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Sample records for histiocytosis orbital lesion

  1. Crystal-storing histiocytosis: a rare lesion in periapical pathology.

    PubMed

    da Cruz Perez, Danyel Elias; Silva-Sousa, Yara Teresinha Corrêa; de Andrade, Bruno Augusto Benevenuto; Rizo, Victor Hugo Toral; Almeida, Luciana Yamamoto; León, Jorge Esquiche; de Almeida, Oslei Paes

    2012-12-01

    Crystal-storing histiocytosis is a rare manifestation of plasma cell dyscrasia/monoclonal gammopathies and lymphoproliferative disorders, characterized by cytoplasmic accumulation of crystallized immunoglobulins in histiocytes. Nevertheless, some reported cases of crystal-storing histiocytosis raise the possibility that this lesion may also be reactive. Crystal-storing histiocytosis in the oral cavity is extremely rare; only one case affecting the tongue has been reported in the English-language literature. In this report, we discuss the case of a 38-year-old man who presented a persistent periapical lesion affecting the maxillary left lateral incisor. Histopathological analysis showed numerous crystal-laden histiocytes associated with a mild plasma cell infiltrate within a fibrous stroma. The plasma cells failed to show clonal light-chain restriction, and the patient had no associated hematologic disorder or systemic disease. Thus, this lesion was probably the result of hypersecretion of immunoglobulins by polyclonal plasma cells found in the periapical lesion. Crystal-storing histiocytosis should be considered in the differential diagnosis of periapical lesions.

  2. Langerhans cell histiocytosis: recurrent lesions affecting mandible in a 10-year-old patient.

    PubMed

    Loducca, S V; Mantesso, A; Araújo, N S; Magalhães, M H

    2001-01-01

    Hand-Schuller-Christian disease is a multifocal variant of eosinophilic granuloma, characterised by the classical triad of bony lesions, exophthalmos and diabetes insipidus. This case relates recurrent Langerhans' cell histiocytosis lesions presented as destruction of periodontal support associated with diabetes in a 10-year-old patient. Medical history suggests that the case represents a case of Hand-Schuller Christian disease.

  3. Dendritic Cells Cause Bone Lesions in a New Mouse Model of Histiocytosis

    PubMed Central

    Grosjean, Frédéric; Nasi, Sonia; Schneider, Pascal; Chobaz, Véronique; Liu, Alexandra; Mordasini, Vanessa; Moullec, Kristell; Vezzoni, Paolo; Lavanchy, Christine; Busso, Nathalie; Acha-Orbea, Hans; Ehirchiou, Driss

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disease caused by the clonal accumulation of dendritic Langerhans cells, which is often accompanied by osteolytic lesions. It has been reported that osteoclast-like cells play a major role in the pathogenic bone destruction seen in patients with LCH and these cells are postulated to originate from the fusion of DCs. However, due to the lack of reliable animal models the pathogenesis of LCH is still poorly understood. In this study, we have established a mouse model of histiocytosis- recapitulating human disease for osteolytic lesions seen in LCH patients. At 12 weeks after birth, severe bone lesions were observed in our multisystem histiocytosis (Mushi) model, when CD8α conventional dendritic cells (DCs) are transformed (MuTuDC) and accumulate. Most importantly, our study demonstrates that bone loss in LCH can be accounted for the transdifferentiation of MuTuDCs into functional osteoclasts both in vivo and in vitro. Moreover, we have shown that injected MuTuDCs reverse the osteopetrotic phenotype of oc/oc mice in vivo. In conclusion, our results support a crucial role of DCs in bone lesions in histiocytosis patients. Furthermore, our new model of LCH based on adoptive transfer of MuTuDC lines, leading to bone lesions within 1–2 weeks, will be an important tool for investigating the pathophysiology of this disease and ultimately for evaluating the potential of anti-resorptive drugs for the treatment of bone lesions. PMID:26247358

  4. Composite cutaneous atypical vascular lesion and Langerhans cell histiocytosis after radiation for breast carcinoma: can radiation induce Langerhans cell histiocytosis?

    PubMed

    Pan, Zenggang; Bland, Kirby I; Wei, Shi

    2011-12-15

    Atypical vascular lesions (AVLs) refer to small vascular proliferations in radiated skin that may progress to angiosarcoma and typically develop after breast-conserving therapy for breast carcinoma. We present a case of composite AVL and Langerhans cell histiocytosis (LCH) in a 57-year-old woman who received surgery and radiation therapy for ductal carcinoma of the breast. The patient developed AVLs 4 years after radiation. Biopsies of multiple erythematous nodules at the same site one year later revealed intermixed AVL and LCH, some of which coexisted within the same lesion. To our knowledge, LCH has not been recorded at the site of radiation in the English language literature. Our case not only highlights the importance of close cutaneous surveillance and a low threshold for biopsy in patients with breast-conserving surgery and radiation therapy, but also raises the possibility of radiation as the inducement of cutaneous LCH.

  5. Langerhans cell histiocytosis with multifocal bone lesions: comparative clinical features between single and multi-systems.

    PubMed

    Imashuku, Shinsaku; Kinugawa, Naoko; Matsuzaki, Akinobu; Kitoh, Toshiyuki; Ohki, Kentaro; Shioda, Yoko; Tsunematsu, Yukiko; Imamura, Toshihiko; Morimoto, Akira

    2009-11-01

    Langerhans cell histiocytosis (LCH) can be a single system or multi-system disease. Both disease types can be associated with multi-focal bone lesions, but their bone involvement patterns have not been compared systematically. Of the new pediatric LCH cases enrolled into the JLSG-02 study during 2002-2007, 67 cases of single system multifocal bone (SMFB) LCH and 97 cases of multi-system bone (MSB) LCH were analyzed to determine if the bone involvement patterns differ in these two types, and whether these differences correlate with outcome. Statistical analysis was performed with Mann-Whitney U test, Fisher's exact test, and other measures. Onset ages were higher for SMFB (P < 0.001), but the two types did not differ in the number of bone lesions per patient. The skull was most frequently affected in both types, followed by the spine. Lesions in the temporal bone (P = 0.002), ear-petrous bone (P < 0.001), orbita (P = 0.003), and zygomatic bone (P = 0.016) were significantly more common in MSB. The two types did not differ in response to treatment, but MSB was associated with a significantly higher incidence of diabetes insipidus (DI) (P < 0.001). Novel measures are required in preventing the development of DI in MSB-type LCH patients with "risk" bone lesions.

  6. Successful treatment with cladribine of Erdheim-Chester disease with orbital and central nervous system involvement developing after treatment of Langerhans cell histiocytosis.

    PubMed

    Perić, Predrag; Antić, Branislav; Knezević-Usaj, Slavica; Radić-Tasić, Olga; Radovinović-Tasić, Sanja; Vasić-Vilić, Jasenka; Sekulović, Leposava; Tarabar, Olivera; Tukić, Ljiljana; Jovandić, Stevo; Magić, Zvonko

    2016-01-01

    Erdheim-Chester disease (ECD) is a rare, systemic form of non-Langerhans cell histiocytosis of the juvenile xanthogranuloma family with characteristic bilateral symmetrical long bone osteosclerosis, associated with xanthogranulomatous extra skeletal organ involvement. In ECD, central nervous system (CNS) and orbital lesions are frequent, and more than half of ECD pa tients carry the V600E mutation of the protooncogene BRAF. The synchronous or metachronous development of ECD and Langerhans cell histiocytosis (LCH) in the same patients is rare, and the possible connection between them is still obscure. Cladribine is a purine substrate analogue that is toxic to lymphocytes and monocytes with good hematoencephalic penetration. We presented a 23-year-old man successfully treated with cladribine due to BRAF V600E-mutation-negative ECD with bilateral orbital and CNS involvement ECD developed metachronously, 6 years after chemotherapy for multisystem LCH with complete disease remission and remaining central diabetes insipidus. During ECD treatment, the patient received 5 single-agent chemotherapy courses of cladribine (5 mg/m2 for 5 consecutive days every 4 weeks), with a reduction in dose to 4 mg/m2 in a fifth course, delayed due to severe neutropenia and thoracic dermatomal herpes zoster infection following the fourth course. Radiologic signs of systemic and CNS disease started to resolve 3 months after the end of chemotherapy, and CNS lesions completely resolved within 2 years after the treatment After 12-year follow-up, there was no recurrence or appearance of new systemic or CNS xanthogranulomatous lesions or second malignancies. In accordance with our findings and recommendations provided by other authors, cladribine can be considered an effective alternative treatment for ECD, especially with CNS involvement and BRAF V600E-mutation-negative status, when interferon-alpha as the first-line therapy fails.

  7. Insufficiency of bone scintigraphy in vertebral lesions of langerhans cell histiocytosis compared to f-18 fluorodeoxyglucose positron emission tomography/computed tomography and diagnostic computed tomography.

    PubMed

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat

    2015-02-05

    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy.

  8. Treatment of Langerhans cell histiocytosis bone lesions with zoledronic acid: a case series.

    PubMed

    Sivendran, Shanthi; Harvey, Harold; Lipton, Allan; Drabick, Joseph

    2011-06-01

    Langerhans cell histiocytosis (LCH) is a rare disease caused by a clonal proliferation of specialized dendritic (Langerhans) cells. Although uncommon, it is potentially fatal and carries significant morbidity. Bone involvement is particularly destructive and to date, no standard of care exists for management of both the disease and the significant bone pain as many of these patients experience. In the literature, 12 patients who had previously been heavily pretreated for their disease had their bone pain treated with a bisphosphonate as extrapolated from the cancer literature. Interestingly, these patients had a complete or near complete resolution of their pain, return of functional status and in 75% of cases radiographic evidence of reduction or regression of disease. Only 6 of these patients were treated with a newer generation bisphosphonate, zoledronic acid. In this paper, we report a case series of 2 patients with LCH bone involvement who received 4 mg of intravenous zoledronic acid monthly for 1 year with complete resolution in their bone pain. In addition, both patients demonstrated reduction in tumor burden after bisphosphonate treatment. Uniquely, our first case is the only reported case in the literature using a bisphosphonate as first line therapy in the treatment of LCH. This case demonstrates the potential role of zoledronic acid therapy in the first line setting for disease stabilization and symptomatic control in patients unable to receive conventional therapy.

  9. Sclerosing Lesions of the Orbit: A Review.

    PubMed

    Lokdarshi, Gautam; Pushker, Neelam; Bajaj, Mandeep S

    2015-01-01

    Orbital sclerosing inflammation is a distinct group of pathologies characterized by indolent growth with minimal or no signs of inflammation. However, contrary to earlier classifications, it should not be considered a chronic stage of acute inflammation. Although rare, orbital IgG4-related disease has been associated with systemic sclerosing pseudotumor-like lesions. Possible mechanisms include autoimmune and IgG4 related defective clonal proliferation. Currently, there is no specific treatment protocol for IgG4-related disease although the response to low dose steroid provides a good response as compared to non-IgG4 sclerosing pseudotumor. Specific sclerosing inflammations (e.g. Wegener's disease, sarcoidosis, Sjogren's syndrome) and neoplasms (lymphoma, metastatic breast carcinoma) should be ruled out before considering idiopathic sclerosing inflammation as a diagnosis.

  10. General Information about Langerhans Cell Histiocytosis (LCH)

    MedlinePlus

    ... grow into (and restore) the body's blood cells. Observation Observation is closely monitoring a patient's condition without giving ... histiocytosis (LCH) skin lesions may include the following: Observation . When severe rashes, pain, ulceration , or bleeding occur, ...

  11. Indications and limitations of endoscopic endonasal orbitotomy for orbital lesion.

    PubMed

    Karaki, Masayuki; Akiyama, Kosuke; Kagawa, Masahiro; Tamiya, Takashi; Mori, Nozomu

    2012-07-01

    Endoscopic endonasal surgical techniques have developed tremendously in the last 20 years. Endoscopic techniques have been applied to the treatment of cranial base lesions, pituitary tumors, orbital lesions, pterygopalatine fossa lesions, infratemporal fossa lesions, posterior cranial fossa lesions, and clival lesions. In some reports, endoscopic endonasal transparanasal orbitotomies have been indicated for lesions localized to the medial and inferomedial parts of the orbit. The aim of this article was to present the technique of endoscopic endonasal orbitotomy (EEO) for orbital extraperiosteal and intraperiosteal lesions, as well as its indications and limitations. We present cases of 4 patients who underwent EEO for typical extraperiosteal and intraperiosteal orbital lesions. We examined the indications and limitations in each case. All 4 orbital lesions were completely removed by EEO with no major complications. The EEO procedure, which does not require a skin incision, is a minimally invasive surgery used for treating orbital retrobulbar lesions. It leads to excellent cosmetic results with little bleeding. In the future, we need to determine its operative indications, safety, and dangers. It is necessary for us to further improve this surgical technique to allow for the generalization of the procedure.

  12. Lymphoma and other lymphoid lesions of the orbit. Preliminary report.

    PubMed

    Kleener, J

    1975-03-01

    The orbit differs from the rest of the organism, excluding the central nervous system, as concerns lymph drainage. This may possible explain some of the peculiar features in lymphoid orbital lesions. The lymphoid tumours of the orbit are discussed on the basis of the classification most widely applied. An illustrative case is reported and it is concluded that even if local therapy may prove successful, patients in whom orbital lymphoid tumours have been diagnosed should be kept under constant observation with a view to prompt institution of treatment upon evidence of generalized disease.

  13. "Histiocytosis X" – A Rare Case Report

    PubMed Central

    Chandrasekaran, Deepak; Chinnaswami, Ravindran; Balasubramaniam, Sivaramakrishnan; Jagdish, Eswari

    2016-01-01

    Histiocytosis X is an idiopathic disease, characterized by a disorder of the reticulo-endothelial system in the human body. Histopathological studies carried out right from the 1800s have seen a significant similarity in the pathologic process of different stages in particular clinical syndromes showing proliferation of mature histiocytes. It was then modified by Lichenstein in 1953 as “Histiocytosis X”. The exact aetiology is unknown; hence, the name “Histiocytosis X”. The disease classically presents with three syndromes namely Eosinophilic granuloma, Letterer-Siwe disease and Hand-Schuller-Christian disease. These syndromes present with a spectrum of clinical manifestations with histiocytic proliferation in the granulomatous lesion. The disease is neither familial nor hereditary, nor does it have any microbiological pathologic origin. This disease can be conservatively managed by antibiotics and steroids or surgical curettage with radiotherapy. We report a five-year-old male child who was incidentally diagnosed to have Histiocytosis X. This patient was managed with a moderate surgical procedure with total avoidance of radiotherapy. An adequate follow-up of this patient shows total regression of the lesion and good bone healing. PMID:27891484

  14. [Adult Langerhans cell histiocytosis].

    PubMed

    de Menthon, Mathilde; Meignin, Véronique; Mahr, Alfred; Tazi, Abdellatif

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare disease affecting both genders and can occur at any age. It often evolves through successive flares, and its severity varies from benign forms that don't require treatment to life threatening disease. Some patients have important functional impairment with psychological and social consequences and prolonged disability. LCH may affect only one organ, with uni- or multifocal involvement or be multisystem disease involving multiple organs. The organs most frequently involved are bones, lung, skin and the endocrinal system. Pulmonary LCH is strongly related to smoking. Some patients have mixed histocytosis combining LCH and other histiocytic disorders. The diagnosis relies on the histological study of tissues samples, and shows tissue infiltration with large cell with pale cytoplasm and reniform nucleus, staining for CD1a and Langerin (CD207) on immunohistochemistry. The BRAF(V600E) mutation is observed in tissue samples in approximately half of patients and the activation of the RAS-RAF-MEK-ERK pathway has been shown to be constantly activated in LCH lesions, regardless the BRAF status. These findings represent an important forward step in the understanding of the physiopathology of the disease. Treatment must be adapted to the severity of the disease and goes from conservative observation to systemic chemotherapy. Therapies targeting the RAS-RAF-MEK-ERK pathway are promising treatments for progressive disease.

  15. [Pulmonary manifestations of Langerhans cell histiocytosis].

    PubMed

    Obert, J; Tazi, A

    2015-10-01

    Pulmonary Langerhans cell histiocytosis is a rare diffuse cystic interstitial pneumonia of unknown etiology that occurs selectively in young smokers of both genders. The multicenter studies conducted by the reference center have better defined the short and medium terms natural history of the disease and the clinical management of patients. A substantial proportion of patients experience a dramatic decline in their lung function soon after diagnosis. Importantly, smoking cessation is associated with a decreased risk of subsequent deterioration. Cladribine, a purine analogue, chemotherapy may dramatically improve lung function in patients with progressive pulmonary Langerhans cell histiocytosis, but this treatment should be used only in the setting of clinical research. Specific pulmonary hypertension therapies (anti-endothelin receptors, inhibitors of phosphodiesterases) may be used with caution in specialized centres for patients with severe pulmonary hypertension, and seem to be well tolerated. The recent identification of the V600E mutation of the BRAF oncogene in approximately half of the Langerhans cell histiocytosis lesions, including pulmonary granulomas, represents an important step forward in the understanding of the pathogenesis of Langerhans cell histiocytosis. Potentially it opens the way to targeted therapies. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  16. [Generalized eruptive histiocytosis-Juvenile xanthogranuloma: clinical spectrum in a pediatric patient].

    PubMed

    Alperovich, Ruth; Grassino, Pedro T; Asial, Raúl; Pasteris, Luis; Boente, María Del Carmen

    2017-04-01

    Both, generalized eruptive histiocytosis and juvenile xanthogranuloma are dendritic histiocytic disorders (also known as non-Langerhans cells histiocytosis) that share clinicopathological and immunohistiochemical characteristics. We present a 3-year-old female patient with skin lesions that were clinically compatible with generalized eruptive histiocytosis, confirmed by histopathological and immunohistochemical studies. During her development the disorder compromised the central nervous system, and surgical intervention of one symptomatic lesion was needed. The histopathological exam of the central nervous system lesion showed Touton cells, compatible with a diagnosis of juvenile xanthogranuloma. This case demonstrates the need to consider these diseases as a spectrum of the same entity.

  17. Langerhans Cell Histiocytosis of the Clavicle

    PubMed Central

    Wang, Shaowu; Zhang, Weisheng; Na, Shengbo; Zhang, Lina; Lang, Zhijin

    2014-01-01

    Abstract We report a rare case of solitary Langerhans cell histiocytosis (LCH) involving the clavicle of an adult female. The patient was a 32-year-old female presenting with 1 month history of progressive pain, swelling, and tenderness in the region near the left sternoclavicular joint. Radiograph, computed tomography, and magnetic resonance imaging showed an osteolytic lesion in the clavicle with tumor extension and soft tissue edema. Surgical curettage of the lesion was performed, and the histopathologic diagnosis was LCH. Because of its rarity and possibly variable presentation, LCH should be included and considered in the differential diagnosis when we encounter a clavicle lesion. PMID:25365405

  18. Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial.

    PubMed

    Lee, Michael; Généreux, Philippe; Shlofmitz, Richard; Phillipson, Daniel; Anose, Bynthia M; Martinsen, Brad J; Himmelstein, Stevan I; Chambers, Jeff W

    2017-06-01

    The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.). ORBIT II was a single-arm trial that enrolled 443 patients at 49U.S. sites; in this study, de novo, severely calcified coronary lesions were treated with OAS prior to stenting. The primary safety endpoint was 30-day MACE: the composite of cardiac death, MI, and TVR (inclusive of target lesion revascularization (TLR)). The primary efficacy endpoint was procedural success: stent delivery with a residual stenosis of <50% without the occurrence of in-hospital MACE.The present analysis reports the final, 3-year follow-up results from ORBIT II. The majority of subjects (88.2%) underwent PCI with drug-eluting stents after orbital atherectomy. There were 360 (81.3%) subjects who completed the protocol-mandated 3-year visit.The overall cumulative rate of 3-year MACE was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%). The 3-year target lesion revascularization rate was 7.8%. In the final 3-year analysis of the ORBIT II trial, orbital atherectomy of severely calcified coronary lesions followed by stenting resulted in a low rate of adverse ischemic events compared with historical controls.Orbital atherectomy represents a safe and effective revascularization strategy for patients with severely calcified coronary lesions. The ORBIT II trial enrolled 443 subjects to study orbital atherectomy followed by stenting for de novo severely

  19. Histiocytosis--an introduction.

    PubMed Central

    Pritchard, J.; Broadbent, V.

