scholarly journals Pediatric Bartonella Infection (Cat Scratch Disease) Presenting as Inguinal Lymphadenopathy

2020 ◽  
Vol 5 ◽  
Author(s):  
Ganesh Maniam ◽  
Aisha Khan ◽  
Raphael Mattamal
Keyword(s):  
Bartonella Henselae ◽  
Surgical Excision ◽  
Empiric Antibiotic Therapy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Cat Scratch Disease ◽  
Positive Serology ◽  
Recent Infection ◽  
Left Groin ◽  
Inguinal Lymphadenopathy

Cat scratch disease is an infectious disease resulting from inoculation of Bartonella species through a cat scratch or bite, often presenting as an erythematous papule at the site of inoculation with nearby painful lymphadenopathy. The diagnosis of this disease is complicated by a wide variety of clinical presentations, as the primary lesion may not be initially noticed. Furthermore, cervical and axillary lymph nodes are the most commonly involved regions of tender lymphadenopathy, but there have been reported cases that do not fit the typical clinical picture – such the case discussed in this report of a pediatric Bartonella henselae infection that initially presented as left inguinal lymphadenopathy with underlying necrosis and abscess formation. In this case, a 9-year-old boy presented to the ED with a 4-day history of increasing mass in the left groin, as well as a subjective fever for the previous 2 days. An ultrasound revealed a necrotic abscess in the left inguinal lymph node which necessitated empiric antibiotic therapy and surgical excision; titers revealed a recent infection with Bartonella henselae. Atypical presentations of cat scratch disease, such as inguinal lymphadenopathy, have historically confounded the diagnosis. However, positive serology studies ultimately yielded the correct diagnoses in these children. Given that cat scratch disease can present in an atypical fashion in approximately 5 - 25% of cases, physicians should keep the disease on the differential even when presented with rare presentations such as inguinal lymphadenopathy; serological testing for B. henselae can be utilized once more likely etiologies have been ruled out.

scholarly journals Felinosis: the elusive-cat scratch disease

2019 ◽  
Vol 5 (2) ◽  
pp. 511
Author(s):  
S. Arulmozhi ◽  
Sithananda Kumar ◽  
Shilpa Divakaran ◽  
Susy Sophia Kurian ◽  
Mary Kurien
Keyword(s):  
Lymph Nodes ◽  
Children And Adolescents ◽  
Chronic Inflammation ◽  
Male Patient ◽  
Bartonella Henselae ◽  
Clinical Manifestations ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Cat Scratch Disease ◽  
Suppurative Lymphadenitis

<p class="abstract">Cat-scratch disease or felinosis is an infection caused by <em>Bartonella henselae</em> which is characterized by chronic inflammation of the lymph nodes. It is one of the causes of regional, unilateral adenitis in children and adolescents. Axillary lymph nodes followed by cervical, pre-auricular and submandibular lymph nodes are the most common sites of involvement. We report a 14 year old male patient with cat scratch disease in whom the initial clinical manifestations were indistinguishable from those of acute bacterial suppurative lymphadenitis.</p>

scholarly journals Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Karaninder S. Mehta ◽  
Vikram K. Mahajan ◽  
Pushpinder S. Chauhan ◽  
Anju Lath Sharma ◽  
Vikas Sharma ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Neck Region ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Metastatic Basal Cell Carcinoma ◽  
Treat All

Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenouscisplatin (50 mg) and 5-florouracil (5-FU, 750 mg) on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

scholarly journals Axillary Nodal Metastasis of Operated Gallbladder Carcinoma – First Remote Site of Aggression.

2021 ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background: Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer.Case summary: A 63-year-old gentleman presented with the complaint of a non-healing ulcer at epigastrium for the last 1 month, after having undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed bilateral axillary metastasis. He then underwent bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later.Conclusion: Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of bilateral axillary lymph nodes as the first distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

scholarly journals Axillary nodal metastasis of operated gallbladder carcinoma: remote site of aggression—a case report

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer. Case presentation A 63-year-old gentleman presented with the complaint of a non-healing ulcer at upper abdomen for the last 1 month. He had undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed isolated bilateral axillary metastasis and the patient underwent a bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later. Conclusion Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of isolated bilateral axillary lymph nodes as a distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

scholarly journals A rare case of unilateral breast filariasis mimicking chronic mastitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2228
Author(s):  
Varsha A. Sharma ◽  
Manmohan M. Kamat ◽  
Jeena K. Sathyan ◽  
Seema Barman ◽  
Shravani Shetye
Keyword(s):  
Benign Lesion ◽  
Rare Condition ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Excision Biopsy ◽  
Axillary Lymph ◽  
Presumptive Diagnosis ◽  
Lower Quadrant ◽  
History Of ◽  
The Right

