Eosinophilic granuloma of spine in adults: a case report and review of literature

A rare case of eosinophilic granuloma in an adult is reported. Eosinophilic granuloma (EG) is a lesion observed more frequently in adults. CT and MRI showed a lytic lesion of the T11 vertebral body. A transpedicular excisional biopsy of the lesion revealed EG. Spinal EG in adults is rare and differs from the childhood disease by the spinal level involvement. Vertebra plana, a condition of spondylitis in which the body of the vertebra is reduced to a sclerotic disc, is not a roentgenographic feature in the 14 cases reported in literature. It should be included in the differential diagnosis of the solitary lytic lesion of vertebrae in adults.     

Primary adenocarcinoma in a kidney allograft: a case report and review of the literature

De novo tumors are common complications after solid organ transplantation. Lymphoma and skin cancers are the most frequently observed malignancies. However, graft carcinomas can be observed to be five times more frequent after kidney transplantation compared to their incidence in the general population. We report a case of a 49-year-old female who developed an early adenocarcinoma of the graft as revealed by acute renal failure. She underwent transplantectomy and chemotherapy with hemodialysis therapy. Carcinoma of the graft is a rare but serious complication usually occurring late after transplantation. Close monitoring of a kidney recipient using abdominal ultrasound may detect this complication at early stages, which may improve the prognosis. Similarly, good screening of donors may prevent tumor transmission.     

结节病肺移植术后原病复发（附一例报告）

１９９５年２月２３日我们为一例终末期肺结节病患者行左单肺移植术，患者已存活二年余，民政部良好。术后第１１及１３个月时纤支镜活检发现左肺有结节病复发，无症状，胸片左肺（一）。除继续用三联免疫抑制上未加其它治疗。本文复习了有关病移植术后现复发的文献。     

Acute lobar nephronia in a renal allograft: a case report and literature review

We report a diabetic renal transplant recipient who presented with fever and right lower quadrant abdominal pain. Acute appendicitis was considered initially and she underwent emergent appendectomy. However, persistent symptoms postoperatively made us perform an imaging study to identify the problems. Abdominal and pelvic computed tomography disclosed several focal wedge-shaped lesions of low attenuation in the renal allograft. Acute lobar nephronia was successfully managed with parenteral antibiotics. The patient recovered without any sequela. A renal allograft in the right iliac fossa complicates the diagnosis among acute renal infection, malignancy, acute rejection, and even acute appendicitis. Biopsy of the renal allograft is sometimes needed due to clinically ambiguous imaging results. In this report, we not only detail the clinical course of such a rare case, but also review the previous 3 cases of acute lobar nephronia in renal allografts in the literature.     

Eosinophilic esophagitis in cystic fibrosis: A case series and review of the literature

Patients with cystic fibrosis (CF) frequently experience gastrointestinal symptoms including nausea, emesis, malnutrition and indigestion; diseases such as gastroesophageal reflux disease (GERD), distal intestinal obstructive syndrome, and cholelithiasis are commonly implicated. We have recently diagnosed eosinophilic esophagitis (EoE) in three patients with CF. EoE is a TH-2 driven, allergen-mediated disease which causes esophageal eosinophilia and presents with symptoms of nausea, feeding intolerance, regurgitation, and dysphagia. EoE is diagnosed when esophageal biopsies reveal greater than 15 eosinophils per high power field in the setting of the appropriate clinical scenario and after exclusion of other causes of esophageal eosinophilia. Although described with increasing frequently in the gastrointestinal literature, there have been no prior cases documenting the co-existence of EoE and CF. We speculate that this is related to lack of familiarity with EoE symptoms by CF providers. We present three patients with CF diagnosed with EoE and review the current literature regarding diagnosis and management, focusing on management issues in patients with CF.     

