yamaguchi K. A case of bipartite patella separation accompanied by subcutaneous rupture of quadriceps tendon. Seikeigeka (Orthopedic Surgery) 2003;54:1563-5. [In Japanese]]. To our knowledge, there have been no reports of this condition in a healthy subject. In this report, we present a case of bipartite patella separation complicated with quadriceps tendon rupture in a patient with no underlying disease. Treatment involving suturing the tendon to the patella and osteosynthesis of the bipartite patella produced a good result.     

Hepatic angiomyolipoma with trace amounts of fat: a case report and literature review

Hepatic angiomyolipoma (AML), a rare benign mesenchymal tumour, is characterised by the presence of mature adipose tissue, smooth-muscle cells and thick-walled blood vessels. Increasing attention to hepatic AMLs has led to the discovery that sufficient proportions of fat often allow for definite diagnoses preoperatively. However, the proportion of fatty tissue in these tumours is highly variable. One case of hepatic AML is reported, where the amount of fat was <1%. In this case, the viral hepatitis markers, including hepatitis B antigen and anti-hepatitis C virus antibody, were negative. The serum alpha-fetoprotein level was 3.4 ng/ml and in the normal range. Abdominal ultrasonography showed a hypoechoic mass measuring 5 cm in diameter and without an obvious capsule in the left lobe of the liver. A dynamic computed tomography scan showed a well-defined and slightly enhanced mass in the medial segment of the left lobe of the liver. Angiography showed that the mass was hypervascular in character. As hepatocellular carcinoma was highly suspected from these preoperative image studies, a left lobectomy was carried out. Microscopically, the amount of fat was too low to establish a diagnosis of hepatic AML. However, positive homatropine methylbromide 45 immunoreactivity of the smooth-muscle cells seemed to assist in arriving at the diagnosis.