Αρχειοθήκη ιστολογίου

Τρίτη 6 Απριλίου 2021

A Boy with a Sublingual Mass

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An 11-year-old previously healthy boy presented to the pediatric emergency department with a progressive, nonpainful, swelling mass in his mouth for the last 2 weeks. The mass caused discomfort without difficulty in talking, swallowing, or breathing.
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Woman with a Painful Rash on Face

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A 37-year-old woman presented to the emergency department (ED) with left lower lip pain, swelling, and rash after receiving a hyaluronic acid injection 4 days ago. Examination of her left outer and inner lip revealed a tender, violaceous, reticulated area in vertical distribution, with pustules (Figures 1 and 2). After consultation with a plastic surgeon, she received a diagnosis of vascular occlusion.
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A Man with Weakness of Half his Face After an Ear Infection

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A 72-year-old man presented to the emergency department with right-sided facial weakness. He reported a 1-week history of right ear swelling and discharge, for which he was receiving amoxicillin-clavulanate. In the 2 days before presentation, he noted increasing dizziness, followed by facial droop and hoarseness of his voice.
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Man With Chest Tightness and Hoarseness

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A 42-year-old man presented with a 1-month history of chest tightness and hoarseness. Physical examination result was noteworthy for nonpalpable brachial and radial pulses. Vital signs, chest radiography, ECG, and laboratory testing results were all normal. Color Doppler ultrasonography of the neck vessels showed left subclavian steal syndrome (Figure 1); there was no blood signal in the origin of the left subclavian artery and a mass measuring 4.2×3.7 cm was found near the left common carotid artery (Figure 2, Video 1).
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Child With Leg Pain

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A healthy 2-year-old boy presented with fever, right leg pain, and functional disability without any history of trauma. Physical examination detected a swollen limb without signs of inflammation and reduced range of movement. Vital signs were within normal limits. Laboratory test results showed a WBC count of 25.7×109/L, C-reactive protein level of 110 mg/L, hemoglobin level of 9.7 g/dL, and 83% hemoglobin S. Radiography, ultrasonography (Figure 1), and magnetic resonance imaging (MRI) (Figure 2) were conducted.
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Man With Wound on the Penile Shaft

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A healthy 25-year-old man presented to the emergency department with a poorly healed wound on the dorsum of the penile shaft. He endorsed inserting a carved domino under the skin 2 weeks before. The peri-incisional skin was necrotic but without visible blood or discharge. Point-of-care ultrasonography over the wound demonstrated a 3-cm foreign body in the superficial soft tissue (Figure 1, Video 1).
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Middle-aged Man Recovering from COVID-19 Pneumonia

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A 63-year-old man underwent follow-up after having coronavirus disease 2019 pneumonia. He was asymptomatic, with a respiratory rate of 16 breaths/min and oxygen saturation of 97% on room air. He had a number of fine scars on his back. While conducting the lung ultrasonographic examination with a convex probe, the physician observed some superficial unexpected vertical shadows and switched to a high-frequency linear probe. The physician detected a small horizontal hyperechogenic line in the subcutaneous tissue, approximately 1 cm below the skin surface, with posterior acoustic shadowing (Figure 1).
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Antibiotics Versus Appendectomy for Acute Appendicitis: Are Antibiotics Really Noninferior?

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CODA Collaborative. A randomized trial comparing antibiotics with appendectomy for appendicitis. N Engl J Med. 2020;383:1907-1919.
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Calcified chondroid mesenchymal neoplasms with FN1-receptor tyrosine kinase gene fusions including FGFR2, FGFR1, MERTK, NTRK1, and TEK: a molecular and clinicopathologic analysis

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Modern Pathology, Published online: 16 March 2021; doi:10.1038/s41379-021-00786-x

Calcified chondroid mesenchymal neoplasms with FN1-receptor tyrosine kinase gene fusions including FGFR2, FGFR1, MERTK, NTRK1, and TEK: a molecular and clinicopathologic analysis
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Genetic differences between benign phyllodes tumors and fibroadenomas revealed through targeted next generation sequencing

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Modern Pathology, Published online: 16 March 2021; doi:10.1038/s41379-021-00787-w

Genetic differences between benign phyllodes tumors and fibroadenomas revealed through targeted next generation sequencing
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Factors associated with myocardial SARS-CoV-2 infection, myocarditis, and cardiac inflammation in patients with COVID-19

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Modern Pathology, Published online: 17 March 2021; doi:10.1038/s41379-021-00790-1

Factors associated with myocardial SARS-CoV-2 infection, myocarditis, and cardiac inflammation in patients with COVID-19
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Nuclear expression of DDIT3 distinguishes high-grade myxoid liposarcoma from other round cell sarcomas

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Modern Pathology, Published online: 17 March 2021; doi:10.1038/s41379-021-00782-1

Nuclear expression of DDIT3 distinguishes high-grade myxoid liposarcoma from other round cell sarcomas
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IBCC – Acute Eosinophilic Pneumonia (AEP)

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Acute Eosinophilic Pneumonia is rare, but it definitely happens.  It typically causes relatively rapid-onset ARDS, frequently leading to mechanical ventilation.  Prompt recognition is critical, because AEP responds beautifully tosteroid therapy. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes  

EMCrit Project by Josh Farkas.

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