RESUMO
OBJECTIVES: An abscess is a localized collection of pus contained within a fibrous capsule. In this study, we aimed to determine the demographic pattern, common anatomical sites, risk factors, and the microbial profile of abscesses in different body sites among children. METHODS: We conducted a prospective study in our pediatric surgical department among children with abscesses in different body sites between January 2019 and December 2022. RESULTS: During the study period, 85 children were included. The participant age range was 0 to 14 years old, and 66% of participants were boys. The most common anatomical sites where abscesses formed were the pelvis (n = 29, 34%), abdomen (n = 22, 26%), neck (n = 14, 16%), and extremities (n = 12, 14%). Risk factors of abscesses in different body sites included cannulation, lymphadenitis, mastitis, perforated appendix, and perianal fistula. We observed that 74% of abscesses were of a polymicrobial nature. CONCLUSION: The most common anatomical sites for abscesses in children included the pelvis, abdomen, neck, and extremities. Most abscesses in these sites were polymicrobial in nature.
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Abscesso , Humanos , Criança , Masculino , Feminino , Estudos Prospectivos , Pré-Escolar , Adolescente , Lactente , Abscesso/microbiologia , Abscesso/patologia , Fatores de Risco , Recém-Nascido , Pelve/patologia , Pescoço/microbiologia , Pescoço/patologia , Extremidades/patologiaRESUMO
Objective: To describe cytologic findings from mandibular and superficial cervical lymph nodes in dogs with thyroid carcinoma and to determine prognostic factors associated with lymph node metastasis. Animals: A total of 71 client-owned dogs with confirmed thyroid carcinoma that had cytologic results from at least 1 mandibular or superficial cervical lymph node between 2010 and 2020. Procedure: Medical records from 2 referral veterinary hospitals were retrospectively reviewed. Cytology of lymph nodes was reviewed for presence of metastasis by diplomates of the American College of Veterinary Pathologists. Thyroid tumor diameter and volume, tumor fixation, bilateral location, vascular invasion, and stage were recorded to determine effects on nodal metastasis. Results: A total of 154 lymph nodes (104 mandibular and 50 superficial cervical lymph nodes) from 71 dogs were cytologically evaluated, and 1/154 (0.6%) and 2/154 (1.3%) lymph nodes were noted to be definitively metastatic or probably metastatic, respectively. Given the infrequent rate of nodal metastasis (1.9% or less), statistical analysis of potential prognostic variables was not completed. Conclusion and clinical relevance: Routine lymph node cytology of mandibular and superficial cervical lymph nodes appeared to be of low yield when assessing for metastasis of canine thyroid carcinomas. The medial retropharyngeal and deep cervical lymph nodes should continue to be evaluated as they appeared to have higher metastatic rates, based on historic reports. Additional studies are needed to determine prognostic factors associated with lymph node metastasis and effects on patient survival.
Résultats cytologiques dans les ganglions lymphatiques cervicaux mandibulaires et superficiels de chiens atteints d'un carcinome thyroïdien. Objectif: Décrire les résultats cytologiques obtenus des ganglions lymphatiques mandibulaires et cervicaux superficiels chez des chiens atteints d'un carcinome thyroïdien et déterminer les facteurs pronostiques associés aux métastases ganglionnaires. Animaux: Un total de 71 chiens appartenant à des clients atteints d'un carcinome thyroïdien confirmé avec des résultats cytologiques d'au moins un ganglion lymphatique cervical mandibulaire ou superficiel entre 2010 et 2020. Procédure: Les dossiers médicaux de 2 hôpitaux vétérinaires de référence ont été examinés rétrospectivement. La cytologie des ganglions lymphatiques a été examinée pour détecter la présence de métastases par des diplomates de l'American College of Veterinary Pathologists. Le diamètre et le volume de la tumeur thyroïdienne, la fixation de la tumeur, la localisation bilatérale, l'invasion vasculaire et le stade ont été notés pour déterminer les effets sur les métastases ganglionnaires. Résultats: Au total, 154 ganglions lymphatiques (104 ganglions lymphatiques mandibulaires et 50 ganglions lymphatiques cervicaux superficiels) provenant de 71 chiens ont été évalués par cytologie, et 1/154 (0,6 %) et 2/154 (1,3 %) ganglions lymphatiques ont été notés comme définitivement métastatiques ou probablement métastatiques, respectivement. Compte tenu du taux peu fréquent de métastases ganglionnaires (1,9 % ou moins), l'analyse statistique des variables pronostiques potentielles n'a pas été complétée. Conclusion et pertinence clinique: La cytologie de routine des ganglions lymphatiques mandibulaires et cervicaux superficiels semblait être de faible rendement lors de l'évaluation des possibilités de métastases des carcinomes thyroïdiens canins. Les ganglions lymphatiques rétropharyngés médiaux et cervicaux profonds doivent continuer à être évalués car ils semblent présenter des taux métastatiques plus élevés, sur la base des rapports historiques. Des études supplémentaires sont nécessaires pour déterminer les facteurs pronostiques associés aux métastases ganglionnaires et les effets sur la survie des patients.(Traduit par Dr Serge Messier).
