OpenMed/multicare-articles huggingface dataset:
An unusual ectopic thymoma clonal evolution analysis: A case report
Authors: Sijia Zhang, Lu Wu, Zhenyu Li, Qianwen Li, Yan Zong, Kuikui Zhu, Leichong Chen, Haifeng Qin, Rui Meng
Journal: Open Life Sci (2023)
Keywords: case report, clonal evolution, ectopic pulmonary thymoma, heterogeneity, immunohistochemical
MeSH terms: Case Reports

Thymomas and thymic carcinomas are rare and primary tumors of the mediastinum which is derived from the thymic epithelium. Thymomas are the most common primary anterior mediastinal tumor, while ectopic thymomas are rarer. Mutational profiles of ectopic thymomas may help expand our understanding of the occurrence and treatment options of these tumors. In this report, we sought to elucidate the mutational profiles of two ectopic thymoma nodules to gain deeper understanding of the molecular genetic information of this rare tumor and to provide guidance treatment options. We presented a case of 62-year-old male patient with a postoperative pathological diagnosis of type A mediastinal thymoma and ectopic pulmonary thymoma. After mediastinal lesion resection and thoracoscopic lung wedge resection, the mediastinal thymoma was completely removed, and the patient recovered from the surgery and no recurrence was found by examination until now. Whole exome sequencing was performed on both mediastinal thymoma and ectopic pulmonary thymoma tissue samples of the patient and clonal evolution analysis were further conducted to analyze the genetic characteristics. We identified eight gene mutations that were co-mutated in both lesions. Consistent with a previous exome sequencing analysis of thymic epithelial tumor, HRAS was also observed in both mediastinal lesion and lung lesion tissues. We also evaluated the intratumor heterogeneity of non-silent mutations. The results showed that the mediastinal lesion tissue has higher degree of heterogeneity and the lung lesion tissue has relatively low amount of variant heterogeneity in the detected variants. Through pathology and genomics sequencing detection, we initially revealed the genetic differences between mediastinal thymoma and ectopic thymoma, and clonal evolution analysis showed that these two lesions originated from multi-ancestral regions.
A case study of soil food web components affected by Fallopia japonica (Polygonaceae) in three natural habitats in Central Europe
Authors: Andrea Čerevková, Lenka Bobuľská, Dana Miklisová, Marek Renčo
Journal: J Nematol (2019)

This study determined the effect of the invasive plant Fallopia japonica on soil physical properties, microbial respiration, microbial biomass carbon content, enzymatic activities, and soil nematode communities. We established in total 30 plots in three natural habitats (forest, grassland, wetland) that were either uninvaded or mostly monospecifically invaded by F. japonica. The soil physical and microbial properties differed among the investigated plots, but the differences were observed to be non-significant between the invaded and the uninvaded plots. Non-metric multidimensional scaling based on nematode species diversity indicated that the total number of identified nematode species and their abundance were higher in the uninvaded compare to the invaded plots. Negative effect of F. japonica on omnivores, plant parasites, and root-fungal feeder nematodes was confirmed by their lower abundance in the invaded compared to the uninvaded plots. In the invaded plots, we also confirmed lower Maturity and Channel index, but higher Enrichment index. Our results thus indicated that the invasive plant F. japonica could affect nematode communities, more than physical or microbial properties, regardless of habitat.


This study determined the effect of the invasive plant Fallopia japonica on soil physical properties, microbial respiration, microbial biomass carbon content, enzymatic activities, and soil nematode communities. We established in total 30 plots in three natural habitats (forest, grassland, wetland) that were either uninvaded or mostly monospecifically invaded by F. japonica. The soil physical and microbial properties differed among the investigated plots, but the differences were observed to be non-significant between the invaded and the uninvaded plots. Non-metric multidimensional scaling based on nematode species diversity indicated that the total number of identified nematode species and their abundance were higher in the uninvaded compare to the invaded plots. Negative effect of F. japonica on omnivores, plant parasites, and root-fungal feeder nematodes was confirmed by their lower abundance in the invaded compared to the uninvaded plots. In the invaded plots, we also confirmed lower Maturity and Channel index, but higher Enrichment index. Our results thus indicated that the invasive plant F. japonica could affect nematode communities, more than physical or microbial properties, regardless of habitat.
Hemophagocytic Lymphohistiocytosis Associated to Klebsiella pneumoniae Infection: A Case Report
Authors: Zhiyu Zhang, Junqian Liu, Jingyue Wang, Yushi Wang
Journal: Front Immunol (2021)
Keywords: klebsiella pneumoniae, ferritin, hemophagocytic lymphohistiocytosis, hemophagocytic syndrome, hyperferritinemia, intensive care unit
MeSH terms: Hyperferritinemia / etiology, Klebsiella Infections / complications, Klebsiella pneumoniae / isolation & purification, Lymphohistiocytosis, Hemophagocytic / etiology, Case Reports, Aged, Ferritins / blood, Humans, Hyperferritinemia / diagnosis, Intensive Care Units, Klebsiella Infections / diagnosis, Lymphohistiocytosis, Hemophagocytic / diagnosis, Male, Ferritins

