OpenMed/multicare-articles huggingface dataset:
TTF1 Expression in Pulmonary Metastatic Rectal Adenocarcinoma
Authors: Sara Aversa, Cristiana Bellan
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Thyroid transcription factor (TTF-1) is a tissue-specific nuclear transcription factor expressed developing thyroid, respiratory epithelium, and diencephalon. TTF-1 is thought to be expressed specifically in most thyroid tumors and in a significant subset of pulmonary neoplasms. However, recent studies on its expression in extrapulmonary carcinomas have demonstrated that TTF-1 is not as specific for lung and thyroid carcinomas as was previously thought: positivity of this marker can be observed, although much less frequently, in some carcinomas arising in other organs, such as the ovaries, endometrium, colon, and breast, as well as in some tumors of the central nervous system. Case reports of patients with TTF-1-positive colon adenocarcinoma are present in medical literature, but there are only a few cases of TTF-1-positive rectal adenocarcinoma. We present the case of a patient with rectal adenocarcinoma with lung metastasis found to be TTF-1-positive on immunohistochemistry. A review of the available literature is also included.
The role of psychological autopsy in investigating a case of atypical suicide in schizophrenia: a case report with a brief review of literature
Authors: Roxana-Mihaela Crișan, Ciprian Ionuț Băcilă, Silviu Morar
Journal: Egypt J Forensic Sci (2022)
Keywords: atypical suicide, covid-19 pandemic, forensic autopsy, psychological autopsy, risk assessment, schizophrenia
MeSH terms: Case Reports

Background:
Self-harm typically is without lethal intent. Death can occur rarely, with suicide taking on an atypical form that raises the suspicion of hetero-aggression. Our study aimed to identify the link between self-harm and suicide intent and also to outline the positive diagnosis of an atypical suicide case which has raised the suspicion of hetero-aggression. For this purpose, the psychological autopsy method should be used regularly in suicide investigation because it not only allows a positive diagnosis of suicide but can also provide a detailed picture of mental degradation and associated suicide risk factors.
Case presentation:
The case of a 26-year-old man from a rural area, found dead in the basement, at home, naked, barricaded inside, is described.
Methods:
The on-site investigation and a complete forensic autopsy were performed. In addition, we apply the psychological autopsy method which gathered enough information to outline the positive diagnosis of suicide. We also made a brief literature review on the suicide risk factors and the behavioral changes that occurred during the COVID-19 pandemic in schizophrenic patients.
Results:
The forensic autopsy revealed that he presented a complex craniofacial trauma as the cause of death (with scalp lacerations, frontal fracture, subarachnoid hemorrhage, and frontal cerebral contusions) associated with torso trauma (with self-inflicted stabbed wounds) with bruises and abrasions on the limbs. The injuries that caused death were self-inflicted and ensued repeatedly hitting his head against blunt objects. Using the psychological autopsy method, we found out that he presented multiple psychiatric hospitalizations for schizophrenia for almost 10 years, recently with reduced compliance to treatment. We also documented two previous suicide attempts and a gradual deterioration of his mental health.
Conclusions:
We highlighted the role of the psychological autopsy (in addition to the judicial investigation and the forensic autopsy) for the diagnosis of committed suicide, for making a rigorous differential diagnosis between accident, hetero-aggression, and suicide, and also in pin-pointing the suicide risk factors.
Supplementary information:
The online version contains supplementary material available at 10.1186/s41935-022-00291-5.
Thrombotic thrombocytopenic purpura: a case presenting with acute ischemic colitis
Authors: Joseph R H See, Tarek Sabagh, Christopher J Barde
Journal: Case Rep Hematol (2013)