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Doenças do Cão , Linfonodos , Metástase Linfática , Neoplasias da Glândula Tireoide , Animais , Cães , Neoplasias da Glândula Tireoide/veterinária , Neoplasias da Glândula Tireoide/patologia , Doenças do Cão/patologia , Linfonodos/patologia , Estudos Retrospectivos , Metástase Linfática/patologia , Masculino , Feminino , Pescoço/patologia , Mandíbula/patologiaRESUMO
OBJECTIVE: To compare the diagnostic accuracy of Contrast Enhanced Computed Tomography (CECT) compared to conventional imaging modalities and histopathological investigation in cervical lymph node metastasis in adults through a novel meta- analysis. METHOD: The review protocol is registered under PROSPERO(CRD42021225704) and performed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis - Diagnostic Test Accuracy (PRISMA- DTA) checklist. Databases like PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2023 to identify the diagnostic potential of CECT in cervical lymph node metastasis of oral carcinoma. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were extracted or calculated if not present for each study. Quality of selected studies was evaluated based on Quality assessment of diagnostic accuracy studies (QUADAS)- 2 tool. Meta-analysis was performed in Meta-Disc 1.4 software and Review Manager 5.3 using a bivariate model parameter for the pooled sensitivity and pooled specificity. Additional analysis was performed in terms of positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (SROC) with Area Under Curve (AUC) and p<0.05 as statistically significant. RESULTS: Six studies were included for qualitative synthesis and as well as for meta-analysis. Two studies had high risk of bias while four studies had low risk of bias. 651 patients underwent CECT and were taken for meta-analysis. The meta-analysis revealed that CECT for diagnosing cervical lymph node metastasis had a pooled sensitivity of 71%, pooled specificity of 14% with 60% Area Under Curve (AUC). +LR of 0.84, -LR of 1.36 and DOR of 0.59. CONCLUSION: CECT has an overall fair diagnostic ability and is a valid and reliable tool in diagnosing the target condition overcoming high reliance on master specialized capacity for their execution and understanding like other conventional imaging techniques. CECT can be concluded for secondary level of prevention for cervical node metastasis of oral carcinoma under early diagnosis and prompt treatment. However, further standardized accuracy studies are indicated to improve the overall diagnostic accuracy of CECT.
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Meios de Contraste , Linfonodos , Metástase Linfática , Neoplasias Bucais , Tomografia Computadorizada por Raios X , Humanos , Linfonodos/patologia , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Neoplasias Bucais/patologia , Neoplasias Bucais/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Pescoço/patologia , Prognóstico , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodosRESUMO
A 25-year-old man presented with gradually increasing swelling of 15 years' duration on the left side of his neck. There had been occasional foul-smelling discharge from the swelling. Local examination revealed an 8 cm × 5 cm oblong-shaped, yellowish to skin-colored, soft, -cerebriform swelling. There were multiple open comedones (Figure 1a). The surrounding skin had small and soft skin-colored papules. On palpation, there was no ulceration, tenderness, induration, or bag of worms. A scar from the past surgery was visible. Systemic examina- tion was unremarkable. The differential diagnosis demonstrated plexiform neurofibroma and nevus lipomatosus cutaneous superficialis (NLCS; Figure 2).