This is a case analysis of a 73-year-old Chinese man admitted to the cardiac intensive care unit (ICU) with fever and general pain. Based on the patient's initial condition of multi-organ function impairment and increased serum ferritin, and after a series of examinations, the patient was diagnosed with Klebsiella pneumonia-induced hemophagocytic lymphohistiocytosis (HLH). Meropenem and dexamethasone were used in combination to treat the patient, and the results were very successful. In this case report, it is further suggested that Klebsiella pneumoniae is a possible trigger of HLH, and a combination of antibiotics and corticosteroids can be effective in treating HLH. It is also recommended that doctors in the ICU of each department should pay attention to the role of hyperferritinemia in the diagnosis of HLH, and ICU admission teams should include ferritin in their monitoring.
Atypical nontraumatic chylothorax in a monoclonal IgM elevated nodal marginal zone lymphoma: A case report and review of the literature
Authors: Lingling Wang, Qian Huang, Jiao Tang, Jun Feng, Yongfen Huang, Jianming Dong, Yuexin Cheng, Hao Xu, Yuqing Miao
Journal: Front Immunol (2022)
Keywords: b cell, igm, chylothorax, immunotherapy, marginal zone lymphoma, nodal marginal zone lymphoma, pleural effusion
MeSH terms: Chylothorax / diagnosis, Chylothorax / etiology, Lymphoma, B-Cell, Marginal Zone / complications, Lymphoma, B-Cell, Marginal Zone / diagnosis, Pleural Effusion, Review, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal, Humans, Immunoglobulin M, Male, Middle Aged, Paraproteins, Paraproteins, Immunoglobulin M, Antibodies, Monoclonal

Nodal Marginal Zone Lymphoma(NMZL) is an indolent lymphoma with a very low clinical incidence and is sometimes difficult to differentiate diagnostically from Lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (LPL/WM). NMZL with elevated monoclonal immunoglobulin M (IgM) is even rarer. Nontraumatic chylothorax can be seen in aggressive lymphoma, which often happens with chest tightness and dyspnea as the primary clinical manifestation. We reported the first case of monoclonal IgM elevated NMZL complicated by atypical nontraumatic chylothorax. A 64-year-old male patient was first admitted to the Department of Respiratory Medicine with symptoms of chest tightness and shortness of breath. He was given several times thoracentesis to drain pleural effusion to improve pulmonary compression symptoms. The patient had a combination of elevated monoclonal IgM and atypical lymph node biopsy pathology. After two times lymph node biopsies and genetic testing, the patient was finally diagnosed with NMZL. Within a short time, he was admitted to the Department of Hematology due to the reappearance of massive pleural effusion, which indicated chylothorax. The patient repeatedly presented with left-sided pleural effusion, and the color went from red to yellow, and finally white. Only about half of the chylothorax cases present with typical clinical manifestations. We report this case intending to draw the attention of clinicians to hematologic malignancies with atypical nontraumatic chylothorax.
Case Report: Multifocal biphasic squamoid alveolar renal cell carcinoma
Authors: Jose Ignacio Lopez
Journal: F1000Res (2016)
Keywords: kidney, biphasic squamoid alveolar renal cell carcinoma, immunohistochemistry, papillary renal cell carcinoma

