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Laugier-Hunziker syndrome:a report of three cases and literature review

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International Journal of Oral Science 2012年第4期4卷 226-230页

作者： Wen-Mei Wang Xiang Wang Ning Duan Hong-Liu Jiang Xiao-Feng Huang Department of Oral Medicine Institute and Hospital of StomatologyNanjing University Medical School Department of Oral Pathology Institute and Hospital of StomatologyNanjing University Medical School

Laugier-Hunziker syndrome （LHS） is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.

关键词： differential diagnosis Laugier-Hunziker syndrome longitudinal melanonychia oral pigmentation

Monocular posterior scleritis presenting as acute conjunctivitis:A case report

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World Journal of Clinical Cases 2020年第20期8卷 5030-5035页

作者： Yan-Zhen Li Xiu-Hong Qin Jian-Min Lu Yong-Ping Wang Department of Ophthalmology The First Affiliated Hospital of Dalian Medical UniversityDalian 116011Liaoning ProvinceChina

BACKGROUND Posterior scleritis is a rare inflammatory ocular disease,characterized by severe and painful inflammation of the *** is often misdiagnosed or underdiagnosed,due to its general and varying clinical presentation profile,which primarily involves pain and visual impairment but which can include eyelid edema,choroidal folds,serous retinal detachment,disc edema,hard exudates in fovea and subretinal *** report here a case of posterior scleritis,with symptoms of eye pain and red eye,initially misdiagnosed as acute *** SUMMARY A 56-year-old man presented to a local hospital with complaint of pain and redness in the right *** initial diagnosis was acute conjunctivitis and he was given antibiotic *** week-long continuance of the symptoms despite treatment,he presented to our *** examination revealed a shallow anterior chamber in the right eye and vision reduction to *** testing by optical coherence tomography,ultrasound biomicroscopy,and fundus photography indicated diagnosis of posterior *** patient was given methylprednisolone(oral)on a tapered reduction schedule(starting with 70 mg/d).According to the peaks and troughs of symptoms,compound betamethasone injection was administered into the bulb,culminating in discontinuation of the oral *** optical coherence tomography showed the subretinal fluid near the optic disc to be completely absorbed after *** Posterior scleritis should be among the differential diagnosis of eye pain and redness,and diagnosis requires further ophthalmic accessory examination,such as by optical coherence tomography.

关键词： Posterior scleritis Eye pain Sclera differential diagnosis Optical coherence tomography Case report

Development and validation of an endoscopic images-based deep learning model for detection with nasopharyngeal malignancies

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Cancer Communications 2018年第1期38卷 632-642页

作者： Chaofeng Li Bingzhong Jing Liangru Ke Bin Li Weixiong Xia Caisheng He Chaonan Qian Chong Zhao Haiqiang Mai Mingyuan Chen Kajia Cao Haoyuan Mo Ling Guo Qiuyan Chen Linquan Tang Wenze Qiu Yahui Yu Hu Liang Xinjun Huang Guoying Liu Wangzhong Li Lin Wang Rui Sun Xiong Zou Shanshan Guo Peiyu Huang Donghua Luo Fang Qiu Yishan Wu Yijun Hua Kuiyuan Liu Shuhui Lv Jingjing Miao Yanqun Xiang Ying Sun Xiang Guo Xing Lv State Key Laboratory of Oncology in South China Collaborative Innovation Center of Cancer MedicineGuangzhou 510060P.R.China Department of Information Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Radiology Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Nasopharyngeal Carcinoma Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Precision Medicine Center Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Radiotherapy Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Guangdong Key Laboratory of Nasopharyngeal Carcinoma diagnosis and Therapy Guangzhou 510060P.R.China

