Discussion: CL should be considered as a differential in patients with multiple aggregated mucosal lesions that appear as polyps on endoscopy. Speculation on etiology has ranged from developmental (failure to establish connections to lymphatic drainage sites), or seen secondarily after trauma, prior surgeries, radiation, lymphatic obstruction possibly secondary to adjacent mass lesion, or previous inflammatory processes. Free intraperitoneal air may suggest impending clinical decline in such patients. Surgical resection is the treatment of choice in symptomatic patients.[1990] Figure 1. (a) Gross image of the sigmoid colon, bottom aspect showing partial deroofing of the mucosa of a simple cystic cavity (b) Hematoxylin and Eosin (H&E) stain 40X (c) D2-40 positivity (brown membranous and cytoplasmic staining) 100X.
Fibrillary glomerulonephritis is a rare condition characterized by glomerular accumulation of non-branching fibrils, leading to hematuria, proteinuria, and hypertension. It is often associated with malignancy but has no known cause. A 66-year-old Caucasian female with a history of vulvar squamous cell carcinoma presented with one month of painless hematuria in the setting of new-onset progressive renal dysfunction and nephrotic range proteinuria. Comprehensive evaluation, including renal biopsy with staining for DnaJ heat shock protein family member B9 (DNAJB9), provided a definitive diagnosis of fibrillary glomerulonephritis. The patient initially received rituximab and prednisone therapy. Unfortunately, her renal function continued to decline over the next month, requiring re-hospitalization with initiation of hemodialysis. To our knowledge, this is the first case describing an association between vulvar squamous cell carcinoma and fibrillary glomerulonephritis.
Hydatid cyst of the liver is a rare zoonotic disease in the United States. It is caused by Echinococcus granulosus. This disease is mainly seen among immigrants from countries where this parasite is endemic. Differential diagnoses of such lesions can include pyogenic or amebic abscesses, in addition to other benign or malignant lesions. We report the case of a 47-year-old woman who presented with symptoms of abdominal pain and was diagnosed with a hydatid cyst of the liver masquerading as a liver abscess. Microscopic and parasitological tests confirmed this diagnosis. The patient was treated and discharged without further complications during follow-up.
Ketosis-prone type 2 diabetes is a form of diabetes that usually presents with diabetic ketoacidosis (DKA) in patients who are not insulin dependent. It is commonly seen in African, African American, and Hispanic populations. Although the pathogenesis is not fully understood yet, it is believed to be caused by stressinduced reversible beta-cell and alpha-cell dysfunction in the pancreas. Here, we describe the case of an 80year-old white female with well-controlled type 2 diabetes mellitus who had unexplained DKA in the setting of a urinary tract infection. The patient's DKA resolved after administering appropriate therapy, and she did not require treatment with insulin on discharge.
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