Filariasis of the breast is a very rare condition. In India, largest number (around 600 million) of people live in endemic areas. Despite the huge number, it is quite rare to find microfilaria in routine smears and body fluids and it is even more rare to find it in breasts. A 40 years old female, presented with a history of lump in the right breast approximately 3x3 cm in size in the right lower quadrant. Findings were confirmed by clinical examination which did not reveal any palpable ipsilateral or contralateral axillary lymph nodes. FNAC showed it as a benign lesion. After local excision, histopathology revealed a filarial worm. Filariasis of the breast is a rare disease. The presence of microfilaria in breasts using FNAC has been reported at times but the presence of the filarial worms can only be confirmed on histopathology, hence a core biopsy or an excision biopsy is a must in all the cases. A presumptive diagnosis of filariasis can be made on sonography if the worms are alive and active, the typical presentation on USG is the filarial dance. Surgical excision of the lump followed by DEC therapy is the treatment of choice for filarial lump of the breast.

scholarly journals Role of Needle Aspiration in Diagnosis and Management of Suppurative Bacille Calmette–Guerin Adenitis: An Institutional Study of 30 Cases

2015 ◽  
Vol 7 (01) ◽  
pp. 021-025 ◽  
Author(s):  
Subrata Pal ◽  
Srabani Chakarabarti ◽  
Jyoti Prakash Phukan ◽  
Sudhanya Biswas ◽  
Anuradha Sinha ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Bacille Calmette Guerin ◽  
Bcg Vaccination ◽  
Suppurative Lymphadenitis

ABSTRACT Context: Regional lymphadenitis is the most common complication of bacille Calmette-Guerin (BCG) vaccination. Most of the BCG lymphadenitis cases are nonsuppurative, but some suppurate and follow abscess formation, rupture, ulceration and cicatrization. Needle aspiration is the rapid, safe and cost-effective method for diagnosis as well as management of suppurative BCG adenitis. Aims: The aims of the present study were to assess the clinical and cytological spectrum of BCG lymphadenitis and to evaluate the role of needle aspiration in the management of suppurative BCG lymphadenitis. Settings and Design: We have approached every cases of ipsilateral axillary lymphadenopathy having history of BCG vaccination. We designed to aspirate the suppurative axillary lymph nodes and follow-up of nonsuppurative cases. Subjects and Methods: 30 cases of BCG adenitis were studied during a period of 2 years. 12 cases of suppurative lymphadenitis were approached by needle aspiration and cytologically evaluated, and all the cases were followed-up for 12 weeks after diagnosis. Anti-tubercular drugs were not applied, and surgical excision was reserved for nonhealing lesions. Statistical Analysis Used: Data tables. Results: Ipsilateral axillary lymph nodes were commonest site and none had constitutional symptoms. Acid-fast bacilli were detected in 11 (91.67%) cases of suppurative BCG lymphadenitis. On follow-up all nonsuppurative adenitis were resolved spontaneously, and 8 suppurative lymphadenitis cases were resolved after 4 weeks of needle aspiration. Four cases needed repeat aspiration among which 3 resolved in 8 weeks, and one needed surgical excision. Conclusions: We recommend needle aspiration as a simple, safe, chief and effective modality, which helps in diagnosis as well as in management of suppurative BCG lymphadenitis.

Lymph Node Merkel Cell Carcinoma with No Evidence of Cutaneous Tumor - Report of Two Cases

1997 ◽  
Vol 83 (5) ◽  
pp. 868-872 ◽  
Author(s):  
Gerardo Ferrara ◽  
Giovanni Pietro lannielio ◽  
Dolores Di Vizio ◽  
Oscar Nappi
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Merkel Cell ◽  
Starting Point ◽  
Cutaneous Tumor ◽  
Epithelial Antigens

We report two cases of Merkel cell carcinoma within inguinal and axillary lymph nodes, respectively, showing no clinicopathologic evidence of a primary (extranodal) tumor; one of our patients was alive with no evidence of disease five years and ten months after the surgical excision of the neoplasm with no postoperative chemotherapy. The diagnosis of nodal Merkel cell carcinoma needs to be supported by a careful immunohistochemical study: in fact, cytokeratin- and neurofilament-positive paranuclear “dots”, as well as epithelial antigens and neuroendocrine markers may be variably expressed in tumor cells, thus requiring the application of a complete antibody panel. In the presence of a nodal Merkel cell tumor, an exhaustive clinico-radiologic search for a primary tumor must be carried out. After the exclusion of any reasonable starting point of the neoplasm, a provisional diagnosis of “primary” nodal Merkel cell carcinoma may be acceptable; since a primary extracutaneous tumor is expected to follow a less aggressive course than a metastatic one, follow-up data may provide indications as to the truly extracutaneous origin of Merkel cell carcinoma.