Background:Due to the occult anatomic location of the nasopharynx and frequent presence of adenoid hyperpla-sia,the positive rate for malignancy identification during biopsy is low,thus leading to delayed or missed diagnosis for nasopharyngeal malignancies upon initial ***,we aimed to develop an artificial intelligence tool to detect nasopharyngeal malignancies under endoscopic examination based on deep ***:An endoscopic images-based nasopharyngeal malignancy detection model(eNPM-DM)consisting of a fully convolutional network based on the inception architecture was developed and fine-tuned using separate training and validation sets for both classification and ***,a total of 28,966 qualified images were *** these images,27,536 biopsy-proven images from 7951 individuals obtained from January 1st,2008,to December 31st,2016,were split into the training,validation and test sets at a ratio of 7:1:2 using simple ***,1430 images obtained from January 1st,2017,to March 31st,2017,were used as a prospective test set to compare the performance of the established model against oncologist *** dice similarity coef-ficient(DSC)was used to evaluate the efficiency of eNPM-DM in automatic segmentation of malignant area from the background of nasopharyngeal endoscopic images,by comparing automatic segmentation with manual segmenta-tion performed by the ***:All images were histopathologically confirmed,and included 5713(19.7%)normal control,19,107(66.0%)nasopharyngeal carcinoma(NPC),335(1.2%)NPC and 3811(13.2%)benign *** eNPM-DM attained an overall accuracy of 88.7%(95%confidence interval(CI)87.8%-89.5%)in detecting malignancies in the test *** the prospective comparison phase,eNPM-DM outperformed the experts:the overall accuracy was 88.0%(95%CI 86.1%-89.6%)vs.80.5%(95%CI 77.0%-84.0%).The eNPM-DM required less time(40 s vs.110.0±5.8 min)and exhibited encouraging performance in

关键词： Nasopharyngeal malignancy Deep learning differential diagnosis Automatic segmentation

Enlarged pancreas: not always a cancer

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Hepatobiliary & Pancreatic Diseases International 2015年第1期14卷 107-108页

作者： Lucia Calculli Davide Festi Raffaele Pezzilli Departments of Radiology Sant'Orsola-Malpighi Hospital Digestive Diseases Sant'Orsola-Malpighi Hospital Internal Medicine Sant'Orsola-Malpighi Hospital

Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging（MRI） was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pancreas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer.

关键词： pancreatic steatosis magnetic resonance image computer tomography IgG4 differential diagnosis clinical course

Role of multidetector computed tomography in patients with acute infectious colitis

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World Journal of Clinical Cases 2022年第12期10卷 3686-3697页

作者： Seung Jung Yu Jae Hyuk Heo Eun Jeong Choi Jong Hyuk Kim Hong Sub Lee Sun Young Kim Jae Hoon Lim Department of Internal Medicine Inje University Busan Paik HospitalBusan 47392South Korea Department of Radiology Myongji HospitalHanyang University College of MedicineGoyang 10475South Korea Department of Cancer Control and Population Health National Cancer CenterGoyang 10408South Korea

BACKGROUND The role of multidetector computed tomography(MDCT)in patients with acute infectious colitis is still *** To examine the usefulness of MDCT in distinguishing the etiology of acute infectious *** Overall,244 patients who met the criteria for acute infectious colitis and visited the Hospital from February 2015 to 2018 were retrospectively enrolled and divided into two groups(bacterial:204,viral:40)according to causes of acute colitis,based on stool *** MDCT parameters,including wall thickening,submucosal edema,mucosal enhancement,serosa involvement,empty colon sign,small bowel involvement,comb sign,continuous distribution,accordion sign,mucosal thickening,and lymph node enlargement,were constructed in a blinded *** MDCT parameters of wall thickening(OR:13.60;95%CI:5.80–31.88;P<0.001),submucosal edema(OR:36.08;95%CI:13.54–96.13;P<0.001),mucosal enhancement(OR:22.55;95%CI:9.28–54.81;P<0.001),serosal involvement(OR:14.50;95%CI:3.33–63.23;P<0.001),empty colon sign(OR:6.68;95%CI: 2.44–18.32;P < 0.001), continuous distribution (OR: 24.09;95%CI: 9.38–61.90;P < 0.001), accordionsign (OR: 9.02;95%CI: 1.12–72.35;P = 0.038), mucosal thickening (OR: 46.41;95%CI: 10.38–207.51;P< 0.001), and lymph node enlargement (OR: 4.39;95%CI: 1.22–15.72;P = 0.023) were significantlyassociated with bacterial colitis. At least one positive finding in four CT outcomes (submucosaledema, mucosal enhancement, continuous distribution, mucosal thickening) in summer showed ahigh probability of bacterial colitis (sensitivity, 41.67;specificity, 92.50;OR: 24.95).CONCLUSIONMDCT provides many clues that can be useful in suggesting a specific etiology of acute infectiouscolitis.