    1994-01-01

    The Histiocytoses are a group of rare and puzzling multisystem disorders, currently regarded as non-malignant but often treated with 'cancer chemotherapy'. In this article, the origins of histiocytes and of the Histiocyte Society's classification of the Histiocytoses are described with suggested minor modifications to the classification. The current nomenclature for the 2 principal diseases, now named 'Langerhans cell histiocytosis' and 'Haemophagocytic Lymphohistiocytosis', is less confusing than the terms originally chosen. The article sets the scene for the succeeding papers, which focus on 'Langerhans cell histiocytosis'. PMID:8075000

  20. A gluteal mass of langerhans cell histiocytosis mimicking malignancy in a two-year-old boy: a case report.

    PubMed

    Ibrahim, Zainal Abidin; Lung, Wong Siong; Long, Pan Kok

    2009-01-01

    Langerhans cell histiocytosis is a disease primarily affects the bone. More than 50 percent of the disease occurs between the age of 1 and 15. We reported a case of a 2 year old boy who presented with a gluteal mass. Radiographic imaging showed an osteolytic lesion suspicious of malignancy. However, the histological diagnosis was Langerhans cell histiocytosis.

  1. Lipid Histiocytosis of the Gallbladder Neck Lymph Node.

    PubMed

    Handra-Luca, Adriana; Ben Romdhane, Mohamed Habib; Straub, Beate Katharina

    2016-01-01

    Lipid histiocytosis of the gallbladder neck lymph node is rarely reported nowadays. Two obese patients presented with gallbladder lithiasis detected on CT scan. The treatment consisted in coelioscopic cholecystectomy. Microscopy revealed subacute/chronic lithiasic cholecystitis and foci of vacuolated cells in the gallbladder neck lymph node. These cells were positive for CD68, CD31, S100 protein, and adipophilin and negative for cytokeratin and Alcian blue. In conclusion, we report lymph node lipid histiocytosis diagnosed microscopically after cholecystectomy. While such lesions may remain unidentified on imaging procedures, the microscopic analysis may require special stains and immunohistochemistry for ruling out adenocarcinoma metastasis.

  2. Langerhans cell histiocytosis: clinical experience with 124 patients.

    PubMed

    Rivera-Luna, R; Martinez-Guerra, G; Altamirano-Alvarez, E; Martinez-Avalos, A; Cardenas-Cardoz, R; Ayon-Cardenas, A; Ruiz-Maldonado, R; Lopez-Corella, E

    1988-08-01

    We cared for 124 pediatric patients with a histologic diagnosis of Langerhans' cell histiocytosis (histiocytosis X) over a period of 14 years. Clinical, laboratory, and radiographic findings were analyzed. The most frequent manifestations were bone lesions, lymph node involvement, and skin infiltration. Liver disease was noted in 50% of patients and lung disease in 23%; hematologic changes were also frequent. Dysfunction and involvement of these three organ systems, plus age of onset, distinguished the group of patients with the highest mortality. All patients with generalized disease or organ dysfunction were treated with systemic chemotherapy. The actuarial survival curve at 10 years was 63%.

  3. Lipid Histiocytosis of the Gallbladder Neck Lymph Node

    PubMed Central

    Ben Romdhane, Mohamed Habib; Straub, Beate Katharina

    2016-01-01

    Lipid histiocytosis of the gallbladder neck lymph node is rarely reported nowadays. Two obese patients presented with gallbladder lithiasis detected on CT scan. The treatment consisted in coelioscopic cholecystectomy. Microscopy revealed subacute/chronic lithiasic cholecystitis and foci of vacuolated cells in the gallbladder neck lymph node. These cells were positive for CD68, CD31, S100 protein, and adipophilin and negative for cytokeratin and Alcian blue. In conclusion, we report lymph node lipid histiocytosis diagnosed microscopically after cholecystectomy. While such lesions may remain unidentified on imaging procedures, the microscopic analysis may require special stains and immunohistochemistry for ruling out adenocarcinoma metastasis. PMID:27847666

  4. Validity of the Lateral Supraorbital Approach as a Minimally Invasive Corridor for Orbital Lesions.

    PubMed

    Adawi, Mohammed M; Abdelbaky, Abdelaal M

    2015-09-01

    Many approaches were recommended for surgical treatment of orbital lesions via either transorbital or transcranial routes. The frontolateral craniotomy through eyebrow skin incision (lateral supraorbital approach) is a combined cranio-orbital approach that could be used in different orbital lesions. To evaluate the efficacy and safety of the lateral supraorbital approach for resection of orbital lesions. Ten patients with different orbital lesions were treated by this minimally invasive technique. The technique is described in details. The postoperative outcome was evaluated with casting light on the specific parameters related to this approach. This study included 6 females and 4 males, ranging in age from 2 years to 65 years with mean age of 37.3 years. Proptosis was the most common presenting complaint. Six patients were operated on via the right supraorbital approach, and 4 patients via the left supraorbital approach. Various pathological lesions were treated. The excision was total in 7 patients, subtotal in 1 patient, and partial in 2 patients. Two patients suffered transient supraorbital hypothesia, 1 patient showed temporary superficial wound infection with CSF leak and 1 patient died within 6 months. The lateral supraorbital approach is a minimally invasive approach that provides excellent exposure of the superior, lateral, and medial orbit, as well as the orbital apex. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. [Orbit: Part 1: anatomy, imaging procedures and retrobulbar lesions].

    PubMed

    Reith, W; Yilmaz, U

    2015-08-01

    The aim of this 2-part review article on diseases of the orbit is to give the reader an insight into the anatomical structure and an overview of the most important diseases in the area of the eye socket. The main focus is on a description of the imaging procedures and their individual advantages and disadvantages. The most important tumors, trauma and degenerative alterations of the orbit are also described.

  6. [Langerhans cell histiocytosis in children under one year].

    PubMed

    Larralde, Margarita; Abad, María E; Gomar, Begoña

    2008-06-01

    Langerhans cell histiocytosis is characterized by a clonal proliferation of activated Langerhans cells that infiltrate various organs of the body. Occurs at any age, from newborn until adulthood, with an incidence peak at 1-4 years. To describe the morphologyc characteristics of skin lesions and clinical course of 15 patients with Langerhans cell histiocytosis. A retrospective review of the medical records of patients with Langerhans cell histiocytosis from Ramos Mejia Hospital and Aleman Hospital, between 1999-2007. Review of medical records from 15 patients, 6 females and 9 males. Skin lesions were congenital in 8 cases and appeared between 2-12 months of age in 7 cases. The patients with congenital presentation only had a cutaneous manifestation; one patient who developed a systemic compromise (lung, liver and spleen) is currently under treatment. Three patients with presentation after birth only had cutaneous lesions, the others had a systemic disease. One of this patients died during treatment. Histopathology showed a histiocytic infiltrate in the papillary dermis with epidermotrophism; inmunomarking with S100 and CD1a was positive. Both clinical manifestation (congenital and after birth) represent different ends of a spectrum of the same condition, with the potencial to develop into disseminated Langerhans cell histiocytosis.

  7. Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies

    PubMed Central

    Khan, Sarah N.; Sepahdari, Ali R.

    2012-01-01

    A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated. PMID:23961022

  8. [Pulmonary Langerhans histiocytosis and Hodgkin's lymphoma].

    PubMed

    Paris, A; Dib, M; Rousselet, M-C; Urban, T; Tazi, A; Gagnadoux, F

    2011-09-01

    Pulmonary Langerhans histiocytosis (PLH) is a rare disease due to the accumulation of Langerhans cells at the level of the bronchioles. These dendritic immunocytes form granulomata and destroy the wall of the airway. We report a case of PLH developing at the same time as Hodgkin's lymphoma in a young woman who smoked tobacco and cannabis. We observed a complete remission of the PLH lesions parallel to the remission of the Hodgkin's lymphoma after chemotherapy, in the absence of any change in the consumption of tobacco and cannabis. This observation leads us to discuss the potential relationships between PLH on one hand, and smoking, the lymphoma and its treatment on the other.

  9. Laryngeal involvement with fatal outcome in progressive nodular histiocytosis: A rare case report

    PubMed Central

    Salunke, Aarti; Belgaumkar, Vasudha; Chavan, Ravindranath; Dobariya, Rinkesh

    2016-01-01

    Progressive nodular histiocytosis (PNH) represents a very rare type of non-Langerhans cell histiocytosis. It is characterized by progressive appearance of papules and nodules without spontaneous resolution. We report a 60-year-old patient with novel clinical features in the form of extensive noduloulcerative lesions, ichthyotic patches, and laryngeal involvement culminating in fatal outcome prior to therapeutic intervention. Although the presenting features were baffling, histopathology and immunohistochemistry clinched the diagnosis of PNH. PMID:27990389

  10. LATE-ONSET SELF-HEALING LANGERHANS CELL HISTIOCYTOSIS: REPORT OF A VERY RARE ENTITY

    PubMed Central

    Afsar, Fatma Sule; Ergin, Malik; Ozek, Gulcihan; Vergin, Canan; Karakuzu, Ali; Seremet, Sila

    2017-01-01

    ABSTRACT Objective: To report a case of late-onset self-healing Langerhans cell histiocytosis. Case description: A 4½-month-old female patient presenting with an eythematopurpuric eruption underwent a skin biopsy for histopathology and was first diagnosed with isolated cutaneous Langerhans cell histiocytosis. Her lesions regressed within a few months and she was retrospectively diagnosed with late-onset self-healing Langerhans cell histiocytosis after being without skin or systemic involvement in a follow-up four years later. Comments: Self-healing Langerhans cell histiocytosis, which is characterized by clonal proliferation of Langerhans cells and presents with cutaneous lesions, is a rare self-limited variant of histiocytosis and can only be diagnosed retrospectively, after the patient remains free from systemic involvement for several years. Although it presents at birth or during the neonatal period, only a few cases of its late-onset type regarding the age of onset have been reported. Purpuric lesions that appear after the neonatal period serve as a clue for late-onset self-healing Langerhans cell histiocytosis and the patients should be monitored regularly for systemic involvement if the diagnosis is confirmed by a cutaneous biopsy.

  11. Infrequent bilateral orbital tumors and simulating lesions: the experience of a Chinese institute.

    PubMed

    Wang, Yi; Kang, Li; Xiao, LiHua

    2009-11-01

    To determine the types, frequency, and clinical features of infrequent bilateral orbital lesions. We reviewed 41 cases of either histopathologically or radiologically verified bilateral orbital lesions. The number and entities in each category were recorded. Clinical data and imaging findings were reviewed. The number and percentage of lesions in each general category were leukemia lesions in eight patients (19.5%), metastatic tumors in seven (17%), optic nerve and meningeal tumors in six (14.6%), secondary tumors in six (14.6%), peripheral nerve lesions in four (9.8%), inflammatory lesions in four (9.8%), and vasculogenic, histiocytic, and miscellaneous lesions, each in two patients (4.9%). These lesions occurred in both childhood and adulthood, but were infrequent in people over 60 years old. Of all cases, 51.2% were benign and 48.8% were malignant. The ocular symptoms and signs presented unilaterally in 18 (43.9%) cases and bilaterally in 23 (56.1%). Of the 15 patients with either metastatic tumors or blood disorders, two (13.3%) had a history of primary neoplasm at presentation. In 19 (46.3%) cases, the configuration of the bilateral lesions was symmetrical, and they were of equal size. Computed tomography scans revealed bone changes in 13 patients (31.7%), while magnetic resonance imaging revealed intracranial extension in nine (22%). Varied lesions can involve the bilateral orbits simultaneously or on follow-up. Through the combination of history, bilateral ocular manifestations, radiologic findings, and systemic examinations, the correct diagnosis can be made, which is valuable for early identification of both metastasis and blood disorders.

  12. Lesions to polar/orbital prefrontal cortex selectively impair reasoning about emotional material.

    PubMed

    Goel, Vinod; Lam, Elaine; Smith, Kathleen W; Goel, Amit; Raymont, Vanessa; Krueger, Frank; Grafman, Jordan

    2017-03-03

    While it is widely accepted that lesions to orbital prefrontal cortex lead to emotion related disruptions and poor decision-making, there is very little patient data on this issue involving actual logical reasoning tasks. We tested patients with circumscribed, focal lesions largely confined to polar/orbital prefrontal cortex (BA 10 & 11) (N=17) on logical reasoning tasks involving neutral and emotional content, and compared their performance to that of an age and education-matched normal control group (N=22) and a posterior lesion control group (N=24). Our results revealed a significant group by content interaction driven by a selective impairment in the polar/orbital prefrontal cortex group compared to healthy normal controls and to the parietal patient group, in the emotional content reasoning trials. Subsequent analyses of congruent and incongruent reasoning trials indicated that this impairment was driven by the poor performance of patients with polar/orbital lesions in the incongruent trials. We conclude that the polar/orbital prefrontal cortex plays a critical role in filtering emotionally charged content from the material before it is passed on to the reasoning system in lateral/dorsal regions of prefrontal cortex. Where unfiltered content is passed to the reasoning engine, either as a result of pathology (as in the case of our patients) or as a result of individual differences, reasoning performance suffers.

  13. Recurrent orbital space-occupying lesions: a clinicopathologic study of 253 cases

    PubMed Central

    Tang, Weiqiang; Hei, Yan

    2013-01-01

    Objective To analyze the clinical features, histopathologic classification and frequencies of various types of recurrent orbital space-occupying lesions. Methods A retrospective study was carried out in 253 consecutive patients with recurrent orbital space-occupying lesions treated by surgical excision in the Institute of Orbital Diseases, the General Hospital of the Armed Police Force from January 2009 to December 2010. Results The patients included 123 males and 130 females aged 2 to 78 years (mean, 36.2 years), and the last recurrence interval after operation ranged from 1 month to 40 years (median, 4.75 years). Of all the cases, 159 (62.8%), 65 (25.7%), 20 (7.9%), 8 (3.2%) and 1 (0.4%) had previously experienced once, twice, three, four and six times of surgeries, respectively. Among them, 29 (11.5%) cases had recurred 3 times or over, and 37 (14.6%) cases got recurrence in 10 or more years postoperatively. Most of the patients with local recurrence presented with various clinical manifestations, while 31 (12.3%) cases were symptom-free. Two hundred and thirty-one (91.3%) cases underwent surgical removal of the recurrent orbital lesions, and another 22 (8.7%) cases had to receive the exenteration of orbit. Categories of these recurrent orbital lesions after operation were as follows: lacrimal gland tumors, 65 (25.7%) cases; vasogenic diseases, 54 (21.3%) cases; neurogenic tumors, 42 (16.6%) cases; secondary tumors, 24 (9.5%) cases; orbital inflammation, 21 (8.3%) cases; myogenic tumors, 14 (5.5%) cases; fibrous and adipose tumors, 12 (4.7%) cases; lympho-hematopoietic tumors, 7 (2.8%) cases; bone or cartilage tumors, 7 (2.8%) cases; orbital cysts, 6 (2.4%) cases; and indefinitely differentiated tumor, 1 (0.4%) case. The 10 top histopathologic diagnoses were lacrimal gland pleomorphic adenoma, hemangiolymphangioma, lacrimal gland adenoid cystic carcinoma, meningioma, inflammatory pseudotumor, neurofibroma, sebaceous gland carcinoma, vascular malformation

  14. [Pulmonary Langerhans cell histiocytosis].

    PubMed

    Popper, H H

    2015-09-01

    Pulmonary Langerhans cell histiocytosis is regarded as a reactive proliferation of the dendritic Langerhans cell population stimulated by chronic tobacco-derived plant proteins due to incomplete combustion but can also occur in childhood as a tumor-like systemic disease. Currently, both these forms cannot be morphologically distinguished. In the lungs a nodular proliferation of Langerhans cells occurs in the bronchial mucosa and also peripherally in the alveolar septa with an accompanying infiltration by eosinophilic granulocytes and destruction of the bronchial wall. Langerhans cells can be selectively detected with antibodies against CD1a and langerin. In the reactive isolated pulmonary form, abstinence from tobacco smoking in most patients leads to regression of infiltration and improvement of symptoms. In high-resolution computed tomography (HRCT) the small star-like scars can still be detected even after complete cessation of tobacco smoking.

  15. A Retrospective Analysis of Oral Langerhans Cell Histiocytosis in an Iranian Population: a 20-year Evaluation

    PubMed Central

    Atarbashi Moghadam, Saede; Lotfi, Ali; Piroozhashemi, Batool; Mokhtari, Sepideh

    2015-01-01

    Statement of the Problem Langerhans cell histiocytosis is a rare disease with unknown pathogenesis and is characterized by local or disseminated proliferation of Langerhans cells. There is no previous investigation on prevalence of oral Langerhans cell histiocytosis in Iranian population. Purpose The purpose of this study was to assess the relative frequency of oral Langerhans cell histiocytosis in an Iranian population and to compare the data with previous reports. Materials and Method Pathology files of Oral and Maxillofacial Pathology Department of Dental School of Shahid Beheshti University of Medical Sciences from 1992 to 2012 were searched for cases recorded as oral Langerhans cell histiocytosis. A total number of 20 cases were found and the clinical information of patients was recorded. Results The relative frequency of oral Langerhans cell histiocytosis was 0.34% and the most common location was the posterior mandible. In addition, the mean age of patients was 27 years and there was a definite male predominance. Most lesions were localized and tooth mobility was the most common oral presentation. Conclusion In Iranian population as in many other countries, the relative frequency of oral Langerhans cell histiocytosis is low. Moreover, tooth mobility and periodontal lesions are the frequent early signs of disease. Therefore, in patients with periodontal problems, good oral health, and no response to the treatment; Langerhans cell histiocytosis must be considered. Additionally, although most cases of oral Langerhans cell histiocytosis are localized, systemic involvement must also be considered and dental professionals have an important role in early detection of the disease. PMID:26535408

  16. Langerhans cell histiocytosis: Current concepts in dentistry and case report

    PubMed Central

    Ramos-Gutiérrez, Efraín; Alejo-González, Francisco; Ruiz-Rodríguez, Socorro; Garrocho-Rangel, José-Arturo

    2016-01-01

    Langerhans cell histiocytosis (LCH), which is a rare granulomatous pediatric disease of unknown etiology, is characterized by the idiopathic proliferation and accumulation of abnormal and clonal Langerhans cells or their marrow precursors, resulting in localized, solitary or multiple destructive lesions. These lesions are most commonly eosinophilic granuloma, which are found in craniofacial bone structures such as the skull and mandible, skin and other organs. In children, the disease has a variable initial presentation, and the clinical course, prognosis and survival are unpredictable. The aims of this report were to present an LCH case in a girl aged 2 years, 8 months and her clinicopathological features, to describe the bucodental management provided, and to discuss special dental considerations of this disease. Key words:Children, dental management, histiocytosis, Langerhans cells. PMID:26855698

  17. A Clinical Update and Radiologic Review of Pediatric Orbital and Ocular Tumors

    PubMed Central

    Rao, Ajay A.; Naheedy, John H.; Chen, James Y.-Y.; Robbins, Shira L.; Ramkumar, Hema L.