A multifocal biphasic squamoid alveolar renal cell carcinoma in a 68-year-old man is reported. Four different peripheral tumor nodules were identified on gross examination. A fifth central tumor corresponded to a conventional clear cell renal cell carcinoma. Biphasic squamoid alveolar renal cell carcinoma is a rare tumor that has been very recently characterized as a distinct histotype within the spectrum of papillary renal cell carcinoma. Immunostaining with cyclin D1 seems to be specific of this tumor subtype. This is the first reported case with multifocal presentation.
Crossed Unfused Ectopic Pelvic Kidneys: A Case Illustration
Authors: Jad A Degheili, Murad M AbuSamra, Fadi El-Merhi, Albert El-Hajj
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Crossed unfused ectopia constitutes a very rare variant of ectopic kidneys, with an approximate incidence of 1 : 75000. We hereby describe a rare case of an incidental finding of crossed unfused ectopic kidneys, in a 45-year-old gentleman incidentally found to have a bladder lesion. The unique blood supply of his kidneys has also been described. The present case also highlights the different subtypes of renal ectopia, the different embryological hypotheses behind their presentation, and the various systematic anomalies, associated with them. Variations in vasculature of ectopic kidneys have been only described in case reports and are crucial to recognize in case any further intervention is needed.
Methadone-induced delayed posthypoxic encephalopathy: clinical, radiological, and pathological findings
Authors: Manoj Mittal, Yunxia Wang, Alan Reeves, Kathy Newell
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Objective. To describe the clinical, radiological and pathological findings in a patient with methadone-induced delayed posthypoxic encephalopathy (DPHE). Case Report. A Thirty-eight-year-old man was found unconscious for an unknown duration after methadone and diazepam ingestion. His initial vitals were temperature 104 degree Fahrenheit, heart rate 148/minute, respiratory rate 50/minute, and blood pressure 107/72 mmhg. He developed renal failure, rhabdomyolysis, and elevated liver enzymes which resolved completely in 6 days. After 2 weeks from discharge he had progressive deterioration of his cognitive, behavioral and neurological function. Brain MRI showed diffuse abnormal T2 signal in the corona radiata, centrum semiovale, and subcortical white matter throughout all lobes. Extensive work up was negative for any metabolic, infectious or autoimmune disorder. Brain biopsy showed significant axonal injury in the white matter. He was treated successfully with combination of steroids and antioxidants. Follow up at 2 year showed no residual deficits. Conclusion. Our observation suggests that patients on methadone therapy should be monitored for any neurological or psychiatric symptoms, and in suspected cases MRI brain may help to make the diagnosis of DPHE. A trial of steroids and antioxidants may be considered in these patients.
A Case Series of Adult-Onset Rasmussen's Encephalitis: Diagnostic and Therapeutic Challenges
Authors: James Francis Castellano, Jenny A Meyer, Fred Alexander Lado
Journal: Front Neurol (2017)
Keywords: rasmussen’s encephalitis, autoimmune epilepsy, electroencephalography, epilepsy, magnetic resonance imaging
MeSH terms: Case Reports

Rasmussen's encephalitis (RE) is a rare neurologic disorder characterized by progressive cerebral hemiatrophy and medically refractory epilepsy. The majority of current literature on this topic is focused on the pediatric population. In this case series, we will review three cases of adult-onset RE, as defined by fulfillment of the 2005 Bien criteria. The diagnostic challenge of characterizing this rare disease will be highlighted by the extensive serum, CSF, and pathologic sampling in all three patients. MR imaging and EEG data will be examined over time to characterize hallmark findings as well as progression. In addition, we will review the various forms of therapy attempted in these three patients, namely anti-epileptic drug therapy and immunomodulatory therapy. We will also utilize this case series to critically evaluate the broader context of atypical presentations of this disease and the value of current diagnostic criteria.
Recurrent Hepatocellular Carcinoma in Patient with Crohn's Disease: Incidental or Expected Outcome of Azathioprine?
Authors: Youssef Botros, Mary Mathews, Hiren Patel, Nihar Shah, Walid Baddoura, Andrew de la Torre
Journal: Case Rep Gastrointest Med (2015)

