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Marshfield, WI, United States

Kasirye Y.,Marshfield Clinic | Talsness S.,Clinical Research | Walters M.P.,Mayo Medical School | Douglas-Jones J.W.E.,Cardiovascular Surgery | And 3 more authors.
Annals of Diagnostic Pathology | Year: 2012

Thymic cysts (congenital or acquired) are believed to account for 3% to 5% of all mediastinal masses. Multilocular thymic cysts are an acquired reactive inflammatory process arising within the thymus gland and are less common than the congenital unilocular type. Multilocular cysts have been reported in association with a variety of neoplastic, autoimmune, and infectious conditions. We report a case of a 23-year-old white man who presented with a 2-week history of progressive right-sided shoulder and chest pain. He was found to have an anterior mediastinal mass involving the thymus. This case of multilocular thymic cyst is particularly unique due to the presence of abundant epithelioid granulomata within the cyst, a finding that has not previously been emphasized as a histologic feature of these lesions, and one that expands the histopathologic differential diagnosis, warranting exclusion of infectious and autoimmune etiologies. © 2012 Elsevier Inc. All rights reserved. Source

Kar P.,Marshfield Clinic | Mitra S.,Marshfield Clinic | Resnick J.M.,Laboratory Pathology | Torbey C.F.,Marshfield Clinic
Clinical Medicine and Research | Year: 2013

Gastric antral vascular ectasia is the source of up to 4% of nonvariceal upper gastrointestinal bleeding. It can present with occult bleeding requiring transfusions or with acute gastrointestinal bleeding. It is associated with significant morbidity and mortality and has been associated with such underlying chronic diseases as scleroderma, diabetes mellitus, and hypertension. Approximately 30% of cases are associated with cirrhosis. We report two cases of gastric antral vascular ectasia with two strikingly different endoscopic appearances. We further describe the clinical, endoscopic, histologic, and therapeutic aspects of this entity. ©2013 Marshfield Clinic. Source

Sun B.,University of Illinois at Chicago | Lapetino S.R.,Laboratory Pathology | Diffalha S.A.L.,Loyola University | Yong S.,Illinois College | And 5 more authors.
Human Pathology | Year: 2016

Summary Yttrium-90 microsphere radioembolization (90Y MRE) is a therapy for liver malignancies by permanently implanting 90Y-containing microspheres into tumors via hepatic artery. The etiology of persistent gastric ulcerations in patients presenting months after treatment remains unclear. Three patients who presented with gastric ulceration 4 to 13 months after 90Y MRE were examined by esophagogastroduodenoscopy and biopsies. Pathological examinations showed multiple 90Y microspheres scattered within the lamina propria and submucosa. Most of the microspheres were distributed in a linear fashion, consistent with an intravascular location; however, the vascular lumen and endothelial cells were not present. The microspheres were surrounded by fibrotic tissue infiltrated by chronic inflammatory cells and rare neutrophils. Epithelial granulation without pititis and miniaturized glands with intervening fibrosis were noted, compatible with chronic ischemic changes. These findings suggest that the persistent gastric ulceration is a result of localized ischemic injury in response to 90Y MRE-induced vascular damage. © 2015 Elsevier Inc. All rights reserved. Source

Usoltseva N.,Marshfield Clinic | Medina-Flores R.,Laboratory Pathology | Rehman A.,Hospital Medicine | Samji S.,Marshfield Clinic | D'Costa M.,Marshfield Clinic
Clinical Medicine and Research | Year: 2014

Spinal subdural abscess (SSA) is an uncommon entity. The exact incidence is unknown, with very few cases reported in the literature. This condition may result in spinal cord compression, thus constituting a medical and neurosurgical emergency. The pathogenesis of SSA is not welldescribed, and the available knowledge is based on case observations only. There is only one case report that describes direct seeding from decubitus ulcers as a possible mechanism for development of SSA. We report a case of subacute onset of quadriplegia in a male patient, age 55 years, due to spinal cord compression from SSA and superimposed spinal subdural hematoma. The direct seeding from decubitus ulcers is thought to be the cause of infection in our patient. We present this case of SSA to elucidate and review the predisposing factors, pathogenesis, clinical presentation, diagnostic modalities, and treatment regarding management of this rare disorder. © 2014 Marshfield Clinic. Source

Rafiullah,Saint Clares Hospital | Resnick J.,Laboratory Pathology | Onitilo A.A.,University of Queensland
BMJ Case Reports | Year: 2014

Oesophageal papillomatosis is a very rare entity, with only 10 cases (including ours) reported in the literature. We report a 51-year-old man with a 25-year history of dysphagia with solids and liquids who failed a trial of proton pump inhibitors and fluticasone. His initial endoscopy revealed a viliform mass with dense eosinophilic infiltrate without neoplasia. Endoscopic ultrasound examination revealed a 4x1.6x0.7 cm mucosal hemicircumferential lesion without regional adenopathy. Pathological findings from the oesophagectomy specimen confirmed oesophageal papillomatosis with no malignancy. Surveillance endoscopy 4 months later revealed the lesion had increased in size. Additional ablative therapies failed, and the patient underwent oesophagectomy. Surveillance CT of the chest and abdomen at 3 months and oesophagogastroduodenoscopy at 6 months were negative. This case illustrates that oesophageal squamous papillomatosis not amenable to medical therapy requires surgical treatment. Copyright 2014 BMJ Publishing Group. All rights reserved. Source

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