    2013-01-01

    While pediatric orbital tumors are most often managed in tertiary care centers, clinicians should be aware of the signs of intraocular and orbital neoplasms. In the pediatric population, a delay in diagnosis of orbital and intraocular lesions, even if benign, can lead to vision loss and deformity. Intraocular lesions reviewed are retinoblastoma, medulloepithelioma, and retinal astrocytic hamartoma. Orbital neoplasms reviewed are rhabdomyosarcoma, neuroblastoma metastases, optic pathway glioma, plexiform neurofibroma, leukemia, lymphoprolipherative disease, orbital inflammatory syndrome, dermoid and epidermoid inclusion cysts, and Langerhans' cell histiocytosis. Vascular lesions reviewed are infantile hemangioma and venous lymphatic malformation. In conjunction with clinical examination, high-resolution ophthalmic imaging and radiologic imaging play an important role in making a diagnosis and differentiating between benign and likely malignant processes. The radiologic imaging characteristics of these lesions will be discussed to facilitate prompt diagnosis and treatment. The current treatment modalities and management of tumors will also be reviewed. PMID:23577029

  18. Orbital tumours and tumour-like lesions: exploring the armamentarium of multiparametric imaging.

    PubMed

    Purohit, Bela S; Vargas, Maria Isabel; Ailianou, Angeliki; Merlini, Laura; Poletti, Pierre-Alexandre; Platon, Alexandra; Delattre, Bénédicte M; Rager, Olivier; Burkhardt, Karim; Becker, Minerva

    2016-02-01

    Although the orbit is a small anatomical space, the wide range of structures present within it are often the site of origin of various tumours and tumour-like conditions, both in adults and children. Cross-sectional imaging is mandatory for the detection, characterization, and mapping of these lesions. This review focuses on multiparametric imaging of orbital tumours. Each tumour is reviewed in relation to its clinical presentation, compartmental location, imaging characteristics, and its histological features. We herein describe orbital tumours as lesions of the globe (retinoblastoma, uveal melanoma), optic nerve sheath complex (meningioma, optic nerve glioma), conal-intraconal compartment (hemangioma), extraconal compartment (dermoid/epidermoid, lacrimal gland tumours, lymphoma, rhabdomysarcoma), and bone and sinus compartment (fibrous dysplasia). Lesions without any typical compartmental localization and those with multi-compartment involvement (veno-lymphatic malformation, plexiform neurofibroma, idiopathic orbital pseudotumour, IgG4 related disease, metastases) are also reviewed. We discuss the role of advanced imaging techniques, such as MR diffusion-weighted imaging (DWI), diffusion tensor imaging, fluoro-2-deoxy-D-glucose positron emission tomography CT (FDG-PET CT), and positron emission tomography MRI (MRI PET) as problem-solving tools in the evaluation of those orbital masses that present with non-specific morphologic imaging findings. Main messages/Teaching points • A compartment-based approach is essential for the diagnosis of orbital tumours. • CT and MRI play a key role in the work-up of orbital tumours. • DWI, PET CT, and MRI PET are complementary tools to solve diagnostic dilemmas. • Awareness of salient imaging pearls and diagnostic pitfalls avoids interpretation errors.

  19. Dissociable effects of subtotal lesions within the macaque orbital prefrontal cortex on reward-guided behavior

    PubMed Central

    Rudebeck, Peter H.; Murray, Elisabeth A.

    2011-01-01

    The macaque orbital prefrontal cortex (PFo) has been implicated in a wide range of reward-guided behaviors essential for efficient foraging. The PFo, however, is not a homogeneous structure. Two major subregions, distinct by their cytoarchitecture and connections to other brain structures, compose the PFo. One subregion encompasses Walker's areas 11 and 13 and the other centers on Walker's area 14. Although it has been suggested that these subregions play dissociable roles in reward-guided behavior, direct neuropsychological evidence for this hypothesis is limited. To explore the independent contributions of PFo subregions to behavior, we studied rhesus monkeys (Macaca mulatta) with restricted excitotoxic lesions targeting either Walker's areas 11/13 or area 14. The performance of these two groups was compared to that of a group of unoperated controls on a series of reward-based tasks that has been shown to be sensitive to lesions of the PFo as a whole (Walker's areas 11, 13 and 14). Lesions of areas 11/13, but not area 14, disrupted the rapid updating of object value during selective satiation. In contrast, lesions targeting area 14, but not areas 11/13, impaired the ability of monkeys to learn to stop responding to a previously rewarded object. Somewhat surprisingly, neither lesion disrupted performance on a serial object reversal learning task, although aspiration lesions of the entire PFo produce severe deficits on this task. Our data indicate that anatomically defined subregions within macaque PFo make dissociable contributions to reward-guided behavior. PMID:21775601

  20. Langerhans cell histiocytosis of the atlas in an adult.

    PubMed

    Zhong, Wo Quan; Jiang, Liang; Ma, Qing Jun; Liu, Zhong Jun; Liu, Xiao Guang; Wei, Feng; Yuan, Hui Shu; Dang, Geng Ting

    2010-01-01

    Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, is a rare disorder (approximately 1:1,500,000 inhabitants) characterized by clonal proliferation and excess accumulation of pathologic Langerhans cells causing local or systemic effects. The exact etiology of LCH is still unknown. LCH could affect patients of any age, although most present when they are children. The most frequent sites of the bony lesions are the skull, femur, mandible, pelvis and spine. A variety of treatment modalities has been reported, but there was no evidence suggesting that any one treatment was more advantageous than another. We present an adult with LCH of the atlas. A 26-year-old young man presented with a 2-month history of neck pain and stiffness. CT revealed osteolytic lesion in the left lateral mass of atlas with compression fracture. Histopathological diagnosis was Langerhans cell histiocytosis by percutaneous needle biopsy under CT guidance. The patient underwent conservative treatment, including Halo-vest immobilization and radiotherapy. At 7-year follow-up, the patient was asymptomatic except for mild motion restriction of the neck. CT revealed a significant reconstruction of the C1 lateral mass.

  1. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions

    PubMed Central

    Khan, Lubna; Malukani, Kamal; Malaiya, Siddharth; Yeshwante, Prashant; Ishrat, Saba; Nandedkar, Shirish S.

    2016-01-01

    Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored. PMID:27621787

  2. Combined unilateral lesions of the amygdala and orbital prefrontal cortex impair affective processing in rhesus monkeys.

    PubMed

    Izquierdo, Alicia; Murray, Elisabeth A

    2004-05-01

    The amygdala and orbital prefrontal cortex (PFo) interact as part of a system for affective processing. To assess whether there is a hemispheric functional specialization for the processing of emotion or reward or both in nonhuman primates, rhesus monkeys (Macaca mulatta) with combined lesions of the amygdala and PFo in one hemisphere, either left or right, were compared with unoperated controls on a battery of tasks that tax affective processing, including two tasks that tax reward processing and two that assess emotional reactions. Although the two operated groups did not differ from each other, monkeys with unilateral lesions, left and right, showed altered reward-processing abilities as evidenced by attenuated reinforcer devaluation effects and an impairment in object reversal learning relative to controls. In addition, both operated groups showed blunted emotional reactions to a rubber snake. By contrast, monkeys with unilateral lesions did not differ from controls in their responses to an unfamiliar human (human "intruder"). Although the results provide no support for a hemispheric specialization of function, they yield the novel finding that unilateral lesions of the amygdala-orbitofrontal cortical circuit in monkeys are sufficient to significantly disrupt affective processing.

  3. A case of bilateral sensorineural hearing loss from Langerhans cell histiocytosis

    PubMed Central

    Henderson, Arthur Harry; Khan, Akbar Ali; Good, Catriona; Baer, Simon T

    2015-01-01

    Langerhans cell histiocytosis is a rare disorder, with resultant bilateral sensorineural hearing loss unreported in adults. A 42-year-old man presented with 4 months of right-sided tinnitus and hearing loss treated initially as otitis media with effusion. He re-presented 5 months later with progressive bilateral hearing loss—sensorineural (>100 dB) on pure tone audiogram. CT showed bilateral petrous temporal bone and calvarial lesions. Biopsy confirmed diagnosis of Langerhans cell histiocytosis and chemotherapy was started. Though uncommon, Langerhans cell histiocytosis should be considered among the differentials of persistent otological symptoms, as its progressive nature can cause bilateral irreversible sensorineural hearing loss. PMID:26341162

  4. Orbital autoimmune inflammatory disorders - Protein regional variability might explain specific lesion location.

    PubMed

    Clarke, Margo S; Plouznikoff, Alexandre; Deschenes, Jean

    2017-01-01

    In ophthalmology, inflammatory diseases target different highly specific regions within the small confine of the orbit. Some entities even prefer a particular location or depth within the same tissue (ex. anterior, intermediate or posterior uveitides, chorioretinitides with unique topographic presentations). Though the location of a lesion strongly influences and helps us in our differential diagnosis, we still don't understand why specific anatomic sites are susceptible to a disease while other areas are spared. We postulate that regional variability in tissue protein expression can sway the immune system's capacity to trigger an autoimmune response. In addition to this site-specific quantitative and qualitative variability in potential antigen expression, we believe that other proteins implicated in the immune cascade, as well as geographic areas of relative resistance, tolerance and susceptibility, may be unequally distributed within the orbit. To illustrate our hypotheses, we review three major types of ocular myositis and describe how the extraocular muscles different embryologic origins and protein disparities might explain the fundamental clinical differences between these orbital inflammatory diseases. We hope that future differential genomics, proteinomics, epigenomics and analysis of RNA species of affected tissues, compared to their non-affected, yet microscopically similar, counterparts, will help us understand why diseases occur where they do. Hopefully, understanding these immune triggers will pave the way to new treatment options for ocular inflammatory diseases and for other auto-inflammatory conditions with a marked predilection for any given site. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Role of granulocyte-macrophage colony stimulating factor (GM-CSF) in the pathogenesis of adult pulmonary histiocytosis X.

    PubMed Central

    Tazi, A; Bonay, M; Bergeron, A; Grandsaigne, M; Hance, A J; Soler, P

    1996-01-01

    BACKGROUND: Pulmonary histiocytosis X is a disorder characterised by the presence of destructive granulomas preferentially involving distal bronchioles, that contain numerous activated Langerhans' cells. Recent studies have shown that granulocyte-macrophage colony stimulating factor (GM-CSF), which is produced by normal bronchiolar epithelium, may play an important part in the distribution and differentiation of Langerhans' cells. The aim of this study was to evaluate the role of this factor in the pathogenesis of pulmonary histiocytosis X. METHODS: Four patients with pulmonary histiocytosis X were examined by immunohistochemical techniques for GM-CSF and CD1a surface molecules. RESULTS: In early lesions the epithelium of bronchioles affected by the disease was strongly positive for GM-CSF and infiltrated by numerous CD1a+ Langerhans' cells organised into granulomas. In contrast, the expression of GM-CSF was substantially lower in bronchioles not affected by the disease, and these bronchioles contained few Langerhans' cells. When destruction by histiocytosis X lesions was more advanced, only remnants of bronchiolar epithelium could occasionally be identified; these remained strongly reactive for GM-CSF. Langerhans' cells within granulomas also moderately expressed this cytokine. CONCLUSIONS: These results support the hypothesis that GM-CSF could be one of the factors responsible for the local accumulation of lymphostimulatory Langerhans' cells in early lesions of pulmonary histiocytosis X. Images PMID:8693443

  6. Atypical Histiocytosis in Red Squirrels (Sciurus vulgaris).

    PubMed

    Smith, S H; Stevenson, K; Del-Pozo, J; Moss, S; Meredith, A

    2017-03-17

    Four red squirrels (Sciurus vulgaris) were subjected to necropsy examination over a 3-year period as part of a broader surveillance study. The squirrels presented with cutaneous, subcutaneous and/or internal swellings and nodules that consisted microscopically of sheets of atypical round cells and multinucleated giant cells. There was moderate anisokaryosis with rare mitoses. Nuclei ranged from oval to indented or C-shaped and some were bizarre, twisted or multilobulated. Many giant cells also had a bizarre morphology, with anisokaryosis within individual cells. Giant cell nuclei were often multilobulated, ring-shaped or segmented. Affected internal organs varied depending on the squirrel, but included lymph node, kidney, intestinal tract and lungs. Representative lesions from each of the four squirrels were negative for acid-fast organisms. Formalin-fixed tissues from all four squirrels and ethanol-fixed tissue from one animal were negative for Mycobacterium by polymerase chain reaction. Immunohistochemically, the majority of mononuclear and multinucleated giant cells in all four squirrels strongly expressed vimentin and class II molecules of the major histocompatibility complex. Otherwise, the atypical mononuclear and multinucleated cells were negative for CD3, Pax-5, Mac387, CD18 and E-cadherin. Based on the combination of cellular morphology, arrangement and immunophenotype, a novel form of atypical histiocytosis is considered most likely in these squirrels, although the exact origin and triggering factors remain uncertain.

  7. Genetics Home Reference: Langerhans cell histiocytosis

    MedlinePlus

    ... cell histiocytosis affects the lungs, liver, or blood-forming (hematopoietic) system; damage to these organs and tissues ... occurs when the Langerhans cells crowd out blood-forming cells in the bone marrow, leads to a ...

  8. Pulmonary involvement in sea-blue histiocytosis.

    PubMed

    Günay, Ersin; Fırat Güven, Selma; Aktaş, Zafer; Sipit, Tuğrul; Ağaçkıran, Yetkin; Ertürk, Hakan

    2012-01-01

    Sea-blue histiocytosis is one of the six types of Niemann-Pick disease. It is characterized by childhood onset of hepatosplenomegaly, lack of neurological involvement and diminished sphingomyelinase activity. Pulmonary system is rarely involved sea-blue histiocytosis. In this paper, we present a 39-years-old male who had previously diagnosed as sea-blue histiocytosis at the age of 15. He was admitted to our clinic due to productive cough, hemoptysis, fever and weight loss. His symptoms did not resolve with the antibiotic treatment and further investigations revealed pulmonary involvement of sea-blue histiocytosis. After diagnostic bronchoalveolar lavage, his symptoms were improved, interestingly. This rare entity was discussed with literature survey.

  9. CT-guided biopsy for Langerhans cell histiocytosis of the atlas: a case report and literature review.

    PubMed

    Yang, Biao; Zhan, Rui-Yu; Guo, Wen-Hao; Liao, Zheng-Yin

    2016-07-14

    Langerhans cell histiocytosis (LCH) is a rare disease, and involvement of the atlas is extremely uncommon. Biopsy of atlas lesions is difficult and risky. In this case report, we describe the performance of percutaneous computed tomography-guided biopsy of an atlantal LCH in a patient with no complication.

  10. "Blind spots" in forensic autopsy: improved detection of retrobulbar hemorrhage and orbital lesions by postmortem computed tomography (PMCT).

    PubMed

    Flach, P M; Egli, T C; Bolliger, S A; Berger, N; Ampanozi, G; Thali, M J; Schweitzer, W

    2014-09-01

    The purpose of this study was to correlate the occurrence of retrobulbar hemorrhage (RBH) with mechanism of injury, external signs and autopsy findings to postmortem computed tomography (PMCT). Six-teen subjects presented with RBH and underwent PMCT, external inspection and conventional autopsy. External inspection was evaluated for findings of the bulbs, black eye, raccoon eyes and Battle's sign. Fractures of the viscerocranium, orbital lesions and RBH were evaluated by PMCT. Autopsy and PMCT was evaluated for orbital roof and basilar skull fracture. The leading manner of death was accident with central regulatory failure in cases of RBH (31.25%). Imaging showed a high sensitivity in detection of orbital roof and basilar skull fractures (100%), but was less specific compared to autopsy. Volume of RBH (0.1-2.4ml) correlated positively to the presence of Battle's sign (p<0.06) and the postmortem interval. Ecchymosis on external inspection correlated with RBH. There was a statistical significant correlation between bulbar lesion and RBH. Orbital roof fracture count weakly correlated with the total PMCT derived RBH volume. Maxillary hemosinus correlated to maxillary fractures, but not to RBH. RBH are a specific finding in forensically relevant head trauma. PMCT is an excellent tool in detecting and quantifying morphological trauma findings particularly in the viscerocranium, one of the most relevant "blind spots" of classic autopsy. PMCT was superior in detecting osseous lesions, scrutinizing autopsy as the gold standard. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. False-positive PET/CT for lymphoma recurrence secondary to Langerhans cell histiocytosis.

    PubMed

    Fotos, Joseph S; Flemming, Donald J; Tulchinsky, Mark

    2011-08-01

    A 28-year-old man with a history of Hodgkin lymphoma that was intensely [F-18]fluoro-2-deoxy-D-glucose-avid at diagnosis had achieved complete remission following appropriate therapy. On surveillance positron emission tomography/computed tomography (CT), new, intensely [F-18]fluoro-2-deoxy-D-glucose-avid lesions (lytic on CT) were seen within the vertebral body of C7, left scapula, and right glenoid. The findings of a biopsy revealed these lesions to be Langerhans cell histiocytosis. Langerhans cell histiocytosis arising in the context of lymphoma is a well-documented phenomenon, and its appearance on positron emission tomography/CT cannot be conclusively distinguished from lymphoma recurrence. This manuscript emphasizes the necessity of biopsy to ensure correct diagnosis and subsequent correct therapy.

  12. Maxillofacial manifestations of Langerhans cell histiocytosis: a clinical and therapeutic analysis of 10 patients.

    PubMed

    Eckardt, A; Schultze, A

    2003-10-01

    The definition of Langerhans cell histiocytosis (formerly known as histiocytosis X) includes the clinical syndromes Hand-Schueller-Christian syndrome, Abt-Letterer-Siwe syndrome, and eosinophilic granuloma. The paper gives an overview of current diagnostic and treatment strategies of LCH. Furthermore, records and clinical data of 10 patients with LCH were evaluated retrospectively. Patients' age ranged from 13 years to 42 years. The mandible was more frequently involved than the maxilla. Three patients (30%) had systemic manifestations of LCH in addition to their oral lesions. The longest follow-up period was 12 years. During follow-up six patients (60%) developed recurrent LCH and received adjuvant chemo- or radiation therapy. For solitary bone lesions, surgical curettage is the recommended treatment. Those patients with multi-organ involvement or recurrent LCH should be included into clinical trials initiated by the Histiocyte Society.

  13. Atlanto-axial langerhans cell histiocytosis in a child presented as torticollis

    PubMed Central

    Tfifha, Miniar; Gaha, Mehdi; Mama, Nadia; Yacoubi, Mohamed Taher; Abroug, Saoussen; Jemni, Hela

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare condition mostly seen in children and adolescents. Eosinophilic granuloma (EG) is one of its three clinical entities and is considered as a benign osteolytic lesion. Many reports of patients with spine histiocytosis are well documented in the literature but it is not the case of atlantoaxial localization. We report here a new observation of atlantoaxial LCH in a 4-year-old boy revealed by persistent torticollis. He was successfully treated with systemic chemotherapy and surgery. Inter-body fusion packed by autologous iliac bone was performed with resolution of his symptoms. It is known that conservative treatment is usually sufficient and surgery should be reserved for major neurologic defects in spine EG. In atlantoaxial lesion, surgical treatment should be frequently considered. PMID:28868307

  14. Electrolytic lesions of the bilateral ventrolateral orbital cortex inhibit methamphetamine-associated contextual memory formation in rats.

    PubMed

    Zhao, Yan; Liu, Peng; Chu, Zheng; Liu, Fei; Han, Wei; Xun, Xi; Dang, Yong-hui

    2015-10-22

    The memories that are formed between rewarding and drug-associated contextual cues have been suggested to contribute to drug addiction relapse. Recent evidence has indicated that the ventrolateral orbital cortex (VLO) plays important roles in reward-based learning and reversal learning. However, whether the VLO is required for methamphetamine-induced contextual memory formation is not well understood. In the present study, a three-phase methamphetamine-induced conditioned place preference (CPP) model was used to investigate the effects of VLO lesions on the formation of drug-associated contextual memories in rats. We found that the VLO lesions themselves elicited no observable effects on place preferences. However, the VLO lesions delayed the acquisition and extinction phases of CPP without affecting the expression level. Furthermore, the VLO lesions did not have an obvious influence on CPP reinstatement. These results indicate that electrolytic lesions of the bilateral ventrolateral orbital cortex can inhibit the formation of methamphetamine-induced contextual memories in rats. Moreover, VLO may not be critically involved in memory storage and retrieval.

  15. Histiocytosis

    MedlinePlus

    ... Vemurafenib, if the BRAF V600E mutation is found Stem cell transplantation Other treatments may include: Antibiotics to fight ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  16. Langerhans cell histiocytosis followed by Hodgkin's lymphoma.

    PubMed

    Park, Ik Soo; Park, In Keun; Kim, Eun Kyoung; Kim, Shin; Jeon, Sang Ryong; Huh, Joo Ryung; Suh, Cheol Won

    2012-12-01

    A 22-year-old man was referred to our institution due to lower back pain and was diagnosed with Langerhans cell histiocytosis of the thoracic and lumbar spine. The patient achieved complete remission with radiotherapy and chemotherapy. One year later, right cervical lymphadenopathy was observed and Hodgkin's lymphoma was confirmed on biopsy. The patient was treated with chemotherapy and autologous stem cell transplantation, and experienced no further symptoms. Further, no evidence of recurrence was observed on follow-up imaging. This report discusses the association between Langerhans cell histiocytosis and Hodgkin's lymphoma.