关键词： Colitis Multidetector computed tomography differential diagnosis Bacterial infections Viral infections

Foreign body granuloma in the tongue differentiated from tongue cancer:A case report

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World Journal of Clinical Cases 2022年第18期10卷 6247-6253页

作者： Zhen-Hua Jiang Ran Xv Li Xia Department of Otolaryngology-Head and Neck Surgery Mianyang Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaMianyang 621000Sichuan ProvinceChina

BACKGROUND Embedded foreign bodies in the tongue are rarely seen in clinical *** untreated foreign body can cause a granuloma which often presents as an enlarged tongue ***,if foreign body ingestion status is unknown,physical examination and magnetic resonance imaging(MRI)tend to lead to suspicion of tongue cancer,especially in older ***,differential diagnosis of an enlarged tongue mass is important,especially because it is closely related to the choice of treatment *** SUMMARY A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 *** had no previous medical *** revealed abnormal signal intensities that were indicative of a ***,the oral surgeon and radiologist arrived at a primary diagnosis of tongue *** patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the *** ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body(bone)in the tongue,even though the patient denied any history of foreign body *** surgical enucleation of the lesion was *** mass which included a fish bone was completely *** post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers,macrophages and chronic inflammatory *** patient recovered without complications over a 2 mo follow-up *** We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue *** MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the *** granuloma,which contained a fish bone,was completely removed via surgery and confirmed via *** diagnosis of the enlarged tongue mass was critical to the selection of treatment method.

关键词： Tongue Foreign body Granuloma Cancer differential diagnosis Case report

Identification of the distinguishing features of Crohn’s disease and ischemic colitis using computed tomographic enterography

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Gastroenterology Report 2017年第3期5卷 219-225,I0002页

作者： Min Chen Erick M.Remer Xiuli Liu Rocio Lopez Bo Shen Department of Gastroenterology/Hepatology Cleveland Clinic FoundationClevelandOHUSA Department of Gastroenterology Zhongnan Hospital of Wuhan UniversityWuhanHubeiChina Section of Abdominal Imaging Imaging InstituteCleveland Clinic FoundationClevelandOHUSA

Background and aims:The differential diagnosis between Crohn’s disease(CD)and ischemic colitis(ISC)is important as their clinical management is *** can easily be misdiagnosed as CD,especially in elderly *** distinctive radiographic features of the two disease entities have not been *** aim of this study is to assess the utility of computed tomographic enterography(CTE)in the differential diagnosis between CD and ***:Patients with confirmed CD and ISC were identified through an electronic medical record search of the Cleveland Clinic *** who had undergone CTE,with or without concurrent colonoscopy and histopathological specimens,were included in this *** images were blindly re-reviewed by an expert gastrointestinal *** sensitivities,specificities,accuracies and positive and negative predictive values for each of the CTE findings in differentiating CD from ISC were *** coefficients(j)were calculated tomeasure diagnosis agreement between CTE and the reference ***:A total of 34 eligible patients were included in this study with 17 having CD and 17 having *** differentiating CD from ISC,the presence ofmucosal hyperenhancement and absence of the“target sign”on CTE showed a sensitivity of 100% each for CD,while the two radiographic features yielded a low specificity of 35.3%and 76.5%,*** presence of stricture had a lower sensitivity of 64.7% for the detection of CD but had a high specificity of 100%.In distinguishing CD fromISC,the accuracy of presence ofmucosal hyperenhancement,stricture and absence of target sign were 67.7%,82.4% and 88.2%,*** combination of the presence ofmucosal hyperenhancement and the absence of the target sign achieved an accuracy of 100%for distinguishing CD from *** was a good correlation between CTE and the reference standard for distinguishing CD fromISC(k=0.882).Conclusions:CTE appeared to be clinically useful

关键词： computed tomographic enterography Crohn’s disease ischemic colitis differential diagnosis