Thrombotic thrombocytopenic purpura (TTP) consists of the pentad of thrombocytopenia, hemolytic anemia, fever, neurologic abnormalities, and renal disease. We present a case report of acute TTP following a bout of ischemic colitis. This report reminds the clinician that ischemic colitis can be an atypical presentation of TTP. The prompt recognition and treatment of this disease process resulted in a good prognosis for our patient.
Case Report: A Rare Case of Metachronous Multiple Primary Lung Cancers in a Patient With Successful Management by Switching From Anti-PD-1 Therapy to Anti-PD-L1 Therapy
Authors: Xinqing Lin, Guihuan Qiu, Fang Li, Haiyi Deng, Yinyin Qin, Xiaohong Xie, Juhong Jiang, Yong Song, Ming Liu, Chengzhi Zhou
Journal: Front Immunol (2021)
Keywords: immunotherapy, metachronous multiple primary lung cancer (mmplc), next-generation sequencing (ngs), re-biopsy, resistance
MeSH terms: B7-H1 Antigen / antagonists & inhibitors, Biomarkers, Tumor / antagonists & inhibitors, Drug Substitution, Immune Checkpoint Inhibitors / therapeutic use, Molecular Targeted Therapy, Neoplasms, Multiple Primary / diagnosis, Neoplasms, Multiple Primary / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, 80 and over, Female, Humans, Immune Checkpoint Inhibitors / administration & dosage, Immune Checkpoint Inhibitors / adverse effects, Immunohistochemistry, Neoplasms, Multiple Primary / etiology, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Symptom Assessment, Tomography, X-Ray Computed, Treatment Outcome, B7-H1 Antigen, Biomarkers, Tumor, CD274 protein, human, Immune Checkpoint Inhibitors, PDCD1 protein, human, Programmed Cell Death 1 Receptor

Without global standard diagnostic criteria, distinguishing multiple primary lung cancers (MPLCs) from intrapulmonary metastasis or histologic transformation has been a big challenge in clinical practice. Here, we described a rare case of metachronous adenocarcinoma and small cell lung cancer (SCLC) in a patient who developed drug resistance to pembrolizumab. Both DNA-sequencing and RNA-sequencing were performed on primary adenocarcinoma and resistant lesions. Through the comparison of primary adenocarcinoma and novel lesion mutation profiles, along with bioinformatic estimation of immune proportion by using RNA sequence data, we revealed the origin and tumor microenvironment of the two lesions. No shared mutations were detected between lung adenocarcinoma (LUAD) and SCLC from the same patient, suggesting these two lesions might be from separate primary lung cancers. Compared to LUAD, SCLC showed a relatively cold microenvironment, including negative PD-L1. The patient obtained durable clinical benefits upon treatment with atezolizumab, without experiencing immune-related adverse events. Disease progression should be monitored with prompt re-biopsy and molecular profiling to spot a potential histologic change and to shed light on therapeutic alternatives. The use of atezolizumab, either alone or in combination with other agents, may be a potential therapeutic strategy for patients with both LUAD and SCLC.
Bilobed testicle diagnosed by ultrasound in a 9-year-old boy
Authors: Romaissaa Boutachali, Sakina Nahmed, Othmane Jbara, Dalal Laoudiyi, Kamilia Chbani, Siham Salam
Journal: Radiol Case Rep (2022)
Keywords: bilobed testicle, incomplete polyorchidism, scrotal mass
MeSH terms: Case Reports