  17. Solitary Extragnathic Langerhans Cell Histiocytosis – A Rare Case

    PubMed Central

    Reddy, Eppalapally Sharath Kumar; Bhavani, Sangala Naga; A, Krishna; Sekhar, Mane Srinivas Muni

    2015-01-01

    Langerhans cell histiocytosis (LCH), mainly affects the skull, vertebrae, ribs and mandible in children and the long bones of adults. Symptoms range from none to pain, swelling and tenderness over the site of the lesion. This disease presents oral manifestations which can sometimes be the first expression of the condition. It occurs in three forms namely eosinophilic granuloma in which isolated or multiple bones are involved, But has a good prognosis whereas other variants Hand-Shuller-Christian disease (chronic dessiminated variant) and Letterer-Siwe disease (acute dessiminated form) have poor prognosis. Occasionally only soft tissues are affected without bony involvement. Males are more commonly affected than females. This article describes a rare variant of eosinophilic granuloma of labial mucosa without bony involvement. PMID:25954715

  18. Pulmonary langerhans cell histiocytosis case with diabetes insipidus and tuberculosis.

    PubMed

    Ugurlu, E; Altinisik, G; Aydogmus, U; Bir, F

    2017-04-01

    A 19-year-old male patient was observed due to having central diabetes insipidus (DI) for five years. He had a history of smoking 5-10 cigarettes a day for two years, but stopped smoking from the last month. The computerized tomography revealed thin-walled cystic lesions in different sizes more dominantly in the upper lobes and consolidated areas in the left upper and lower lobes. The wedge resection from the right lower lobe revealed pulmonary langerhans cell histiocytosis. Follow-up acid-fast bacteria (AFB) examinations revealed (+++) and antituberculous treatment was started. On the 40th day of the anti-tuberculosis treatment, the patient applied once again due to fever and chest pain. Although infiltrations persisted in the left upper and middle zones in the postero-anterior lung rontgenogram, right-sided pneumothorax was detected. The case is considered tuberculosis and the patient continued to receive anti-TB treatment under the close supervision.

  19. Langerhans cell histiocytosis followed by hodgkin lymphoma: a case report.

    PubMed

    Safaei, Akbar; Bagheri, Mandana; Shahryari, Jahanbanoo; Noori, Sadat; Esmailzade, Elmira

    2015-05-01

    Langerhans cell histiocytosis (LCH) is a rare neoplasm defined as the proliferation of bone marrow langerhans cells, which is a kind of dendritic cells. The major pathological features of LCH are expression of CD1a and S100 as well as Birbeck granules. Its presentation can differ from a mild bone lesion to a multi-systemic evolved malignant neoplasm; however, the latter outcome is almost rare. Thus, LCH is mostly known as a benign neoplasm. In this study, we present a case of LCH followed by Hodgkin lymphoma (HL). Accompaniment of this disease with malignant lymphoma is rare and considered as case report. Several cases in which malignant lymphoma occurred prior to LCH are reported; however, few cases can be found with LCH followed by malignant lymphomas.

  20. Solitary extragnathic langerhans cell histiocytosis - a rare case.

    PubMed

    V, Yashoda; E, Sharath Kumar Reddy; S N, Bhavani; A, Krishna; Sekhar, M S Muni

    2015-03-01

    Langerhans cell histiocytosis (LCH), mainly affects the skull, vertebrae, ribs and mandible in children and the long bones of adults. Symptoms range from none to pain, swelling and tenderness over the site of the lesion. This disease presents oral manifestations which can sometimes be the first expression of the condition. It occurs in three forms namely eosinophilic granuloma in which isolated or multiple bones are involved, But has a good prognosis whereas other variants Hand-Shuller-Christian disease (chronic dessiminated variant) and Letterer-Siwe disease (acute dessiminated form) have poor prognosis. Occasionally only soft tissues are affected without bony involvement. Males are more commonly affected than females. This article describes a rare variant of eosinophilic granuloma of labial mucosa without bony involvement.

  1. Isolated lesion of the medial orbital wall following endonasal surgery. Isolated fractures of the medial orbital wall.

    PubMed

    Scassellati-Sforzolini, G; Cavina, C; Scassellati-Sforzolini, B; Vancini, F; Cavina, C

    Isolated fractures of the medial orbital wall are infrequent. The diagnostic triad includes: adduction block, exotropia with diplopia in all directions of gaze, positive passive duction in abduction. Sometimes a slight enophthalmos is present. Computed tomography shows the extension and the seat of the fracture. The authors illustrate the case of a 60 year old male who presented with a breach of the medial orbital wall following endonasal surgery. The patient was successfully operated using an iliac bone graft inserted via an eyebrow-nasal cutaneous approach, after a previous attempt with a transconjunctival approach performed in another hospital had failed. A good functional and aesthetic result was observed within the first year after surgery. After almost 11 years a full adduction is still present and diplopia is absent. The authors underline the importance of an early diagnosis and prompt surgical treatment. The fat-muscle entrapment should be removed and the bone defect closed. A close cooperation between ophthalmologist and plastic surgeon is suggested.

  2. Smoking-related interstitial pneumonias and pulmonary Langerhans cell histiocytosis.

    PubMed

    Caminati, Antonella; Harari, Sergio

    2006-06-01

    The relationship between cigarette smoke and interstitial lung diseases (ILDs) is not clear. Respiratory bronchiolitis (RB), usually found as an incidental histologic abnormality in otherwise asymptomatic smokers, is characterized by the accumulation of cytoplasmic golden-brown-pigmented macrophages within respiratory bronchioles. A small proportion of smokers have a more exaggerated response that, in addition to the bronchiole-centered lesions, provokes interstitial and air space inflammation and fibrosis extending to the nearby alveoli. This set of histologic changes is called RB-ILD, and results in clinical symptoms. Desquamative interstitial pneumonia (DIP) is characterized by panlobular involvement, diffuse mild-to-moderate interstitial fibrosis, and massive alveolar filling with macrophages. It is well known that the histopathologic patterns of RB-ILD and DIP may overlap, and that the key features for differentiating these disorders are the distribution and the extent of the lesions: bronchiolocentric in RB-ILD and diffuse in DIP. It has been proposed that RB, RB-ILD, and DIP may be different components of the same histopathologic disease spectrum, representing various degrees of severity of the same process caused by chronic smoking, although this is still controversial. Pulmonary Langerhans' cell histiocytosis is also strongly related to cigarette smoking and is characterized by the proliferation of specific histiocytes, known as Langerhans' cells, and their infiltration of organ systems. Although RB, RB-ILD, DIP, and Pulmonary Langerhans' cell histiocytosis are considered as discrete entities of smokers, it is not infrequent to find a mixture of pathologic features rendering the histopathologic diagnosis difficult.

  3. Rare C-6 vertebral involvement in a child with histiocytosis X: case report.

    PubMed

    Salehpour, Firouz; Tubbs, R Shane; Zarrintan, Sina; Meshkini, Ali; Hadidchi, Shahram; Pourfathi, Hojjat; Azhough, Ramin; Fakhrjou, Asharf; Goodrich, James T; Khaki, Amir Afshin

    2007-01-01

    The authors present a rare case of C-6 vertebral involvement in a 12-year-old boy with histiocytosis X. The patient presented with limitation in movements of neck and upper extremities. Computed tomography (CT) and magnetic resonance (MRI) imaging were used in the preoperative workup. Surgery was performed via an anterior cervical approach along with stabilization using a fibula strut graft and plate fixation. Pathological assessment showed infiltration of Langerhans cells accompanied by a mixture of many eosinophils, giant cells, neutrophils and foamy cells. The patient went on to make a full recovery with complete resolution of his motor weakness. In an extensive review of the literature there are very few cases of cervical histiocytosis X reported. In addition, surgical management of this type of lesion has rarely been discussed.

  4. Impact of Amygdala, Orbital Frontal, or Hippocampal Lesions on Threat Avoidance and Emotional Reactivity in Nonhuman Primates

    PubMed Central

    Machado, Christopher J.; Kazama, Andy M.; Bachevalier, Jocelyne

    2015-01-01

    The authors measured the effects of bilateral amygdaloid, orbital frontal, or hippocampal lesions on emotional reactivity and passive avoidance in rhesus monkeys (Macaca mulatta). Animals were presented with 8 neutral or 8 aversive objects, each paired with a highly preferred food reward. Shamoperated control animals displayed heightened defensive behaviors and typically would not approach or retrieve the food when paired with a potential predator (coiled rubber snake), 2 conditioned aversive stimuli for laboratory-housed monkeys (a capture net and leather handling gloves), and 1 object displaying a threatening social signal (direct eye contact from a human-like doll). Animals with amygdala lesions, but not hippocampal or orbital frontal lesions, showed less tension-related behaviors and diminished passive avoidance of the rubber snake and its matched neutral item (a coiled piece of hose) relative to control animals. All operated groups displayed normal patterns of behavior toward conditioned and socially aversive objects. These results expand our understanding of how the primate brain evaluates reward and threat, and indicate a highly specialized role for the amygdala in mediating passive avoidance and emotional reactivity to potentially life-threatening stimuli. PMID:19348528

  5. Bisphosphonates in Langerhans Cell Histiocytosis: An International Retrospective Case Series

    PubMed Central

    Chellapandian, Deepak; Makras, Polyzois; Kaltsas, Gregory; van den Bos, Cor; Naccache, Lamia; Rampal, Raajit; Carret, Anne-Sophie; Weitzman, Sheila; Egeler, R. Maarten; Abla, Oussama

    2016-01-01

    Background Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH), which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results Ten patients (77%) had a single system bone disease, and 3 (23%) had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years). Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve (92%) achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years). One patient did not respond. No major adverse effects were reported in this series. Conclusion Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted. PMID:27413525

  6. [Frequency of hearing disorders in children with langerhans' cell histiocytosis].

    PubMed

    Kürten, T; Groeger, M; Angerstein, W

    2008-02-01

    The aims of the study were to find out the frequency of hearing disorders in children with Langerhans' cell histiocytosis (LCH) and to find out possible risk factors for hearing disorders due to the disease itself and the therapy. 30 patients with LCH were examined audiologically by using standard audiometric procedures. In cases of central nervous system (CNS) lesions, brainstem evoked response audiometry (BERA) was done additionally. A significant hearing disorder was defined as a hearing impairment affecting speech, thus being characterized by the following features: Both ears should present either conductive and/or sensorineural hearing loss of at least moderate degree. The frequencies important for speech development (1 - 4 kHz) had to be affected. Also, prolongation of BERA interpeak latencies was regarded as a significant hearing impairment, because those children had an increased risk for a central auditory and speech processing disorder. In our study 3 patients had a significant hearing disorder according to our definition. The prevalence of a significant hearing disorder is increased in patients with LCH compared to the prevalence of permanent hearing disorders in German children. We found the following risk factors for the development of a significant hearing disorder: LCH of the temporal bone, CNS lesions. We recommend periodical audiological follow up examinations for LCH patients with lesions of the temporal bone and/or the brain. BERA is indicated in cases with CNS lesions, because central auditory and speech processing disorders are possible in those patients.

  7. Lateral Orbital Rim Osteotomy in the Treatment of Certain Skull Base Lesions

    PubMed Central

    Pritz, Michael B.

    2002-01-01

    Quantitative data from a recent human cadaveric study suggested that removal of the lateral orbital rim alone may be sufficient to reach many targets for which the orbitozygomatic craniotomy has been used. Consequently, a lateral orbital rim osteotomy was substituted for an orbitozygomatic craniotomy in seven patients with a variety of pathologies located in the anterior, middle, and interpeduncular fossae. In each case, lateral orbitotomy provided a satisfactory surgical corridor for diagnosis and treatment. Compared with the orbitozygomatic craniotomy, the lateral orbital rim osteotomy offers several advantages: technical simplicity, shorter operating time, and a low risk of postoperative malocclusion. If, however, prolonged access to a wide expanse of the anterior portion of the middle fossa and inferotemporal area is needed, an orbitozygomatic approach is a better choice. ImagesFigure 2Figure 3 PMID:17167633

  8. [Neuroimaging of Langerhans cell histiocytosis in the central nervous system of children].

    PubMed

    De La Hoz Polo, M; Rebollo Polo, M; Fons Estupiña, C; Muchart López, J; Cruz Martinez, O

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disease characterized by the accumulation within tissues of anomalous dendritic cells similar to Langerhans cells. The clinical presentation varies, ranging from the appearance of a single bone lesion to multisystemic involvement. Central nervous system (CNS) involvement, manifesting as diabetes insipidus secondary to pituitary involvement, has been known since the original description of the disease. Two types of CNS lesions are currently differentiated. The first, pseudotumoral lesions with infiltration by Langerhans cells, most commonly manifests as pituitary infiltration. The second, described more recently, consists of neurodegenerative lesions of the CNS associated with neurologic deterioration. This second type of lesion constitutes a complication of the disease; however, there is no consensus about the cause of this complication. Our objective was to describe the radiologic manifestations of LCH in the CNS in pediatric patients. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  9. Differential effects of amygdala, orbital prefrontal cortex, and prelimbic cortex lesions on goal-directed behavior in rhesus macaques.

    PubMed

    Rhodes, Sarah E V; Murray, Elisabeth A

    2013-02-20

    We assessed the involvement of the orbital prefrontal cortex (PFo), the prelimbic region of the medial prefrontal cortex (PL), and the amygdala in goal-directed behavior. Rhesus monkeys were trained on a task in which two different instrumental responses were linked to two different outcomes. One response, called "tap," required the monkeys to repeatedly touch a colored square on a video monitor to produce one kind of food reward. The other response, called "hold," required persistent contact of an identical stimulus, and it produced a different kind of food reward. After training, we assessed the effects of sensory-specific reinforcer devaluation as a way to probe each monkey's use of goal-directed behavior. In this procedure, monkeys were allowed to consume one of the two foods to satiety and were then tested for tap/hold preference under extinction. Unoperated control monkeys showed a reduction in the response associated with obtaining the devalued food, called the "devaluation effect," a hallmark of goal-directed behavior. Monkeys with bilateral lesions of PFo or the amygdala exhibited significantly reduced devaluation effects. Results from monkeys with PL lesions were equivocal. We conclude that both PFo and the amygdala play a significant role in goal-directed behavior in monkeys. Notably, the findings for PFo challenge the idea that orbital and medial prefrontal regions are exclusively dedicated to object- and action-based processes, respectively.

  10. Differential effects of amygdala, orbital prefrontal cortex and prelimbic cortex lesions on goal-directed behavior in rhesus macaques

    PubMed Central

    Rhodes, Sarah E. V.; Murray, Elisabeth A.

    2013-01-01

    We assessed the involvement of the orbital prefrontal cortex (PFo), the prelimbic region of the medial prefrontal cortex (PL), and the amygdala in goal-directed behavior. Rhesus monkeys were trained on a task in which two different instrumental responses were linked to two different outcomes. One response, called ‘Tap’, required the monkeys to repeatedly touch a colored square on a video monitor, to produce one kind of food reward. The other response, called ‘Hold’, required persistent contact of an identical stimulus, and it produced a different kind of food reward. Following training, we assessed the effects of satiety-specific reinforcer devaluation as a way to probe each monkey’s use of goal-directed behavior. In this procedure, monkeys were allowed to consume one of the two foods to satiety, and were then tested for Tap/Hold preference under extinction. Unoperated control monkeys showed a reduction in the response associated with obtaining the devalued food, called the devaluation effect, a hallmark of goal-directed behavior. Monkeys with bilateral lesions of PFo or the amygdala exhibited significantly reduced devaluation effects. Results from monkeys with PL lesions were equivocal. We conclude that both PFo and the amygdala play a significant role in goal-directed behavior in monkeys. Notably, the findings for PFo challenge the idea that orbital and medial prefrontal regions are exclusively dedicated to object- and action-based processes, respectively. PMID:23426666

  11. Langerhans cell histiocytosis arising from a BCC: a case report and review of the literature.

    PubMed

    Patel, Payal; Talpur, Rakhshandra; Duvic, Madeleine

    2010-06-01

    Langerhans cell histiocytosis (LCH) is a rare disease characterized by a proliferation of Langerhans cells. Several organs may be involved, including the skin, bone, and central nervous system. Adult onset of LCH and solely localized cutaneous involvement are quite uncommon. Langerhans cell histiocytosis has been found in combination with other skin lesions and systemic conditions, but no definitive conclusion exists for this phenomenon. We present a case report of a 63-year-old woman who initially presented with 3 pink papules on her forehead that had developed sequentially within 1 month, all diagnosed by biopsy as basal cell carcinoma (BCC) and appropriately treated. Concurrent with the appearance of the third BCC, the patient began developing crusted ulcerative nodules on her scalp. Biopsy of 1 scalp nodule revealed a BCC, but a repeat biopsy of the same nodule weeks later revealed LCH. Langerhans cell histiocytosis arising from a BCC is extremely rare. No absolute explanation exists regarding the transformation of a BCC into LCH, but understanding the behavior of Langerhans cells may give us better insight into how this process could occur.

  12. Severe periodontal disease manifested in chronic disseminated type of langerhans cell histiocytosis in a 3-year old child.

    PubMed

    Bansal, Monika; Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219.

  13. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child

    PubMed Central

    Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    ABSTRACT% Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219. PMID:25709306

  14. Efficacy of High Frequency Ultrasound in Localization and Characterization of Orbital Lesions.

    PubMed

    Nagaraju, Rashmi M; Gurushankar, G; Bhimarao; Kadakola, Bindushree

    2015-09-01

    The complicated anatomy of orbit and the wide spectrum of pathological conditions present a formidable challenge for early diagnosis, which is critical for management. Ultrasonography provides a detailed cross sectional anatomy of the entire globe with excellent topographic visualization and real time display of the moving organ. To evaluate the efficacy of high frequency Ultrasound in localization of orbital diseases and to characterize various orbital pathologies sonologically. Hundred eyes of 85 patients were examined with ultrasound using linear high frequency probe (5 to 17 MHz) of PHILPS IU22 ultrasound system. Sonological diagnosis was made based on location, acoustic characteristics, kinetic properties and Doppler flow dynamics. Final diagnosis was made based on clinical & laboratory findings/higher cross-sectional imaging/surgery & histopathology (as applicable). Diagnostic accuracy of ultrasonography was evaluated and compared with final diagnosis. The distinction between ocular and extraocular pathologies was made in 100% of cases. The overall sensitivity, specificity, NPV and accuracy of ultrasonography were 94.2%, 98.8%, 92.2% & 94.9% respectively for diagnosis of ocular pathologies and 94.2%, 99.2%, 95.9% & 95.2% respectively for extra ocular pathologies. Ultrasonography is a readily available, simple, cost effective, non ionizing and non invasive modality with overall high diagnostic accuracy in localising and characterising orbital pathologies. It has higher spatial and temporal resolution compared to CT/MRI. However, CT/MRI may be indicated in certain cases for the evaluation of calcifications, bony involvement, extension to adjacent structures and intracranial extension.

