Chronic necrotizing pulmonary aspergillosis (CNPA) is an unusual form of pulmonary aspergillosis arising in the setting of mildly immune compromised state or altered local defense system. CNPA rarely shows histological findings mimicking bronchocentric granulomatosis (BCG), which is characterized by peribronchiolar granulomatous destruction. We describe a case representing CNPA with elements of BCG. A-64 year-old woman was admitted because of atypical pneumonia with multi-focal variable sized consolidations and cavitary lesions on high-resolution computed tomography (HRCT). The open lung biopsy specimen showed large areas of necrotizing pneumonia with some scattered aspergillus hyphae within the lung parenchyma. Some terminal bronchioles were found to be destroyed and were replaced by peribronchiolar granulomatous inflammation. There was no evidence of angioinvasion by aspergillus or aspergillous emboli. Despite vigorous antifungal agent and steroid treatment, she died of acute airway obstruction by bronchial casts on the thirty-fourth hospital day.
Aspergillosis/etiology/*pathology ; Case Report ; Chronic Disease ; Female ; Granuloma/etiology/pathology ; Human ; Lung Diseases, Fungal/etiology/*pathology ; Middle Age ; Necrosis

A case of intramural sparganosis of jejunum presenting as intestinal obstruction is described. Resected intestine from a 48 year old man with acute abdomen revealed a degenerated sparganum in the submucosa with typical tissue reaction and extensive edema. The tissue reaction was basically granulomatous, consisting of layers of inner palisading histiocytes and outer mononuclear cell infiltration. Many calcospherules were prominent within the degenerated worm. Eosinophil infiltration was scanty.
Granuloma/pathology ; Humans ; Intestinal Obstruction/*etiology ; Jejunal Diseases/etiology ; Male ; Middle Aged ; Sparganosis/*diagnosis

A 56-year-old male had presented with left nasal bleeding repeatedly for 4 days. The pathological examination after resection showed pyogenic granuloma. Its etiology and pathogenesis, clinical features, pathological features and treatments were reviewed.
Epistaxis ; etiology ; Granuloma, Pyogenic ; complications ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Nasal Septum ; pathology

OBJECTIVETo investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.

METHODTen patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.

RESULTSAll the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).

CONCLUSIONSIn chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.

Brain Abscess ; etiology ; Cerebellar Diseases ; etiology ; Cholesteatoma ; pathology ; Chronic Disease ; Granuloma ; pathology ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Meningitis ; etiology ; Otitis Media ; complications ; pathology ; Retrospective Studies ; Tympanic Membrane

Adult ; Female ; Humans ; Nasal Polyps ; etiology ; pathology ; Periapical Granuloma ; complications ; Tomography, X-Ray Computed

Adult ; Arthropathy, Neurogenic ; etiology ; immunology ; pathology ; Female ; Granuloma, Plasma Cell ; complications ; immunology ; pathology ; Humans ; Lung Neoplasms ; complications ; immunology ; pathology

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.
Aged ; Breast/*pathology ; Female ; Granuloma/*etiology/pathology ; Humans ; Mammography ; Medicine, East Asian Traditional/*adverse effects ; Metaplasia ; Ossification, Heterotopic/*etiology ; Osteocytes/pathology

Inflammatory myofibroblastic tumors (IMTs) are benign neoplasms that can occur at different anatomic sites with nonspecific clinical symptoms. A 48-yr-old woman presented with a 2-month history of a relapsed oral ulcer, progressive dyspnea, and a thoracic pain induced by breathing. A tumorous mass was noticed in the right costodiaphragmatic recess on chest computed tomography and magnetic resonance imaging, and the patient underwent a right costotransversectomy with excision of the tumor, which originated from the 12th intercostal nerve. Histology and immunohistochemistry showed that the tumor was an IMT of the intercostal nerve. The patient's postoperative course was not favorable; dyspnea persisted after surgery, and a progressive pulmonary compromise developed. The cause of the respiratory failure was found to be bronchiolitis obliterans, which in this case proved to be a fatal complication of paraneoplastic pemphigus associated with an IMT. This case of IMT of the spinal nerve in the paravertebral region is unique in terms of its location and presentation in combination with paraneoplastic pemphigus, which is rare. A brief review of the heterogeneous theories concerning the pathogenesis, clinicopathological features, and differential diagnosis of this disease entity is presented.
Diagnosis, Differential ; Fatal Outcome ; Female ; Granuloma, Plasma Cell/complications/*pathology ; Humans ; Intercostal Nerves/*pathology ; Lung Diseases/etiology/pathology ; Middle Aged ; Paraneoplastic Syndromes/etiology/*pathology ; Pemphigus/etiology/*pathology ; Peripheral Nervous System Neoplasms/complications/*pathology

