American Journal of Medical Case Reports

Pulmonary Tuberculosis is the leading cause of cavitary lung disease globally. Although clinical scenario of majority of the disorders causing cavitation and hemoptysis are overlapping, special emphasis should be given on smoking history and concomitant clubbing especially in elderly population. CT thorax will differentiate probability of malignancy as cause of cavity by delineating its pericavitary nodularity, irregular wall, thickness and size. Bronchoscopy is must in all the cases, will help to confirm the diagnosis and ruling out underlying malignancy. Squamous cell carcinoma is known to cause cavitation and the only histological lung cancer type causing such radiological abnormality. In this case report we described a elderly male patient presented with persistent intermittent hemoptysis with chest pain and clubbing on clinical evaluation. Initially diagnosed as a case of smear positive pulmonary tuberculosis finally we confirmed as Primary Lung cancer of Squamous cell origin. High index of suspicion is must in such cases, with bronchoscopy and cytopathology expertise in lung histopathology will be crucial in confirming diagnosis.

American Journal of Medical Case Reports. 2014, 2(8), 164-166. DOI: 10.12691/ajmcr-2-8-6
Pub. Date: September 09, 2014

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Blastoid Variant of Mantle Cell Lymphoma- a Rare Case Report

by Rajeev sen, Sumiti Gupta, Meenu Gill, Rachneet Kohli, Veena Gupta and Renuka Verma

Case Report

Mantle cell lymphoma is now recognised as a rare but distinct entity in the revised WHO classification.It is now well recognised that MCL represent a broad spectrum of different histopathological subtypes. The term blastic or blastoid variant is generally used to describe cases with a homogeneous population of cells displaying lymphoblastic morphology. The blastic form of MCL may be difficult to diagnose however immunophenotyping and molecular analysis show typical mantle cell lymphoma pattern. We present a case of 30 year old male presenting with inguinal mass which was diagnosed as blastic transformation of mantle cell lymphoma based on routine histopathology and immunohistochemistry.

American Journal of Medical Case Reports. 2014, 2(8), 161-163. DOI: 10.12691/ajmcr-2-8-5
Pub. Date: September 07, 2014

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A Case of Hypophosphatemic Rickets with the Secondary Hyperparathyroidism

by Barış Sarıakçalı, Esma Jamaspishvili, Mehtap Evran, Murat Sert and Tamer Tetiker

Case Report

Secondary hyperparathyroidism is an unusual complication of hypophosphatemic rickets during the treatment. As there is growing evidence that a high phosphate diet may induce secondary hyperparathyroidism and even tertiary hyperparathyroidism caused by hyperplasia of the parathyroid glands. Serum calcium, phosphate and also parathyroid hormone should be measured regularly to catch the early diagnosis of secondary hyperparathyroidism during the treatment of hypophosphatemic rickets patients, since this stage is reversible with the arrangement of calcitriol and phosphate. We report a case of secondary hyperparathyroidism due to hypophosphatemic rickets patient, under the treatment of regular calcitriol and oral phosphate related to her serum phosphate levels. She had been treated since her childhood ages for growth retardation and bone deformities. She had, subsequently developed significant hyperparathyroidism during follow up.

American Journal of Medical Case Reports. 2014, 2(8), 158-160. DOI: 10.12691/ajmcr-2-8-4
Pub. Date: September 04, 2014

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Duplicated Inferior Vena Cava Co-existing with Pancreatic Divisum and Duplicated Right Renal Collecting System

by Olusegun Sheyin, Uyi Aideyan, Ayobami Eluwole and Joan Culpepper-Morgan

Case Report

Background: Duplication of the inferior vena cava (IVC) is a rare anomaly reported to occur in 0.2-3% of the population. To the best of our knowledge, there is no report of on the coexistence of duplicated IVC with pancreatic divisum in the literature. We report an incidental finding of duplicated IVC co-existing with pancreatic divisum and duplicated collecting system of the right kidney in a 25 year old man. Case Description: A 25 year-old man with history of chronic abdominal pain since childhood presented with a non-radiating epigastric abdominal pain, beginning a few hours prior to presentation. Physical examination was notable for tenderness and guarding in the epigastrium without rebound tenderness. Abdominal ultrasound revealed a normal appearing liver and spleen, but it showed a duplicated right renal collecting system. Abdominal CT revealed a duplicated IVC, a duplicated collecting system of the right kidney, and a prominent dorsal pancreatic duct consistent with pancreatic divisum. The patient was scheduled for out-patient Endoscopic Retrograde Cholangiopancreatography (ERCP), but he was lost to follow-up. Conclusion: This case describes a previously unreported co-existence of duplicated IVC with pancreatic divisum and duplicated right renal collecting system. The patient was planned for ERCP, but was lost to follow-up.

American Journal of Medical Case Reports. 2014, 2(8), 155-157. DOI: 10.12691/ajmcr-2-8-3
Pub. Date: August 26, 2014

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Delayed Psoas Hematoma after Echis Carinatus Bite: An Unusual Manifestation

by Manoj Lakhotia, Hans Raj Pahadiya, Harish Kumar, Jagdish Singh, Gopal Raj Prajapati and Ravi Sangappa Jainapur

Case Report

Bleeding manifestations are common with viperine snake bite. Common bleeding manifestations include bleeding from site of bite, bleeding gums, epistaxis, hemoptysis, hematuria, hematemesis and intracranial bleed. Bleeding in retroperitoneal, plural and pericardial spaces have also been described. Delayed bleeding in the muscle is a rare complication. We report a patient of viperine bite who developed Psoas hematoma after eight days of bite. The patient had low platelet count and normal coagulation profile. He responded to intravenous dexamethasone. In appropriate setting, the possibility of soft tissue bleeding should be considered in a patient of snake bite inspite of coagulation profile being normal. To the best of our knowledge this is the first case report of delayed Psoas hematoma after Echis carinatus bite.

American Journal of Medical Case Reports. 2014, 2(8), 152-154. DOI: 10.12691/ajmcr-2-8-2
Pub. Date: August 26, 2014

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Primary Pulmonary Lymphoma with Metastases – A Rare Presentation

by Sumiti Gupta, Pansi Gupta, Rajneesh Kalra, Meenu Gill, Atulya Atreja and Dhruva Chaudhary

Case Report

Primary pulmonary non-Hodgkin’s lymphoma is a very rare neoplasm. It is represented most commonly by marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. We here in report a case of 64 year old male presented with a lung mass that was diagnosed to be NHL, with metastases to liver and kidney. It represents only 3-4% of extranodal NHL, less than 1% of NHL, and only 0.5- 1% of primary pulmonary malignancies. Current treatment options are surgery, chemotherapy, and radiotherapy.

American Journal of Medical Case Reports. 2014, 2(8), 149-151. DOI: 10.12691/ajmcr-2-8-1
Pub. Date: August 20, 2014

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