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Psychiatric disorders associated with acquired brain pathology.

Acquired brain pathology can be associated with diverse psychiatric manifestations. Three major types of psychiatric disorders potentially found in cases of acquired brain pathology are examined: (1) psychosis, (2) mood disorders, and (3) personality disorders with special emphasis in so-called "acquired psychopathy." Two types of psychotic manifestations are reviewed: (a) Schizophrenia-like psychosis; (b) Other delusional disorder, specifically, somatoparaphrenia and delusional misidentification syndromes, which include reduplicative paramnesias, Capgras syndrome, Frégoli syndrome, and "doubl…

Silicone oil mimicking pathology on CT imaging.

An 81-year-old man was taken to Accident & Emergency after a fall. CT brain imaging demonstrated a well-defined, homogenous, hyperdense mass in the posterior segment of the left eye. Reported as vitreous haemorrhage, an urgent ophthalmological assessment was instigated.Detailed history revealed previous vitreoretinal procedures for multiple retinal detachments. Ophthalmological examination confirmed presence of silicone oil in this eye.The appearance of silicone oil in the eye has become an increasingly prevalent finding given its continued use in complex vitreoretinal procedures since 1962. C

[Eyelid Tumors: Clinical Aspects of Ophthalmic Pathology].

BACKGROUND: Lid tumors show a heterogenous clinical spectrum. Tumors which display some criteria of malignancy may histologically be diagnosed as inflammatory lesions without any neoplastic component. In contrast, malignant tumors can induce changes on the lid margin mimicking inflammatory changes. MATERIAL AND METHODS/RESULTS: Certain examples of lid tumors are shown to illustrate potential pitfalls as well as clinical unequivocal cases. The clinical appearance of the lesions is correlated with the histologic findings. CONCLUSION: Lid tumors can develop from different structures of the eyel

Huntington's Disease: Calcium Dyshomeostasis and Pathology Models.

Huntington's disease (HD) is a severe inherited neurodegenerative disorder characterized by motor dysfunction, cognitive decline, and mental impairment. At the molecular level, HD is caused by a mutation in the first exon of the gene encoding the huntingtin protein. The mutation results in an expanded polyglutamine tract at the N-terminus of the huntingtin protein, causing the neurodegenerative pathology. Calcium dyshomeostasis is believed to be one of the main causes of the disease, which underlies the great interest in the problem among experts in molecular physiology. Recent studies have fo…

In situ neoplasia in lymph node pathology.

In situ neoplasia represents the earliest form of malignant progression and is characterized by localization limited to the compartment corr … ISFN) and in situ mantle cell neoplasia (ISMCN). This review summarizes the clinical features, histopathology, genetics, and differential diagnoses of these two entities, including distinction from both their overly malignant counterparts and a variety of reactive processes.

Autoimmune Hepatitis Overlap Syndromes and Liver Pathology.

Autoimmune hepatitis (AIH) may have an atypical serum alkaline phosphatase elevation, antimitochondrial antibodies, histologic features of bile duct injury/loss, or cholangiographic findings of focal biliary strictures and dilations. These manifestations characterize the overlap syndromes. Patients can be classified as having AIH with features of primary biliary cholangitis, primary sclerosing cholangitis, or a cholestatic syndrome. The gold standard of diagnosis is clinical judgment. Histologic evaluation is a major diagnostic component. Treatment is based on algorithms; outcomes vary dependi

Pathology of balloon-expandable transcatheter aortic valves.

BACKGROUND: The Placement of AoRtic TraNscathetER Valves trials (PARTNER) showed favorable safety and efficacy versus medical or surgical therapy in inoperable, high, and intermediate surgical risk patients with severe aortic stenosis. However, the biological responses to transcatheter aortic valves have not been well characterized. OBJECTIVES: The aim of this study was to perform pathologic assessment of Edwards SAPIEN transcatheter aortic valves removed either at autopsy or surgically during the PARTNER I and II clinical trials. METHODS: Explanted valves and frame were evaluated for pathol

Tendon Pathology in Hypercholesterolemia and Familial Hypercholesterolemia.

PURPOSE OF REVIEW: Hypercholesterolemia (HC), or high cholesterol, is usually caused by diet, other health conditions, or inherited diseases, such as familial hypercholesterolemia (FHC). Studies have shown patients with hypercholesterolemia are more prone to tendon injury and impaired healing. Nonetheless, the mechanism by which high cholesterol alters the biochemical and biomechanical properties of tendon and the healing environment is not well defined. This review highlights scientific findings on the relationship between hypercholesterolemia and treatments and tendon pathology at the cellul…

Acute Pancreatitis: Etiology, Pathology, Diagnosis, and Treatment.

Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe pancreatitis is challenging to the clinician. C-reactive protein, pro-calcitonin, and the Bedside Index for Severity of Acute Pancreatitis appeared to be the best tools

Bilateral otoneurological pathology: To operate or not?

OBJECTIVE: To illustrate our experience when managing a complex patient with potentially life-threatening bilateral otological disease facing multisensory compromise including complete loss of audiovestibular function and visual disturbance Clinical presentation: A 67 year old lady, presented with a large left vestibular schwannoma and extensive right cholesteatoma encircling the otic capsule. She underwent translabyrinthine resection of the vestibular schwannoma, resulting in profound sensorineural hearing loss, vestibular hypofunction and corneal scarring following an initial temporary facia

A case of hypercalcemia with double pathology.

Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously. Usually, the co-diagnosis was made subseq

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… Unfortunately, the family decided not to do a definitive diagnosis of the parathyroid gland pathology because of perceived surgical risk. … In conclusion, we are reporting a case of hypercalcemia with possible double pathology. Work-up diagnosed both primary hyperparathyroidism and multiple myeloma as a cause of her hypercalcemia. …

Social stress induces neurovascular pathology promoting depression.

Studies suggest that heightened peripheral inflammation contributes to the pathogenesis of major depressive disorder. We investigated the effect of chronic social defeat stress, a mouse model of depression, on blood-brain barrier (BBB) permeability and infiltration of peripheral immune signals. We found reduced expression of the endothelial cell tight junction protein claudin-5 (Cldn5) and abnormal blood vessel morphology in nucleus accumbens (NAc) of stress-susceptible but not resilient mice. CLDN5 expression was also decreased in NAc of depressed patients. Cldn5 downregulation was sufficient

[Pathogenesis and molecular pathology of vestibular schwannoma].

Schwannomas are benign Schwann cell-derived tumors of the peripheral nerve sheath often involving the vestibular cranial nerve (vestibular schwannoma). Histologically, they consist of bipolar spindle cells and show a moderate cellularity. Typically, Antoni A regions with a storiform pattern and loose Antoni B regions are intermingled. Verocay bodies are the pathognomonic palisading structures. Malignant transformation is rare. Merlin (schwannomin), the protein product of NF2, is inactivated by mutations, loss of heterozygosity or methylation. Within neurofibromatosis type 2, a germline mutatio

Lateral Ankle Instability and Peroneal Tendon Pathology.

Surgeons should understand the anatomic, vascular, biomechanical, and predisposing factors related to lateral ankle instability and peroneal tendon injuries, including peroneal tendinitis and tenosynovitis, peroneal tendon tears and ruptures, as well as peroneal tendon subluxation and dislocation. Surgeons should understand the treatment options and recommendations for patients who have lateral ankle instability and peroneal tendon injuries from the perspective of a sports medicine foot and ankle specialist. In addition, surgeons should be aware of arthroscopic approaches and an algorithm for

Patient-Reported Outcomes for Acute Gallstone Pathology.

BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire. This was then given out prospectively to patients presenting with…

Recent advances in molecular pathology of craniopharyngioma.

Craniopharyngiomas are rare epithelial tumours arising along the path of the craniopharyngeal duct. Two major histological subtypes have been recognised, the papillary and the adamantinomatous. Craniopharyngiomas remain challenging tumours to manage and are associated with significant morbidities and mortality. Recent advances in the molecular pathology of these neoplasms have identified BRAF mutations in the papillary variant, offering promising options for targeted pharmacological treatment. The involvement of β-catenin and the Wnt pathway in the tumorigenesis of the adamantinomatous subtype…

Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology.

Sacral insufficiency fractures (SIFs) are a common cause of back pain in the elderly. SIFs mimic the symptoms of lumbar spine pathology and so are commonly missed or underdiagnosed. Here we present four cases of missed SIFs that were subsequently identified and treated. One patient was treated as mechanical lower back ache, another patient underwent root block and two patients underwent surgery for lumbar canal stenosis. None experienced relief of their symptoms after these procedures. Retrospective analysis of X-ray and magnetic resonance imaging data revealed SIFs that were confirmed by comp…

Other Gynecologic Pathology in Endometrial Cancer Patients.

BACKGROUND: To evaluate the prevalence and features of other gynecologic or surgical lesions in endometrial cancer (EMC) patients. MATERIALS AND METHODS: Clinico-pathological data of EMC patients who were treated in the institution from 1995 to 2012 were collected. Data collected were age, stage of disease according to the FIGO 2009 criteria (FIGO), histopathology, tumor grade, adjuvant therapy, other gynecologic or surgical lesions, follow-up period, and living status. RESULTS: The mean age of 396 patients was 56.7 ± 10.64 years. Abnormal uterine bleeding was the most common presenting symp…