Intra-abdominal pulmonary sequestration: a case report and literature review

Pulmonary sequestration is a rare congenital malformation mostly located in the thorax, while intra-abdominal pulmonary sequestration is an extremely rare type of pulmonary sequestration usually diagnosed during the first 6 months of life. Only 1 case of intra-abdominal pulmonary sequestration in a patient older than 60 years has been reported in the current literature. It is difficult to differentiate an intra-abdominal pulmonary sequestration from other retroperitoneal tumors. A definitive diagnosis is always made by histological examination. Intra-abdominal pulmonary sequestration commonly responds well to surgical resection and is associated with excellent results and prognosis. The authors present the case of a 74-year-old asymptomatic man with a retroperitoneal mass which was completely excised and revealed by histopathological study to be an intra-abdominal pulmonary sequestration.     

Fulminant pulmonary lymphangioleiomyomatosis: a case report and review of the literature

Pulmonary lymphangioleiomyomatosis is a very rare disease that affects women of childbearing age. It presents a challenge for the anesthesiologist during mechanical ventilation because of the restrictive pattern caused by the disease and because of such complications as recurrent pneumothorax and hemoptysis. We report the fulminant course of lymphangioleiomyomatosis in a 38-year-old woman with a history of recurrent spontaneous pneumothorax whose condition was unsuspected. The literature is reviewed.     

Eosinophilic enteritis presenting as acute intestinal obstruction: a case report and review of the literature

A 37-year-old man was admitted to our hospital complaining of severe abdominal pain and vomiting. His abdomen was distended, and there was diffuse tenderness and guarding in all four quadrants. Laboratory examinations revealed leukocytosis without eosinophilia. Abdominal radiograph revealed air-fluid levels in the small intestine. Computed tomography confirmed a dilatation of the small intestine and the presence of ascites. An emergency laparotomy was performed for a diagnosis of peritonitis due to intestinal obstruction. A large amount of yellow transudate was present in the abdominal cavity. An area of induration in the ileum was identified about 40 cm from the ileocecal valve. The ileum proximal to the induration was dilated, and the site of obstruction seemed to be the indurated segment. A partial iliectomy was performed. Histologically, dense infiltration of eosinophils was found transmurally, and eosinophilic enteritis was diagnosed. One year later, the patient was free of gastrointestinal symptoms. The relevant literature on eosinophilic gastroenteritis is discussed.     

Primary pulmonary leiomyosarcoma: case report and review of literature.

A case of primary leiomyosarcoma of the lung is added to the literature. Previously, 66 cases were documented. This is a case of a 55-year-old male, a pulmonary cripple for many years, with a collapsed left lower lobe found by roentgenogram, verified by bronchoscopy and bronchograms. Biopsy of lesion was reported as low grade leiomyosarcoma. Despite pulmonary function studies showing a vital capacity of 37% of predicted normal, a left pneumonectomy was preformed. Postoperatively, the patient had a tachycardia which gradually decreased in the next several months. Two months following operation pulmonary function studies were essentially unchanged from those made preoperatively. Arterial gas studies are presented pre and postoperatively.     

Eosinophilic granuloma of the cervical spine. A case report and review of the literature

This is a report of a case of eosinophilic granuloma involving the second cervical vertebra in a 33-year-old woman. There have been 32 case reports in the literature describing eosinophilic granuloma presenting as cervical spine disease. Due to its intimate relation to the central nervous system, the opportunity for neurological sequelae and neurosurgical intervention is common in cervical eosinophilic granuloma. In this report a brief history of eosinophilic granuloma is reviewed and case histories from the literature with cervical spine involvement are summarized. The therapeutic options are described and a recommended protocol for management is outlined.     

Eosinophilic granuloma of the growing epiphysis. A case report and review of the literature

A six-year follow-up study of an eosinophilic granuloma of bone occurring in the growing epiphysis of a five-year-old boy is reported. This is the seventh such case reported in the literature. Eosinophilic granuloma of bone occurring in the epiphysis can extend into the metaphysis by destroying the growth plate.     

