Severe hyperlipemia-induced pseudoerythrocytosis - Implication for misdiagnosis and blood transfusion: A case report and literature review.

paythelady.612 shared this article with you from Inoreader Severe hyperlipemia-induced pseudoerythrocytosis - Implication for misdiagnosis and blood transfusion: A case report and literature review. Μέσω pubmed: "world j clin cases"... Severe hyperlipemia-induced pseudoerythrocytosis - Implication for misdiagnosis and blood transfusion: A case report and literature review. World J Clin Cases. 2020 Oct 06;8(19):4595-4602 Authors: Zhao XC, Ju B, Wei N, Ding J, Meng FJ, Zhao HG Abstract BACKGROUND: Severe hyperlipemia (SHLE) has an impact on the results of many kinds of laboratory tests. Complete blood count (CBC) examination by automated blood cell counter (ABCC) is a quick and convenient measurement for screening abnormalities of blood cells that are triggered by various pathogenic insults in disease diagnosis and for monitoring changes in the treatment of existing hematological conditions. However, CBC results are frequently affected by many intrinsic and extrinsic factors from blood samples, such as in the setting of hypergammaglobulinemia and certain anticoagulants. SHLE could also affect CBC results. CASE SUMMARY: A 33-year-old Chinese male presented with painful foot numbness and abdominal pain. He was initially misdiagnosed as having a myeloproliferative neoplasm (MPN) because of the marked abnormalities in CBC examination by the ABCC. Morphological evaluation of the bone marrow smears and biopsy showed no evidence of MPN. Gene mutations in Breakpoint cluster regions-Abelson murine leukemia viral oncogene homologue 1 (BCR-ABL1), Janus kinase 2 (JAK2), calreticulin (CALR), myeloproliferative leukemia virus (MPL), and colony-stimulating factor 3 receptor (CSF3R) were negative. Having noticed the thick chylomicron layer on blood samples and the dramatically fluctuating CBC results, we speculated that the fat droplets formed by shaking the blood samples in the setting of SHLE were mistakenly identified as blood cells due to the limited parameters of ABCC. Therefore, we removed a large part of the chylomicron layer and then reexamined the CBC, and the CBC results, as we expe cted, differed significantly from that of the sample before the chylomicron layer was removed. These significant differences had been validated by the subsequently repeated laboratory tests by measuring dual blood samples that the chylomicron layer was removed in one sample and was not in another, and comparing the CBC results. Computerized tomography reexamination of the upper abdomen revealed an exudative lesion surrounding his pancreas. After intensive consultation, definitive diagnosis was made as recurrent pancreatitis, hyperlipemia and pseudoerythrocytosis. CONCLUSION: SHLE may become a potential cause of misdiagnosis of hyperlipemia-related diseases as MPNs and the resultant mistreatment. It may also lead to the misinterpretation of transfusion indications in patients with hematological disorders who critically need blood transfusion for supportive treatment. PMID: 33083423 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report.

paythelady.612 shared this article with you from Inoreader Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report. Μέσω pubmed: "world j clin cases"... Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report. World J Clin Cases. 2020 Oct 06;8(19):4603-4608 Authors: Lei QY, Jiao DC, Han XW Abstract BACKGROUND: Hilar cholangiocarcinoma (CC) is a common malignant tumor with high malignancy and poor prognosis. Most patients have lost the opportunity to undergo radical surgery when diagnosed. Although palliative drainage or biliary stent placement is a preferable choice, the tumor cannot be controlled. This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage, thereby prolonging the survival time of patients. CASE SUMMARY: A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice. He was admitted to the hospital because of the recurrence of jaundice. Preoperative imaging and pathological biopsy revealed hilar CC (Bismuth-Corlette type IIIa). First, the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved. To further treat hilar CC and remove the biliary drainage tube as far as possible, the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation. After 1 mo of brachytherapy, the re-examination revealed that the obstructive lesions disappeared, and the drainage tube was finally removed. During the following 10 mo of follow-up, the patient's hilar CC did not recur. CONCLUSION: The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC. PMID: 33083424 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resorption of upwardly displaced lumbar disk herniation after nonsurgical treatment: A case report.