  15. Efficacy of High Frequency Ultrasound in Localization and Characterization of Orbital Lesions

    PubMed Central

    Gurushankar, G; Bhimarao; Kadakola, Bindushree

    2015-01-01

    Background The complicated anatomy of orbit and the wide spectrum of pathological conditions present a formidable challenge for early diagnosis, which is critical for management. Ultrasonography provides a detailed cross sectional anatomy of the entire globe with excellent topographic visualization and real time display of the moving organ. Objectives of the study To evaluate the efficacy of high frequency Ultrasound in localization of orbital diseases and to characterize various orbital pathologies sonologically. Materials and Methods Hundred eyes of 85 patients were examined with ultrasound using linear high frequency probe (5 to 17 MHz) of PHILPS IU22 ultrasound system. Sonological diagnosis was made based on location, acoustic characteristics, kinetic properties and Doppler flow dynamics. Final diagnosis was made based on clinical & laboratory findings/higher cross-sectional imaging/surgery & histopathology (as applicable). Diagnostic accuracy of ultrasonography was evaluated and compared with final diagnosis. Results The distinction between ocular and extraocular pathologies was made in 100% of cases. The overall sensitivity, specificity, NPV and accuracy of ultrasonography were 94.2%, 98.8%, 92.2% & 94.9% respectively for diagnosis of ocular pathologies and 94.2%, 99.2%, 95.9% & 95.2% respectively for extra ocular pathologies. Conclusion Ultrasonography is a readily available, simple, cost effective, non ionizing and non invasive modality with overall high diagnostic accuracy in localising and characterising orbital pathologies. It has higher spatial and temporal resolution compared to CT/MRI. However, CT/MRI may be indicated in certain cases for the evaluation of calcifications, bony involvement, extension to adjacent structures and intracranial extension. PMID:26500977

  16. Diagnosis and Intralesional Corticotherapy in Oral Ulcers Occurring as the Sole Manifestation of Langerhans Cell Histiocytosis. A Case Report

    PubMed Central

    Gambirazi, Liane; Libório, Tatiana; Nunes, Fábio; Sugaya, Norberto; Migliari, Dante

    2016-01-01

    This article reports a case of oral mucosa lesions as the sole manifestation in Langerhans cell histiocytosis (LCH). This is a very uncommon manifestation of LCH since this disease preferably affects the bones with frequent involvement of the jaws. LCH may also involve other organs, particularly the lungs, liver, lymph nodes, and skin. The highlights of this report are the differential diagnosis, immunohistochemical analysis and, mostly, the therapeutic approach. PMID:27398106

  17. Langerhans Cell Histiocytosis of the Clavicle in an Adult: A Case Report and Review of the Literature

    PubMed Central

    Udaka, Toru; Susa, Michiro; Kikuta, Kazutaka; Nishimoto, Kazumasa; Horiuchi, Keisuke; Sasaki, Aya; Kameyama, Kaori; Nakamura, Masaya; Matsumoto, Morio; Chiba, Kazuhiro; Morioka, Hideo

    2015-01-01

    Langerhans cell histiocytosis (LCH) usually occurs in children under the age of 10 years with a predilection for the skull, spine, rib and humerus. Solitary LCH occurring in an adult clavicle is uncommon with limited reports to date. The lesion in our patient was curetted with the intent to make a diagnosis, which subsequently lead to the remission of the symptom and the disease. At the final follow-up after 1 year, no local recurrence or metastasis is observed. PMID:26600774

  18. Impact of lesion location on procedural and acute angiographic outcomes in patients with critical limb ischemia treated for peripheral artery disease with orbital atherectomy: A CONFIRM registries subanalysis.

    PubMed

    Lee, Michael S; Mustapha, Jihad; Beasley, Robert; Chopra, Paramjit; Das, Tony; Adams, George L

    2016-02-15

    This analysis compares the procedural and acute angiographic outcomes in patients with critical limb ischemia (CLI) treated with orbital atherectomy in above-the-knee (ATK)/popliteal (POP) lesions versus below-the-knee (BTK) lesions. Lesion location affects the procedural outcomes and the opportunity for limb salvage in patients with CLI suffering from peripheral artery disease (PAD). The CONFIRM registry series was analyzed and includes 1109 real-world patients (1544 lesions) suffering from CLI treated with orbital atherectomy. The rates of dissection, perforation, slow flow, vessel closure, spasm, embolism, and thrombus formation were compared between CLI patients with ATK/POP lesions and BTK lesions. Patients with ATK/POP lesions had a higher final residual stenosis (10 vs. 9%; P = 0.004) and use of more adjunctive therapies (e.g. balloons and stents; 1.3 vs. 1.1%; P < 0.001) compared to patients with BTK lesions. Patients with BTK had higher incidence of perforation (1.5 vs. 0.2%; P = 0.005), slow flow (7.7 vs. 5.0%; P = 0.03) and spasm (10.3 vs. 4.2%; P < 0.001) but lower incidence of embolism (0.4 vs. 5.1%; P < 0.001). Plaque modification with orbital atherectomy was successful in CLI patients regardless of lesion location. BTK lesions were associated with increased rates of perforation, slow flow and spasm which may be explained by more challenging procedural characteristics in these patients such as smaller vessel size and tortuosity. The higher incidence of emboli in ATK/POP lesions is most likely attributed to the higher prevalence of severe calcium observed in this cohort. © 2015 Wiley Periodicals, Inc.

  19. [Secondary biliary cirrhosis in a patient with histiocytosis X].

    PubMed

    Romão, Zita; Pontes, J; Andrade, P; Leitão, M C; Donato, A; Freitas, Diniz

    2002-01-01

    Histiocitose X or Histiocytosis of the Langerhans cells represents a complex spectrum of clinical alterations, resulting from infiltration by anomalous histiocytes of various organs, including the skin, bones, lungs, lymphatic ganglia and liver. Liver disease is rare and the mechanism by which lesions appear is unknown. Cholestasis results from phenomena of sclerosant colangitis, which affects the intrahepatic ducts, or from proliferation of histiocytic cells in the periportal areas. Some patients develop biliar cyrrhosis. The authors present the clinical case of a 62-year-old female patient, hospitalized for chronic cholestasis, diabetes and gallstone in the main bile duct. She had metastatic lesions of the hypophysis and bones, the biopsies of which revealed infiltration by histiocytic cells. Endoscopic Retrograde Colangiopancreatography (E.R.C.P.) revealed dilatation of intrahepatic bile ducts and stenosis of left hepatic duct. A histological study of the hepatic biopsy showed chronic cholestasis and areas of fibrosis, without infiltration by histiocytic granulomas, which were observed in the medular biopsy and in the thyroid nodule cytology.

  20. The presence of cytokines in Langerhans' cell histiocytosis.

    PubMed

    de Graaf, J H; Tamminga, R Y; Dam-Meiring, A; Kamps, W A; Timens, W

    1996-12-01

    Langerhans' cell histiocytosis (LCH) is characterized by an accumulation and/or proliferation of cells with a Langerhans' cell (LC) phenotype. The aetiology and pathogenesis of LCH are unknown; it is suggested that LCH is caused by an immunological dysregulation. Production of cytokines is a central feature of immunological regulation. LCH lesions and normal LCs were studied for the presence of cytokines known to influence the functioning of LCs: IL-1 alpha, IL-1 beta, IL-4, GM-CSF, IFN-gamma, TGF-alpha, TGF-beta, bFGF, and TNF-alpha. Cytokines were abundantly present within LCH lesions; LCH cells stained for IL-1 alpha, IL-1 beta, IL-4, GM-CSF, TGF-alpha, TGF-beta, TNF-alpha, and IFN-gamma. Macrophages, lymphocytes, eosinophil granulocytes, and, surprisingly, multinucleated giant cells were also sources of cytokines. These results suggest that cytokines play a prominent role in the pathogenesis of LCH and may explain phenomena that often occur in LCH, such as osteolysis and fibrosis and the recruitment of typical inflammatory infiltrates. The results also suggest that a 'down-regulatory' signal is lacking in LCH, resulting in an accumulation and/or proliferation of abnormal LCs.

  1. Central nervous system disease in Langerhans cell histiocytosis.

    PubMed Central

    Grois, N.; Tsunematsu, Y.; Barkovich, A. J.; Favara, B. E.

    1994-01-01

    Diabetes insipidus and anterior pituitary dysfunction, are familiar central nervous system (CNS) complications of Langerhans cell histiocytosis (LCH) but the pathophysiology and biological behaviour of other forms of CNS involvement in LCH are poorly understood. In an attempt to improve our understanding of these rare complications, we studied 23 patients with LCH in whom neuroradiological abnormalities, with or without neurological dysfunction other than diabetes insipidus, developed during the course of disease. Neuroradiological abnormalities were of three basic types (a) poorly-defined changes in white matter, (b) well-defined changes in white and grey matter and (c) extra-parenchymal "tumoural" masses. There was a profusion of associated neurological signs and symptoms in most cases but some patients were asymptomatic. The neuropathological features were complex but infiltration of the CNS by histiocytes with xanthomatous change, particularly prominent in mass lesions, was common in the 13 cases in which biopsies were done. Patients with lytic lesions of the skull and diabetes insipidus are evidently most at risk of developing these rare manifestations of LCH. Therapeutic questions could not be answered from this study because no standard treatment had been given and outcome varied widely. Images Figure 7 Figure 1 Figure 2 Figure 3 PMID:8075002

  2. Langerhans cell histiocytosis case with dense metaphyseal band sign.

    PubMed

    Kikkawa, Ichiro; Aihara, Toshinori; Morimoto, Akira; Watanabe, Hideaki; Furukawa, Rieko

    2013-02-01

    Eosinophilic granuloma, a type of Langerhans cell histiocytosis, exhibits a classic vertebral collapse, which is called vertebra plana (Calve's disease) and it manifests as a solitary bony lesion. Vertebra plana can cause severe pain in patients. Bisphosphonates (clodronate, pamidronate and zoledronic acid) have been recently used to treat osteolytic bone lesions of LCH. Zoledronic acid has 100 times relative potency that of pamidronate. We report a case of a 10-year-old girl who had zoledronic acid treatment for severe back pain due to vertebra plana. X-ray photographs of the patient's body showed dense metaphyseal band sign, which can be found in lead poisoning, treated leukemia, healing rickets, recovery from scurvy, vitamin D hypervitaminosis, congenital hypothyroidism and hypoparathyroidism. Increased biological potent zoledronic acid deprived her of severe back pain due to vertebra plana and might cause dense metaphyseal band sign of her skeleton. Conclusion; We have cured the severe back pain of a 10-year-old girl case of eosinophilic granuloma with zoledronic acid. After that treatment, X-ray photographs of the patient's body showed dense metaphyseal band sign. There have been few such cases reported until now.

  3. A case of thymic Langerhans cell histiocytosis with diabetes insipidus as the first presentation.

    PubMed

    Chen, Xiaoyan; Huang, Xiaochun; Qiu, Yuan; Chen, Hanzhang; Fu, Yingyu; Li, Xinchun

    2013-03-01

    Langerhans cell histiocytosis (LCH) is an idiopathic group of reactive proliferative diseases linked to aberrant immunity, pathologically characterized by clonal proliferation of Langerhans cells. LCH rarely involves the thymus. We report a case of thymic LCH with diabetes insipidus as the first presentation, without evidence of myasthenia gravis and without evidenced involvement of the skin, liver, spleen, bones, lungs and superficial lymph nodes. This present case may have important clinical implications. In screening for LCH lesions, attention should be attached to rarely involved sites in addition to commonly involved organs. Follow-up and imageological examination are very important to a final diagnosis.

  4. Primary Langerhans Cell Histiocytosis of the Vulva: Case Report and Review of the Literature.

    PubMed

    Zudaire, Tamara; Guarch, Rosa; Valcayo, Ana; García, Kelly; Resano, Miguel Ángel; Requena, Diego; Rodríguez, Mercedes

    2017-03-01

    Langerhans cell histiocytosis (LCH) of the vulva is rare and even moreso in postmenopausal women. Twenty-six cases of primary vulvar LCH have been described in the current literature, and only 8 cases are in postmenopausal women. We report an additional case of primary vulvar LCH in a 59-yr-old woman with subsequent multiorgan involvement. In this article, we briefly describe the clinical presentation, histopathological findings, and immunohistochemistry results of vulvar LCH. We want to emphasize the importance of recognizing this entity in a woman with vulvar lesions both for the clinician and the pathologist.

  5. IgG4-related disease with cavernous sinus and intra-orbital lesions diagnosed by nasal mucosa biopsy.

    PubMed

    Nakata, Ruka; Yoshimura, Shunsuke; Motomura, Masakatsu; Tsujino, Akira; Hayashi, Tomayoshi; Hara, Minoru

    2016-09-29

    IgG4-related disease is a systemic disease characterized by lesions with IgG4 positive plasma cell infiltration in the involved organs and a raised serum IgG4 level. We report a patient of 70-year-old male presented orbital inflammation of IgG4-related disease. The patient developed right eye pain, double vision, and reduced eye sight. MRI image revealed mild right ocular proptosis and swelling of right carvenous sinus, bilateral intraorbital extraocular muscles and right optic nerve. Right optic nerve showed ring-like enhancement. IgG4-related disease was suspected with increased serum IgG4 level of 355 mg/dl, mediastinal lymphadenopathy and prostate enlargement. Transbronchial lung biopsy and prostate needle biopsy were administered with negative results. The eye related symptoms resolved with time, but serum IgG4 continuously increased. IgG4-related disease was diagnosed by nasal mucosa biopsy, which showed IgG4 positive plasma cells within the inflammatory infiltrate. This report emphasizes the usefulness of nasal mucosa biopsy for the diagnosis of IgG4 related disease with lesions difficult to approach.

  6. Oral manifestations of chronic disseminated histiocytosis. A report of 10 cases.

    PubMed

    Mínguez, Ignacio; Mínguez, Juan Manuel; Bonet, Jaime; Peñarrocha, Miguel; Sanchis, José María

    2004-01-01

    Chronic disseminated histiocytosis is a systemic disorder resulting from tumor proliferation of Langerhans-type histiocytic cells. The etiology and pathogenesis are not fully clear, though the clinical manifestations are the result of the accumulation and infiltration of these types of cells in organs and tissues. The present study reports 10 patients (6 boys and 4 girls) with chronic disseminated histiocytosis. The patient age at onset of the disease varied from 4 months to 3.2 years (mean 1.7 years). All patients had oral lesions, and in 5 cases these were the first manifestation of the disease. The most frequent alterations were gingival bleeding (7 cases), aphthae measuring over 1 cm in diameter (6 cases), maxillary osteolytic lesions (6 cases), tooth loss due to expulsive folliculitis (5 cases), oral candidiasis (4 cases), orofacial swelling (3 cases), aphthae measuring under 1 cm in diameter (3 cases), and nonspecific oral pain (2 cases). All the oral lesions disappeared with the treatments prescribed, though some patients developed new outbreaks and exacerbations of the disease.

  7. Orbital

    NASA Astrophysics Data System (ADS)

    Hanson, Robert M.

    2003-06-01

    ORBITAL requires the following software, which is available for free download from the Internet: Netscape Navigator, version 4.75 or higher, or Microsoft Internet Explorer, version 5.0 or higher; Chime Plug-in, version compatible with your OS and browser (available from MDL).

  8. Liver involvement in Langerhans' cell histiocytosis. Case report.

    PubMed

    Dina, Ion; Copaescu, Catalin; Herlea, Vlad; Wrba, Fritz; Iacobescu, Claudia

    2006-03-01

    Langerhans'cell histiocytosis (Histiocytosis X) is a rare disease of unknown cause characterized by oligoclonal proliferation of Langerhans cells. It occurs mostly in children and young adults and involves one or more body systems such as bone, hypothalamus, posterior pituitary gland, lymph nodes, liver or various soft tissues. The diagnosis is always made by a histological approach. We report a case of Langerhans'cell histiocytosis in a young patient with clinical signs of diabetes insipidus and hepatic involvement in whom the immunohistochemical analysis of the liver tissue led to the definitive diagnosis.

  9. Immunophenotype analysis of malignant histiocytosis of the intestine.

    PubMed Central

    Salter, D M; Krajewski, A S; Dewar, A E

    1986-01-01

    Five cases of malignant histiocytosis of the intestine and one case of true histiocytic lymphoma were studied using immunohistological techniques. In paraffin sections tumour cells in all cases were shown to contain alpha-1-antitrypsin and to express the leucocyte common antigen. Four of the five cases of malignant histiocytosis of the intestine and the case of histiocytic lymphoma expressed the epithelial membrane antigen. Cryostat sections in four cases of malignant histiocytosis of the intestine showed that most tumour cells reacted with anti-T cell monoclonal antibodies. Only a minority expressed a typical monocyte macrophage phenotype. Images PMID:3512610

  10. Thymic Langerhans cell histiocytosis mimicking lymphoma.

    PubMed

    Yağci, Begül; Varan, Ali; Uner, Aysegül; Akyüz, Canan; Büyükpamukçu, Münevver

    2008-12-01

    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by clonal expansion of antigen presenting Langerhans cells. Different clinical features can be seen according to the involved organs and systems. Multisystem disease with organ dysfunction is more common in infants, whereas single system disease is usually observed in older children. The disease can affect any system or organ throughout the body. Thymus is a rarely involvement site reported in LCH and usually is accompanied by skin, bone or lung disease. Here we report a 12-year-old male with thymic involvement by LCH clinically mimicking lymphoma.

  11. Intralymphatic Histiocytosis: A Report of 2 Cases.

    PubMed

    Gómez-Sánchez, M E; Azaña-Defez, J M; Martínez-Martínez, M L; López-Villaescusa, M T

    2017-02-27

    Intralymphatic histiocytosis is a benign condition characterized by poorly defined erythematous plaques (sometimes forming a reticular pattern) as well as the presence of nodules and vesicles. Its etiology and pathogenesis appear to be related to chronic inflammation in the affected area, prior surgery, or systemic disease, particularly rheumatoid arthritis. We report on 2 new cases, both associated with joint surgery in the affected area and osteoarticular disease (primary synovial osteochondromatosis and rheumatoid arthritis). This is a chronic disease and there is no specific treatment. Different treatment options were chosen in the 2 cases described. A spectacular response to treatment with oral pentoxifylline and topical tacrolimus was observed in 1 of the patients.

  12. Liver involvement in Langerhans cell histiocytosis.

    PubMed

    Wong, Adelaine; Ortiz-Neira, Clara L; Reslan, Walid Abou; Sharon, Raphael; Pinto-Rojas, Alfredo; Kaura, Deepak; Anderson, Ronald

    2006-10-01

    Liver involvement in Langerhans cell histiocytosis (LCH) typically presents with hepatomegaly and other signs of liver dysfunction. We present an 11-month-old child having only minimally elevated liver enzymes as an indication of liver involvement. Using sonography as the initial diagnostic tool followed by MRI, LCH of the liver was revealed. A review of sonographic, CT, MRI and MR cholangiopancreatography findings in liver LCH is presented. We recommend that physicians consider sonography and MRI screening for liver involvement in patients with newly diagnosed LCH, as periportal involvement may be present with little or no liver function abnormality present, as in this patient.

  13. Tc 99m bone scan and fluorodeoxyglucose positron emission tomography in evaluation of disseminated langerhans cell histiocytosis

    PubMed Central

    Sager, Sait; Yilmaz, Sabire; Sager, Gunes; Halac, Metin

    2010-01-01

    Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder in which pathological langerhans cells accumulate in a variety of organs. Manifestations may include lung infiltrates, lymph node involvements, bone lesions, hepatic, hematopoietic and endocrine dysfunctions. In this case report we present fluorine-18 positron emission tomography (F-18 PET/CT) and bone scintigraphy findings of a 18-year-old male patient with disseminated LCH, mimicking multiple hypermetabolic metastatic lesions. Clinicians should be aware that LCH infiltrations can be seen as intense uptake and to differentiate infiltrations from other metastatic intense uptake with fluorodeoxyglucose PET/CT and bone scintigraphy, clinical and laboratory findings should be kept in mind. PMID:21713226

  14. Endocrine changes in histiocytosis of the hypothalamic-pituitary axis.

    PubMed

    Toro Galván, Silvia; Planas Vilaseca, Alejandra; Michalopoulou Alevras, Theodora; Torres Díaz, Alberto; Suárez Balaguer, Javier; Villabona Artero, Carles

    2015-02-01

    Histiocytosis is characterized by proliferation of cells from the mononuclear phagocyte system, and may be divided into Langerhans cell histiocytosis (LCH) and non-Langerhans cell histiocytosis (including Erdheim-Chester disease [ECD]). While diabetes insipidus (DI) is the most common hypothalamic-pituitary consequence, anterior pituitary deficiencies are less known. This study analyzed the frequency and progression of pituitary hormone deficiencies and the radiographic findings in 9 patients (7 with LCH and 2 with ECD) with hypothalamic-pituitary (HP) axis. Eighty-nine percent of patients had DI (62% at diagnosis), and 78% had one or more anterior pituitary deficiencies (71% at diagnosis). HP involvement is relatively common in patients diagnosed with histiocytosis and hormone deficiencies may be present at diagnosis or appear gradually during the course of disease. Regular monitoring of these patients is recommended. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  15. Genetics Home Reference: histiocytosis-lymphadenopathy plus syndrome

    MedlinePlus

    ... Histiocytosis-lymphadenopathy plus syndrome (also known as SLC29A3 spectrum disorder) is a group of conditions with overlapping ... considered to be part of the same disease spectrum. While some affected individuals have signs and symptoms ...

