Pulmonary interstitial cholesterol crystals associated with diffuse lung cysts in adult: a case report and literature review

Zhang, Min; Tie, Hongtao; Wang, Chenglong; Wu, Qingchen

doi:10.1186/s13019-016-0397-z

Cited by 6 publications

(7 citation statements)

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“…This kind of reaction can be seen in necrobiotic foci, in the wake of a local hemorrhage, foci with blood breakdown products, in relation to a disrupted keratin- or mucin-bearing cyst [28-31], or in response to tissue necrosis or foreign or implanted lipidic material (old-fashioned paraffin injections causing granulomatous paraffinomas [10]). The detection of iron in case 3 partially supports a prior local event generating blood breakdown products.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

Wolkow

Sutula

et al. 2018

Ocul Oncol Pathol

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Background/Aims: Xanthelasma is an unreliable indicator of systemic hyperlipidemia. A review in search of unusual histopathologic features of cellular composition that might correlate with systemic hyperlipidemia was conducted. Methods: An observational case series of 3 cases was performed. Slides were stained and analyzed with hematoxylin and eosin, Masson trichrome, and periodic acid-Schiff as well as for iron. Three lesions displayed an atypical morphologic finding and were subjected to immunohistochemical analysis for CD3, CD20, CD68, CD163, S100, and adipophilin. Results: The three lesions comprised in this study had classical xanthoma cells with densely packed fine vacuoles. The xanthoma cells were CD68, CD163, and adipophilin positive and S100 negative. In case 1, extracellular, nonpolarizing cholesterol crystalloids displayed totally negative staining for all biomarkers. In cases 2 and 3, the cholesterol granulomas were surrounded and permeated by CD68- or CD163-positive epithelioid and giant cells and by CD3-positive T lymphocytes. The 3 cases each harbored squamous cysts. Conclusion: In case 1, the uninflamed extracellular cholesterol crystalloids were associated with severely dysregulated systemic hyperlipidemia. In cases 2 and 3, the cholesterol granulomas were interpreted as a local manifestation of a cyst that might have partially ruptured and did not portend serious hyperlipidemia.

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Section: Discussionmentioning

confidence: 99%

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

Wolkow

Sutula

et al. 2018

Ocul Oncol Pathol

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“…Due to the rareness of the condition limited data regarding long-term follow-up is available but most reports indicate that early diagnosis and immediate surgical intervention leads to excellent results, with normalization of LV size and function, resolution of mitral regurgitation, especially when operated in early childhood [5–7]. However, other studies report on persistent mitral regurgitation, arrhythmia, sudden cardiac death, exacerbation of heart failure or coronary stenosis, necessitating surgical reintervention or even heart transplantation [2,8,9].…”

Section: Introductionmentioning

confidence: 99%

Myocardial function in patients with anomalous left coronary artery from the pulmonary artery syndrome: A long-term speckle tracking echocardiographic study

et al. 2019

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BackgroundAnomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Retrograde flow from the right coronary artery (RCA) through natural collaterals to the low-pressure main pulmonary artery causes extensive ischemia. Limited data concerning the extent of permanent myocardial damage and functional recovery after surgical repair in the long-term follow-up is available.AimDetermination of the incidence of incipient myocardial dysfunction in ALCAPA patients in the long-term observation using tissue Doppler and speckle tracking echocardiography.Methods and resultsEighteen ALCAPA patients after surgical repair (at median age of 7 months, range 3–167) underwent echocardiographic examination after (median) 17 years. All but 4 patients in NYHA class II presented well at follow-up. No narrowing in proximal LCA was detected in color Doppler. The initial (pre-surgical) left ventricular (LV) ejection fraction of 33±17% almost normalized to 55±6%, but was lower than in the age, sex and body surface area matched control group: 62±5% (p<0.001). At follow-up, LV global longitudinal strain (LS): -15.8±3.3% vs -21.9±1.7%; right ventricular LS: -20.6±3.9% vs -24.9±4.6%; left atrial LS: 27.7±4.3% vs 41.0±11.5%; right atrial LS: 26.8±7.4% vs 44.0±7.9% and early pulsed wave to tissue Doppler mitral filling ratio (E/E’): 8.1±2.6 vs 5.8±1.3 were impaired in the ALCAPA population in comparison to the control group (p<0.01 for all comparisons). LV radial and circumferential strain did not differ between groups. Mean LS in the ALCAPA patients in the RCA region was -19.0±4.4%, while in the LCA region -13.8±7.3% (p<0.00001).ConclusionsDespite good clinical condition and normalized LV ejection fraction in ALCAPA patients after surgical repair in the long-term follow-up, the diastolic and longitudinal systolic function of all cardiac chambers remained impaired, especially in the LCA region. Lifelong surveillance of repaired ALCAPA patients is needed.