Bilobed testis is an extremely rare congenital malformation, and even rarer on the right side. Only 7 cases have been reported in the literature. We describe the case of a 9-year-old boy with a right bilobed testicle confirmed on ultrasound and discovered incidentally as a mass on physical examination. The aim of our work is to consider the bilobed testicle as a differential diagnosis of a testicular mass despite its rarity and to show the importance of ultrasound and MRI for its definitive diagnosis to avoid unnecessary surgery.
Neurocysticercosis Diagnosed by Taenia solium PCR on Brain Biopsy
Authors: Sean Wei Xiang Ong, Jean-Marc Chavatte, Jonathan Wei Zhong Chia, Ramez Wadie Kirollos, Yih Yian Sitoh, Cristine Ding, Monica Chan
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Neurocysticercosis is a common cause for brain lesions and adult-onset epilepsy in endemic countries. However, diagnosis is challenging in the absence of typical radiologic or histopathologic features. In this case report, we present a case of a 35-year-old male with a new-onset seizure and a rim-enhancing temporal lobe lesion. Radiologic features were nonspecific, and brain biopsy was performed. Histologic features showed only nonspecific granulomatous inflammation, and the diagnosis of neurocysticercosis was confirmed only with polymerase chain reaction (PCR) testing on brain biopsy tissue demonstrating PCR products consistent with Taenia solium. This case highlights the diagnostic role of PCR in such clinical situations whereby the diagnosis is unclear after initial routine evaluation.
Spinal epidural hematoma in a patient on chronic anticoagulation therapy performing self-neck manipulation: a case report
Authors: Jesse Cooper, Patrick Battaglia, Todd Reiter
Journal: Chiropr Man Therap (2019)
Keywords: anticoagulants, spinal epidural hematoma, spinal manipulation
MeSH terms: Hematoma, Epidural, Spinal / surgery, Manipulation, Spinal / adverse effects, Case Reports, Anticoagulants / therapeutic use, Atrial Fibrillation / drug therapy, Hematoma, Epidural, Spinal / diagnostic imaging, Hematoma, Epidural, Spinal / etiology, Humans, Laminectomy, Male, Middle Aged, Warfarin / therapeutic use, Anticoagulants, Warfarin

Background:
Spinal epidural hematoma is a rare condition usually secondary to trauma and coagulopathy. To the best of our knowledge, we present the first case of a patient with an iatrogenic hypercoaguable state performing self-neck manipulation, which resulted in a spinal epidural hematoma and subsequent quadriparesis.
Case presentation:
A 63-year-old man presented to the emergency department with worsening interscapular pain radiating to his neck 1 day after performing self-manipulation of his cervical spine. He was found to be coagulopathic upon admission, secondary to chronic warfarin therapy for the management of atrial fibrillation. Approximately 48 h after the manipulation, the patient became acutely quadriparetic and hypotensive. Urgent magnetic resonance imaging revealed a multilevel spinal epidural hematoma from the lower cervical to thoracic spine.
Conclusions:
Partial C7, complete T1 and T2, and partial T3 bilateral laminectomy was performed for evacuation of the spinal epidural hematoma. Following a 2-week course of acute inpatient rehabilitation, the patient returned to his baseline functional status. This case highlights the risks of self-manipulation of the neck and potentially other activities that significantly stretch or apply torque to the cervical spine. It also presents a clinical scenario in which practitioners of spinal manipulation therapy should be aware of patients undergoing anticoagulation therapy.
Multiple microvenular hemangioma: A case report
Authors: Dong Fang Ai, Yan Li, Aikaj Jindal, Ping Li
Journal: Oncol Lett (2014)
Keywords: microvenular hemangioma

The current study reports a case of multiple microvenular hemangioma (MH). A 35-year-old male presented with dark red maculopapules on the trunk and limbs that had been apparent for 5 years. The number of lesions exceeded 100 in total. A histological examination demonstrated multiple, irregular, branching venules in the dermis, without any endothelial atypia. On immunohistochemical analysis of the vascular structures, the endothelial cells stained positive for CD31, CD34 and factor VIII, and the perivascular cells stained positive for SMA and HHF-35. These observations were consistent with a diagnosis of MH, and should be differentiated from the most common differential diagnosis of patch-stage Kaposi's sarcoma. There was no clear effect following topical application of recombinant human interferon α-2b gel.
Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review
Authors: Hao Wu, Rui Zheng
Journal: Open Med (Wars) (2020)
Keywords: streptococcus anginosus, bacteremia, splenic abscess, treatment, urinary infection
MeSH terms: Case Reports