paythelady.612 shared this article with you from Inoreader Resorption of upwardly displaced lumbar disk herniation after nonsurgical treatment: A case report. Μέσω pubmed: "world j clin cases"... Resorption of upwardly displaced lumbar disk herniation after nonsurgical treatment: A case report. World J Clin Cases. 2020 Oct 06;8(19):4609-4614 Authors: Wang Y, Liao SC, Dai GG, Jiang L Abstract BACKGROUND: The spontaneous resorption of lumbar disk herniations (LDHs) has been widely reported. However, the majority of these reports analyze the resorption of LDHs that were displaced backwards or downwards. There have been few reports on the spontaneous resorption of upwardly displaced L4/5 LDH that has caused femoral nerve symptoms. CASE SUMMARY: A 55-year-old woman presented to our hospital with acute pain in her left leg. She had been suffering from recurrent lower back pain for approximately 1 year and began to feel pain accompanied with numbness at the anterior aspect of her left leg 7 d previously. On examination, a typical L4 nerve stimulation was noted. An upwardly displaced LDH at the L4/5 level was revealed by magnetic resonance imaging. The patient attained complete relief of her symptoms after 10 wk of nonsurgical treatment and the upwardly displaced herniation almost entirely disappeared. There was no recurrence during a follow-up of 2 years. CONCLUSION: Clinicians should be aware that the nerves disturbed by LDHs vary according to the direction of the herniations and the probable resorption of upwardly displaced LDHs should be considered before making a decision on surgery. PMID: 33083425 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary hepatic myelolipoma: A case report and review of the literature.

paythelady.612 shared this article with you from Inoreader Primary hepatic myelolipoma: A case report and review of the literature. Μέσω pubmed: "world j clin cases"... Primary hepatic myelolipoma: A case report and review of the literature. World J Clin Cases. 2020 Oct 06;8(19):4615-4623 Authors: Li KY, Wei AL, Li A Abstract BACKGROUND: Primary hepatic myelolipoma is a rare hepatic mesenchymal tumor mixed by adipose tissue and bone marrow, and there is a lack of general guidelines related to its epidemiology and clinical management. CASE SUMMARY: A 26-year-old woman was admitted to our department complaining of a newly found tumor on her left lobe of the liver. The tumor was painless and not associated with any systemic or localized compressive symptoms. Serological tests disclosed a slight increase of gamma-glutamyl transpeptidase (70.0 U/L) and total bilirubin (19.2 μmol/L). Ultrasonography showed a mass about 5.0 cm × 5.0 cm in size that was located in the left lobe of the liver and displayed hyperechoic and well-encapsulated characteristics. Surgical resection was applied, and the following histopathological examination observed a variable proportion of myeloid tissues scattering throughout mature fibrotic adipose tissues, in which myeloid, erythroid, and megakaryocytic cells can be found in magnified view. The follow-up did not show any changes 6 mo after surgery. CONCLUSION: This case highlights an extremely rare hepatic mesenchymal tumor, the primary hepatic myelolipoma, and discloses the common characteristics behind this disease and gives clinical recommendations. PMID: 33083426 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report.

paythelady.612 shared this article with you from Inoreader Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report. Μέσω pubmed: "world j clin cases"... Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report. World J Clin Cases. 2020 Oct 06;8(19):4624-4632 Authors: Li Y, Guo LJ, Ma YC, Ye LS, Hu B Abstract BACKGROUND: Esophageal carcinosarcoma, usually presenting as a pedunculated polypoid mass, is a rare malignancy with coexisting sarcomatoid and carcinomatous components. Its imaging and endoscopic characteristics are similar to those of leiomyosarcoma, liposarcoma and so forth. The diagnosis needs histological confirmation. Surgical resection is the traditional therapy. Endoscopic resection is minimally invasive but still controversial. This paper reports the case of a patient with a giant esophageal carsinosarcoma who underwent a palliative endoscopic resection. CASE SUMMARY: A 55-year-old male patient presented with dysphagia and weight loss for 1 mo. Imaging and endoscopy showed a gray-white, polypoid, stalk-like mass, with a bulky pedicle located in the middle and lower esophagus. The mass almost filled the whole esophageal lumen, but the endoscope could still pass through. Despite the suspicion of a malignancy, repeated biopsies indicated necrosis and inflammation. After multidisciplinary team consultation, an endoscopic resection to diagnose and relieve the obstruction was recommended. The pedicle of the mass was cut off, the bleeding was stopped, and the mass was cut into pieces and pulled out. The mass was 26 cm × 5 cm × 4 cm in size. The final diagnosis was esophageal carcinosarcoma. No postoperative complications occurred. After 1 mo, the patient gained 6 kg and endoscopic reexamination revealed no obstruction. Radical surgery with lymph node dissection was carried out successfully. This lesion was the largest endoscopical ly resected esophageal carcinosarcoma reported to date. CONCLUSION: Endoscopic palliative resection can help obtain adequate tissue for diagnosis and relieve obstructions in patients with giant esophageal carcinosarcoma. PMID: 33083427 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review.

