Mimicking

模仿
  • 文章类型: Journal Article
    现代神经影像学方法并不能完全排除颅内动脉瘤的误诊,这可能导致与并发症风险相关的不必要的手术。然而,错误诊断的动脉瘤的手术干预非常罕见。这项研究的目的是证明两个假阳性动脉瘤的临床病例,并对致力于假阳性动脉瘤的发生率和病因的文献进行系统回顾,确定与假阳性动脉瘤相关的危险因素。在两个数据库(PubMed和WebofScience)中使用关键字“模仿颅内动脉瘤”进行文献检索,“表现为颅内动脉瘤”,“颅内动脉瘤假阳性”,并进行了“神经外科手术”。在两个数据库中的初始搜索中共发现了243篇论文。最终分析包括16篇论文(包括20例患者)。有10个女人和10个男人。假阳性动脉瘤的最常见位置是大脑中动脉(MCA)的分叉。在后循环中,在基底动脉上发现了假阳性动脉瘤,或者在椎-基底交界处.颅内动脉瘤假性诊断的主要原因包括动脉闭塞伴血管残端形成,漏斗加宽,开窗术,动脉夹层,造影剂外渗,和静脉静脉曲张.总之,总结我们的分析结果,我们可以说,假阳性动脉瘤的手术干预在血管神经外科中是一个被低估的问题。尽管发表的临床观察非常罕见,对假阳性动脉瘤进行错误手术干预的实际频率未知.
    Modern neuroimaging methods do not completely rule out false diagnoses of intracranial aneurysms which can lead to an unwarranted operation associated with risks of complications. However, surgical interventions for falsely diagnosed aneurysms are quite rare. The purpose of this study is to demonstrate two clinical cases of false-positive aneurysms and a systematic review of the literature dedicated to the incidence and etiology of false-positive aneurysms, identifying risk factors associated with false-positive aneurysms. A literature search in two databases (PubMed and Web of Science) using keywords \"mimicking an intracranial aneurysm\", \"presenting as an intracranial aneurysm\", \"false positive intracranial aneurysms\", and \"neurosurgery\" was conducted. A total of 243 papers were found in the initial search in two databases. Sixteen papers (including 20 patients) were included in the final analysis. There were 10 women and 10 men. The most common location of false-positive aneurysms was the bifurcation of the middle cerebral artery (MCA). In the posterior circulation, false-positive aneurysms were identified either on the basilar artery, or at the vertebro-basilar junction. The main causes of false intracranial aneurysm diagnosis included artery occlusion with vascular stump formation, infundibular widening, fenestration, arterial dissection, contrast extravasation, and venous varix. In conclusion, summarizing the results of our analysis, we can say that surgical interventions for false-positive aneurysms are an underestimated problem in vascular neurosurgery. Despite extremely rare published clinical observations, the actual frequency of erroneous surgical interventions for false-positive aneurysms is unknown.
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  • 文章类型: Case Reports
    血吸虫病,一种寄生虫病,是由血吸虫属的血吸虫引起的。神经血吸虫病是最严重的血吸虫病,当宿主的大脑和脊髓对卵子的沉积作出反应时,导致神经症状.神经血吸虫病引起各种体征和症状,比如脊髓病,神经根病,颅内压升高.
    一名来自埃塞俄比亚的12岁儿童,下肢进行性无力,持续2个月。除了弱点,患者下肢也有刺痛感和麻木。此外,他有膀胱和肠失禁。脊柱MRI显示有粘液乳头状室管膜瘤的征象,但组织病理学结果显示血吸虫病。术后,患者的下肢无力(手指闪烁)略有改善。然而,他的节制能力没有改善。
    曼氏血吸虫感染最常见的神经系统表现是脊髓病,其中包括亚急性脊髓病和急性横贯性脊髓炎。马尾和延髓圆锥是最常受影响的区域。
    当脊柱血吸虫病表现为模仿脊柱肿瘤时,它提出了一个复杂的临床挑战,需要一个全面的跨学科方法,以确保准确的诊断和有效的治疗。这是当务之急的保健医生,以提高他们的知识和这种罕见的寄生虫感染的认识,特别是在流行的地区。
    UNASSIGNED: Schistosomiasis, a parasitic disease, is caused by blood flukes from the schistosoma genus. Neuroschistosomiasis is the most severe form of schistosomiasis, which occurs when the host\'s brain and spinal cord react to the deposition of eggs, leading to neurological symptoms. Neuroschistosomiasis causes various signs and symptoms, such as myelopathy, radiculopathy, and elevated intracranial pressure.