Assuntos
Lipomatose , Pescoço , Neoplasias Cutâneas , Humanos , Masculino , Adulto , Lipomatose/diagnóstico , Lipomatose/patologia , Pescoço/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Nevo/patologia , Nevo/diagnóstico , Neurofibroma Plexiforme/diagnóstico , Neurofibroma Plexiforme/patologia , Diagnóstico DiferencialAssuntos
Dorso , Pescoço , Prurido , Humanos , Pescoço/patologia , Prurido/etiologia , Prurido/diagnóstico , Exantema/diagnóstico , Exantema/etiologia , Exantema/patologia , Masculino , Feminino , Diagnóstico DiferencialRESUMO
BACKGROUND/AIM: Compared to other cervical localizations, masses of the nuchal region are rare in the clinical practice of otolaryngologists. This study presents the relevant etiologies of nuchal tumors. PATIENTS AND METHODS: This study included 61 cases (5.3%) from 1,150 consecutive cervical biopsies/neck tumor excisions between 2010 and 2022. Lipomatosis or Madelung fat neck diagnoses were excluded. RESULTS: Seventy-seven percent of the biopsies included lymph node tissue. Among the patients, 26 were female and 35 were male. The average diameter of the tumors was 3.5 cm (1.5-9 cm). Of the 33 non-malignant formations (54%, 42.3 years), lymphadenopathy (e.g., toxoplasmosis and tuberculosis) was found in 58% of cases. Lipomas were most common among benign tumors (8 out of 14). Malignant tumors (46%, 63.4 years) included lymphomas (10 cases, 6 recurrences) and metastases (18 cases). The metastases were predominantly squamous cell carcinomas of the pharynx (9 cases, 5 recurrences) and the skin (7 cases, 4 recurrences), as well as two cases of adenocarcinomas from the lung and pancreas. CONCLUSION: Indications of the malignant genesis of a nuchal mass include older patient age and a history of carcinomas in the head and neck region. In carcinomas of the posterior and parietal scalp and neck skin, the nuchal region should be included in the staging and follow-up examinations.
Assuntos
Neoplasias de Cabeça e Pescoço , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Diagnóstico Diferencial , Idoso , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Biópsia , Adolescente , Adulto Jovem , Idoso de 80 Anos ou mais , Pescoço/patologiaRESUMO
Purpose: Lateral lymph node metastasis (LLNM) is very common in medullary thyroid carcinoma (MTC), but there is still controversy about how to manage cervical lateral lymph nodes, especially for clinically negative MTC. The aim of this study is to develop and validate a nomogram for predicting LLNM risk in MTC. Materials and methods: A total of 234 patients from two hospitals were retrospectively enrolled in this study and divided into LLNM positive group and LLNM negative group based on the pathology. The correlation between LLNM and preoperative clinical and ultrasound variables were evaluated by univariable and multivariable logistic regression analysis. A nomogram was generated to predict the risk of the LLNM of MTC patients, validated by external dataset, and evaluated in terms of discrimination, calibration, and clinical usefulness. Results: The training, internal, and external validation datasets included 152, 51, and 31 MTC patients, respectively. According to the multivariable logistic regression analysis, gender (male), relationship to thyroid capsule and serum calcitonin were independently associated with LLNM in the training dataset. The predictive nomogram model developed with the aforementioned variables showed favorable performance in estimating risk of LLNM, with the area under the ROC curve (AUC) of 0.826 in the training dataset, 0.816 in the internal validation dataset, and 0.846 in the external validation dataset. Conclusion: We developed and validated a model named MTC nomogram, utilizing available preoperative variables to predict the probability of LLNM in patients with MTC. This nomogram will be of great value for guiding the clinical diagnosis and treatment process of MTC patients.