Hepatocellular carcinoma (HCC) usually occurs in patients with underlying risk factors such as liver cirrhosis and chronic hepatitis B. Although patients with Crohn's disease (CD) are at an increased risk to develop malignancies such as colon cancer, the incidence of HCC in this population is extremely rare. We report a case of 62-year-old male with long history of CD treated with azathioprine (AZA) and aminosalicylic acid (ASA) who was incidentally diagnosed with HCC, for which left hepatectomy was done. Four years later during routine follow-up, patient had another hepatic lesion and underwent resection of the mass. The mechanism of occurrence of HCC in patient with CD is still controversial and may include immune mediated changes and medication related complications. AZA was reported in all case reports of CD that developed HCC. Through this report we hope to explore the complex pathophysiological mechanisms contributing to the development of HCC in the Crohn's disease patient population.
Cutaneous Horn-Related Kaposi's Sarcoma: A Case Report
Authors: Nilufer Onak Kandemir, Banu Dogan Gun, Figen Barut, Nilgun Solak Tekin, Sukru Oguz Ozdamar
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Cutaneous horn is characterized by the accumulation of abnormal keratinized material and may occur in association with a variety of benign, premalignant, and malignant cutaneous lesions. Cutaneous horn occurs very rarely in association with soft-tissue neoplasias. A cutaneous horn located on the toe was completely removed by excision in a 78-year-old male patient. Macroscopic examination revealed a hemorrhagic nodular lesion, 0.5 cm in diameter, located on the dermis underlying the cutaneous horn with a height of 1 cm. Histopathological examination revealed a neoplastic lesion consisting of fusiform cells and extravasated erythrocytes underlying the compact keratin mass. The immunohistochemical analysis showed immunoexpression of endothelial markers and HHV8 in fusiform cells. The case was evaluated as "cutaneous horn developed in a nodular stage Kaposi's sarcoma." Our case is the second case of cutaneous horn related to Kaposi's sarcoma reported in the English literature and is presented in this case report with its clinical and histopathological features.
Phthriasis palpebrarum mimicking lid eczema and blepharitis
Authors: Burak Turgut, Julide Kurt, Onur Catak, Tamer Demir
Journal: J Ophthalmol (2009)
MeSH terms: Case Reports

Phthiriasis palpebrarum (PP) is a rare eyelid infestation caused by phthirus pubis. We report a case of PP mimicking lid eczema and blepharitis. A 68-year-old woman had moderate itching in both eyes. Her initial diagnosis was considered to be lid eczema or blepharitis because of findings similar to exfoliative lesions and color changes in eyelids and to excretions over eyelashes. Careful observation revealed many lice and translucent nits, protuberances and hyperpigmentary changes, and the buried lice in both eyelids. No hyperemia or secretion was observed on the lids and in the conjunctiva in both eyes. The patient was treated with pilocarpine hydrochloride 4% drops. At the end of the first week, no louse or nit was present. Although it was known that PP is a rare cause of blepharoconjunctivitis, it might observe as an isolated infestation of the eyelids and this condition can easily be misdiagnosed as lid eczema and blepharitis.
Mucinous Adenocarcinoma of the Colon with Clear Cell Component: A Case Report and Literature Review
Authors: Andrija Karačić, Gabrijela Stanić, Domagoj Štritof, Branko Bakula, Dubravka Jandrić, Inka Kekez
Journal: Case Rep Pathol (2022)
MeSH terms: Case Reports

Clear cell adenocarcinomas of the colon are defined as a subtype of colorectal adenocarcinoma with clear cell morphology. A 65-year old man was admitted to a Gastroenterology Department for diagnostic evaluation of a tumor in the sigmoid colon found on CT. There, the patient developed complete bowel obstruction and was operated urgently, where intraoperatively, a large tumor in the sigmoid fixated to the lateral abdominal wall was revealed. A subtotal colectomy was performed. Histopathological analysis of the surgical specimen was conducted. The immunohistochemistry staining was positive for CEA, CDX2, and CD20 and negative for CK7, CD10, MUC2, AFP, and PAS staining. Mismatch repair protein testing was negative. The pathological diagnosis was mucinous carcinoma with a clear cell component which bears an extremely low incidence that has been scarcely reported in literature. This stresses the need for more case reports like ours to be published.
An unusual location of juvenile angiofibroma: a case report and review of the literature
Authors: Ravishankar Pillenahalli Maheshwarappa, Amit Gupta, Juhi Bansal, Mahesh Virupaksha Kattimani, Sachin Shivayogappa Shabadi, Suresh Chandra Baser
Journal: Case Rep Otolaryngol (2013)

A 10-year-old boy presented with left-sided nasal obstruction and epistaxis. Endoscopic evaluation revealed a polypoid mass in the vestibule arising from the lateral wall of the nasal cavity anteroinferior to the left inferior turbinate. Computed tomography (CT) scan showed a soft tissue opacity in the vestibule of the left nasal cavity. After the endoscopic excision of the mass, postoperative and histopathological analyses confirmed the diagnosis of an angiofibroma.
[Mucopyocele of the middle turbinate: a case report]
Authors: José Antônio Pinto, Pedro Paulo V C Cintra, Ana Carla Souza de Marqui, Delmer J P Perfeito, Roberto D P Ferreira, Rubens H da Silva
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Mucocele / diagnosis, Paranasal Sinus Diseases / diagnosis, Turbinates, Case Reports, English Abstract, Chronic Disease, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Mucocele / etiology, Paranasal Sinus Diseases / complications, Tomography, X-Ray Computed