    UNASSIGNED: A 12-year-old child from Ethiopia who presented with progressive weakness in his lower extremities that has been ongoing for 2 months. Alongside the weakness, the patient also experienced tingling sensations and numbness in his lower extremities. Additionally, he had bladder and bowel incontinence. Spinal MRI showed signs suggestive of myxopapillary ependymoma, but the histopathology result showed schistosomiasis. Postoperatively, the patient had a slight improvement in terms of lower extremity weakness (flickering of the digits). However, there was no improvement in his continence ability.
    UNASSIGNED: The most common neurological manifestation of Schistosoma mansoni infection is myelopathy, which includes subacute myeloradiculopathy and acute transverse myelitis. The cauda equina and conus medullaris are the areas most frequently affected.
    UNASSIGNED: When spinal schistosomiasis presents itself as a mimicking spinal tumour, it poses a complex clinical challenge that necessitates a comprehensive interdisciplinary approach to ensure accurate diagnosis and effective treatment. It is imperative for healthcare practitioners to enhance their knowledge and awareness of this uncommon parasitic infection, particularly in regions where it is prevalent.
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  • 文章类型: Case Reports
    毛细血管瘤,通常在皮肤和粘膜组织中发现,很少在脊髓内遇到,提出了重大的诊断挑战。我们报告了一名66岁女性患者的脊髓圆锥硬膜内髓外毛细血管瘤的罕见病例。由于存在囊性形成和壁结节增强,因此根据MRI发现,我们的初步诊断倾向于囊性血管母细胞瘤。然而,手术探查和随后的病理检查显示病变为毛细血管血管瘤。就作者所知,该病例可能是首次有文献记载的脊髓毛细血管瘤,其模拟囊性血管母细胞瘤。
    Capillary hemangiomas, usually found in skin and mucosal tissues, are rarely encountered within the spinal cord, presenting a significant diagnostic challenge. We report a rare case of intradural extramedullary capillary hemangioma at the conus medullaris in a 66-year-old female patient. Our initial diagnosis leaned towards a cystic hemangioblastoma based on MRI findings due to the presence of cystic formation with an enhanced mural nodule. However, surgical exploration and subsequent pathological examination revealed the lesion as a capillary hemangioma. To the authors\' knowledge, this case may represent the first documented instance of a spinal capillary hemangioma that mimics a cystic hemangioblastoma.
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  • 文章类型: Case Reports
    尽管气道异物吸入(FBA)在任何年龄段都很常见,肺部未识别和保留的异物可能导致严重的并发症,如肺脓肿或支气管扩张。在极少数情况下,FBA可能与许多其他疾病(例如哮喘,肿瘤,肺嗜酸性粒细胞增多)。这里,我们报道了一个罕见的9岁男孩错过FBA的病例,其胸部CT扫描提示左下叶有空洞性病变,模仿先天性肺气道畸形(CPAM)。然而,令人惊讶的是,柔性支气管镜检查发现花生滞留在左下叶的外侧基底段,随后由镊子取回,避免了不必要的手术肺叶切除术。因此,FBA可以模仿其他疾病(例如CPAM),并且可能需要高度怀疑和额外的诊断技术(例如柔性支气管镜)来区分它们。此外,在儿童呼吸道疾病的鉴别诊断中,即使没有误吸史,也应考虑FBA。
    Although airway foreign body aspiration (FBA) is a common occurrence in any age group, unrecognized and retained foreign bodies in lungs may result in severe complications, such as lung abscess or bronchiectasis. In rare cases, FBA may present with similar clinical features as many other diseases (e.g. asthma, tumor, pulmonary eosinophilia). Here, we report a rare case of missed FBA in a nine-year-old boy, whose chest CT scan was suggestive of a cavitary lesion in the left lower lobe mimicking congenital pulmonary airway malformation (CPAM). However, surprisingly, flexible bronchoscopy revealed a peanut lodged in the lateral basal segment of left lower lobe, which was subsequently retrieved by a forceps and avoided unnecessary surgical lobectomy. Therefore, FBA can mimic other disorders (e.g. CPAM), and a high index of suspicion and additional diagnostic techniques (e.g. flexible bronchoscopy) may be required to distinguish them. Additionally, FBA should be considered in the differential diagnosis of respiratory disorders in children even lack of aspiration history.
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  • 文章类型: Case Reports
    SARS-CoV-2感染是一种主要影响上呼吸道和肺的大流行。它可能导致已知的炎性风湿性疾病的再激活和/或各种肉芽肿性疾病的开始。坏死性结节性肉芽肿病(NSG)是一种罕见的疾病,可与恶性肿瘤混淆,肉芽肿性多血管炎,和结节病.在此,我们报道了SARS-CoV-2感染后NSG的发展,该感染模仿肉芽肿性血管炎。
    SARS-CoV-2 infection is a pandemic that affects predominantly upper airways and lungs. It may lead to reactivation of known inflammatory rheumatic diseases and/or initiation of various granulomatous disorders. Necrotising sarcoid granulomatosis (NSG) is a rare condition that can be confused with malignancy, granulomatosis with polyangiitis, and sarcoidosis. Herein we reported the development of NSG following a SARS-CoV-2 infection which mimicked granulomatosis with polyangiitis.
