Delayed stinging insect reactions

Publication date: Available online 20 July 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Elissa M. Abrams, Allan B. Becker




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Etiologic and differential diagnostic significance of tumor location in the supraclavicular fossa

Objective

Patients presenting with a cervical mass are common for head and neck specialists and present a diagnostic challenge against the backdrop of a wide variety of etiologies. The objective of the present study was to evaluate the significance of a mass in the supraclavicular fossa for etiology, diagnostic procedure, and therapy.

Study Design

Individual retrospective cohort study.

Methods

We reviewed the data of 211 consecutive cases (116 male, 95 female) with excisional biopsy or tumor removal of a supraclavicular mass.

Results

In 202 of 211 cases, a biopsy was taken from a lymph node. In 182 biopsies, a malignant lymphadenopathy was found (117 metastases, 65 malignant lymphoma). The histologic findings of metastatic diseases were adenocarcinoma (48), followed by squamous cell carcinoma (22). The majority of primary carcinomas were located below the clavicle (94), in the lung (32), in the breast (29), and in the head and neck region (18). In the left supraclavicular fossa, only metastases of the genitourinary tract were significantly more frequent (16 of 17). In nonmalignant tumors (29), tuberculosis (11) was most prevalent. In 79% of biopsies, the neck mass was the first manifestation of the disease.

Conclusion

The location of a cervical mass in the supraclavicular fossa provides a strong indication of malignancy. A biopsy is mandatory in the majority of patients presenting with a supraclavicular mass. In cases of metastatic disease, the location of a cervical mass helps identify the primary site. Histologic findings are essential for further diagnostic steps, therapy, and prognosis.

Levels of Evidence

4. Laryngoscope, 2017

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Intraoperative ventilation and postoperative respiratory assistance

1A013C01

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Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region

Abstract

According to National Cancer Registry Program, Thiruvananthapuram district of Kerala, has the highest relative frequency of thyroid carcinomas; nevertheless, limited data exist regarding its socio-demographic and clinico-pathological characteristics. The aims of the study were to assess the: (1) demographic characteristics, (2) histopathological features and the relative frequency of various thyroid carcinoma cases and papillary thyroid carcinoma (PTC) subtypes, (3) rising trend of papillary microcarcinomas, and (4) associated lesions. A retrospective study wherein 170 cases of thyroid malignancies reported in our single institution over a period of 8 years period was reviewed. PTC accounted for 97% cases, followed by medullary (n = 4; 2.4%) and follicular carcinoma (n = 1; 0.6%). There was female preponderance (p = 0.0379) with a lower median age in females (p = 0.0275). Among the PTCs, conventional type constituted 53.4% cases (n = 87), followed by microcarcinomas (n = 34; 20.9%), follicular variant (n = 28; 17.2%), and others 14 cases (8.5%). Thirty-three cases (19.4%) showed multifocality, 5 cases (2.9%) extra-thyroid extension, and 19 cases (11.2%) lymph node metastasis. Two cases developed recurrences and three cases, metastasis. The associated lesions were significantly higher in females (p = 0.0059); most common being multinodular goiter (MNG; n = 67; 41.1%), followed by Hashimoto thyroiditis (n = 44; 27%) and lymphocytic thyroiditis (n = 28; 17.2%); MNG being associated with follicular (p = 0.0129), and Hashimoto thyroiditis with conventional variant (p = 0.0475). The frequency of microcarcinomas significantly increased in the past 4 years (p = 0.0291) and was associated with MNG (p = 0.0055), Hurthle cell nodule (p = 0.0315) and absent lymph node metastasis (p = 0.0147). The primary treatment modality was total thyroidectomy. Papillary microcarcinoma cases increased significantly in the past 4 years and were significantly associated with MNG and Hurthle cell nodule. It is challenging to distinguish the various PTC subtypes as recognition of these histological variants warrants better patient management.

http://ift.tt/2tJLr6w

Clinico-Bacteriological Study of Chronic Otitis Media and its Prevalence in Tertiary Care Hospital

Abstract

This Retrospective observational study was done over a period of 5 years, consisting of 2530 patients with chronic otitis media (COM) attended ENT OPD of a tertiary care hospital of Central India.COM commonly occurs in the age group from 11 to 20 years (37.12%). Females are more predominantly effected than males. Mucosal type (76.4%) is more common. Complications were associated with squamous type of COM.Pus culture showed positive growth of Pseudomonas in 33.9% cases. COM is a common public health problem that is often wrongly trivialized by people. Health awareness campaign, improved health education and easy accessibility to health care facilities can reduce the morbidity and mortality of this disease and therefore can reduce the incidence of this disease.

http://ift.tt/2udXgWc

Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region

Abstract

According to National Cancer Registry Program, Thiruvananthapuram district of Kerala, has the highest relative frequency of thyroid carcinomas; nevertheless, limited data exist regarding its socio-demographic and clinico-pathological characteristics. The aims of the study were to assess the: (1) demographic characteristics, (2) histopathological features and the relative frequency of various thyroid carcinoma cases and papillary thyroid carcinoma (PTC) subtypes, (3) rising trend of papillary microcarcinomas, and (4) associated lesions. A retrospective study wherein 170 cases of thyroid malignancies reported in our single institution over a period of 8 years period was reviewed. PTC accounted for 97% cases, followed by medullary (n = 4; 2.4%) and follicular carcinoma (n = 1; 0.6%). There was female preponderance (p = 0.0379) with a lower median age in females (p = 0.0275). Among the PTCs, conventional type constituted 53.4% cases (n = 87), followed by microcarcinomas (n = 34; 20.9%), follicular variant (n = 28; 17.2%), and others 14 cases (8.5%). Thirty-three cases (19.4%) showed multifocality, 5 cases (2.9%) extra-thyroid extension, and 19 cases (11.2%) lymph node metastasis. Two cases developed recurrences and three cases, metastasis. The associated lesions were significantly higher in females (p = 0.0059); most common being multinodular goiter (MNG; n = 67; 41.1%), followed by Hashimoto thyroiditis (n = 44; 27%) and lymphocytic thyroiditis (n = 28; 17.2%); MNG being associated with follicular (p = 0.0129), and Hashimoto thyroiditis with conventional variant (p = 0.0475). The frequency of microcarcinomas significantly increased in the past 4 years (p = 0.0291) and was associated with MNG (p = 0.0055), Hurthle cell nodule (p = 0.0315) and absent lymph node metastasis (p = 0.0147). The primary treatment modality was total thyroidectomy. Papillary microcarcinoma cases increased significantly in the past 4 years and were significantly associated with MNG and Hurthle cell nodule. It is challenging to distinguish the various PTC subtypes as recognition of these histological variants warrants better patient management.

http://ift.tt/2tJLr6w

Clinico-Bacteriological Study of Chronic Otitis Media and its Prevalence in Tertiary Care Hospital

Abstract

This Retrospective observational study was done over a period of 5 years, consisting of 2530 patients with chronic otitis media (COM) attended ENT OPD of a tertiary care hospital of Central India.COM commonly occurs in the age group from 11 to 20 years (37.12%). Females are more predominantly effected than males. Mucosal type (76.4%) is more common. Complications were associated with squamous type of COM.Pus culture showed positive growth of Pseudomonas in 33.9% cases. COM is a common public health problem that is often wrongly trivialized by people. Health awareness campaign, improved health education and easy accessibility to health care facilities can reduce the morbidity and mortality of this disease and therefore can reduce the incidence of this disease.

http://ift.tt/2udXgWc