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“…Наиболее часто холестериновая гранулема поражает височную кость и полости среднего уха, область внутреннего уха, турецкого седла клиновидной кости, однако, по данным некоторых источников, также может образовываться в околоносовых пазухах, молочных железах, средостении, легких, тимусе, органах мошонки, области основания черепа, глазницы, кожи, матке, ородентальной области [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

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“…На сегодняшний день диагностика холестериновой гранулемы верхушки пирамиды височной кости становится проще, благодаря новым методам визуализации, таким как магнитнорезонансная томография (МРТ) и КТ [18][19][20]. С помощью магнитно-резонансной томографии можно точно определить местоположение и размер холестериновой гранулемы, которая обычно проявляется высокой интенсивностью сигнала на T1-и T2-взвешенных изображениях [3,[18][19][20][21][22]. ХГ также может проявлять высокую интенсивность сигнала в режиме «FLAIR» МРТ и низкую интенсивность сигнала при диффузионно-взвешенном МРТ.…”

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“…МРТ чрезвычайно эффективна в дифференциальной диагностике ХГ с другими неконтрастноусиленными массами, такими как холестеатомы, параганглиомы и энцефалоцеле, что позволяет проводить надлежащую предоперационную подготовку [19][20][21][22][23]. Несмотря на то что применение контрастных материалов выдвигает компьютерную томографию (КТ) на второй план как неспецифический метод диагностики TM формы ХГ, недавние наблюдения пирамидной формы ХГ с использованием компьютерного сканирования с высоким разрешением демонстрируют (по крайней мере в некоторых случаях) разрушение костной перегородки между пневматическими трактами и пространствами костного мозга [3,7,[22][23][24].…”

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Clinical observation of the patient with cholesterol granuloma of middle ear

Славский¹,

Sel’skaya²,

Svistushkin³

et al. 2020

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Cholesterol granuloma is a cyst-like benign neoplasm containing cholesterol crystals usually surrounded by a fibrous capsule. Cholesterol crystals surrounded by giant multinucleated cells and lymphoid-histiocytic cellular infiltrates, which is a morphological manifestation of the body’s immune response. Therefore, cholesterol granuloma may be regarded as a favorable course of the inflammatory process, which previously could have a more active carious-granulation course. Most often, cholesterol granuloma affects the temporal bone and the middle ear cavity, the inner ear region, sella turcica of the sphenoid bone (Royer M. C., Pensak M. L.,2007). Clinical manifestations of cholesterol granuloma largely depend on its location. This pathology belongs to rare metabolic disorders with relatively few references to it in world literature. Currently, the diagnosis of apex petrosus cholesterol granulomas has been simplified by the new imaging techniques, such as Magnetic Resonance Imaging (MRI) and Computer Tomography (CT), which help us to save time for diagnostic and the percentage of errors in the diagnosis is reduced.

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Pulmonary interstitial cholesterol crystals associated with diffuse lung cysts in adult: a case report and literature review

Cited by 6 publications

References 4 publications

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

The Significance of Extracellular Cholesterol Crystals or a Cholesterol Granuloma in Xanthelasma

Myocardial function in patients with anomalous left coronary artery from the pulmonary artery syndrome: A long-term speckle tracking echocardiographic study

Clinical observation of the patient with cholesterol granuloma of middle ear

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