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Presented by: Paul Hofman, France
• A 42-year old man born in Zurich presented to the Dermatology department for a painful skin lesion located in the hand one month after a vacation in Colombia
• The patient underwent a large debridement by a general surgeon with successful excision |
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| Image 1 | Image 2 | Image 3 | Image 4 | Image 5 |
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| Diagnosis & Comments [0] |
| Handout: Download |
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Presented by: Paul Hofman, France
• A 29 year-old man, born in Cameroon, was admitted in 2005 for a tumefaction of the superior lip associated with lacrimation of the left eye
• In 2007, he presented with a deformation of the lip, of the left cheek and of the nose with a nasal obstruction
• In 2008, he presented a monstruous deformation of the nose with a huge sweelling of the lip and a palatine ulceration
• A cutaneous biopsy was performed |
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Presented by: Gieri Cathomas, Switzerland
Slide of Lung tissue and lymph node.
Case history: 73 years old male with a space occupying lesion in the upper lobe of the right lung. Negative cytology.
Resection of the upper lobe of the right lung with local lymph nodes. |
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Presented by: Niels Willi, Switzerland
A 33 years old man presented himself to the dermatologist because of recently appeared genital problems. Antecedent was uneventful. |
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Presented by: Vsevolod Zinserling, Saint-Petersburg, Russian Federation
Male patient Ivan V, 31 ys old., before the last illness healthy, but with obesity. Got ill acute, with fever till 39 degrees C. Was hospitalized on the 3 day in the intensive care unit in severe condition caused by respiratory insufficiency, where intubation and later on tracheostomy were done. The clinical diagnosis of “swine influenza” was supported by RT PCR and serology (increase of antibody level 0-640). In spite of intensive treatment including antibiotics and antiviral drugs, patient died on the 35th day of the illness.
At the autopsy remarkable changes were found only in the lungs: necrotic posttrachestomic tracheitis, large abscesses in the lower lobes of the lungs in the stage of organization, bilateral fibrinous pleuritis. The rest of lung tissue was dark red, firm.
During the histological examination in the lungs were noted changes typical for rather old abscesses, late stages of respiratory distress syndrome. The changes typical for influenza (virus induced transformation of epithelial cells) were expressed only in the moderate number of the cells. We notified numerous intraalveolar macrophages, partly with vacuolated cytoplasma, and PAS-positive inclusions. Some cells had slightly enlarged hyperchromic nuclei. Similar changes were noted in other organs as well.
Postmortem RT PCR in lungs and spleen for influenza A H1N1 swine (-). Postmortem bacteriology of lungs: E.coli, nonpathogenic corynebacteria, enterococcus, S. viridans and S.epidermiditis.
During the immunohistochemical investigation we notified in lungs strong positive reaction with serum against Chlamydia trachomatis, moderate against adenovirus and weak against influenza H1N1. The reactions with sera against HSV1/2, CMV, EBV, RS, entero- and parvoviruses, Mycoplasma pneumoniae were negative.
During the electron microscopic investigation of lungs we succeeded to evaluate numerous elementary and reticular bodies of Chlamydia, in brain only reticular ones predominantly in cytoplasma of endothelial cells. In their nuclei several PML –nuclear bodies were found. |
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| Slide 1a | Slide 1b | Slide 1c - x100 |
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| Diagnosis & Comments [0] |
| Handout: Download |
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Presented by: Sebastian Lucas, London, United Kingdom
29yr old female African. Presented short of breath, with bilateral non-specific infiltrates on chest X ray. HIV test positive. Sputum and bronchio-alveolar lavage both negative. So proceeded to open lung biopsy.
Slide of lung biopsy (H&E) |
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| Handout: Download |
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Presented by: Sebastian Lucas, London, United Kingdom
Male 36yr, gay, and had visited the USA. Presented in 1982 with shortness of breath. Transbronchial biopsy negative. Developed diarrhoea; rectal biopsy negative.
Died in multi-organ failure 10 weeks later without a specific diagnosis. At autopsy, lung consolidation seen. Other organs grossly normal.
Slide of autopsy lung (H&E) |
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| Handout: Download |
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Presented by: Gieri Cathomas, Switzerland
66 yr old male with a nodular lymphangitis of the right arm. Patient is owner of an aquarium (fish tank). Skin biopsy.
Slide of skin. |
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Presented by: Gieri Cathomas, Switzerland
38y old male with chronic hepatitis C, genotype 4. Previous biopsy 4 years earlier showed mild activity (Metavir A1, F0).
Slide of liver biopsy. |
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| Slide 1 - HE | Slide 1 - Sirius |
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