Invasive Mammary Carcinoma With Paneth Cell–Like Eosinophilic Cytoplasmic Granules: Is It an Entity?

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Sakshi Sakshi ◽  
Yuri Persidsky ◽  
Kathleen Reilly ◽  
Suad Taraif
Keyword(s):  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Case Reports ◽  
Paneth Cell ◽  
Case Series ◽  
Surgical Excision ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Cytoplasmic Granules

Abstract Breast carcinomas with Paneth cell–like eosinophilic cytoplasmic granules are rare and commonly reported in association with acinic cell carcinoma or microglandular adenosis. Paneth cell–like differentiation has been described outside the GI tract, including lung, liver, pancreas, lacrimal glands, and prostate. Very little is known about the significance of these granules and whether they represent a metaplastic or possibly a therapy-related change. There are only 45 reported cases involving the breast, mostly individual case reports or 2 to 3 case series. Although the clinical experience is limited, most of the reported cases seem clinically indolent. Here we present a 74-year-old female with a mammographically detected 1.1-cm left breast retroareolar mass for which she underwent a biopsy and subsequent lumpectomy with axillary dissection. Histology revealed an invasive ductal carcinoma, with Paneth cell–like eosinophilic PAS-positive cytoplasmic granules in the background of extensive ductal carcinoma in situ (DCIS). Similar granules were seen in some ducts involved by DCIS. Invasive carcinoma and DCIS were present throughout the 5.5-cm lumpectomy beyond the grossly measured 4.0-cm mass. There was extensive lymphovascular invasion and tumor was present at all the surgical resection margins. Twelve of the 13 axillary lymph nodes had macrometastases. The tumor was ER and PR positive and HER2 negative. Clinically, there were extensive bony metastases involving the skull, spine, sternum, iliac bones, and femur. There were also multiple lung nodules and mediastinal lymph nodes that were positive for metastasis on biopsy. The patient is still undergoing chemotherapy and radiotherapy 6 months following surgical excision. Our case demonstrates the heterogeneity of this entity as the clinical course in our patient has been very aggressive. A collaborative effort must be established to compile a larger case series to better our understanding of this increasingly reported histological observation and whether it represents a distinct entity.

Malignant Eccrine Spiradenoma

2002 ◽  
Vol 126 (5) ◽  
pp. 591-594 ◽  
Author(s):  
Imran Mirza ◽  
Robert Kloss ◽  
Steven C. Sieber
Keyword(s):  
Distant Metastases ◽  
Surgical Excision ◽  
Tamoxifen Therapy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Therapeutic Modalities ◽  
Positive Immunostaining

Abstract Malignant transformation of eccrine spiradenoma is extremely rare. We describe the case of a 70-year-old man with malignant eccrine spiradenoma of the forearm and metastases to the axillary lymph nodes. Surgical excision with adequate margins and lymph node dissection was performed. Tamoxifen therapy was instituted after obtaining positive immunostaining results for estrogen receptor. After 41 months of follow-up, there has been no recurrence or distant metastases. Wide local excision and close follow-up are crucial in the management of malignant eccrine spiradenoma. The role of other therapeutic modalities, including hormonal therapy, remains to be determined.

Ocular complications of cat scratch disease

2020 ◽  
Vol 104 (12) ◽  
pp. 1640-1646 ◽  
Author(s):  
Alan Johnson
Keyword(s):  
Bartonella Henselae ◽  
Case Series ◽  
Retinal Artery Occlusion ◽  
Evidence Base ◽  
Artery Occlusion ◽  
Cat Scratch Disease ◽  
Positive Serology ◽  
History Of ◽  
Systemic Symptoms ◽  
Parinaud’S Oculoglandular Syndrome

Cat scratch disease (CSD) in humans is caused by infection with Bartonella henselae or other Bartonella spp. The name of the disease reflects the fact that patients frequently have a history of contact (often involving bites or scratches) with infected cats. Patients with CSD typically develop lesions at the site where the skin is broken together with regional lymphadenopathy but may go on to exhibit systemic symptoms and with deep-seated infections at a range of sites including the eye. Patients with CSD may present with a range of inflammatory eye conditions, including Parinaud’s oculoglandular syndrome, neuroretinitis, multifocal retinitis, uveitis and retinal artery occlusion. Bartonella spp. are fastidious bacteria that are difficult to culture from clinical specimens so microbiological diagnosis is frequently made on the basis of positive serology for anti-Bartonella antibodies or detection of bacterial DNA by PCR. Due to the lack of clinical trials, the evidence base for optimal management of patients with CSD-associated eye infections (including the role of antibiotics) is weak, being derived from single reports or small, uncontrolled case series.

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