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Carcinoma Neuroendócrino , Metástase Linfática , Nomogramas , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/cirurgia , Carcinoma Neuroendócrino/diagnóstico , Adulto , Linfonodos/patologia , Linfonodos/cirurgia , Idoso , Pescoço/patologia , Tireoidectomia , PrognósticoRESUMO
Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by an invasive form of Chlamydia trachomatis, typically affecting the anogenital area with regional lymphatic involvement. Extragenital manifestations are rare but can occur, particularly if the bacterium is inoculated out of the genital tract. To our knowledge, only 13 cases of symptomatic neck LGV have been published so far in the medical literature. We describe a case of a young man living with HIV with bilateral, rapid-growing and painful neck swelling, whose definite diagnosis was challenging. The patient underwent extensive investigation, including repeated ultrasound-guided fine-needle aspirations, microbiological exams and histological characterisation. Genotyping revealed C. trachomatis L2 serovar, confirming LGV as a final diagnosis, affecting neck lymph nodes. Treatment with doxycycline combined with surgical drainage led to clinical resolution. This case emphasises the importance of a comprehensive testing strategy to identify LGV, especially in individuals reporting unprotected oral sex, with unexplained neck lymphadenitis.
Assuntos
Chlamydia trachomatis , Doxiciclina , Infecções por HIV , Linfogranuloma Venéreo , Pescoço , Humanos , Masculino , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/complicações , Linfogranuloma Venéreo/tratamento farmacológico , Pescoço/patologia , Infecções por HIV/complicações , Doxiciclina/uso terapêutico , Chlamydia trachomatis/isolamento & purificação , Adulto , Antibacterianos/uso terapêutico , Drenagem , Linfonodos/patologiaRESUMO
INTRODUCTION: Mycetoma is a chronic granulomatous inflammatory disease of the subcutaneous tissue, which affects deep structures and bone. Most cases of actinomycetoma are caused by members of the genus Nocardia. CASE PRESENTATION: Here we report the case of a 43-year-old male who presented a disseminated mycetoma on the forearm, chest and neck, characterized by enlarged and erythematous lesions through which seropurulent material drains, and numerous atrophic scars. Molecular identification was performed by 16S gene amplification and sequencing. Nocardia mexicana was identified with 100% identity. Trimethoprim-sulfamethoxazole, diaminodiphenyl sulfone and amikacin was a successful treatment after 6 months. CONCLUSIONS: Nocardia mexicana is a rare organism that causes mycetoma. We report a case of extensive mycetoma on the forearm with spread to the neck and thorax associated with manipulation of the mouth of a calf.
Assuntos
Antibacterianos , Antebraço , Micetoma , Pescoço , Nocardiose , Nocardia , RNA Ribossômico 16S , Tórax , Humanos , Masculino , Adulto , Nocardia/isolamento & purificação , Nocardia/genética , Micetoma/microbiologia , Micetoma/tratamento farmacológico , Micetoma/diagnóstico , Nocardiose/microbiologia , Nocardiose/tratamento farmacológico , Nocardiose/diagnóstico , Antebraço/microbiologia , Antebraço/patologia , Tórax/diagnóstico por imagem , Tórax/microbiologia , Pescoço/patologia , Antibacterianos/uso terapêutico , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , DNA Bacteriano/genética , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Amicacina/uso terapêutico , DNA Ribossômico/genética , DNA Ribossômico/químicaRESUMO
Pseudoaneurysm is the formation of a sac due to damage in the continuity of the arterial wall. Iatrogenic carotid artery aneurysm is a rare, life-threatening complication following fine needle aspiration (FNA). We are presenting here a case of pseudoaneurysm following FNA with a literature review.
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Falso Aneurisma , Humanos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/diagnóstico , Biópsia por Agulha Fina/efeitos adversos , Lesões das Artérias Carótidas/etiologia , Lesões das Artérias Carótidas/diagnóstico , Lesões das Artérias Carótidas/diagnóstico por imagem , Doença Iatrogênica , Pescoço/patologiaRESUMO
The thymus derives from the third branchial pouch, which migrates to the mediastinum through the central region of the neck. During the migration, particles split off and develop separately. The prevalence of ectopic thymus is 20-40%. The purpose of this retrospective case series study was to investigate the prevalence of embryological tissue remnants in the central region, in patients treated for thyroid lesions. Between January 1 2018 and September 1 2020, 84 patients who underwent central neck dissection were selected. Clinicopathological data as age, gender, histopathological result and TNM stage were analyzed. Ectopic tissue in the central neck region was discovered in 28 cases. The prevalence of ectopic lesions showed increase in Stage I thyroid carcinomas. There was no significant correlation with patients' age, gender, or with the stage. We emphasize the clinicopathological role of ectopic tissues, which can occur in the central region of the neck.