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  • 文章类型: Case Reports
    肺错构瘤是最常见的切除的肺良性肿瘤。间充质囊性亚型是由多个囊肿和结节组成的罕见且经常双侧发生的变体。在这里,我们介绍了一名无症状的70岁女性,其右肺门区域有一个大的,主要是囊性的生长。胸部计算机断层扫描和氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描成像将其起源追溯到右中叶。总体特征提示原发性肺癌或其他囊性肺病。因为经支气管肺活检未能建立组织学诊断,右中叶切除术采用胸腔镜手术.大体手术标本有一个单个且相当大(8.0×4.0cm)的囊性病变,其中包含多个黄白色结节。最终诊断为间叶囊性和软骨样错构瘤。这个特殊的案例值得注意,考虑到最初与原发性肺癌的临床相似。
    Pulmonary hamartoma is the most commonly resected benign neoplasm of lung. The mesenchymal cystic subtype is a rare and often bilaterally occurring variant composed of multiple cysts and nodules. Herein, we present an asymptomatic 70-year-old woman with a large and mostly cystic growth of right hilar region. Computed tomography of the chest and fluorodeoxyglucose positron emission tomography/computed tomography imaging traced its origins to right middle lobe. Overall features suggested primary lung cancer or perhaps other cystic lung disease.Because transbronchial lung biopsy failed to establish a histologic diagnosis, right middle lobectomy was undertaken by video-assisted thoracoscopic surgery. The gross surgical specimen harbored a single and sizeable (8.0 × 4.0 cm) cystic lesion containing multiple yellow-white nodules. A diagnosis of mesenchymal cystic and chondroid hamartoma was ultimately rendered. This particular case is noteworthy, given the initial clinical resemblance to primary lung cancer.
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  • 文章类型: Case Reports
    怀疑为恶性肿瘤的病变需要由多学科团队管理。放射学和病理学诊断方式的利用可确保正确的诊断,从而确保及时的干预。

    变形杆菌是革兰氏阴性棒。它是一种高度能动的细菌,属于肠杆菌科。由P引起的肺部感染和肺炎极为罕见,并且发生在患有慢性衰弱或慢性肺部疾病的患者中。
    一位65岁的老妇人出现干咳,劳累时呼吸困难,持续4个月的胸痛。她接受了包括抗生素在内的多种药物治疗,但症状没有得到任何缓解。进行胸部计算机断层扫描,报告左肺上叶有多个相关肺结节。印象是转移性肺部疾病合并急性感染。因此,对患者进行了重新评估,并进行了诊断性支气管镜检查,包括多次支气管内活检和支气管肺泡灌洗.革兰氏染色显示革兰氏阴性杆菌,细菌鉴定为奇异假单胞菌。
    怀疑为恶性肿瘤的肿块性病变应在多个医学学科的参与下进行处理,以确保正确和及时的诊断。这是为了避免管理失误。
    UNASSIGNED: Lesions that are suspected for malignancy need be managed by a multidisciplinary team. Utilization of radiological as well as pathological diagnostic modalities ensures correct diagnosis and thus timely intervention.
    UNASSIGNED:
    UNASSIGNED: Proteus mirabilis is a Gram-negative rod. It is a highly motile bacterium that belongs to the Enterobacteriaceae. Lung infection and pneumonia caused by p. mirabilis is extremely rare and occurs in patients with chronic debilitation or chronic lung disease.
    UNASSIGNED: A 65-year-Old Woman presented with dry cough, dyspnoea on exertion, and chest pain of 4 months\' duration. She received multiple medications including antibiotics but without any resolution of her symptoms. Computed Tomography scan of the chest was performed reported a tumor in the upper lobe of the left lung with multiple associated pulmonary nodules. The impression was that of metastatic lung disease with superimposed acute infection. Accordingly, the patient was reevaluated and a diagnostic bronchoscopy with multiple endobronchial biopsies and broncho-alveolar lavage was done. The gram stain showed Gram-Negative Bacilli and the bacteria identified P. mirabilis.
    UNASSIGNED: Mass lesions suspected for malignancy should be managed with involvement of multiple medical disciplines, to ensure correct and timely diagnosis. This is to avoid miss-management.