Bilateral posterior scleritis presenting as acute primary angle closure:A case report

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World Journal of Clinical Cases 2021年第15期9卷 3779-3786页

作者： Chao Wen Hui Duan Department of Anesthesia The First Affiliated Hospital of Dalian Medical UniversityDalian 116001Liaoning ProvinceChina Department of Ophthalmology The First Affiliated Hospital of Dalian Medical UniversityDalian 116001Liaoning ProvinceChina

BACKGROUND Scleritis is a rare disease and the incidence of bilateral posterior scleritis is even ***,misdiagnosis of the latter is common due to its insidious onset,atypical symptoms,and varied *** report here a case of bilateral posterior scleritis that presented with acute eye pain and intraocular hypertension,and was initially misdiagnosed as acute primary angle *** the literature on such cases will not only increase physicians’awareness but also help to improve accurate *** SUMMARY A 53-year-old man was referred to our hospital to address a 4-d history of bilateral acute eye pain,headache,and loss of vision,after initial presentation to a local hospital 3 d *** initial examination revealed bilateral cornea edema accompanied by a shallow anterior chamber and visual acuity reduction,with left-eye amblyopia(>30 years).There was bilateral hypertension(by intraocular pressure:28 mmHg in right,34 mmHg in left)and normal ***,acute primary angle closure was *** and ocular hypotensive drugs were prescribed,but the symptoms continued to worsen over the 3-d treatment *** imaging examinations(i.e.,anterior segment photography and ultrasonography)indicated a diagnosis of bilateral posterior ***,topical atropine,and steroid eye drops were prescribed along with intraocular pressure-lowering *** optical coherence tomography(OCT)showed gradual improvements in subretinal fluid under the sensory retina,thickened sclera,and ciliary body *** Bilateral posterior scleritis can lead to secondary acute angle *** requires ophthalmic accessory examinations(i.e.,ultrasound biomicroscopy,Bscan,and OCT).

关键词： Acute primary angle closure Posterior scleritis differential diagnosis B-scan Optical coherence tomography Case report

Acute appendicitis in a patient after a uterus transplant: A case report

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World Journal of Clinical Cases 2019年第24期7卷 4270-4276页

作者： Jakub Kristek Michal Kudla Jaroslav Chlupac Robert Novotny Tomas Mirejovsky Libor Janousek Jiri Fronek Department of Transplant Surgery Institute for Clinical and Experimental MedicinePrague 14021Czech Republic Department of Anatomy Second Faculty of MedicineCharles UniversityPrague 15006Czech Republic Department of Clinical and Transplant Pathology Institute for Clinical and Experimental MedicinePrague 14021Czech Republic First Faculty of Medicine Charles UniversityPrague 12108Czech Republic

BACKGROUND Acute appendicitis in a solid organ transplant recipient is a rare occurrence, and experience remains limited. Appendicitis in uterine transplant recipients has never been reported. Immunocompromised patients with acute abdomen often present late and with attenuated symptoms. The differential diagnosis in a transplanted patient is broad and challenging due to possible existing complications associated with the graft, effects of immunosuppression, and altered anatomical *** SUMMARY A 26-year-old woman suffering from absolute uterine factor infertility received a uterus transplant. In the post-transplant period, she suffered from leukopenia and recurrent acute cellular rejection. Her compliance was suboptimal. She travelled to an exotic destination despite the physician's recommendation not to do so. Following her vacation, she presented with abdominal discomfort, nausea and diarrhoea. There was no sign of acute abdomen;the abdominal ultrasound was negative on day 0. Clostridium difficile colitis was verified and treated with perorally administered vancomycin. On day 4, the discomfort changed to pain;the ultrasound scan revealed a finding suggestive of appendicitis. Surgical exploration revealed perforated appendicitis, and appendectomy was *** a surgical point of view, the patient's follow-up was uneventful. The patient underwent a successful embryo transfer 6 months after the appendectomy. The patient gave birth to a healthy boy at the 35 th week of *** A high index of suspicion of an atypical course and symptomatology of acute abdomen should be maintained in immunosuppressed patients.

关键词： Uterus Organ transplantation Noncompliance Acute abdomen Colitis differential diagnosis Case report