paythelady.612 shared this article with you from Inoreader Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review. Μέσω pubmed: "world j clin cases"... Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review. World J Clin Cases. 2020 Oct 06;8(19):4633-4643 Authors: Long X, Zhang L, Cheng Q, Chen Q, Chen XP Abstract BACKGROUND: Hepatic lymphangioma, a malformation of the liver lymphatic system, is a rare benign neoplasm and usually coexists with other visceral lymphangiomas. Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy. CASE SUMMARY: A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with, including Schistosome japonicum infection and jaundice, and also together with imaging results, which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase. The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation. Finally, the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation. The pathological examination indicated the mass as hepatic lymphangioma. The patient has been followed up for 30 mo without recurrence. To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future, we reviewed the published literature of soli tary hepatic lymphangioma for its clinical symptoms, imaging presentation, operative techniques, histology features and prognosis. CONCLUSION: Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma. PMID: 33083428 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraosseous venous malformation of the maxilla after enucleation of a hemophilic pseudotumor: A case report.

paythelady.612 shared this article with you from Inoreader Intraosseous venous malformation of the maxilla after enucleation of a hemophilic pseudotumor: A case report. Μέσω pubmed: "world j clin cases"... Intraosseous venous malformation of the maxilla after enucleation of a hemophilic pseudotumor: A case report. World J Clin Cases. 2020 Oct 06;8(19):4644-4651 Authors: Cai X, Yu JJ, Tian H, Shan ZF, Liu XY, Jia J Abstract BACKGROUND: Hemophilic pseudotumor (HP) is a rare complication in patients with hemophilia. The lesion most frequently occurs in the long bones, pelvis, small bones of the hands and feet, or rarely in the maxillofacial region. Postoperative changes in HP are seldom arrested, whereas angiogenesis characterized by disturbed wound healing in HP may cause vascular malformations. CASE SUMMARY: We report the case of an 11-year-old boy who was affected by maxillary intraosseous venous malformation. Enucleation of an HP without factor replacement was performed initially on the right side of the maxilla 3 years ago. The patient was referred to us because of painless swelling in the same location. Factor replacement and subtotal maxillectomy were performed. Pathological examinations revealed intraosseous venous malformation. CONCLUSION: This study is the first to document the development of intraosseous venous malformation after enucleation of an HP in the maxillofacial region. Angiogenesis characterized by disturbed wound healing in patients with hemophilia may be pivotal in the pathogenesis of this condition. PMID: 33083429 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intravesically instilled gemcitabine-induced lung injury in a patient with invasive urothelial carcinoma: A case report.

paythelady.612 shared this article with you from Inoreader Intravesically instilled gemcitabine-induced lung injury in a patient with invasive urothelial carcinoma: A case report. Μέσω pubmed: "world j clin cases"... Intravesically instilled gemcitabine-induced lung injury in a patient with invasive urothelial carcinoma: A case report. World J Clin Cases. 2020 Oct 06;8(19):4652-4659 Authors: Zhou XM, Wu C, Gu X Abstract BACKGROUND: Gemcitabine is a chemotherapy agent with relatively low toxicities, as a valid option for elderly patients with underlying diseases. Gemcitabine-induced pulmonary toxicities are rare and various, ranging from self-limited episodes of bronchospasm to fatal, progressive, severe, interstitial pneumonitis and respiratory failure. Intravesical gemcitabine instillations are commonly used to reduce recurrence or progression for non-muscle-invasive bladder cancer or urothelial cancer. Few severe toxicities have been reported for the intravesical instillation is assumed to be completely separated from the systemic circulation. CASE SUMMARY: A 67-year-old patient received 30 cycles of intravesical gemcitabine instillation after transurethral resection and developed a 1-wk fever, cough, hemoptysis, and dyspnea. After a thorough checkup, bilateral consolidation and infiltration of the lungs were documented and a percutaneous lung biopsy confirmed organizing pneumonia after treatment with broad-spectrum empirical antibiotics failed. Tapered corticosteroids were administered, and pulmonary toxicity gradually resolved. CONCLUSION: Gemcitabine-induced pulmonary toxicities present with various manifestations. In spite of the rare pulmonary involvement by the intravesical gemcitabine instillation, health care professionals who administer gemcitabine chemotherapy in this way should monitor for gemcitabine-induced pulmonary toxicities, particularly in patients with high-risk factors. PMID: 33083430 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bochdalek hernia masquerading as severe acute pancreatitis during the third trimester of pregnancy: A case report.

