Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Nov 2022
Case ReportsTakotsubo Like Cardiomyopathy with Concomitant Pheochromocytoma: A Rare Presentation.
Pheochromocytoma classically presents with headache, diaphoresis, palpitations and, raised blood pressure. Rarely, it manifests as cardiomyopathy. Herein, we present a case of a 42-year woman who presented with heart failure and on work-up was found to have pheochromocytoma leading to Takotsubo-like cardiomyopathy. ⋯ Within two weeks of presentation and before surgical excision of the mass, she recovered from cardiomyopathy. After medical optimisation, the patient underwent elective adrenalectomy, which on histological evaluation revealed pheochromocytoma. Key Words: Cardiomyopathy, Pheochromocytoma, Adrenal mass.
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J Coll Physicians Surg Pak · Nov 2022
Case ReportsPancreatic Tuberculosis mimicking as a Pancreatic Mass Lesion.
Tuberculosis is a global health problem and commonly affects the respiratory system. The involvement of the pancreas in this disease is a rare event. We hereby report a case of a young male who presented with right hypochondrial pain along with significant weight loss. ⋯ Endoscopic ultrasound-guided biopsy of the pancreatic lesion revealed evidence of caseation necrosis along with epithelioid granuloma, findings suggestive of tuberculosis. He was started on anti-tuberculous therapy for 6 months and a repeat CT scan showed complete disappearance of the mass lesion and resolution of symptoms. Key Words: Tuberculosis, Pancreatic mass, Endoscopic ultrasound, Biopsy.
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Granulomatous lobular mastitis (GLM) is an infrequent inflammatory breast disease, which can simulate malignancy on the basis of clinical and imaging features. It is typically found in parous or lactating women. The differential diagnosis of granulomatous mastitis includes infections caused by bacterial, fungal or mycobacterial agents, and autoimmune disorders like rheumatoid arthritis, sarcoidosis, giant cell vasculitis, and granulomatosis with polyangiitis. ⋯ The majority of cases of GLM are still "idiopathic" as this pattern of inflammation still remains a mystery. We herein report three cases of CNGM and review the relevant literature. Key Words: Granulomatous mastitis, Corynebacterium, Gram-positive rods, Inflammatory breast disease, Cystic neutrophilic granulomatous mastitis.
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J Coll Physicians Surg Pak · Nov 2022
Case ReportsA Case of Neuromyelitis Optica with Systemic Lupus Erythematosus.
Neuromyelitis Optica (NMO) is a rare idiopathic autoimmune demyelinating disease of the central nervous system (CNS) having a relapsing course. It consists of optic neuritis, longitudinally extensive transverse myelitis (LETM) which involves 3 or more neighbouring portions of the spine and positive serology for anti-NMO IgG antibodies. NMO is often misdiagnosed as multiple sclerosis (MS). ⋯ She had seropositivity for anti-aquaporin-4 (anti-AQP4) receptor antibody. An accurate clinical diagnosis is important to initiate timely immunosuppressive therapy to prevent disability. Key Words: Neuromyelitis Optica, Transverse myelitis, Systemic lupus erythematosus.