  16. Preserved stimulus-reward and reversal learning after selective neonatal orbital frontal areas 11/13 or amygdala lesions in monkeys

    PubMed Central

    Kazama, Andy; Bachevalier, Jocelyne

    2012-01-01

    Neither lesions of orbital frontal (OFC) areas 11/13 nor selective amygdala lesions alter the ability to learn stimulus-reinforcer association and reversal discriminations in adult monkeys. Here, we investigated whether the same conclusion will hold true when the same lesions occur in infancy. Infant rhesus monkeys received sham-operations, neurotoxic amygdala lesions, or aspiration OFC 11/13 lesions at 8–10 days of age and were trained on object discrimination reversal (ODR) tasks. Performance on a single pair (1-pair) ODR was assessed at the age of 3 months and 3 years, and then animals were tested in a 5-pairs ODR task in which they had to concurrently learn and reverse five discrimination problems. The results indicated that the ability to solve a single-pair discrimination problem followed by six reversals appears to be late maturing in monkeys but is spared following selective lesions of either OFC areas 11/13 or amygdala, even with the use of the more challenging 5-object ODR task. Finally, performance in the 1-pair ODR at 3 years was comparable to that following adult-onset lesions, indicating that neither OFC areas 11/13 nor amygdala are critical for the development of reversal learning. PMID:22494813

  17. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report.

    PubMed

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae; Kim, Sang-Ha

    2015-10-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

  18. Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report

    PubMed Central

    Choi, Yeun Seoung; Lim, Jung Soo; Kwon, Woocheol; Jung, Soon-Hee; Park, Il Hwan; Lee, Myoung Kyu; Lee, Won Yeon; Yong, Suk Joong; Lee, Seok Jeong; Jung, Ye-Ryung; Choi, Jiwon; Choi, Ji Sun; Jeong, Joon Taek; Yoo, Jin Sae

    2015-01-01

    Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus. PMID:26508947

  19. Langerhans cell histiocytosis masquerading as acute appendicitis: Case report and review

    PubMed Central

    Karimzada, Mohammad M; Matthews, Michele N; French, Samuel W; DeUgarte, Daniel; Kim, Dennis Y

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare syndrome characterized by unifocal, multifocal unisystem, or disseminated/multi-system disease that commonly involves the bone, skin, lymph nodes, pituitary, or sometimes lung (almost exclusively in smokers) causing a variety of symptoms from rashes and bone lesions to diabetes insipidus or pulmonary infiltrates. We present a previously unreported case of gastrointestinal LCH as well as a novel characteristic lesion affecting the colon of a young woman who presented with signs and symptoms mimicking acute on chronic appendicitis. Immunohistochemical analysis of appendectomy specimen and nodular specimens on colonoscopy demonstrated S-100, CD1a, and langerin reactivity. The patient underwent systemic chemotherapy with cytarabine and demonstrated excellent response to therapy. PMID:28360976

  20. Solitary Langerhans cell histiocytosis of the hard palate: a diagnostic pitfall

    PubMed Central

    Varsha, Dalal; Kaur, Manveen; Chaudhary, Neena; Siraj, Fouzia

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease characterized by an abnormal proliferation of immature dendritic cells. It is predominantly seen in children with adults showing less than ten times the incidence compared to childhood. The clinical presentation and organ involvement is highly variable. Oral manifestations generally consist of mucosal ulceration associated with lesions of the underlying bone. Lesions limited to the oral mucosa are rare. We present a case of a 45-year-old male who presented with an ulcer on the hard palate showing histopathologic features of LCH. The present case is a reminder of the possibility of occurrence of this unusual entity in the oral cavity. Appropriate use of immunohistochemistry is advocated to avoid diagnostic pitfalls. PMID:27703428

  1. Langerhans cell histiocytosis or tuberculosis on a medieval child (Oppidum de la Granède, Millau, France - 10th-11th centuries AD).

    PubMed

    Colombo, Antony; Saint-Pierre, Christophe; Naji, Stephan; Panuel, Michel; Coqueugniot, Hélène; Dutour, Olivier

    2015-06-01

    In 2008, a skeleton of a 1 - 2.5-year-old child radiocarbon dated from the 10th - 11th century AD was discovered on the oppidum of La Granède (Millau, France). It presents multiple cranial osteolytic lesions having punched-out or geographical map-like aspects associated with sequestrum and costal osteitis. A multi 3D digital approach (CT, μCT and virtual reconstruction) enabled us to refine the description and identify the diploic origin of the lytic process. Furthermore, precise observation of the extent of the lesions and associated reorganization of the skeletal micro-structure were possible. From these convergent pieces of evidence, the differential diagnosis led to three possibilities: Langerhans cell histiocytosis, tuberculosis, or Langerhans cell histiocytosis and tuberculosis.

  2. Progressive spinocerebellar degeneration "plus" associated with Langerhans cell histiocytosis: a new paraneoplastic syndrome?

    PubMed Central

    Goldberg-Stern, H; Weitz, R; Zaizov, R; Gornish, M; Gadoth, N

    1995-01-01

    Langerhans cell histiocytosis (LCH), formerly known as histiocytosis-X, manifests by granulomatous lesions consisting of mixed histiocytic and eosinophilic cells. The hallmark of LCH invasion into the CNS is diabetes insipidus, reflecting local infiltration of Langerhans cells into the posterior pituitary or hypothalumus. In five patients who had early onset LCH with no evidence of direct invasion into the CNS, slowly progressive spinocerebellar degeneration accompanied in some by pseudobulbar palsy and intellectual decline was seen. Neurological impairment started 2.5 to seven years after the detection of LCH. No correlation was found between the clinical syndrome and location of LCH or its mode of treatment. An extensive search for metabolic, toxic, neoplastic, and hereditary aetiologies for progressive cerebellar degeneration was negative. It seems that the clinical entity described here may be considered a new paraneoplastic syndrome related to LCH. It may be induced by the eosinophil derived neurotoxin, which was shown to cause damage to Purkinje cells and pyramidal neurons. Images PMID:7876848

  3. [Recurrent infections of the respiratory tract and staphylococcal pneumonia with septic shock and total respiratory failure in a patient with histiocytosis X].

    PubMed

    Wawrzyńska, L; Meleniewska-Maciszewska, A; Burakowski, J

    1994-01-01

    Disseminated pulmonary infiltrates, cutaneous lesions and diabetes insipidus in a female patients with a history of recurrent pneumothorax and persistent respiratory tract infections suggested the diagnosis of histiocytosis X. The pathological examination of a biopsy lung tissue specimen confirmed that diagnosis. In the course of treatment many dangerous complications were observed. The intensive therapy including artificial ventilation (24 days) was fully effective and settle the beneficial clinical outcome.

  4. The effect of orbital prefrontal cortex lesions on performance on a progressive ratio schedule: implications for models of inter-temporal choice.

    PubMed

    Kheramin, S; Body, S; Herrera, F Miranda; Bradshaw, C M; Szabadi, E; Deakin, J F W; Anderson, I M

    2005-01-06

    In a previous experiment [Kheramin S, Body S, Mobini S, Ho M-Y, Velazquez-Martinez DN, Bradshaw CM, et al. Effects of quinolinic acid-induced lesions of the orbital prefrontal cortex on inter-temporal choice: a quantitative analysis. Psychopharmacology 2002;165: 9-17], destruction of the orbital prefrontal cortex (OPFC) in rats altered choice between two delayed food reinforcers, enhancing preference for the larger reinforcer. Theoretical analysis based on a quantitative model of inter-temporal choice [Ho M-Y, Mobini S, Chiang T-J, Bradshaw CM, Szabadi E. Theory and method in the quantitative analysis of 'impulsive choice' behaviour: implications for psychopharmacology. Psychopharmacology 1999;146:362-72] indicated that the lesion had increased the relative value of the larger of the two reinforcers due to a general reduction of absolute reinforcer value. The present experiment tested this hypothesis using a reinforcement schedule that did not entail either explicit choice or delayed reinforcement. Ten rats received quinolinic acid-induced lesions of the OPFC, and ten rats received sham lesions. The rats were trained under a progressive-ratio schedule of food reinforcement for 60 daily sessions. Response rates in successive ratios were a bitonic (inverted-U) function of ratio size. Analysis of the data using a three-parameter equation derived from a quantitative model of ratio schedule performance [Killeen PR. Mathematical principles of reinforcement. Behav. Brain Sci. 1994;17:105-72] revealed that the parameter specifying hypothetical reinforcer value was significantly lower in the OPFC-lesioned group than in the sham-lesioned group, consistent with the hypothesis that destruction of the OPFC resulted in devaluation of the food reinforcer.

  5. A case of adult Langerhans cell histiocytosis showing successfully regenerated osseous tissue of the skull after chemotherapy.

    PubMed

    Suzuki, Takahiro; Izutsu, Koji; Kako, Shinichi; Ohta, Satoshi; Hangaishi, Akira; Kanda, Yoshinobu; Motokura, Toru; Chiba, Shigeru; Kurokawa, Mineo

    2008-04-01

    Langerhans cell histiocytosis (LCH) is a proliferative disorder of Langerhans cells and extremely rare in adults. Adult LCH is often associated with osteolytic bone lesions, but large bone-defective lesions have been rarely reported. We report an adult case of LCH accompanied by large osteolytic lesions in the skull that successfully responded to chemotherapy. A 47-year-old woman with LCH who had multiple, large osteolytic areas of more than 3 cm in diameter in the skull was admitted to our hospital. She was treated with systemic chemotherapy consisting of prednisolone, vinblastine, and 6-mercaptopurine. Twelve months later, when she completed the treatment, osteolytic areas were covered with hard osseous tissue, and X-ray examination confirmed regeneration of the bone. This case indicates that chemotherapy can be effective even for the treatment of large osteolytic lesions in adult LCH patients.

  6. [Langerhans cell histiocytosis with atypical and early neonatal debut].

    PubMed

    García-Rodríguez, Esther; Bernabeu-Wittel, José; Calderón-López, Gemma; Pavón-Delgado, Antonio

    2016-04-01

    Langerhans cell histiocytosis is a systemic disease associated with the proliferation of this type of cells in tissues. Its prevalence is estimated at 1-9/100 000. Bone is the most frequently affected organ, followed by the skin, lymph nodes, haematopoietic system, pituitary gland, lungs and liver. In the majority of cases, onset occurs during childhood, with peak between one and three years of age, and poor prognosis before two years of age. The haematological forms (pancytopenia) are usually aggressive in infants. We report a case of Langerhans cell histiocytosis with neonatal onset and complex diagnosis: maintained and significant leukocytosis was the predominant data for the first two months of life, so some type of leukemia was considered. However, the most common blood disorder in Langerhans cell histiocytosis is pancytopenia rather than leukocytosis, so that the diagnosis was delayed.

  7. [Ischemic eosinophilic granuloma and pulmonary histiocytosis with a regressive course].

    PubMed

    Gérard, R; Keller, A; Taylor, S; Hoffmeyer, P; Peter, R

    2007-09-01

    Langerhans' histiocytosis or histiocytosis X is a rare intrinsically benign disease producing a destructive tumor with a variable clinical presentation and an often unpredictable clinical course. Focal forms such as eosinophilic granuloma of the bone only require minimal care but the gravity of multisystem forms causing organic dysfunction sometimes require aggressive chemotherapy. Bone involvement is generally observed in children mostly boys. Both sporadic and chronic forms are noted. We report a case observed in a 17-year-old adolescent who presented an exceptional association of bony destruction of the pelvis with extended asymptomatic pulmonary involvement. The lung disease led to the initial diagnosis and optimal surgical, pathological and radiological management.

  8. The role of vascular endothelial growth factor in Langerhans cell histiocytosis.

    PubMed

    Dina, Attias; Zahava, Vadasz; Iness, Miselevich

    2005-02-01

    In angiogenesis, new blood vessels are generated from pre-existing ones. It plays a major role in tumor growth and metastasis. The main pro-angiogenic factor is the vascular endothelial growth factor (VEGF). VEGF displays high specificity for vascular endothelial cells and also elicits a pronounced angiogenic response in a variety of in vivo models. VEGF withdrawal has been shown to result in regression of vasculature in tumors. The pathogenic and the angiogenic processes of Langerhans cell histiocytosis (LCH) are not yet clear. The purpose of this study was to investigate the extent of the angiogenic response in LCH tumors. The authors examined tissue sections from LCH patients with single lesion (5 patients) or multisystem disease (5 patients). The preparations were examined by using monoclonal anti-VEGF antibody, CD34, and factor VIII-like antigen. VEGF was expressed in 70% of the cases examined. All the multisystem lesions were positive, as were two of the five single-lesion tumors. LCH cells expressed VEGF. The blood vessel density was significantly higher within the lesion than in normal margins. The findings that VEGF was expressed in LCH cells and that all multisystem lesions were VEGF producers raise the possibility of using anti-angiogenic drugs to treat these patients. Further studies to explore the role of angiogenesis in LCH are warranted.

  9. The potential cost-effectiveness of the Diamondback 360® Coronary Orbital Atherectomy System for treating de novo, severely calcified coronary lesions: an economic modeling approach

    PubMed Central

    Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P.

    2015-01-01

    Background: Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360® Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. Methods and results: In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p < 0.001) lower, approximately US$2700. Estimated mean revascularization costs were lower by US$1240 in the base case. These cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings. Even in the low-value scenario, the use of the OAS is cost-effective with a cost per life-year gained of US$11,895. Conclusions: Based on economic modeling

  10. The potential cost-effectiveness of the Diamondback 360® Coronary Orbital Atherectomy System for treating de novo, severely calcified coronary lesions: an economic modeling approach.

    PubMed

    Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P

    2016-04-01

    Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360(®) Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p < 0.001) lower, approximately US$2700. Estimated mean revascularization costs were lower by US$1240 in the base case. These cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings. Even in the low-value scenario, the use of the OAS is cost-effective with a cost per life-year gained of US$11,895. Based on economic modeling, the recently approved coronary OAS device is

  11. Pineal gland abnormalities in Langerhans cell histiocytosis.

    PubMed

    Grois, N; Prosch, H; Waldhauser, F; Minkov, M; Strasser, G; Steiner, M; Unger, E; Prayer, D

    2004-09-01

    The most common types of central nervous system (CNS) disease in Langerhans cell histiocytosis (LCH) comprise involvement of the hypothalamic-pituitary region (HPR) and neurodegenerative changes in the cerebellum, basal ganglia or pons. In the review process of magnetic resonance images (MRI) from 129 LCH patients a high frequency of cysts within or large pineal glands was noted by chance. To prove whether this observation was specific for LCH or not, we compared MRI findings of the HPR in LCH patients with a control group of 55 non-LCH patients with the same age and sex distribution. In LCH patients, the pineal gland was significantly larger and also the number of pineal cysts was significantly higher as compared to the control group. No difference was found regarding the size or frequency of cystic changes between patients who had received chemotherapy prior to the MRI and untreated patients. In the LCH patients, we further found a significant correlation of pineal gland enlargement with involvement of the HPR, but not with neurodegenerative changes. Analysis of melatonin (the principal hormone of the pineal gland) levels in 24 hr urine in 14 LCH patients did not reveal a melatonin deficiency or overproduction in the LCH group as compared to 6 normal controls. The pineal gland is another site of possible CNS involvement in LCH. LCH CNS patients did not show an overt disturbance in melatonin levels. The role of the pineal gland in CNS LCH remains to be defined. Copyright 2004 Wiley-Liss, Inc.

  12. Malignant histiocytosis. A phenotypic and genotypic investigation.

    PubMed Central

    Cattoretti, G.; Villa, A.; Vezzoni, P.; Giardini, R.; Lombardi, L.; Rilke, F.

    1990-01-01

    Ten cases of malignant histiocytosis (MH) were evaluated for clinical and histopathologic features, phenotype, and rearrangement of T cell receptor (TCR) beta, gamma, and alpha and immunoglobulin (Ig) genes (7/10). All cases were HLA-DR+ and CD30-positive. Four cases had molecular evidence of T cell lineage such as TCR beta, gamma, and alpha rearrangements, and one additional case synthesized the cytoplasmic TCR beta chain. The remaining five cases did not show unequivocal T, B, natural killer (NK) cell, or macrophagic origin, and three of them had germline TCR and Ig genes. Ultrastructural analysis was not helpful for the definition of the cell lineage. Most myelomonocytic markers (MAC387, CD13, CD14, CD64, CD68) were either negative on the MH cells or were expressed on cells with rearranged TCR gene. Precursor (CD34, CD7) and NK (CD16, CD56, and CD57) cell markers were not found. The lineage of a number of cases of MH remains unresolved. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 PMID:2349962

  13. [Histiocytosis X of the jaw. I. Anatomico-clinical study apropos of 61 cases].

    PubMed

    Chomette, G; Auriol, M; Ragot, J P; Guilbert, F

    1987-01-01

    61 cases of histiocytosis X of jaws were reported here. They occurred more often in man (72% of men) than in woman, with an average age of 27 years. The mandible was affected more frequently than the maxilla. Clinically, dental expulsion, gingival swelling, fractures or pain were the usual symptoms. Roentgenographic examination showed either central or peripheral (alveolar bone) osteolytic areas. The histologic diagnosis was easy when eosinophilic polymorphous leukocytes or histiocytes were preponderant. In the other cases, immunohistochemistry (positivity of S-100 protein) and electron microscopy (presence of Birbeck granules about paraffin embedded specimens) were of a great usefulness. The prognosis of the disease was mainly related to the diffusion of lesions to other skeletal portions or extraskeletal localizations (37% of our cases). It has been improved by combination of chemotherapy to surgery (despite of frequent recurrences), 40 upon 45 patients are well after a follow-up of 2 to 10 years after the last localization.

  14. Langerhans cell histiocytosis as a possible differential diagnosis of painful scoliosis.

    PubMed

    Huang, Kuo-Yuan; Lin, Ruey-Mo; Yan, Jing-Jou; Lin, Chii-Jeng

    2007-07-01

    We report on a 5-year 8-month-old boy suffering from spinal Langerhans cell histiocytosis (LCH), who had initial symptoms of back and abdominal pain, as well as tilting of the shoulder that mimicked hemivertebra of T10 with scoliosis, as revealed by radiography. The LCH-involved vertebra did not demonstrate the classic radiographic picture of vertebra plana until the vertebral body symmetrically collapsed about 6 months later, when the patient's scoliosis disappeared. The delayed diagnosis of LCH was confirmed by biopsy after another 6 months. Polyostotic lesions affecting C6, T5, T9-12, and L2 were found. This case represented an unusual presentation of LCH as an early disease entity, which resulted in a misdiagnosis of painful scoliosis. We believe we are the first to report LCH as a differential diagnosis of painful scoliosis.

  15. Pulmonary crystal-storing histiocytosis diagnosed by computed tomography-guided fine-needle aspiration.

    PubMed

    Todd, William U; Drabick, Joseph J; Benninghoff, Michael G; Frauenhoffer, Elizabeth E; Zander, Dani S

    2010-04-01

    Crystal-storing histiocytosis (CSH) is a rare process most often occurring in conjunction with an underlying hematopoietic neoplasm, usually multiple myeloma or low-grade B-cell lymphoma. We report the first case of pulmonary CSH diagnosed by fine-needle aspiration biopsy. A patient with a history of urothelial carcinoma developed a lung nodule, which was evaluated by fine-needle aspiration biopsy. Cytologic examination revealed macrophages with abundant cytoplasmic crystals diagnostic of CSH. Based on this cytologic interpretation, additional clinical laboratory evaluation was pursued and revealed a previously unknown monoclonal serum protein. CSH must be differentiated from other non-neoplastic and neoplastic lesions and when diagnosed, should trigger a search for an underlying lymphoproliferative disorder.

  16. Role of (18)F-FDG PET/CT in patients affected by Langerhans cell histiocytosis.

    PubMed

    Albano, Domenico; Bosio, Giovanni; Giubbini, Raffaele; Bertagna, Francesco

    2017-07-26

    Langerhans cell histiocytosis (LCH) is a rare hematological disorder for which the utility of(18)F-FDG PET/CT is unclear. Our aim was to explore the metabolic features of LCH and the possible role of(18)F-FDG PET/CT in LCH evaluation. We found 17 patients with histologically proven LCH who underwent 17(18)F-FDG PET/CT scans for staging and 42 scans for restaging/follow-up purposes. PET/CT results were compared with those obtained from other conventional imaging modalities (bone scintigraphy, plain radiogram, computed tomography, magnetic resonance). (18)F-FDG PET/CT was positive in 15/17 patients, and it detected 36/37 lesions; all bone and extraskeletal lesions, except for a cecal lesion, were(18)F-FDG-avid. Only 1/4 of the patients with lung LCH had hypermetabolic lesions. The average SUVmax of the FDG-avid lesions was 7.3 ± 6.7, the average lesion-to-liver SUVmax ratio was 3.4 ± 2.5, and the average lesion-to-blood pool SUVmax ratio was 4 ± 3.2. In comparison to other imaging methods,(18)F-FDG PET/CT detected additional lesions or was able to evaluate treatment response earlier in 33/74 cases; it was confirmatory in 38/74 and detected fewer lesions in 3/74 (all three with lung LCH). (18)F-FDG PET/CT seems to be useful for evaluating LCH when compared to conventional imaging, except in pulmonary cases. It can be used both for staging and restaging purposes.

