Measurement of cerebrospinal fluid ACE level in aseptic meningitis: diagnostic?

Neurosarcoidosis (NS) is a rare disease, affecting only 3%–10% of patients with sarcoidosis. The clinical presentation can be protean and often represents a diagnostic challenge. Cerebrospinal fluid (CSF) ACE level has poor sensitivity, but high specificity for establishing a diagnosis of NS. We present a case of NS in a middle-aged African American woman who presented with dysphagia and dysphonia. An extensive radiological workup was negative for structural brain disease. CSF studies demonstrated lymphocyte predominant pleocytosis with an elevated ACE level. A diagnosis of possible neurosarcoidosis was made. She responded to systemic steroid therapy with complete resolution of her symptoms over the next five months. In the appropriate clinical setting, an elevated CSF ACE level could be of paramount importance for making a diagnosis of NS.

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Extra-nodal Rosai-Dorfman Disease Confined to Breast

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.087 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S41-S42

Author(s):

E Ozluk ◽

R Shackelford

Keyword(s):

Plasma Cells ◽

African American Woman ◽

American Woman ◽

Lymphocytic Infiltration ◽

Needle Aspiration ◽

Left Breast ◽

Unknown Etiology ◽

Diagnostic Challenge ◽

Ductal Cells ◽

Rosai Dorfman Disease

Abstract Introduction/Objective First described by Rosai and Dorfman in 1969, Rosai-Dorfman Disease (RDD) is an uncommon, idiopathic, reactive lymph node process with an unknown etiology. It may involve extra-nodal organs including the skin, bone, soft tissue, and eyes. However, breast involvement is rare and RDD confined to breast without nodal involvement is extremely uncommon. Methods Here we present a case of RDD confined to breast. The patient was a 51-year-old African American woman who was found to have an irregular, solid left breast mass on routine mammogram, which had speculated irregular margins and measured of 37.0 x 32.0 x 32.0 mm. She did not have any symptoms, nor any palpable lymph nodes. The clinician stated that the lesion was highly suspicious for a breast malignancy and requested a fine needle aspiration (FNA) of the mass, followed by total excision. Results An FNA was interpreted as atypical histiocytic cells in a mixed lymphoid background. Histopathologic examination revealed an ill-defined mass with sheets of histiocytes, plasma cells, and a mixed lymphocytic population, with occasional germinal centers. Some of the histiocytes were spindle shaped and associated with storiform collagen deposition. The histiocytes had single and multiple nuclei and exhibited occasional emperipolesis. Immunohistochemical staining with S100 diffusely highlighted the histiocytes, whereas CD1a was negative. CD3 and CD20 immunostains were positive for mixed-type lymphocytic infiltration. Cytokeratin staining was performed and reassuringly stained only the benign ductal cells. A diagnosis of RDD of the breast was made, based on these histopathologic findings. Conclusion We report an example of an extra-nodal RDD involving the mammary gland that was initially suspected to be breast carcinoma. RDD may still be a diagnostic challenge, especially in a patient with suspected carcinoma. It is the pathologist’s role to lead the clinician to the proper diagnosis and render a correct histopathologic diagnosis.

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Melanocytic Colonization of a Meningothelial Meningioma: Histopathological and Ultrastructural Findings with Immunohistochemical and Genetic Correlation: Case Report

Neurosurgery ◽

10.1227/01.neu.0000068990.79680.f6 ◽

2003 ◽

Vol 53 (1) ◽

pp. 211-215 ◽

Cited By ~ 12

Author(s):

Scott L. Nestor ◽

Arie Perry ◽

Ozlem Kurtkaya ◽

Patrice Abell-Aleff ◽

Aldo M. Rosemblat ◽

...