Organ abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.
MR imaging findings of a patient with isolated intrahepatic splenosis mistaken for hepatocellular carcinoma
Authors: Kulyada Somsap, Nittaya Chamadol, Attapol Titapun, Chawalit Pairojkul, Sakkarn Sangkhamanon
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Splenosis refers to the autotransplantation of splenic tissue throughout different anatomic compartments secondary to trauma or splenic surgery. The liver is an uncommon location for splenic implants and imaging findings are often described as non-specific. We report MRI findings of a patient with a large liver mass that was first diagnosed as a malignant tumour but histopathology revealed that it was actually intrahepatic splenosis. The signal characteristics of this mass were low intensity on T 1 and high intensity on T 2 weighted images; arterial enhancement, which became more homogeneous in the later phases; and a relative hypointensity on the delayed phase images. Because a high level of awareness is necessary for making a correct diagnosis of this condition, one should consider the possibility of intrahepatic splenosis in a patient with a history of abdominal trauma or splenic surgery.
Lupus and the Lungs: The Assessment and Management of Pulmonary Manifestations of Systemic Lupus Erythematosus
Authors: Raj Amarnani, Su-Ann Yeoh, Emma K Denneny, Chris Wincup
Journal: Front Med (Lausanne) (2021)
Keywords: acute lupus pneumonitis, interstitial lung disease (ild), pleural effusion, pleurisy, pulmonary arterial hypertension, pulmonary vasculitis, shrinking lung syndrome, systemic lupus erythematosus (sle)
MeSH terms: Review

Pulmonary manifestations of systemic lupus erythematosus (SLE) are wide-ranging and debilitating in nature. Previous studies suggest that anywhere between 20 and 90% of patients with SLE will be troubled by some form of respiratory involvement throughout the course of their disease. This can include disorders of the lung parenchyma (such as interstitial lung disease and acute pneumonitis), pleura (resulting in pleurisy and pleural effusion), and pulmonary vasculature [including pulmonary arterial hypertension (PAH), pulmonary embolic disease, and pulmonary vasculitis], whilst shrinking lung syndrome is a rare complication of the disease. Furthermore, the risks of respiratory infection (which often mimic acute pulmonary manifestations of SLE) are increased by the immunosuppressive treatment that is routinely used in the management of lupus. Although these conditions commonly present with a combination of dyspnea, cough and chest pain, it is important to consider that some patients may be asymptomatic with the only suggestion of the respiratory disorder being found incidentally on thoracic imaging or pulmonary function tests. Treatment decisions are often based upon evidence from case reports or small cases series given the paucity of clinical trial data specifically focused on pulmonary manifestations of SLE. Many therapeutic options are often initiated based on studies in severe manifestations of SLE affecting other organ systems or from experience drawn from the use of these therapeutics in the pulmonary manifestations of other systemic autoimmune rheumatic diseases. In this review, we describe the key features of the pulmonary manifestations of SLE and approaches to investigation and management in clinical practice.
Frequent Sips of the Water for the Management of Gastroesophageal Reflux Induced Refractory Cough: A Case Report and Review of the Literature
Authors: Hassan Tariq, Jasbir Makker, Rafeeq Ahmed, Trupti Vakde, Harish Patel
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Background:
Chronic cough is often associated with gastroesophageal reflux disease (GERD). The role of gastroenterologist in the management of the chronic cough is to identify and manage GERD. Ineffective esophageal motility is often associated with GERD induced cough. Chronic cough is often refractory to medical and surgical management despite adequate acid control. Unresponsiveness warrants a thorough pulmonary evaluation. The pathophysiology of refractory cough in these patients is poorly understood, and hence management is often challenging.
Case presentation:
A 75-year-old woman from Ghana was evaluated for GERD associated chronic cough. A 48-hour ambulatory pH study revealed acid exposure of 4.9% and high-resolution manometry showed decreased lower esophageal sphincter pressure, an inadequate response to medical and surgical management of GERD. Postfundoplication ambulatory pH testing demonstrated well-controlled acid reflux but her cough still persisted. Repeat manometry showed an ineffective motility disorder (IEM). Taking frequent sips of water eventually resolved her chronic cough.
Conclusion:
Frequent sips of water can be used in the management of the gastroesophageal reflux and ineffective motility induced cough. It results in increased esophageal clearance of acid, nonacid reflux, and ingested pharyngeal secretions, thus breaking the cycle of cough generated increased intra-abdominal pressure with reflux and more cough.
"Crack lung and heart" presenting after chemotherapy in a 65-year-old man with non-Hodgkin lymphoma
Authors: G G Alvarez, R H C van der Jagt
Journal: Curr Oncol (2008)
Keywords: cocaine, non-hodgkin lymphoma, “crack lung”