Assuntos
Coristoma , Pescoço , Neoplasias da Glândula Tireoide , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pescoço/patologia , Pessoa de Meia-Idade , Coristoma/patologia , Coristoma/epidemiologia , Adulto , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/cirurgia , Achados Incidentais , Timo/patologia , Esvaziamento Cervical , Idoso , Estadiamento de NeoplasiasRESUMO
BACKGROUNDS: Manifestation of cystic hygroma in adulthood is very rare. The rarity of cystic hygroma in adults has caused problems in its diagnosis and management and few studies have reported cystic hygroma in adults. CASE PRESENTATION: In this study, we reported a rare case with cervical cystic hygroma in adults. We report a 20-year-old Iranian male (Iranian ethnicity) with a diagnosis of right-side neck cystic hygroma and discuss the presentation, diagnosis, and clinical, radiological, and operative aspects of it. CONCLUSION: Cystic hygromas are a rare occurrence in adults. They are typically asymptomatic, rarely complicated, and can be mistaken for a cystic neck mass. This study showed that in our case, surgical resection may be a safe and effective treatment for cystic hygroma, with minimal risk of complications during the procedure.
Assuntos
Linfangioma Cístico , Humanos , Linfangioma Cístico/cirurgia , Linfangioma Cístico/diagnóstico , Linfangioma Cístico/diagnóstico por imagem , Masculino , Adulto Jovem , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Pescoço/diagnóstico por imagem , Pescoço/cirurgia , Pescoço/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Objective: To assess the risk factors of cervical lymph node metastasis in elderly patients aged 65 years and older diagnosed with papillary thyroid cancer (PTC). Design and method: In this retrospective analysis, we included a total of 328 elderly patients aged 65 years and older diagnosed with PTC. We thoroughly examined clinical features from these patients. Utilizing univariate and multivariate logistic regression analyses, we aimed to identify factors contributing to the risk of central and lateral lymph node metastasis (CLNM/LLNM) in this specific population of PTC patients aged 65 years and older. Results: In the univariate analysis, CLNM was significantly associated with tumor size, multifocality, bilaterality, and microcalcification, while only tumor size ≥ 1cm (OR = 0.530, P = 0.019, 95% CI = 0.311 - 0.900) and multifocality (OR = 0.291, P < 0.001, 95% CI = 0.148 - 0.574) remained as risk factors in the multivariate analysis. LLNM was confirmed to be associated with male (OR = 0.454, P < 0.020, 95% CI = 0.233 - 0.884), tumor size ≥ 1cm (OR = 0.471, P = 0.030, 95% CI = 0.239 - 0.928), age ≥ 70 (OR = 0.489, P = 0.032, 95% CI = 0.254 - 0.941), and microcalcification (OR = 0.384, P = 0.008, 95% CI = 0.189 - 0.781) in the multivariate analysis. In elderly PTC patients with CLNM, male gender (OR = 0.350, P = 0.021, 95% CI = 0.143 - 0.855), age ≥ 70 (OR = 0.339, P = 0.015, 95% CI = 0.142 - 0.810), and bilaterality (OR = 0.320, P = 0.012, 95% CI = 0.131 - 0.779) were closely associated with concomitant LLNM in both univariate and multivariate analyses. Conclusion: For elderly PTC patients aged 65 and older, tumor size ≥ 1cm and multifocality are significant risk factors for CLNM. Meanwhile, male, tumor size ≥ 1cm, age ≥ 70, and microcalcification are crucial predictors for LLNM. In patients already diagnosed with CLNM, male, age ≥ 70, and bilaterality increase the risk of LLNM.