Mucormycosis of the renal allograft: case report and review of the literature

Fungal infection is an uncommon complication after renal transplantation. We describe a rare form of mucormycosis in the renal graft. Our method was to review chart data and to perform medline searches. The patient was a 42-year-old man who underwent living-unrelated kidney transplantation in Egypt and returned to Israel on POD 8. Within the ensuing 4 weeks he experienced acute rejection which responded to treatment with steroids. Few days after discharge he was readmitted because of fever and graft dysfunction. An infected large perigraft collection was drained, but the patient became anuric and septic. Kidney biopsy showed infarcted necrotic tissue infiltrated by fungi which grew Mucor species. Despite initial improvement following graft nephrectomy and antifungal treatment the patient died of sepsis. Literature review revealed only three additional cases of graft infection due to Mucorales. We conclude that Renal graft infection due to Mucorales is an extremely rare and potentially lethal complication. Living unrelated donation in third world countries might be a possible risk factor. Fungal colonization may occur during transplantation. A high index of suspicion, leading to early diagnosis and initiation of antifungal treatment, in addition to graft nephrectomy, are keys to a more favorable outcome. Received: 12 July 2000 Revised: 18 December 2000 Accepted: 6 September 2001     

Multiple pulmonary hamartomas; a case report and review of the literature.

Bilateral multiple hamartomas were found in a woman suspected of having metastatic malignancy of the lung. As extensive investigation for the primary tumour was unrevealing, a left exploratory thoracotomy and histological examination established the diagnosis. In view of the benign character of the tumours, local excision alone was performed. No surgical intervention was performed on the right side. Repeat chest films 12 months after surgery did not show the appearance of new lesions in the left lung or any increase in the size of the nodules in the right lung. This is the 12th case so far reported. The clinical characteristics and surgical management of these tumours are discussed.     

Unilateral absence of a pulmonary artery in absent pulmonary valve syndrome: a case report and review of literature.

A six-year-old boy presented to the Cardiology clinic with history of mild cyanosis and dyspnea on exertion from age 1. He had a to-and-fro murmur at the middle left sternal border. Chest examination was normal but chest x-ray showed a small left lung. Echocardiography established the diagnosis of tetralogy of Fallot (TOF) and absent pulmonary valve with severe pulmonary regurgitation and moderate stenosis at the pulmonary valve site. There was severe dilatation of the main and right pulmonary arteries. The left pulmonary artery (LPA) could not be seen. Angiography failed to show a LPA. This case of an absent LPA associated with absent pulmonary valve syndrome is discussed and the literature is reviewed.     

Recurrence of light chain nephropathy in a renal allograft. A case report and review of the literature.

Myeloma and monoclonal gammopathies can affect the kidney in many ways with cast nephropathy and light chain deposition disease being the most commonly recognised histological entities. Renal transplantation in these patients remains controversial both because of the risk of recurrent disease affecting the graft and also because of concerns around the possibility of disease relapse within the patient. We suggest that the histological pattern of disease within the native kidneys is crucial in the overall assessment of these patients for renal transplantation. Those patients in whom renal deposition of light chains is associated with a proliferative glomerulonephritis have a considerably worse graft survival than those presenting with cast nephropathy.     

Surgical pulmonary embolectomy for submassive pulmonary embolism: a case report and review of the literature

We present an interesting case of recurrent syncope which was found to be submassive Pulmonary Embolism (PE) with right atrial thrombus. Patient underwent successful surgical pulmonary embolectomy with removal of right atrial thrombus. Follow-up computed tomography revealed bilateral patent pulmonary circulation with normal right ventricle function and pulmonary artery pressure on echocardiography. We also reviewed the literature for the patients operated for submassive pulmonary embolism and their results.     

Conservative management of a pulmonary artery bullet embolism: case report and review of the literature.

A case of pulmonary artery bullet embolism managed by observation with no complications at 9-month follow-up prompted a review of the literature. We found a total of 32 cases reported since 1966, with no deaths. Fourteen of the patients were managed by observation and five patients were followed with no resulting complications noted. Conservative management of selected cases of pulmonary artery bullet emboli may be warranted in light of the risks of extraction. These cases should continue to be reported with follow-up.