Keyword(s):

Unusual Case ◽

Clinical Presentation ◽

African American Woman ◽

Molecular Genetic ◽

American Woman ◽

Dermatofibrosarcoma Protuberans ◽

Molecular Genetic Study ◽

Total Resection ◽

Ultrastructural Findings

Abstract OBJECTIVE AND IMPORTANCE Melanocytic colonization of nonpigmented extracranial tumors has been reported in adenocarcinomas, squamous cell carcinomas, skin appendage tumors, and dermatofibrosarcoma protuberans. To our knowledge, melanocytic colonization of a meningioma has not previously been described. CLINICAL PRESENTATION We report an unusual case of a 70-year-old African-American woman who presented with a large frontoparietal meningioma that extended through the calvarium. INTERVENTION Craniotomy with gross total resection of the tumor was performed. Histochemistry, immunocytochemistry, ultrastructural analysis, and molecular genetic study via fluorescence in situ hybridization confirmed melanocytic colonization of a meningothelial meningioma. CONCLUSION With the inclusion of meningothelial meningioma, the spectrum of tumors affected by melanocytic colonization continues to expand.

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Rational Emotive Behavior Therapy With a Depressed African American Woman

PsycTHERAPY Dataset ◽

10.1037/v00492-001 ◽

2013 ◽

Author(s):

Debbie Joffe Ellis

Keyword(s):

African American ◽

Behavior Therapy ◽

African American Woman ◽

Rational Emotive Behavior Therapy ◽

American Woman ◽

Emotive Behavior ◽

Rational Emotive ◽

Rational Emotive Behavior

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Merle’s travel: A Quest For Completeness In Paule Marshall’s The chosen place, the timeless people.

History Research Journal ◽

10.26643/hrj.v5i4.7092 ◽

2019 ◽

Vol 5 (4) ◽

pp. 36-42

Author(s):

Dr. K. Radah ◽

G. Gayathri

Keyword(s):

African American ◽

Social Context ◽

African American Women ◽

African American Woman ◽

American Woman ◽

Community Level ◽

Dominant Culture ◽

True Self ◽

American Women ◽

Human Need

African American women have been silenced and kept ignorant by the dominant culture and it is the human need to create and maintain a true self in a social context. However, such an endeavor becomes an ordeal for those who are doubly oppressed, for those who are muted and mutilated physically and psychically through the diabolic crossfire of caste/race, sex and colonialism. This paper focuses on, an African American Woman, throughout her journey of life, seeking completeness in terms of family, society and community level.

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Self-Care And The African-American Woman

10.2986/tren.068-0497 ◽

2005 ◽

Author(s):

Barbara A. PERRYMAN

Keyword(s):

African American ◽

African American Woman ◽

Self Care ◽

American Woman

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Self-Reflective Insights on What I Have Learned in an Evolving Academic Career Model: Accounting Scholarship, Administration, and Diversity

Issues in Accounting Education ◽

10.2308/iace-52145 ◽

2018 ◽

Vol 33 (3) ◽

pp. 5-16 ◽

Cited By ~ 2

Author(s):

Carolyn M. Callahan

Keyword(s):

African American Woman ◽

Academic Career ◽

American Woman ◽

Vantage Point ◽

Business College ◽

Personal Experiences ◽

Career Model ◽

Accounting Model ◽

The Impact

ABSTRACT In this paper, I offer personal insights based on my experiences (thus far) in an evolving academic accounting career model. While I value all aspects of an academic career responsibilities (teaching, research, and service), this narrative focuses primarily on the role of accounting scholarship and, broadly, the impact of diversity on the same. I offer these perspectives and personal experiences from the unique vantage point as an African American woman, focused first on contributing to top-tired accounting scholarship, and more recently on roles as an administrator of an accounting department and business college. While my academic journey is unique by objective measures (often dubbed “trailblazing” by others), I offer suggestions that may be useful to any academic who is dedicated to success in our field. Given the evolving accounting model and challenges ahead, my overriding goal remains to encourage junior accounting colleagues to persevere, as an accounting academic career is richly rewarding.