  17. Neonatal lesions of orbital frontal areas 11/13 in monkeys alter goal-directed behavior but spare fear conditioning and safety signal learning.

    PubMed

    Kazama, Andy M; Davis, Michael; Bachevalier, Jocelyne

    2014-01-01

    Recent studies in monkeys have demonstrated that damage to the lateral subfields of orbital frontal cortex (OFC areas 11/13) yields profound changes in flexible modulation of goal-directed behaviors and deficits in fear regulation. Yet, little consideration has been placed on its role in emotional and social development throughout life. The current study investigated the effects of neonatal lesions of the OFC on the flexible modulation of goal-directed behaviors and fear responses in monkeys. Infant monkeys received neonatal lesions of OFC areas 11/13 or sham-lesions during the first post-natal week. Modulation of goal-directed behaviors was measured with a devaluation task at 3-4 and 6-7 years. Modulation of fear reactivity by safety signals was assessed with the AX+/BX- fear-potentiated-startle paradigm at 6-7 years. Similar to adult-onset OFC lesions, selective neonatal lesions of OFC areas 11/13 yielded a failure to modulate behavioral responses guided by changes in reward value, but spared the ability to modulate fear responses in the presence of safety signals. These results suggest that these areas play a critical role in the development of behavioral adaptation during goal-directed behaviors, but not or less so, in the development of the ability to process emotionally salient stimuli and to modulate emotional reactivity using environmental contexts, which could be supported by other OFC subfields, such as the most ventromedial subfields (i.e., areas 14/25). Given similar impaired decision-making abilities and spared modulation of fear after both neonatal lesions of either OFC areas 11 and 13 or amygdala (Kazama et al., 2012; Kazama and Bachevalier, 2013), the present results suggest that interactions between these two neural structures play a critical role in the development of behavioral adaptation; an ability essential for the self-regulation of emotion and behavior that assures the maintenance of successful social relationships.

  18. Periodontal disease associated with Langerhans' cell histiocytosis: case report.

    PubMed

    Rapp, G E; Motta, A C

    2000-01-01

    A clinical case of Langerhans' cell histiocytosis, type eosinophilic granuloma, in a young adult patient is presented. Because of the occurrence of oral manifestations in initial stages of the disease, there is a need for a differential diagnosis, especially with the early-onset periodontitis.

  19. Pulmonary Langerhans' cell histiocytosis: radiologic resolution following smoking cessation.

    PubMed

    Mogulkoc, N; Veral, A; Bishop, P W; Bayindir, U; Pickering, C A; Egan, J J

    1999-05-01

    We describe two patients with histologically proven pulmonary Langerhans' cell histiocytosis in whom radiologic improvement occurred following smoking cessation. The patients had 23- and 25-pack-year smoking histories, respectively. High-resolution CT revealed multiple small nodules, located predominantly in the upper and middle lung fields. There was a close temporal relationship between smoking cessation and radiologic improvement.

  20. Localized Langerhans cell histiocytosis masquerading as Brodie's abscess in a 2-year-old child: a case report

    PubMed Central

    Chang, Wei-Fang; Hsu, Yi-Chih; Wu, Yi-Der; Kuo, Chun-Lang; Huang, Guo-Shu

    2016-01-01

    Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, refers to a spectrum of diseases characterized by idiopathic proliferation of histiocytes that produce either focal (localized LCH) or systemic manifestations (Hand-Schüller-Christian disease and Letterer-Siwe disease). Localized LCH accounts for approximately 60-70 % of all LCH cases. Osseous involvement is the most common manifestation and typically involves the flat bones, along with lesions of the skull, pelvis, and ribs. Localized LCH in bone shows a wide spectrum of clinical manifestations and radiologic features that may mimic those of infections as well as benign and malignant tumors. The diagnostic imaging findings of localized LCH are also diverse and challenging. The penumbra sign is a common and characteristic magnetic resonance imaging (MRI) feature of Brodie's abscess, but is rarely seen in localized LCH. In this report, we describe a case of localized LCH misdiagnosed as Brodie's abscess in a 2-year-old child based on clinical symptoms, laboratory findings, and pre-diagnostic MRI findings (penumbra sign). Therefore, the penumbra sign is not sufficient to clearly establish the diagnosis of Brodie's abscess, and the differential diagnosis of localized LCH should be considered when a child with an osteolytic lesion presents with a penumbra sign. PMID:27065773

  1. [Erdheim-Chester disease: a non-Langerhans cell histiocytosis. A clinical-case and review of the literature].

    PubMed

    Valentini, D; Cappelli, C; Mizzoni, F; Noto, C; Toscano, D; Foco, M; Trasimeni, G

    2004-05-01

    We make a retrospective evaluation of clinical and radiologic features, treatment, and outcome of Erdheim-Chester disease, a rare non-Langerhans cell histiocytosis. We report a case of Erdheim-Chester disease and review 60 cases from the literature. These cases are consider to have Erdheim-Chester disease when they have either typical bone radiographs (symmetrical long bones osteosclerosis) and/or histologic criteria disclosing histiocytic infiltration with distinctive immunohistochemical phenotype of the non-Langerhans cell histiocytes with positive staining for CD68 and negative staining for S-100 protein and CD1a. Our patient undergoes chemiotherapy according to the LCH-II stratification and therapy plan (Vinblastine, Etoposide and Prednisone) and thereafter receives Carboplatin and Etoposide, and Somatostatin. She is alive and clinically well 33 months after onset of symptoms and the lesions don't appear to progress at imaging examinations. In conclusion, Erdheim-Chester disease may be confused with Langerhans cell histiocytosis as it sometimes shares the same clinical (exophthalmos, diabetes insipidus) or radiologic (osteolytic lesions) findings. However, the characteristics radiological pattern of Erdheim-Chester disease together the immunohistochemical phenotype of hystiocytic infiltration supports the theory that Erdheim-Chester disease is a unique disease entity distinct.

  2. [A disseminated form of Langerhans histiocytosis associated with diabetes insipidus and diabetes mellitus].

    PubMed

    Ben Ghorbel, I; Houman, M H; B'chir, S; Chamakhi, S; Miled, M

    2001-05-01

    Langerhans' cell histiocytosis is a rare disorder of unknown etiology characterized by a wide clinical spectrum and varied behavior. Diabetes insipidus is a relatively common feature in Langerhans' cell histiocytosis. The presence of both diabetes insipidus and mellitus associated with histiocytosis in an adult is rare. To our knowledge, only three previous cases have been reported. We report the clinical presentation, pathologic findings and clinical progress in an adult female who had disseminated Langerhans' cell histiocytosis (hypothalamic infiltration, multifocal bone involvement) associated with both diabetes insipidus and mellitus. The pathogenesis of diabetes mellitus in such an association will be discussed.

  3. Selective aspiration or neurotoxic lesions of orbital frontal areas 11 and 13 spared monkeys’ performance on the object discrimination reversal task

    PubMed Central

    Kazama, Andy; Bachevalier, Jocelyne

    2009-01-01

    Damage to the orbital frontal cortex (OFC) has long been associated with reversal learning deficits in several species. In monkeys, this impairment follows lesions that include several OFC subfields. However, the different connectional patterns of OFC subfields together with neuroimaging data in humans have suggested that specific OFC areas play distinctive roles in processing information necessary to guide behavior (Kringelbach and Rolls, 2004; Barbas, 2007; Price, 2007). More specifically, areas 11 and 13 contribute to a sensory network, whereas medial areas 10, 14, and 25 are heavily connected to a visceromotor network. To examine the contribution of areas 11 and 13 to reversal learning, we tested monkeys with selective damage to these two OFC areas on two versions of the ODR task using either 1 or 5 discrimination problems. We compared their performance with that of sham-operated controls and of animals with neurotoxic amygdala lesions, which served as operated controls. Neither damage to areas 11 and 13 nor damage to the amygdala affected performance on the ODR tasks. The results indicate that areas 11 and 13 do not critically contribute to reversal learning and that adjacent damage to OFC subfields (10, 12, 14 and 25) could account for the ODR deficits found in earlier lesion studies. This sparing of reversal learning will be discussed in relation to deficits found in the same animals on tasks that measure behavioral modulation when relative value of affective (positive and negative) stimuli was manipulated. PMID:19261875

  4. Selective aspiration or neurotoxic lesions of orbital frontal areas 11 and 13 spared monkeys' performance on the object discrimination reversal task.

    PubMed

    Kazama, Andy; Bachevalier, Jocelyne

    2009-03-04

    Damage to the orbital frontal cortex (OFC) has long been associated with reversal learning deficits in several species. In monkeys, this impairment follows lesions that include several OFC subfields. However, the different connectional patterns of OFC subfields together with neuroimaging data in humans have suggested that specific OFC areas play distinctive roles in processing information necessary to guide behavior (Kringelbach and Rolls, 2004; Barbas, 2007; Price, 2007). More specifically, areas 11 and 13 contribute to a sensory network, whereas medial areas 10, 14, and 25 are heavily connected to a visceromotor network. To examine the contribution of areas 11 and 13 to reversal learning, we tested monkeys with selective damage to these two OFC areas on two versions of the ODR task using either one or five discrimination problems. We compared their performance with that of sham-operated controls and of animals with neurotoxic amygdala lesions, which served as operated controls. Neither damage to areas 11 and 13 nor damage to the amygdala affected performance on the ODR tasks. The results indicate that areas 11 and 13 do not critically contribute to reversal learning and that adjacent damage to OFC subfields (10, 12, 14, and 25) could account for the ODR deficits found in earlier lesion studies. This sparing of reversal learning will be discussed in relation to deficits found in the same animals on tasks that measure behavioral modulation when relative value of affective (positive and negative) stimuli was manipulated.

  5. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus.

    PubMed

    Gordon, Michael S; Gordon, Murray B

    2016-01-01

    Etiologies of a thickened stalk include inflammatory, neoplastic, and idiopathic origins, and the underlying diagnosis may remain occult. We report a patient with a thickened pituitary stalk (TPS) and papillary thyroid carcinoma (PTC) whose diagnosis remained obscure until a skin lesion appeared. The patient presented with PTC, status postthyroidectomy, and I(131) therapy. PTC molecular testing revealed BRAF mutant (V600E, GTC>GAG). She had a 5-year history of polyuria/polydipsia. Overnight dehydration study confirmed diabetes insipidus (DI). MRI revealed TPS with loss of the posterior pituitary bright spot. Evaluation showed hypogonadotropic hypogonadism and low IGF-1. Chest X-ray and ACE levels were normal. Radiographs to evaluate for extrapituitary sites of Langerhans Cell Histiocytosis (LCH) were unremarkable. Germinoma studies were negative: normal serum and CSF beta-hCG, alpha-fetoprotein, and CEA. Three years later, the patient developed vulvar labial lesions followed by inguinal region skin lesions, biopsy of which revealed LCH. Reanalysis of thyroid pathology was consistent with concurrent LCH, PTC, and Hashimoto's thyroiditis within the thyroid. This case illustrates that one must be vigilant for extrapituitary manifestations of systemic diseases to diagnose the etiology of TPS. An activating mutation of the protooncogene BRAF is a potential unifying etiology of both PTC and LCH.

  6. An 'eruptive' variant of juvenile xanthogranuloma associated with langerhans cell histiocytosis.

    PubMed

    Tran, Don T; Wolgamot, Gregory M; Olerud, John; Hurst, Stan; Argenyi, Zsolt

    2008-10-01

    The development of juvenile xanthogranuloma (JXG) as a sequel to langerhans cell histiocytosis (LCH) treated with chemotherapy is rare and the hypothesis is intriguing. This is a case of a 19-year-old woman who presented with progressive development of tan-red papules on the axilla and eyelids over a 1.5-year time span. A biopsy of an axillary lesion showed a prominent dermal infiltrate of foamy histiocytoid cells with occasional Touton-type multinucleate giant cells, consistent with JXG. Three years later, the patient presented with additional similar papules on the axilla and vulva as well as a painful mass in the pelvic bone and diabetes insipidus with an associated pituitary mass. An iliac crest bone biopsy showed an eosinophil-rich infiltrate admixed with histiocytoid cells with reniform nuclei, which expressed S100 and CD1a, consistent with a diagnosis of LCH. Nonetheless, an additional axillary papule was once again consistent with JXG, with negative reaction for S100 and CD1a with no Birbeck granules by electron microscopy. This case is unique by the co-existing presentation of multiple cutaneous JXG lesions and internally confined LCH lesions without an apparently associated chemotherapy, corroborating the concept that JXG and LCH may share a common histogenesis.

  7. Langerhans cell histiocytosis: literature review and descriptive analysis of oral manifestations.

    PubMed

    Madrigal-Martínez-Pereda, Cristina; Guerrero-Rodríguez, Vanesa; Guisado-Moya, Blanca; Meniz-García, Cristina

    2009-05-01

    Langerhans cell histiocytosis (LCH) is a rare disease, of unknown pathogenesis, characterized by intense and abnormal proliferation of bone marrow-derived histiocytes (Langerhans cells). It can present both local and systemic manifestations involving bone, skin and mucosal tissue, and internal organs. Three basic clinical forms develop: Letterer-Siwe disease (subacute or acute disseminated form), Hand-Schüller-Christian disease (disseminated chronic form) and eosinophilic granuloma (localized chronic form). LCH may manifest orally with single or multiple lesions of the alveolar or basal bone, ulcerated mucosal lesions accompanied by adenopathies and/or periodontal lesions, presenting gingival inflammation, bleeding, recession, necrosis, odontalgia, dental hypermobility and premature loss of teeth. The principal differential diagnoses include advanced periodontal disease or a periapical process of dental or periodontal origin. The odontologist plays a vital role in the diagnosis and multidisciplinary treatment of such patients, by performing routine examinations for periodic follow-up of the disease and its possible oral manifestations, bearing in mind that these may be the first or only signs of LCH.

  8. Langerhans' cell histiocytosis involving posterior elements of the dorsal spine: An unusual cause of extradural spinal mass in an adult.

    PubMed

    Tyagi, Devendra K; Balasubramaniam, Srikant; Savant, Hemant V

    2011-07-01

    Langerhans cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells occurring as an isolated lesion or as part of a systemic proliferation. It is commoner in children younger than 10 years of age with sparing of the posterior elements in more than 95% of cases. We describe a case of LCH in an adult female presenting with paraplegia. MRI revealed a well-defined extradural contrast enhancing mass at D2-D4 vertebral level involving the posterior elements of spine. D2-5 laminectomy with excision of lesion was performed which lead to marked improvement of patients neurological status. Histopathology was suggestive of eosinophilic granuloma. We describe the case, discuss its uniqueness and review the literature on this rare tumor presentation.

  9. Langerhans’ cell histiocytosis involving posterior elements of the dorsal spine: An unusual cause of extradural spinal mass in an adult

    PubMed Central

    Tyagi, Devendra K.; Balasubramaniam, Srikant; Savant, Hemant V.

    2011-01-01

    Langerhans cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells occurring as an isolated lesion or as part of a systemic proliferation. It is commoner in children younger than 10 years of age with sparing of the posterior elements in more than 95% of cases. We describe a case of LCH in an adult female presenting with paraplegia. MRI revealed a well-defined extradural contrast enhancing mass at D2-D4 vertebral level involving the posterior elements of spine. D2-5 laminectomy with excision of lesion was performed which lead to marked improvement of patients neurological status. Histopathology was suggestive of eosinophilic granuloma. We describe the case, discuss its uniqueness and review the literature on this rare tumor presentation. PMID:23125497

  10. Strategies for the Prevention of Central Nervous System Complications in Patients with Langerhans Cell Histiocytosis: The Problem of Neurodegenerative Syndrome.

    PubMed

    Imashuku, Shinsaku; Arceci, Robert J

    2015-10-01

    Diseases of the central nervous system (CNS) are common in patients with Langerhans cell histiocytosis (LCH). Besides active LCH lesions, neurodegenerative (ND) lesions of the cerebellum and/or basal ganglia may occur as late sequelae of LCH. While the etiology of this ND disease remains unclear, biomarkers in cerebrospinal fluid (CSF) may reflect the activity of CNS disease in these patients. However, no well-planned CSF studies have yet been performed in patients at high risk for ND-CNS-LCH. Potential parallels with other neuroinflammatory/neurodegenerative disease suggest the utility of examining these other disorders in establishing strategies for the prevention and/or treatment of ND-CNS-LCH.

  11. Canine cutaneous histiocytoma is an epidermotropic Langerhans cell histiocytosis that expresses CD1 and specific beta 2-integrin molecules.

    PubMed Central

    Moore, P. F.; Schrenzel, M. D.; Affolter, V. K.; Olivry, T.; Naydan, D.

    1996-01-01

    Canine cutaneous histiocytoma (CCH) is a common, benign neoplasm of the dog. Histiocytomas most commonly occur as solitary lesions that undergo spontaneous regression. The age-specific incidence rate for histiocytomas drops precipitously after 3 years, although histiocytomas occur in dogs of all ages. Langerhans cells (LCs) in humans and dogs express abundant major histocompatibility complex class II molecules and a variety of leukocyte antigens characteristic of dendritic cell differentiation including CD1a, CD1b, CD1c, and CD11c. The immunophenotype of CCH resembled that of cutaneous LCs by virtue of the expression of CD1 molecules (CD1a, -b, and -c), CD11c, and major histocompatibility complex class II. Furthermore, histiocytoma cells had a tropism for epidermis, which was also consistent with an epidermal LC lineage. The expression of adhesion molecules such as CD11b (variable), CD44, CD54 (ICAM-1), and CD49d (VLA-4) in CCH indicated that the infiltrating cells had some of the characteristics of activated LCs, as these molecules are not expressed by normal, resting canine epidermal LCs. CCH did not express Thy-1 or CD4. Thy-1 expression is a characteristic of human and canine dermal dendrocytes, which are perivascular dendritic antigen-presenting cells closely related to epidermal LCs. CD4 expression is prevalent in human LC histiocytosis, and in this respect CCH differed from human LC histiocytosis. Here we demonstrate that CCH is a localized form of self-limiting LC histiocytosis, which predominantly expresses an epidermal LC phenotype. CCH occurs as solitary or, less commonly, as multiple cutaneous nodules or plaques, which rarely may extend beyond the skin to local lymph nodes. Regression of CCH occurs spontaneously in the vast majority of cases in primary and secondary sites, and is mediated by CD8+ alpha beta T cells. The high frequency of CCH within the general canine population offers the potential that the dog may provide an interesting model system to

  12. New insights in lymphangioleiomyomatosis and pulmonary Langerhans cell histiocytosis.

    PubMed

    Torre, Olga; Elia, Davide; Caminati, Antonella; Harari, Sergio

    2017-09-30

    Lymphangioleiomyomatosis (LAM) and pulmonary Langerhans cell histiocytosis (PLCH) are rare diseases that lead to progressive cystic destruction of the lungs. Despite their distinctive characteristics, these diseases share several features. Patients affected by LAM or PLCH have similar radiological cystic patterns, a similar age of onset, and the possibility of extrapulmonary involvement. In this review, the recent advances in the understanding of the molecular pathogenesis, as well as the current and most promising biomarkers and therapeutic approaches, are described. Copyright ©ERS 2017.

