An adolescent boy underwent laparoscopic evaluation with persisting fever associated with colicky abdominal pain of about 3 weeks duration after a CT study of his abdomen revealed mesenteric adenopathy. Histopathological evaluation of the excised mesenteric nodes showed features of histiocytic necrotising lymphadenopathy suggestive of Kikuchi-Fujimoto lymphadenopathy which was confirmed on immunehistochemistry staining. Kikuchi-Fujimoto's disease involving the mesenteric nodes is extremely unusual and can be confounding with a mistaken diagnosis of and prolonged treatment for tuberculosis. The authors present a case of Kikuchi-Fujimoto's disease involving the mesenteric lymph nodes and discuss the various aspects of diagnosis and management of the case along with a review of published literature.
We report a rare case of gallbladder duplication in a young male patient with acute pyocoele in one vesicle and acute cholecystitis with cystadenoma in the other; another unusual feature was the absent or obliterated cystic duct in the proximal vesicle and non-communication with the second vesicle or the biliary system. Ultrasound examination had suggested a septate gallbladder; the diagnosis of dual gallbladder was made per-operatively during separation of the distal moiety which was presumed to be an adherent duodenum initially. Intraoperative cholecystogram confirmed the diagnosis and both gallbladders were removed successfully laparoscopically.A high degree of awareness, detailed preoperative investigations when anomalies are suspected and intraoperative cholangiography are necessary for accurate detailing of the biliary tree to avoid inadvertent damage to the biliary ductal system and overlooking of second or third gallbladder during surgery.
SummaryA young adult in her third decade presented with a 2-week history of catching left upper abdominal pain and was detected to have a cystic lesion occupying almost the entire spleen. Laparoscopic total splenectomy was carried out, and the cyst wall revealed a true mesothelial cyst with no squamous metaplasia. The various aspects of mesothelial cysts, including immunophenotyping and treatment modalities, are briefly discussed.
BACKGROUND
Digital Pacinian corpuscle hyperplasia is an extremely rare, painful condition that generally follows local trauma. We report a case of painful digital Pacinian corpuscle hyperplasia of the right index finger that was preceded by a dog bite at the same site over one and a half years ago. To the best of our knowledge, this is the first instance of a Pacinian corpuscle hyperplasia following dog bite. The literature is reviewed and immunohistological features are outlined.
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