Crack cocaine can cause a variety of pulmonary and cardiac complications. Pulmonary findings in a 65- year-old man with non-Hodgkin lymphoma who presented with shortness of breath not resolving with antibiotics are presented here. The usual manifestation of "crack lung" in an unusual clinical circumstance underlines the importance of a clinical history in such cases. The finding of "crack lung" preceded the diagnosis of probable "crack heart." No other similar published case reports could be identified in the literature.
Case report: Cutaneous pseudolymphoma caused by a Leishmania infantum infection in a patient treated with anti-TNF antibody for plaque psoriasis
Authors: Sarah Scholl, Daniel Schuster, Kristin Technau-Hafsi, Katarina Stete, Siegbert Rieg, Annette M May, Christian Bogdan, Franziska Schauer
Journal: Front Med (Lausanne) (2022)
Keywords: adalimumab, anti-tnf therapy, cutaneous leishmaniasis, skin pseudolymphoma, skin ulceration
MeSH terms: Case Reports

For psoriasis, which affects up to 2% of the population and adalimumab is approved from the age of 4 years. Here, we present a middle-aged Italian man with long-term history of plaque psoriasis and psoriasis arthropathica and adalimumab therapy. He developed ulcers or nodules within the psoriatic plaques, resembling cutaneous infection with Leishmania infantum. TNF and other cytokines such as IL-12 and IFN-γ are central in the early control of the infection. Discontinuation of the anti-TNF-treatment resolved the infection without specific therapy.
A rare case of traumatic bilateral fibular head fractures
Authors: Anastasios Chytas, Antonios Spyridakis, John Gigis, Theodoros Beslikas, Nikolaos Panos, John Christoforidis
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Avulsion fibular head fractures are rare. There is only one reference of bilateral fibular fractures after epileptic seizure. We aim to present the mechanism and the treatment of this rare injury. We present the case of a 30-year-old woman who was hit by a car on the anteromedial side of both knees. Clinical and radiographic control showed bilateral fibular head fractures. Knee instability was not found at both knees and MRI did not show any concomitant ligament ruptures. Bone bruises of both medial condyles found in MRI explain the mechanism of this injury. The patient was treated conservatively with functional knee braces for 6 weeks allowing full range of motion, but otherwise mobilised as normal without any support. Six weeks after the trauma, there were no symptoms while the fractures sites had united completely after 6 months. One year postinjury the patient was free from symptoms.
Novel Method for Removing Embedded Cactus Spines in the Emergency Department
Authors: Andrew M Ford, Steven T Haywood, Douglas R Gallo
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Injuries from cactus spines can present challenges to Emergency Medicine providers. When the patient has mental limitations that prevent cooperation with removal, these challenges grow. Traditional removal techniques have several drawbacks including prolonged time for complete removal and incomplete removal. We present the case of a 22-year-old with a history of low-functioning autism and congenital motor dysfunction with a cactus spine injury to a large surface area of her chest, abdomen, and extremities. Conscious sedation utilizing intramuscular ketamine and Operating Room (OR) hair removal mitts were utilized to quickly and effectively remove the cactus spines. The patient had efficient, painless resolution of her injury without need for additional spine removal.