pulmicort and Granuloma--Plasma-Cell

A 59-year-old woman suffered from fever and upper abdominal pain. The computed tomography (CT) scan revealed a liver lesion. Conventional imaging techniques (CT, magnetic resonance imaging, contrast-enhanced ultrasonography) did not allow for a consistent diagnosis. Fine needle biopsy of the liver lesion was performed. Histologically, fibrotic inflammation was found and an inflammatory pseudotumor (IPT) diagnosed. Despite treatment with steroids and antibiotics, the size of the IPT increased; thus, surgical resection was necessary. In case of fever of unknown origin, IPT should be considered as a potential diagnosis.

Topics: Abdominal Pain; Anti-Bacterial Agents; Biopsy, Fine-Needle; Budesonide; Diagnosis, Differential; Female; Fever of Unknown Origin; Granuloma, Plasma Cell; Hepatectomy; Humans; Liver; Liver Diseases; Magnetic Resonance Imaging; Middle Aged; Tomography, X-Ray Computed; Ultrasonography

Mucous membrane plasmacytosis (MMP) is a rare idiopathic condition characterized by infiltration of the mucosa by non neoplastic plasma cells. In this report we describe a case of mucous membrane plasmacytosis of the nose in a 72-year-old woman patient affected by B-cell chronic lymphocytic leukemia (B-CLL). Two different biopsies of the lesion showed diffuse plasma cell, lymphocyte and granulocyte infiltration compatible with granulation tissue. A complete exeresis of the neoplasm was performed endoscopically without complications, allowing the diagnosis of MMP; a monthly follow up was performed with no signs of local relapse 15 months after surgery. Topical steroid therapy with budesonide nasal spray was administered. There is no standardized treatment for MMP: we have reported good result of surgical approach in a unique case of nasal MMP in a patient with B-CLL; the relation between these two diseases deserves more studies.

Topics: Administration, Intranasal; Aged; Anti-Inflammatory Agents; Biopsy; Budesonide; Endoscopy; Female; Foam Cells; Granulation Tissue; Granulocytes; Granuloma, Plasma Cell; Humans; Immunoglobulin kappa-Chains; Immunoglobulin lambda-Chains; Leukemia, Lymphocytic, Chronic, B-Cell; Lymphocytes; Nasal Mucosa; Plasma Cells; Postoperative Care; Tomography, X-Ray Computed; Turbinates

Severe upper airway stenosis was diagnosed in a 23 year old woman who presented with hoarseness, cough and dyspnoea 8 yrs after initial diagnosis of ulcerative colitis. The respiratory symptoms worsened over the next few months, the patient eventually developing dysphagia and ultimately severe upper airway obstruction. The narrowest site was the glottis, which was severely stenosed by inflammatory swellings. Systemic corticosteroids led to rapid clinical improvement and restoration of normal airway patency within a few months. Ulcerative colitis is frequently associated with extraintestinal inflammatory manifestations. In the respiratory tract these usually take the form of chronic bronchitis, which occasionally develops into bronchiectasis. This case confirms that the inflammation can also involve the larynx and large airways.

Topics: Adult; Bronchodilator Agents; Budesonide; Colitis, Ulcerative; Drug Therapy, Combination; Female; Granuloma, Plasma Cell; Humans; Laryngostenosis; Prednisone; Pregnenediones; Tracheal Stenosis