OBJECTIVETo observe the change in quantity and morphology of nerve fibers in different periods in granulation tissue in full-thickness burn wound.

METHODSThe granulation tissue samples were harvested from 40 patients with full-thickness burn in our unit at 1st, 2nd, 3rd and 4th post burn week (PBW), 10 samples were obtained at each time point. Donor site tissues from 10 burn patients were used as normal control. Immunofluorescent staining technique with anti-neurofilament (NF) monoclonal antibody was employed to examine the expression of nerve fibers in granulation tissue and normal skin. The morphology of nerve fibers was observed with fluorescence microscope and laser scanning confocal microscope.

RESULTSFluorescence microscopy showed: nerve fibers were short and rare at 1 PBW, the ratio of nerve fibers positive area was (0.14 +/- 0.08)%. Nerve fibers increased slightly and were in single filament without branches, and the positive area ratio of nerve fibers (0.40 +/- 0.09)% was much lower than that of normal control [(0.62 +/- 0.12)%, P < 0.05]. Nerve fibers increased significantly and were arranged like a mesh with more branches and sproutings, and the positive area ratio of nerve fibers was (0.73 +/- 0.16)% at 3 PBW. The quantity of nerve fibers at 4 PBW was similar to that of 3 PBW, and the positive area ratio of nerve fibers was (0.66 +/- 0.13)%. Observations under LSCM: the nerve fibers were short at 1, 2 PBW; was irregular at 3 PBW, among them some were swollen and distorted, and fragmentation and vacuolation were observed. They became aggregated at 4PBW with less branches, similar to that at 3 PBW. The structures of nerve fibers in normal control were intact, without obvious pathological changes.

CONCLUSIONThe change in quantity and morphology of nerve fibers in burn wound is related to the time of granulation tissue development.

Adult ; Burns ; pathology ; Female ; Fluorescent Antibody Technique ; Granuloma ; etiology ; pathology ; Humans ; Male ; Middle Aged ; Nerve Fibers ; metabolism ; pathology ; Nerve Regeneration ; Neurofilament Proteins ; immunology ; Skin ; innervation ; Wound Healing

Good's syndrome is extremely rare. This adult-onset condition is characterized by a thymoma with immunodeficiency, low B- and T-cell counts, and hypo-gammaglobulinemia. The initial clinical presentation is either a mass-lesion thymoma or a recurrent infection. Patients with Good's syndrome are very susceptible to infections; common respiratory and opportunistic infections can be life-threatening. There are no reports of granulomatous lung disease in patients with Good's syndrome, although it has been observed in patients with common variable immunodeficiency, of which Good's syndrome is a subset. We describe a 53-year-old male thymoma patient who presented with respiratory symptoms caused by granulomatous lung disease and an opportunistic infection. He died of uncontrolled fungal infection despite repeated intravenous immunoglobulin and supportive care. Clinicians should look for evidence of immunologic dysfunction in thymoma patients presenting with severe recurrent infections, especially opportunistic infections.
Fatal Outcome ; Granuloma, Respiratory Tract/diagnosis/*etiology/therapy ; Humans ; Immunologic Deficiency Syndromes/*complications/immunology/pathology ; Lung Diseases/diagnosis/*etiology/therapy ; Male ; Middle Aged ; Thymoma/*complications/immunology/pathology ; Thymus Neoplasms/*complications/immunology/pathology