paythelady.612 shared this article with you from Inoreader Bochdalek hernia masquerading as severe acute pancreatitis during the third trimester of pregnancy: A case report. Μέσω pubmed: "world j clin cases"... Bochdalek hernia masquerading as severe acute pancreatitis during the third trimester of pregnancy: A case report. World J Clin Cases. 2020 Oct 06;8(19):4660-4666 Authors: Zou YZ, Yang JP, Zhou XJ, Li K, Li XM, Song CH Abstract BACKGROUND: The occurrence of a diaphragmatic hernia during the third trimester of pregnancy is rare; to our knowledge, there has only been a single case report related to congenital Bochdalek hernia complicated with mild acute pancreatitis during pregnancy. Nonspecific symptoms and lack of experience due to its rarity make the diagnosis of this condition very challenging. We report a case of diaphragmatic hernia accompanied by mild acute pancreatitis in the third trimester of pregnancy, which was misdiagnosed as severe acute pancreatitis. CASE SUMMARY: A 19-year-old woman presented at gestation of 31+2 weeks with continuous distension pain for 3 d in the left lumbar region of no obvious cause. Ultrasonographic findings of left ureterectasis, with nonspecific lumbago and abdominal pain, led to the misdiagnosis of renal colic. Increased serum amylase and/or lipase levels indicated acute pancreatitis. Following the treatment of pancreatitis, her condition deteriorated. The patient was finally diagnosed with a diaphragmatic hernia complicated with mild acute pancreatitis on magnetic resonance imaging at our hospital. Caesarean section was performed at gestation of 31+6 weeks, followed by hernia repair, and the pancreatitis was treated sequentially. The patient was discharged in good condition 20 d after the surgery. CONCLUSION: In this case, surgical treatment was not the same as that for non-pregnant diaphragmatic hernia repair. It is important to first perform a cesarean section before commencing the therapy. PMID: 33083431 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Localized primary gastric amyloidosis: Three case reports.

paythelady.612 shared this article with you from Inoreader Localized primary gastric amyloidosis: Three case reports. Μέσω pubmed: "world j clin cases"... Localized primary gastric amyloidosis: Three case reports. World J Clin Cases. 2020 Oct 06;8(19):4667-4675 Authors: Liu XM, Di LJ, Zhu JX, Wu XL, Li HP, Wu HC, Tuo BG Abstract BACKGROUND: Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein in the stomach and can mimic various diseases on endoscopic examination, including gastrointestinal stromal tumors, gastric cancer and ulcers. CASE SUMMARIES: Here, we report a series of three cases of localized gastric amyloidosis mimicking gastric mucosa-associated lymphoid tissue (MALT) lymphoma on endoscopic examination that were evaluated over the past ten years in our hospital. The different detection times of this rare disease resulted in three completely different outcomes, indicating the strong importance of early detection, diagnosis and treatment. The difficulties encountered in making an accurate diagnosis and differential diagnosis are highlighted, and this report provides clinical experience for the diagnosis of localized primary gastric amyloidosis. CONCLUSION: Localized gastric amyloidosis is a rare metabolic disease that resembles MALT lymphoma. Early detection, diagnosis and treatment of localized gastric amyloidosis result in an excellent prognosis. PMID: 33083432 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parathyroid adenoma combined with a rib tumor as the primary disease: A case report.

paythelady.612 shared this article with you from Inoreader Parathyroid adenoma combined with a rib tumor as the primary disease: A case report. Μέσω pubmed: "world j clin cases"... Parathyroid adenoma combined with a rib tumor as the primary disease: A case report. World J Clin Cases. 2020 Oct 06;8(19):4681-4687 Authors: Han L, Zhu XF Abstract BACKGROUND: Parathyroid adenoma is a benign parathyroid tumor, with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis. Its clinical manifestations are complex and changeable; thus it is easily missed or misdiagnosed. Approximately 85% of patients with parathyroid adenoma develop primary hyperparathyroidism, and abnormalities in bones, kidneys and other organs can occur. Brown tumors are rare. CASE SUMMARY: We report a rare case of fibrocystic osteitis associated with a parathyroid adenoma, which was discovered by chance due to a rib tumor. Abnormally elevated serum parathyroid hormone and calcium ion were found before surgery. We suspected primary hyperparathyroidism, and color Doppler ultrasound suggested the presence of a thyroid mass. With informed consent by the patient and her family, we first removed the rib tumor, and one week later, resection of the parathyroid adenoma and thyroid mass was performed on both sides, and the patient recovered well after surgery. CONCLUSION: In the case of parathyroid adenoma combined with brown tumor, the bone cyst will gradually decrease in size with time without treatment. If not, surgery should be performed as soon as possible. PMID: 33083434 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.