Assuntos
Metástase Linfática , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Humanos , Masculino , Feminino , Idoso , Fatores de Risco , Câncer Papilífero da Tireoide/patologia , Metástase Linfática/patologia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/epidemiologia , Idoso de 80 Anos ou mais , Linfonodos/patologia , Pescoço/patologiaRESUMO
BACKGROUND: Lymphatic malformations are vascular developmental anomalies varying from local superficial masses to diffuse infiltrating lesions, resulting in disfigurement. Patients' outcomes range from spontaneous regression to severe sequelae notwithstanding appropriate treatment. The current classification guides, in part, clinicians through the decision-making process, prognosis prediction and choice of therapeutic strategies. Even though the understanding of molecular basis of the disease has been recently improved, a standardized management algorithm has not been reached yet. RESULTS: Here, we report our experience on five children with different lymphatic anomalies of the head and neck region treated by applying a multidisciplinary approach reaching a consensus among specialists on problem-solving and setting priorities. CONCLUSIONS: Although restitutio ad integrum was rarely achieved and the burden of care is challenging for patients, caregivers and healthcare providers, this study demonstrates how the referral to expert centres can significantly improve outcomes by alleviating parental stress and ameliorating patients' quality of life. A flow-chart is proposed to guide the multidisciplinary care of children with LMs and to encourage multidisciplinary collaborative initiatives to implement dedicated patients' pathways.
Assuntos
Anormalidades Linfáticas , Humanos , Anormalidades Linfáticas/terapia , Anormalidades Linfáticas/patologia , Feminino , Masculino , Criança , Pescoço/patologia , Cabeça , Pré-Escolar , Lactente , Qualidade de VidaRESUMO
Fluorescence confocal microscopy (FCM) is an optical technique that uses laser light sources of different wavelengths to generate real-time images of fresh, unfixed tissue specimens. Unlike conventional histologic evaluation methods, FCM is able to assess fresh tissue samples without the associated cryo artifacts typically observed after frozen sectioning. The purpose of this study was to evaluate the utility of FCM imaging in the differential diagnosis of cervical lymphadenopathy. Twenty-two cervical lymph node specimens from patients with lymphadenopathy of unknown origin were imaged by FCM. Two pathologists independently evaluated the scans for suspicion of malignancy and preliminary diagnosis. Malignancy was reliably excluded or confirmed by both pathologists with a sensitivity of 90.9% for pathologist 1 and 100% for pathologist 2. The specificity was 100% for both pathologists. For the preliminary diagnosis, almost perfect agreement with the final diagnosis was observed for both pathologists (κ = 0.94 for pathologist 1 and κ = 1.00 for pathologist 2). This is the first study to investigate lymph node specimens with different diagnoses, including lymphoma, using FCM. Our results indicate that differential diagnosis of lymph node specimens is feasible in FCM images, thus encouraging further exploration of FCM imaging in lymph node specimens to accelerate diagnosis and open the possibility of digitizing diagnosis on fresh, unfixed tissue.
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Linfonodos , Linfadenopatia , Microscopia Confocal , Humanos , Linfadenopatia/patologia , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/diagnóstico , Microscopia Confocal/métodos , Feminino , Linfonodos/patologia , Linfonodos/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Diagnóstico Diferencial , Microscopia de Fluorescência , Pescoço/patologia , Pescoço/diagnóstico por imagem , Linfoma/patologia , Linfoma/diagnóstico , Linfoma/diagnóstico por imagemRESUMO
The differential diagnosis of a rapidly enlarging neck mass consists of many different benign ((haemorrhagic) cyst) and malignant (anaplastic thyroid cancer (ATC) and lymphoma) causes. ATC is a rare disease with a median survival of 6 months. As early diagnosis and management are key for fast-growing cancers, in our centre we have implemented a dedicated short-stay in-hospital fast-track diagnostic work-up for patients with a rapid growing mass in the neck. The goal of this track is to have a fast diagnostic and therapeutic plan for this disease. Based on three clinical cases we discuss our experience with this fast-track diagnostic work-up for rapidly growing mass in the neck and illustrate the additional value in this clinical entity.