Mucopycocele of the middle turbinate is an uncommon disease. Most mucoceles are situated in the frontal and/or ethmoid sinuses. In this paper we will describe a mucopyocele of the middle turbinate associated with pansinus disease.
More Than Skin Deep: An Unusual Case of a Migrating Pacemaker Lead
Authors: Rami H Mahmoud, Brooke A Hensley
Journal: Cureus (2023)
Keywords: pacemaker, pacemaker failure, pacemaker lead, pacemaker lead migration, pacemaker lead perforation
MeSH terms: Case Reports

Pacemakers are commonly utilized in clinical practice and are generally well tolerated; therefore, clinicians may not be exposed to potential complications associated with pacemakers. This case report aims to illustrate the clinical presentation of a pacemaker lead migration, an uncommon potential complication. We present an 83-year-old male with a past medical history of complete atrioventricular block managed with a permanent pacemaker who presented with an open wound on his right chest. He had capped, abandoned right-sided leads from a previous pacemaker. At presentation, there was blood-tinged, yellow drainage and visible erosion of his electrodes. Computed tomography showed the right ventricular pacing lead perforating the right ventricle. Pacemaker lead migration outside of the chest wall is rare. Perforations may present asymptomatically or strikingly with effusions, pneumothoraces, hemothoraces, or cardiac tamponade. Management options include lead repositioning or extraction.
Case Report: Acquired Haemophilia A Following mRNA-1273 Booster Vaccination Against SARS-CoV-2 With Concurrent Diagnosis of Pleomorphic Dermal Sarcoma
Authors: Marlene Plüß, Christina Mitteldorf, Christoph Johannes Szuszies, Björn Tampe
Journal: Front Immunol (2022)
Keywords: sars-cov-2 vaccination, acquired haemophilia a, booster vaccination, factor viii autoantibodies, mrna-1273, pleomorphic dermal sarcoma
MeSH terms: COVID-19, Hemophilia A / diagnosis, Hemophilia A / drug therapy, Sarcoma, Viral Vaccines, Case Reports, 2019-nCoV Vaccine mRNA-1273, Aged, COVID-19 Vaccines / adverse effects, Humans, SARS-CoV-2, Vaccination / adverse effects, COVID-19 Vaccines, Viral Vaccines, 2019-nCoV Vaccine mRNA-1273, Factor 8 deficiency, acquired

While the global pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is still ongoing and new virus variants are emerging, there is a universal need for vaccines to protect individuals from severe complications and ideally control the pandemic by enabling herd immunity. Several vaccines against SARS-CoV-2 have been approved and are widely used to stem the recurring waves of coronavirus disease 2019 (COVID-19). Post-marketing surveillance is essential to record even rare safety issues related to these new vaccines. Among these issues, several autoimmune phenomena have been recorded in temporal association with and feasibly triggered by a vaccination. Acquired haemophilia A (AHA) is a rare condition characterized by new-onset haemorrhagic diathesis caused by an inhibitor of blood clotting factor VIII (FVIII), often in the elderly and most commonly associated with autoimmune or malignant disease. There have been a small number of AHA cases triggered by vaccinations, including those against SARS-CoV-2. We report the first case of AHA in temporal association with an mRNA-1273 booster vaccination. The diagnosis was made promptly, and the patient received appropriate care including immunosuppression using glucocorticoids, cyclophosphamide (CYC) and rituximab (RTX). The haemorrhage ceased after escalation of treatment, and the patient is recovering. Concurrent malignancy was initially ruled out using a wide scope of diagnostic tests, but pleomorphic dermal sarcoma (PDS) of the forehead occurred after initiation of specific AHA immunosuppressive treatment. Since large vaccination programs are ongoing worldwide and potential adverse events during post-marketing surveillance have been reported following vaccination against SARS-CoV-2, this case illustrates challenges in rare events occurring in association with SARS-CoV-2 vaccination and to proof a causal relationship. Therefore, there is an urgent need for reporting any events in association with SARS-CoV-2 vaccination, but also a crucial discussion about possible concurrent triggers and follow-up information about individual patients.