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Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
Primary – The patient develops a painless papule at the site of inoculation, which develops into a chancre with a smooth base and raised, firm borders. A chancre does not develop in every case, and may go unnoticed due to its painless nature. Inguinal lymphadenopathy is often present. The chancre will typically heal spontaneously in 2–8 weeks, followed by a period of clinical latency.
Perianal and Anal Canal Neoplasms
Published in Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens, Neoplasms of the Colon, Rectum, and Anus, 2007
Both groins must be examined carefully to detect any enlargement of lymph nodes. Enlarged or suspicious lymph nodes in the groin area should be assessed by excision or biopsy because inguinal lymphadenopathy caused by reactive hyperplasia is common.
Hidradenoma papilliferum of the perineum; a rare tumour in a rare location
Published in Journal of Obstetrics and Gynaecology, 2023
Saliha Sağnıç, Sinan Serdar Ay, Hasan Aykut Tuncer, Selen Doğan, Tayup Şimşek
A 23-year-old virgin woman with a 4–5 year history of itching and bleeding due to irritation of a 2 × 2 cm mass lesion on the perineum, was referred to our tertiary hospital due to suspicion of vulvar cancer. There was no change in size in the last 3 years. She stated no changes occurred during her menstrual period. Her past medical history was unremarkable. Clinical examination revealed a single well-circumscribed, skin-colored, smooth, non-ulcerated, non-tender polypoid mass lesion arising from the perineum (Figure 1). The rest of the gynecological examination was normal without any inguinal lymphadenopathy. Since our patient was a virgin, smear and human papillomavirus tests were not performed. We performed an excisional biopsy of the mass for diagnosis under local anaesthesia. Histopathological examination suggested the diagnosis of hidradenoma papilliferum. Immunohistochemical studies revealed CK 7 positivity in luminal cells and p63 positivity in the myoepithelial cells. The patient was discharged with no complaint following the procedure. Follow-up of the patient shows no actual recurrence. Written informed consent was obtained from the patient for publication of this case report and accompanying image. Ethics committee approval was unnecessary due to the nature of the study.
Comparative evaluation of the clinical presentation and epidemiology of the 2022 and previous Mpox outbreaks: a rapid review and meta-analysis
Published in Infectious Diseases, 2023
George N. Okoli, Paul Van Caeseele, Nicole Askin, Ahmed M. Abou-Setta
The results are summarised in Table 3. Overall, lymphadenopathy was present in 66% of Mpox cases (Supplementary Appendix 4), with a higher proportion observed for previous (77%) compared with the 2022 (56%) outbreaks. Similarly, axillary lymphadenopathy was present in 19% of cases (Supplementary Appendix 5), with a higher proportion observed for previous (56%) compared with the 2022 (1%) outbreaks, while cervical lymphadenopathy was present in 52% of cases (Supplementary Appendix 6) and with a higher proportion observed for previous (71%) compared with the 2022 (26%) outbreaks. On the other hand, while overall 58% of cases had inguinal lymphadenopathy (Supplementary Appendix 7), a higher proportion was observed for the 2022 (62%) compared with the previous (51%) outbreaks.
Methotrexate-associated lymphoproliferative disorder with histopathological features of histiocytic necrotizing lymphadenitis
Published in Modern Rheumatology Case Reports, 2021
Shuko Kaito, Masashi Goto, Mikiko Iguchi, Yoshiaki Okuno, Koki Moriyoshi, Hiroshi Koyama
An 84-year-old Japanese woman who had been treated with MTX for RA for 15 years visited our hospital with complaints of general malaise and weakness of the extremities for 2 weeks. Cervical, axillary, and inguinal lymphadenopathy was found in the physical examination. Laboratory findings on her first visit showed significant thrombocytopenia, anaemia, elevated aminotransferases, and elevated CRP levels. Her peripheral blood contained some difficult-to-classify cells that we supposed were of lymphoid origin. The level of soluble interleukin-2 receptor (sIL-2R) was markedly elevated (12,061 U/mL). A computed tomography (CT) scan showed numerous enlarged systemic lymph nodes. We suspected MTX-LPD and withdrew MTX immediately. The patient was hospitalised and administered leucovorin (folic acid). Platelet transfusion was given on the first and third day in hospital. Bone-marrow aspiration showed normocellular marrow without lymphomatous lesions. Flow cytometric analysis revealed excessive proliferation of cells expressing T cell surface markers and no finding of B cell clonality. Cervical lymph node biopsy revealed a well-circumscribed area of necrosis showing abundant karyorrhectic nuclear debris. Around the necrosis, infiltration of histiocytes (CD68 positive in immunohistochemical staining) was seen. There were lymphoid cells in diverse maturation stages. These features were compatible with HNL (Figure 1). There was no formation of epithelioid cell granuloma, proliferation of atypical lymphocytes, or malignant cell growth. Immunohistochemical staining for CD3, CD5, CD10, and CD20 showed no evidence of malignant lymphoma.