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SPUC December 15, 2008 [email protected] CASE 1. CASE 1 Diagnosis: Coccidioidomycosis. Coccidioidomycosis. Diagnosis Coccidioidomycosis - Endemic fungal infection of the desert southwestern United States - Generally a self-limited illness in healthy persons.

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SPUC December 15, 2008 [email protected]

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SPUC

December 15, 2008

[email protected]


CASE 1


CASE 1 Diagnosis: Coccidioidomycosis


Coccidioidomycosis


Diagnosis Coccidioidomycosis

- Endemic fungal infection of the desert

southwestern United States

- Generally a self-limited illness in healthy persons.

- Immunosuppressed persons who contract it

are at increased risk for disseminated infection

Janis E. Blair, MD; Jerry D. Smilack, MD; Sean M. Caples, DO. Coccidioidomycosis in Patients With Hematologic Malignancies

Arch Intern Med. 2005;165:113-117


Histoplasmosis


Cryptococcosis


CASE 2


Case 2 Diagnosis: Leiomyoma


  • Mesenchymal tumors of the gastrointestinal tract are less frequent than epithelial neoplasms but they are by no means rare.

  • Gastrointestinal stromal tumors (GISTs):

  • Most common mesenchymal tumor of the GI tract

  • Histopathology:

    • cellular spindled

    • epithelioid

    • pleomorphic lesions

    • express KIT (CD117) and CD34 proteins


  • True leiomyomas of the muscularis propria:

  • Common in the esophagus and rare in the gastric body and antrum

  • Most frequent mesenchymal tumor of the esophagus:

    • Leiomyomas outnumber GIST by a ratio of 3 to 1


CASE 3


Case 3 Diagnosis: Thymoma AB


Thymoma Type B1


CLASSIFICATION OF THYMOMAS


CASE 4


Case 4 Diagnosis: Giant Cell Tumor of Tendon Sheet


CASE 5


Case 5 Diagnosis: Fibrous Dysplasia


Fibrous dysplasia, benignt tumor (developmental arrest)

Components of normal bone are present, but they fail to

differentiate into mature structures.

Occurs as one of three clinical patterns:

1. involvement of a single bone (monostotic)

2. involvement of multiple bones( polyostotic)

3. Polyostotic disease, associated with cafe au lait skin pigmentations and endocrine abnormalities, precocious puberty (McCune- Albright syndrome). Somatic, not hereditary. Skeletal, skin, and endocrine lesions from G protein that constitutively activates adenyl cyclase with resultant cyclic adenosin monophosphate overproduction and cellular hyperfunctioning.


CASE 6


Case 5 Diagnosis: Chemical / Reactive Gastropathy


  • CHRONIC, REACTIVE (CHEMICAL) GASTROPATHY

  • - Very common in current clinical practice.

  • Changes usually more prominent in the prepyloric region

  • The usual underlying causes include chronic bile reflux and long-term NSAID intake.


CHRONIC, REACTIVE (CHEMICAL) GASTROPATHY

  • The histopathologic features:

  • mucosal edema

  • congestion

  • fibromuscular hyperplasia in the lamina propria

  • foveolar hyperplasia with a corkscrew appearance in the most severe forms

  • The foveolar epithelium characteristically: reactive nuclear features and reduction of mucin.

  • The epithelial changes occur with little background chronic inflammation.

Arch Pathol Lab Med—Vol 132, October 2008


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