Male ; Humans ; Penis ; Granuloma/etiology* ; Pelvis ; Iatrogenic Disease

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

PURPOSE: To investigate periorbital lipogranuloma cases that developed after autologous fat injection and to determine various treatment outcomes from these cases. METHODS: This retrospective study involved 27 patients who presented with periocular mass (final diagnosis of lipogranuloma) and had history of facial autologous fat injection. The collected data included information on patient sex, age, clinical presentation, number and site of fat injections, interval between injections, duration from injection to symptom onset, fat harvesting site, use of cryopreservation, and treatment outcome. RESULTS: The most common presenting symptom was palpable mass (92.6%), followed by blepharoptosis and eyelid edema. The mean time from injection to symptom onset was 13.6 +/- 29.2 months (range, 2 to 153 months). Patients were managed by intralesional triamcinolone injection (six patients) and surgical excision (three patients); 18 patients were followed without treatment. Among the six patients who underwent intralesional triamcinolone injection, five showed complete resolution, and one showed partial resolution. Among the 18 patients who were followed without management, three showed spontaneous resolution over a 5-month follow-up period. CONCLUSIONS: Lipogranuloma can develop in the eyelid after autologous fat injection into the face. Both surgical excision and intralesional triamcinolone injection yield relatively good outcomes. Simple observation can be a good option because spontaneous resolution can occur in a subset of patients.
Adipose Tissue/*transplantation ; Adult ; Autografts ; Cosmetic Techniques/*adverse effects ; Eyelid Diseases/diagnostic imaging/*etiology/therapy ; Female ; Granuloma, Foreign-Body/diagnostic imaging/*etiology/therapy ; Humans ; Injections ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Orbital Diseases/diagnostic imaging/*etiology/therapy ; Retrospective Studies ; Rhytidoplasty/*adverse effects ; Young Adult

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

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

OBJECTIVE: To explore the clinical features and treatments of contact granuloma of larynx. METHOD: To find the best treatments by analyzing the clinical features, related causes and the treatments of the 13 contact granuloma of larynx cases, which have complete data, of our department from Jan 2005 to Dec 2012, also by comparing the effect of conservative treatment and operation treatment. RESULT: Contact granuloma of larynx is more common in men (84.6%). The main causes are gastro esophageal reflux, chronic cough, habitual hawk and endotracheal intubation disease. However, a big part (38.4%) gets the disease without any other disease history. The main clinical feature of the disease includes: sensation of foreign matter in throat, easy to get exhausted when talking and voice hoarse, but also 30.7% without any feature in throat. Among the 13 cases, 6 were treated by operation and the first recurrence was 66.6%. The cure rate was 50% after one or two operations. The other 7 were treated in conservative way, including anti- Gastro esophageal reflux, avoiding excessive talking, reducing habitual hawk ,or without any medical treatment. The cure rate was 57.1%. The total cure rate was 53.8%. However, it is nonsense to comparing the two different treatments (Chi2 = 0.066, P > 0.05). CONCLUSION There is still no standard treatment for contact granuloma of larynx and the effect is not good enough. The treatment should be depending on individual case. Conservative treatment is the first choice. However, operation should be considered if the patient has obviously hoarse and his granuloma is too large to breathe well.
Chronic Disease ; Female ; Gastroesophageal Reflux ; complications ; Granuloma, Laryngeal ; etiology ; therapy ; Hoarseness ; etiology ; Humans ; Intubation, Intratracheal ; Male ; Recurrence

In April of this year, one patient was under left posterior nostril packing treatment with gauze balls as his left nostril bleeding. 3 days later the balls were removed. Soon after, he had foreign body sensation in his throat and the discomfort was increasingly severe. Under electronic laryngoscopy a big neoplasm like nasopharynx granulation was discovered and therefore resected when he was in general anesthesia. Under light microscope, it was found out that the neoplasm had fibrogenesis, angiogenesis, infiltration and interstitial osteoporosis edema. In pathological diagnosis, it was nasopharyngeal inflammatory granulation tissue.
Adult ; Granuloma ; etiology ; Humans ; Iatrogenic Disease ; Male ; Nasopharynx

