Mouth, lips, and perioral region
Robin Lewallen, Adele Clark, Steven R. Feldman in Clinical Handbook of Contact Dermatitis, 2014
The signs and symptoms of contact dermatitis in the oral cavity are less well defined than those seen with other regions covered in this series. The classic symptomatology of itching and scaling is often absent. Instead, the non-keratinized oral mucosa seems to show a different set of reaction patterns in response to contactants. Lichenoid reactions are a particularly important pattern seen involving the oral mucosa. While oral lichen planus is the prototypical example of this pattern, extrinsic agents such as drugs and contactants should not be overlooked as a potential etiology.1 Clinically, there may be white reticular patches, erythema, or erosions. The lesions may be asymptomatic or associated with intense burning. The differential diagnosis is broad and often requires a myriad of techniques to finally arrive at the correct diagnosis. A biopsy is typically warranted and helps to rule out things such as connective tissue disease, immunobullous disease and malignancy. Eosinophils seen on histology are helpful in pointing the diagnosis away from lichen planus and favoring an extrinsic driving force such as a drug or contactant.
Less Common Lung and Bronchial Tumours; Bronchiolo-Alveolar Ca., Carcinoids, Hamartomas, Reticuloses, Protein Disorders, Lung Deposits and Leukaemia.
Fred W Wright in Radiology of the Chest and Related Conditions, 2022
Haemangiopencytomas may arise in most tissues of the body, and in the thorax may arise in the lung, pleura or chest wall. Within the lung most arise centrally and present as well defined solid masses. They later spread in all directions towards the lung periphery. Some arise in previously irradiated tissue. Both the primary tumours and secondary nodal deposits may exhibit speckled calcification. Most are very vascular and give rise to a 'blush' on angiography or enhance with IV contrast agents on CT examinations. A biopsy may give rise to considerable pain. Those arising outside the lungs not uncommonly give rise to lung deposits. A case in a young woman arose bilaterally from the subclavian arteries and caused bilateral Pancoast-like masses, with bilateral Pancoast syndromes. Two cases occurring in the external temporal fossae have lasted 10 and 30 years, both with metastases.
Liver Fibrosis
Denis Le Bihan, Mami Iima, Christian Federau, Eric E. Sigmund in Intravoxel Incoherent Motion (IVIM) MRI, 2018
The stage of liver fibrosis is a strong determinant of the risk of hepatocellular carcinoma and its prognosis, so staging of hepatic fibrosis is important in the management of patients with chronic liver disease [1, 2]. End-stage liver fibrosis (cirrhosis) causes liver failure and is typically irreversible, whereas liver fibrosis in the early to intermediate stages can be treatable [3]. Therefore, early detection and staging of liver fibrosis are crucial for planning and monitoring the response to therapy. Liver biopsy followed by histopathologic assessment is commonly performed to stage liver fibrosis. However, biopsy may have severe complications, including hemorrhage and infection. Biopsy also has inherent drawbacks, including sampling error because of the small specimen sample, interobserver disagreement, and low patient acceptance [4–6]. Despite these limitations, biopsy is still considered the golden standard for staging liver fibrosis. Therefore, noninvasive methods have been developed for assessing hepatic fibrosis, including serum markers and imaging-based methods.
A novel diagnostic technique of measuring labial minor salivary gland secretions using sodium fluorescein dye: Implications for patients with dry eyes
Published in Seminars in Ophthalmology, 2022
The proposed technique is useful for a quick and easy assessment in clinics. For example, it can be used to monitor the secretions of MSGs in health and diseases like SS, individuals receiving radiotherapy to the head and neck region. The secretions can be collected for biochemical and immunological assays directly from the source. MSGs are relevant for dental surgeons, rheumatologists, and ophthalmologists. There are not many studies focusing on MSGs flow rates. The diseases affecting MSGs or oral mucosa require evaluation of their functional status. Tissue biopsy is diagnostic but is an invasive technique. Periotron technique measures only a limited area of labial mucosa. The techniques employing the salivary flow from a specific area and extrapolated onto the whole lower lip are dependent on the density of small glands in that area and secretion from these glands.
A case of pleomorphic adenoma of the lacrimal gland invading the lower orbit
Published in Orbit, 2022
Ryosei Kado, Satoru Kase, Yuka Suimon, Susumu Ishida
On MRI, common pleomorphic adenoma is round or oval and localized in the lacrimal gland. On the other hand, pleomorphic adenoma in this case was unique, showing a large multinodular gourd-shaped configuration on coronal section MRI. The differential diagnoses included intraorbital hematoma, malignant lymphoma, and epithelial tumors including adenoid cystic carcinoma. In this case, it was difficult to diagnose pleomorphic adenoma preoperatively as the imaging findings were different from those of typical pleomorphic adenoma. Therefore, biopsy could be considered for making a correct diagnosis and determining eventual treatments. However, for pleomorphic adenoma, biopsy is often avoided, as it may damage the capsule, disseminate tumor cells, and lead to recurrence during long-term follow-up periods7 and subsequent malignant transformation.2 In this case, we successfully resected the total tumor and diagnosed it as pleomorphic adenoma. This report highlights the fact that ophthalmologists should keep variations of tumor configurations in mind, and consider total removal without incisional biopsy when pleomorphic adenoma is suspected.
Feasibility of genomic profiling with next-generation sequencing using specimens obtained by image-guided percutaneous needle biopsy
Published in Upsala Journal of Medical Sciences, 2019
Miyuki Sone, Yasuaki Arai, Shunsuke Sugawara, Takatoshi Kubo, Chihiro Itou, Tetsuya Hasegawa, Noriyuki Umakoshi, Noboru Yamamoto, Kumiko Sunami, Nobuyoshi Hiraoka, Takashi Kubo
The primary outcome was the rate of successful genomic analysis with specimens obtained by percutaneous needle biopsy. The secondary outcomes were profiling of genetic alterations, technical success rate of biopsy procedures, adverse events evaluated using the Common Terminology Criteria for Adverse Events v. 4.0, rate of success in pathological diagnosis, and cause of failed genomic analysis. Technical success of the biopsy procedure was defined as obtaining tissue sections with imaging confirmation of the biopsy needle within the target. Successful NGS analysis was defined as the ability to perform genomic analysis by NGS using DNA extracted from the specimen. The causes of failed NGS analysis were categorized as: (i) failure of the puncture of the target site (sampling error); (ii) unprocessed for DNA extraction due to insufficient specimen volume; (iii) insufficient DNA volume; and (iv) deteriorated DNA quality. We also calculated the rate of successful genomic analysis excluding NGS analysis that failed due to reasons unrelated to the biopsy procedures, i.e. reasons (ii) and (iv).
Related Knowledge Centers
- Interventional Cardiology
- Microscope
- Tissue
- Pathology
- Medical Test
- Surgeon
- Interventional Radiology
- Sampling
- Cell
- Fine-Needle Aspiration