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  • 文章类型: Case Reports
    骨样骨瘤是一种良性骨肿瘤,通常起源于长骨的干phy端和干hy端区域。疼痛往往是首发症状,它可以模仿许多疾病。在这里,我们报告了一名36岁的男性患者,他主诉腰痛向右肢放射一年.在病人的病史中,物理治疗,富血小板血浆,普瑞巴林,使用了度洛西汀,唯一的好处是吲哚美辛。要求对股骨进行X光检查,磁共振成像证实了骨样骨瘤的诊断。尽管进行了治疗,但应牢记骨样骨瘤作为持续性疼痛的鉴别诊断。
    Osteoid osteoma is a benign bone tumor that commonly arises from the metaphyseal and diaphyseal regions of long bones. Pain is often the first symptom, and it can mimic many diseases. Herein, we report a 36-year-old male patient who presented with complaints of lower back pain radiating to the right extremity for a year. In the patient\'s history, physical therapy, platelet-rich plasma, pregabalin, and duloxetine were used, with the only benefit from indomethacin. An X-ray of the femur was requested, and the diagnosis of osteoid osteoma was confirmed by magnetic resonance imaging. Osteoid osteoma should be kept in mind as a differential diagnosis of persistent pain despite treatment.
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  • 文章类型: Journal Article
    背景:肉瘤在形态学和免疫组织化学方面可能与恶性黑色素瘤相似,这使得在诊断过程中很难区分这两种肿瘤。本系统综述旨在总结最初诊断为黑色素瘤的肉瘤病例的可用证据。
    方法:全面搜索MEDLINE/Pubmed,EMBASE,和SCOPUS数据库进行到2023年3月。我们纳入了最初被诊断为恶性黑色素瘤的肉瘤患者的病例系列和病例报告。遵循PRISMA指南。
    结果:共纳入23例病例报告和4例病例系列,共34例患者。临床表现是异质的,涉及最多的解剖区域是下肢(24%),头/颈(24%),和上肢(21%)。据报道,S100的IHC阳性(69%),HMB45(63%),黑色素A(31%),和MiTF(3%)。第二次评估的主要原因是不寻常的表现(48%)和不确定的诊断(28%)。在17/34患者(50%)中调查了EWSR1易位,在16/17(94%)中发现阳性。最终诊断为透明细胞肉瘤(50%)或其他软组织肉瘤(50%)。
    结论:黑色素瘤和一些组织学肉瘤有许多相似之处。在非典型病变的情况下,应该考虑第二个诊断,和ESWR1易位应进行调查。
    BACKGROUND: Sarcoma may show similarities to malignant melanoma in terms of morphologic and immunohistochemical aspects, making it difficult to differentiate between these two neoplasms during the diagnostic process. This systematic review aims to summarize available evidence on cases of sarcoma that were initially diagnosed as melanoma.
    METHODS: A comprehensive search of the MEDLINE/Pubmed, EMBASE, and SCOPUS databases was conducted through March 2023. We included case series and case reports of sarcoma patients that were initially diagnosed as malignant melanoma. PRISMA guidelines were followed.
    RESULTS: Twenty-three case reports and four case series with a total of 34 patients were included. The clinical presentation was heterogeneous, and the most involved anatomical regions were lower limbs (24%), head/neck (24%), and upper limbs (21%). IHC positivity was reported for S100 (69%), HMB45 (63%), MelanA (31%), and MiTF (3%). The main reasons for a second assessment were unusual presentation (48%) and uncertain diagnosis (28%). EWSR1 translocation was investigated in 17/34 patients (50%) and found to be positive in 16/17 (94%). The final diagnosis was clear cell sarcoma (50%) or other soft tissue sarcomas (50%).
    CONCLUSIONS: Melanoma and some histotypes of sarcoma share many similarities. In cases of atypical lesions, a second diagnosis should be considered, and ESWR1 translocation should be investigated.
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  • 文章类型: Case Reports
    结节病是一种多器官的全身性疾病,有多种临床表现。患者会出现神经系统并发症。神经结节病可能危及生命;因此,早期识别和治疗是关键。这里,我们介绍了一例55岁的非裔美国男性,他主诉头晕和左侧无力;经过精心的影像学检查和膀胱肿块活检,他最终被诊断为神经结节病.神经结节病仍然是一个诊断难题,因为它可以在临床和影像学上模拟多种疾病,包括多发性硬化症。中枢神经系统淋巴瘤,多发性骨髓瘤,和进行性多灶性白质脑病。
    Sarcoidosis is a multi-organ systemic disease that presents with several clinical manifestations, and patients can develop neurologic complications. Neurosarcoidosis may be life-threatening; therefore, early recognition and treatment are key. Here, we present a case of a 55-year-old African American male who presented with a complaint of dizziness and left-sided weakness; he ultimately received a diagnosis of neurosarcoidosis after elaborate radiographic investigations and bladder mass biopsy. Neurosarcoidosis remains a diagnostic dilemma as it can clinically and radiographically mimic multiple conditions including multiple sclerosis, central nervous system lymphoma, multiple myeloma, and progressive multifocal leukoencephalopathy.
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