OBJECTIVE: To explore the endoscopic management of petrous apex cholesterol granuloma through trans-sphenoid sinus-clivus approach. METHOD: One case of right-side petrous apex cholesterol granuloma were undertaken surgical treatment through trans-sphenoid sinus-clivus approach, then the possibility of any other approach and their advantages and disadvantages were analyzed. RESULT: The operation was success without any complications. Patient's hearing was recovered and tinnitus vanished. The patient was discharge from hospital at the third day after operation, and followed up for four month without recurrence. CONCLUSION Trans-sphenoid sinus clivus endoscopic management of petrous apex cholesterol granuloma is effective and safe. The operators can monitor internal carotid artery then to access to the diseased region with reducing risk.
Cranial Fossa, Posterior ; surgery ; Endoscopy ; methods ; Female ; Granuloma ; etiology ; surgery ; Humans ; Sphenoid Sinus ; surgery ; Young Adult

BACKGROUNDBrucellosis can mimic various multisytem diseases, showing wide clinical polymorphism that frequently leads to misdiagnosis and treatment delay, further increasing the complication rates. In this study, we aimed to examine bone marrow biopsy findings in brucellosis cases presenting with hematologic abnormalities.

METHODSForty-eight brucellosis cases were prospectively investigated. Complaints and physical examination findings of patients were recorded. Patients' complete blood count, routine biochemical tests, erythrocyte sedimentation rate, C-reactive protein and serological screenings were performed. Bone marrow biopsy and aspiration was performed in patients with cytopenia, for bone marrow examination and brucella culture, in accordance with the standard procedures from spina iliaca posterior superior region of pelvic bone.

RESULTSOf the 48 patients, 35 (73%) were female and 13 (27%) were male. Mean age was (34.8 ± 15.4) years (age range: 15 - 70 years). Anemia, leukopenia, thrombocytopenia and pancytopenia were found in 39 (81%), 28 (58%), 22 (46%) and 10 patients (21%), respectively. In the examination of bone marrow, hypercellularity was found in 35 (73%) patients. Increased megacariocytic, erythroid and granulocytic series were found in 28 (58%), 15 (31%) and 5 (10%) patients, respectively. In addition, hemophagocytosis was observed in 15 (31%) patients, granuloma observed in 12 (25%) and increased eosinophil and plasma cells observed in 9 (19%) patients.

CONCLUSIONAccording to the results of our series, hemophagocytosis, microgranuloma formation and hypersplenism may be responsible for hematologic complications of brucellosis.

Adolescent ; Adult ; Aged ; Biopsy ; methods ; Bone Marrow ; metabolism ; pathology ; Brucellosis ; complications ; metabolism ; physiopathology ; C-Reactive Protein ; metabolism ; Female ; Granuloma ; etiology ; metabolism ; physiopathology ; Humans ; Hypersplenism ; etiology ; metabolism ; physiopathology ; Male ; Middle Aged ; Prospective Studies ; Young Adult

Granulomatous hypophysitis is a rare pituitary condition that commonly presents with enlargement of the pituitary gland. A 31-year-old woman was admitted to the hospital with a severe headache and bitemporal hemianopsia. Magnetic resonance imaging (MRI) showed an 18 x 10-mm sellar mass with suprasellar extension and compression of the optic chiasm. Interestingly, brain MRI had shown no abnormal finding 4 months previously. On hormonal examination, hypopituitarism with mild hyperprolactinemia was noted. The biopsy revealed granulomatous changes with multinucleated giant cells. We herein report this rare case and discuss the relevant literature.
Adult ; Biopsy ; Female ; Giant Cells/pathology ; Granuloma/complications/*diagnosis/therapy ; Headache/etiology ; Hemianopsia/etiology ; Humans ; Hyperprolactinemia/etiology ; Hypopituitarism/etiology ; Inflammation/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Optic Chiasm/pathology ; Pituitary Diseases/complications/*diagnosis/therapy ; Pituitary Function Tests ; Pituitary Gland/*pathology/surgery ; Predictive Value of Tests ; Severity of Illness Index ; Treatment Outcome