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Overshunting-Related Cervical Myelopathy Causing Progressive Gait Disturbance: A Case Report

Case Reports in Neurology ◽

10.1159/000514551 ◽

2021 ◽

pp. 312-317

Author(s):

Eva Vister ◽

Sebastiaan Hammer ◽

Rudolf W.M. Keunen ◽

Astrid L. Rijssenbeek ◽

Niels A. van der Gaag

Keyword(s):

Cerebrospinal Fluid ◽

Cervical Myelopathy ◽

Complete Resolution ◽

Late Complication ◽

Gait Disturbance ◽

Shunt Revision ◽

Proper Treatment ◽

Cervical Stenosis ◽

Vp Shunt ◽

Associated Symptoms

A complication of ventriculoperitoneal (VP) shunting is overdrainage or overshunting of cerebrospinal fluid, which can cause formation of hygroma but in rare cases also cervical myelopathy at a later stage. In this article, we describe a very late complication of VP shunting. We present a 75-year-old man, previously given a VP shunt at the age of 46, who developed a progressive gait disturbance and ataxia of the limbs after 27 years. MRI showed a cervical stenosis and myelopathy as a result of venous engorgement due to chronic overshunting of the VP shunt. Revision of the VP shunt resulted in complete resolution of his neurological symptoms and the cervical myelopathy. Cervical myelopathy due to chronic overshunting is a rare and potentially very late complication of a VP shunt. Our case underlines the importance of awareness of this complication while proper treatment can reverse the associated symptoms fully.

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False elevations in urinary metanephrines: under-recognised pitfall with 24-hour urinary volume collection

BMJ Case Reports ◽

10.1136/bcr-2020-241147 ◽

2021 ◽

Vol 14 (2) ◽

pp. e241147

Author(s):

Terry Shin ◽

Thanh Duc Hoang ◽

Mary Thomas Plunkett ◽

Mohamed K M Shakir

Keyword(s):

African American Woman ◽

Urine Volume ◽

American Woman ◽

Secondary Hypertension ◽

Reference Laboratory ◽

Urine Collection ◽

Urinary Volume ◽

Normal Limits ◽

Incorrect Diagnosis ◽

Urinary Metanephrines

One pitfall in 24-hour urine collection is the input of incorrect urinary volume by the reference laboratory. This may lead to an incorrect diagnosis of pheochromocytoma or paraganglioma. A 48-year-old African-American woman was seen in the clinic for an elevated 24-hour urine metanephrine screen during workup for secondary hypertension. Urine volume was found to be incorrectly inputted by the lab as 9750 mL rather than 975 mL. The urinary metanephrines were then recalculated and the 24-hour urinary metanephrines resulted within normal limits. This case highlights this unique and potentially under-recognised error in testing with 24-hour urine volume collection.

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Peripheral Retinal Neovascularization with Vitreous Hemorrhage in HIV Retinopathy

Case Reports in Ophthalmology ◽

10.1159/000477161 ◽

2017 ◽

Vol 8 (2) ◽

pp. 353-357 ◽

Cited By ~ 1

Author(s):

Kim Jiramongkolchai ◽

Tin Yan Alvin Liu ◽

J. Fernando Arevalo

Keyword(s):

African American ◽

Laser Photocoagulation ◽

African American Woman ◽

American Woman ◽

Vitreous Hemorrhage ◽

Retinal Ischemia ◽

Retinal Neovascularization ◽

Clinical Spectrum

We report a case of peripheral retinal neovascularization and vitreous hemorrhage in the setting of HIV retinopathy that can serve to extend the clinical spectrum of this condition. A 53-year-old African-American woman with AIDS was referred for decreased vision in the left eye and was found to have peripheral retinal neovascularization and vitreous hemorrhage. She had a workup that was negative for etiologies of retinal ischemia. Peripheral laser photocoagulation was used to treat areas of nonperfusion. To our knowledge, this is the first reported case of peripheral retinal neovascularization and vitreous hemorrhage in the setting of HIV retinopathy, and it can serve to extend the clinical spectrum of this condition.

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