  13. Malignant histiocytosis in a Bernese mountain dog presenting as a mandibular mass.

    PubMed Central

    Carioto, L

    1997-01-01

    A Bernese mountain dog was evaluated because of a gingival mass, multiple abdominal masses, and a pulmonary mass. Malignant histiocytosis was diagnosed based on cytological examination of splenic and bone marrow aspirates and histological examination of a bone marrow biopsy and the gingival mass. The case demonstrates that malignant histiocytosis is difficult to diagnose due to the variety of histiocytic disorders. PMID:9028594

  14. Late-Onset Langerhans Cell Histiocytosis with Cerebellar Ataxia as an Initial Symptom

    PubMed Central

    Pyun, Jung-Min; Park, Hyeyoung; Moon, Kyung Chul; Jeon, Beomseok

    2016-01-01

    Late-onset progressive cerebellar ataxia is a diagnostic challenge because of a poor correlation between genotype and phenotype, and a broad range of secondary causes that extend beyond the neurological field. We report the case of a 45-year-old woman admitted after 2 years of slowly progressing cerebellar ataxia, dysarthria, and emotional instability. Notably, she was diagnosed with diabetes insipidus at the age of 35. As ‘idiopathic cerebellar ataxia’ was suspected, diagnostic tests, including genetic testing as well as serum and cerebrospinal fluid analyses, and brain magnetic resonance imaging (MRI) were performed. All results were normal except those of MRI, performed 9 months prior to admission, which showed multiple dot-like white matter lesions with unclear cause. On a repeated brain MRI, a new lesion presenting as a 1.5-cm-sized highly enhancing mass attached to the right frontal skull was found. A sharply marginated lytic skull defect was also evident on skull X-ray, which corresponded to the lesion mass. Given these new radiological findings, a systemic review of the patient's medical history for rare secondary causes of cerebellar ataxia was performed, with particular attention to her past ‘diabetes insipidus’. The mass, lytic lesion of the skull, white matter lesion, diabetes insipidus, and cerebellar ataxia all suggested a final diagnosis of Langerhans cell histiocytosis (LCH), which was confirmed histopathologically. This is a rare case of late-onset LCH with an unusual initial symptom which underlines the importance of carefully reviewing the patient's medical history and broadening the search for etiologies beyond the nervous system. PMID:27920713

  15. Langerhans Cell Histiocytosis Mimicking Periapical Pathology in a 39-Year-Old Man.

    PubMed

    Peters, Scott M; Pastagia, Julie; Yoon, Angela J; Philipone, Elizabeth M

    2017-08-29

    Langerhans cell histiocytosis (LCH) is a clonal neoplastic proliferation of Langerhans-type dendritic cells, with more than 50% of cases of LCH seen in children younger than 15 years of age. The most common clinical presentation of LCH is solitary or multiple bony lesions. The jaws are affected in approximately 10%-20% of cases, with a strong predilection for the mandible. The maxilla is involved in only 1% of head and neck cases. When the jaws are involved, lesions of LCH may mimic periapical pathology as seen in patients requiring endodontic therapy or bone loss as seen in periodontal disease. We report the case of a 39-year-old man with LCH involving the posterior maxilla. This is a rare presentation of LCH with respect to both location and patient age. Clinicians should consider LCH when developing a differential diagnosis of an apical radiolucency of vital teeth or teeth that fail to respond to endodontic therapy and be aware of its clinical and radiographic mimics. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. Adult multisystem langerhans cell histiocytosis presenting with central diabetes insipidus successfully treated with chemotherapy.

    PubMed

    Choi, Jung-Eun; Lee, Hae Ri; Ohn, Jung Hun; Moon, Min Kyong; Park, Juri; Lee, Seong Jin; Choi, Moon-Gi; Yoo, Hyung Joon; Kim, Jung Han; Hong, Eun-Gyoung

    2014-09-01

    We report the rare case of an adult who was diagnosed with recurrent multisystem Langerhans cell histiocytosis (LCH) involving the pituitary stalk and lung who present with central diabetes insipidus and was successfully treated with systemic steroids and chemotherapy. A 49-year-old man visited our hospital due to symptoms of polydipsia and polyuria that started 1 month prior. Two years prior to presentation, he underwent excision of right 6th and 7th rib lesions for the osteolytic lesion and chest pain, which were later confirmed to be LCH on pathology. After admission, the water deprivation test was done and the result indicated that he had central diabetes insipidus. Sella magnetic resonance imaging showed a mass on the pituitary stalk with loss of normal bright spot at the posterior lobe of the pituitary. Multiple patchy infiltrations were detected in both lung fields by computed tomography (CT). He was diagnosed with recurrent LCH and was subsequently treated with inhaled desmopressin, systemic steroids, vinblastine, and mercaptopurine. The pituitary mass disappeared after two months and both lungs were clear on chest CT after 11 months. Although clinical remission in multisystem LCH in adults is reportedly rare, our case of adult-onset multisystem LCH was treated successfully with systemic chemotherapy using prednisolone, vinblastine, and 6-mercaptopurine, which was well tolerated.

  17. Immunohistochemical detection of the apoptosis-related proteins FADD, FLICE, and FLIP in Langerhans cell histiocytosis.

    PubMed

    Bank, Micha I; Gudbrand, Charlotte; Rengtved, Pia; Carstensen, Henrik; Fadeel, Bengt; Henter, Jan-Inge; Petersen, Bodil Laub

    2005-06-01

    Langerhans cell histiocytosis (LCH) is characterized by an accumulation of dendritic Langerhans cells in granulomatous lesions in various organs. The etiology of LCH remains enigmatic. Fas/APO-1/CD95 belongs to the "death receptor" family of apoptosis regulators and has been implicated in the downregulation of immune responses. The authors examined the expression of three proteins that are engaged in the Fas signaling cascade-FADD/Fas-associated death domain-containing protein, FLICE/FADD-like interleukin-1beta-converting enzyme (both pro-apoptotic), and FLIP/FLICE-inhibitory protein (anti-apoptotic)-in lesions from LCH patients. Immunohistochemistry was performed on paraffin-embedded tissue specimens from 43 children with LCH. The infiltrates were scored according to the amount of positive pathologic Langerhans cells (pLCs). In all investigated specimens, the majority of the pLCs expressed FADD, active FLICE, and FLIP. The clinical outcome of the disease could not be correlated to the expression of the investigated proteins. This study shows a high expression of the apoptosis-related proteins FADD, active FLICE, and FLIP in pLCs. The authors previously showed that pLCs express Fas and Fas ligand. Taken together, these findings suggest that the Fas signaling pathway may be involved in the pathogenesis of LCH.

  18. Central precocious puberty in multisystem Langerhans cell histiocytosis: a case report.

    PubMed

    Municchi, G; Marconcini, S; D'Ambrosio, A; Berardi, R; Acquaviva, A

    2002-06-01

    The authors describe a girl with multisystem Langerhans cell histiocytosis (LCH) who developed central precocious puberty (CPP). At the age of 19 months she presented with otorrhea and polypoid formations in the ear canal; polyps were removed and LCH suspected. She subsequently developed diabetes insipidus with a documented lesion of the pituitary stalk; she received chemotherapy and began therapy with l-desamino-8-D-argininevasopressin. Growth hormone deficiency was diagnosed at the age of 4.4 years and GH replacement therapy started. The patient has been off therapy for LCH since the age of 6. Signs of pubertal development appeared at 7.5 years (bone age 8 years) and gonadotropin-releasing hormone analog (GnRHa) treatment was started. During the observation period she developed central hypothyroidism. Development of CPP during LCH is extremely rare; to the authors 'knowledge, no patient has been described so far. The authors believe that CPP was secondary to LCH and did not represent a casual finding, even in the absence of hypothalamic-pituitary axis involvement. The presence of preceding lesions producing excessive cytokine levels, with damage on the neurosecretory apparatus that inhibits the GnRH pulse generator, represents the most intriguing hypothesis. The possibility of CPP development should be considered during the follow-up of these patients.

  19. Congenital "self-healing" Langerhans cell histiocytosis (Hashimoto-Pritzker disease): a report of two cases with the same cutaneous manifestations but different clinical course.

    PubMed

    Mandel, Victor Desmond; Ferrari, Chiara; Cesinaro, Anna Maria; Pellacani, Giovanni; Del Forno, Corrado

    2014-12-01

    Congenital self-healing Langerhans cell histiocytosis or Hashimoto-Pritzker disease is a rare condition present at birth or in the neonatal period characterized by small reddish-brown crusted papulonodular lesions. In most cases these lesions are not accompanied by systemic findings and tend to involute spontaneously within weeks or months, but in other cases there may be extracutaneous involvement and/or recurrence of the disease. This emphasizes that the clinical course is variable and a long-term follow-up is mandatory in order to reveal possible systemic involvement. We describe two cases of congenital self-healing Langerhans cell histiocytosis with widespread and very similar cutaneous manifestations but different clinical course. The first patient had multisystemic disease (with lymph nodes, bones, liver and lungs affected) that required systemic therapy. The second patient had cutaneous and bony lesions that resolved spontaneously. We think that the adjective "self-healing" is misleading and should be abandoned. We stress the importance of a complete systemic evaluation and the necessity of a long-term follow-up. © 2014 Japanese Dermatological Association.

  20. [Langerhans cell histiocytosis presenting as isolated adenitis in an infant: case report].

    PubMed

    Soriano-Ramos, María; Salcedo Lobato, Enrique; Baro Fernández, María; Blázquez-Gamero, Daniel

    2016-08-01

    Langerhans cell histiocytosis in infants is a rare condition, and presentation as an isolated cervical adenitis is exceptional at this age. We describe the case of a 3-month-old female infant presenting with a neck mass in the right mandibular angle with poor response to antibiotic treatment. Fine needle aspiration was performed and confirmed the diagnosis of Langerhans cell histiocytosis with complementary tests showing no features of systemic involvement. Langerhans cell histiocytosis should be considered in the differential diagnosis of subacute neck masses with poor outcome in infants and physicians should consider performing a fine needle aspiration to establish the diagnosis.

  1. Langerhans cell histiocytosis presenting as hypothyroid goitre: a unique presentation.

    PubMed

    Marupudi, Krishna Chaitanya; Karanth, Suman S; Thomas, Joseph

    2014-12-02

    Langerhans cell histiocytosis (LCH) is a disease involving the antigen presenting cells, which can range from a single system involvement with an indolent course to a multisystem disease with increased morbidity. We present a rare case of LCH presenting as hypothyroid goitre that was successfully treated as per the LCH III trial protocol with a combination of vinblastine and oral prednisolone. We highlight the need for awareness of this rare presentation of LCH as a painless goitre which is often misdiagnosed as poorly differentiated thyroid carcinoma or overlooked as a benign disease.

  2. Viruses and Langerhans cell histiocytosis: is there a link?

    PubMed Central

    McClain, K.; Weiss, R. A.

    1994-01-01

    As a rare, sporadic disease Langerhans cell histiocytosis (LCH) presents a difficult problem in defining a likely etiology. Epidemiological data would not a priori lead one to choose a viral etiology. However, there are rare tumours which occur as sequelae of common infections from Epstein-Barr virus or human papilloma viruses. Likewise some viruses can cause cells to elaborate cytokines which could ultimately stimulate Langerhans cell growth. There is only a small amount of experimental data testing the hypothesis that viruses might be associated with LCH. The theoretical constructs surrounding this question and new data refuting the association are summarised. PMID:8075003

  3. Ultrasonographic features of Langerhans cell histiocytosis of the thyroid

    PubMed Central

    Chen, En-Dong; Cheng, Pu; Cai, Ye-Feng; Xiang, Ying-Ying; Zheng, Hua-Min; Xing, Hai-Xia; Li, Quan

    2014-01-01

    Langerhans cell histiocytosis (LCH) is a rare disease, especially when it involves the thyroid gland. Awareness of ultrasonic features will be helpful for a clinician who should consider this disease in the differential diagnosis from other more common thyroid disorders, especially prior to surgery. Here, we report two patients who have histologically confirmed LCH of the thyroid and summarize the reported cases with ultrasonographic scans from the last 10 years (n=10). Ultrasonograms showed isolated or multiple hypoechoic nodules in unilateral or bilateral thyroid gland. Internal acoustic features of most nodules was heterogeneous (n=5) or hypoechoic (n=2). PMID:24696742

  4. Clinical outcomes of radiation therapy in the management of Langerhans cell histiocytosis.

    PubMed

    Kotecha, Rupesh; Venkatramani, Rajkumar; Jubran, Rima F; Arkader, Alexandre; Olch, Arthur J; Wong, Kenneth

    2014-12-01

    Langerhans cell histiocytosis (LCH) is a rare disease with variable clinical presentation. In the present study, we report on the effectiveness and clinical complications of radiation therapy in children with LCH. We retrospectively reviewed all patients with LCH treated with radiation therapy over a 6-decade period at a single institution. Radiotherapy data, clinical features, radiographic data, and vital status were analyzed. The mean age at diagnosis for 69 patients was 5.3 years (3 mo to 37 y) and the median duration of follow-up was 6 years (7 d to 32 y). Radiation therapy was performed for 169 sites, primarily bone lesions. The median radiotherapy dose was 10 Gy (2.5 to 45 Gy). Radiographic follow-up data were available for 139 of the sites treated and clinical follow-up was available for 156 of sites treated. The radiographic local control was 91.4%, and 13% of lesions showed complete sclerosis or reconstitution of bone. A total of 90.4% of patients reported stabilization or improvement in lesion-related symptoms, most often pain. Twelve patients had diabetes insipidus at diagnosis or during follow-up. Eight of these patients received radiation treatment to the pituitary and none experienced a reduction in desmopressin dosage posttreatment. Radiation complications were few, including femoral neck fracture in 1 patient and facial asymmetry in 3 patients. No secondary malignancies were observed. Radiotherapy for LCH has high rates of local control and symptomatic improvement. Importantly, however, there is evidence of short-term and long-term morbidity when children are treated with low-dose irradiation.

  5. How I treat Langerhans cell histiocytosis

    PubMed Central

    Allen, Carl E.; Ladisch, Stephan

    2015-01-01

    “Langerhans cell histiocytosis” (LCH) describes a spectrum of clinical presentations ranging from a single bone lesion or trivial skin rash to an explosive disseminated disease. Regardless of clinical severity, LCH lesions share the common histology of CD1a+/CD207+ dendritic cells with characteristic morphology among an inflammatory infiltrate. Despite historical uncertainty defining LCH as inflammatory vs neoplastic and incomplete understanding of mechanisms of pathogenesis, clinical outcomes have improved markedly over the past decades through cooperative randomized clinical trials based on empiric therapeutic strategies. Significant advances include recognition of high- and low-risk clinical groups defined by hematopoietic and/or hepatic involvement, and of the importance of optimal intensity and of duration of chemotherapy. Nevertheless, mortality of high-risk patients, disease recurrence, lack of robustly tested salvage strategies, and significant disease morbidity of both high- and low-risk patients remain challenges. Recent discovery of recurrent somatic mutations in mitogen-activated protein kinase pathway genes at critical stages of myeloid hematopoietic differentiation in LCH patients supports redefinition of the disease as a myeloproliferative disorder and provides opportunities to develop novel approaches to diagnosis and therapy. PMID:25827831

  6. Isolated Langerhans cell histiocytosis of the sublingual gland in an adult.

    PubMed

    Yang, Shaodong; Chen, Xinming; Zhang, Jiali; Fang, Qiong

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of pathologic Langerhans cells. Its clinical presentation is highly variable, that range from single-system, limited disease to severe, multi-organ disease with high mortality. LCH usually affects children and young adults. The most frequent sites for LCH are the bone, skin, lung, pituitary gland, and lymph nodes. Salivary gland involvement by LCH is extremely rare, and only a few cases of LHC involving the parotid glands have been reported in the English literature. To our knowledge, the involvement of the sublingual gland as a part of single or multisystem LCH has not been previously described. Herein we reported the first case of primary LCH of the sublingual gland. A 40-year-old woman presented with a 2-month history of a painless mass on the right sublingual area. Excision of the lesion including the right sublingual gland was performed. Histopathological diagnosis of LCH was rendered. The patient remains free of symptoms 17 months after surgery.

  7. Isolated Langerhans cell histiocytosis of the sublingual gland in an adult

    PubMed Central

    Yang, Shaodong; Chen, Xinming; Zhang, Jiali; Fang, Qiong

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of pathologic Langerhans cells. Its clinical presentation is highly variable, that range from single-system, limited disease to severe, multi-organ disease with high mortality. LCH usually affects children and young adults. The most frequent sites for LCH are the bone, skin, lung, pituitary gland, and lymph nodes. Salivary gland involvement by LCH is extremely rare, and only a few cases of LHC involving the parotid glands have been reported in the English literature. To our knowledge, the involvement of the sublingual gland as a part of single or multisystem LCH has not been previously described. Herein we reported the first case of primary LCH of the sublingual gland. A 40-year-old woman presented with a 2-month history of a painless mass on the right sublingual area. Excision of the lesion including the right sublingual gland was performed. Histopathological diagnosis of LCH was rendered. The patient remains free of symptoms 17 months after surgery. PMID:26722591

  8. New clinical score for disease activity at diagnosis in Langerhans cell histiocytosis

    PubMed Central

    Choi, Won-ik; Jeong, You Cheol; Kim, Sun Young; Kim, So Dam; Pribis, John Paul; Kim, Hee-Jin; Koh, Kyung-Nam; Im, Ho-Joon; Lee, Young-Ho

    2011-01-01

    Background The clinical presentation and course of Langerhans cell histiocytosis (LCH) are variable, ranging from an isolated, spontaneously remitting bone lesion to multisystem disease with risk organ involvement. Treatment of LCH ranges from a wait-and-see attitude to intensive multidrug therapy and, in some cases, bone marrow transplantation. It is necessary to develop an objective score for assessing disease activity in patients with LCH. We propose a new clinical scoring system to evaluate disease activity at diagnosis that can predict the clinical outcomes of LCH and correlate it with clinical courses. Methods Clinical data, obtained from children diagnosed with LCH at Asan Medical Center and Hanyang University Hospital between March 1998 and February 2009, were studied retrospectively. The scoring system was developed according to the basic biological data, radiological findings, and physical findings and applied to a database containing information on 133 patients. Results The median age of the 133 patients (74 male, 59 female) was 52 months (range, 0.6-178 months), and LCH was diagnosed based on CD1a positivity. At diagnosis, the score distributions were highly asymmetrical: the score was between 1 and 2 in 75.9% of cases, 3-6 in 15.8%, and greater than 6 in 8.3%. Initial scores above 6 were highly predictive of reactivation and late complications. Conclusion This new LCH disease activity score provides an objective tool for assessing disease severity, both at diagnosis and during follow-up. PMID:22065974

  9. [A case of pulmonary Langerhans cell histiocytosis discovered by CT mass screening and followed by bronchoalveolar lavage].

    PubMed

    Watanabe, Hiroshi; Maemondo, Makoto; Okouchi, Shinya; Suzuki, Takuji; Kikuchi, Toshiaki; Tazawa, Ryushi; Ebina, Masahito; Saijo, Yasuo; Hoshikawa, Yasushi; Nukiwa, Toshihiro

    2006-11-01

    A 42-year-old woman who had a cigarette index of 420 had many cavitary lesions predominantly in the upper areas of both lungs. The lesions were detected on a health examination using CT. Analysis with bronchofiberscopy showed increased CD1a positive cells in bronchoalveolar fluid (BALF). Histological examination by video-associated lung biopsy demonstrated that both S-100 and vimentin-positive cells were present in the peribronchial fibrotic lesions. From these data, this disease was diagnosed as pulmonary Langerhans cell histiocytosis (PLCH). Three months after the cessation of smoking, the cavity lesions disappeared. As the image findings improved, CD1a positive cells in BALF decreased (4.9% --> 1.8%) and the CD4/CD8 ratio in BALF increased (1.66 --> 6.16). So far, there is no report describing the time course of both CD1a positive cells and CD4/CD8 ratio in BALF after cessation of smoking in PLCH. These findings attract our interest on the PLCH.

  10. Mercaptopurine Treatment in an Adult Man with Orbital and Intracranial Rosai-Dorfman Disease

    PubMed Central

    Arnao, Valentina; Riolo, Marianna; Savettieri, Giovanni

    2016-01-01

    Background. Rosai-Dorfmann disease (RDD) is a rare, idiopathic non-Langerhans cell histiocytosis, affecting children and young adults, that commonly presents as painless, massive cervical lymphadenopathy with fever, weight loss, and polyclonal hypergammaglobulinemia. Cervical lymphadenopathy and extranodal involvement are the main presentations. On the contrary, ophthalmic involvement and localisation in the central nervous system are rare. Case Report. An old man was admitted to our hospital for first seizure. Brain imaging studies revealed on the left an extra-axial thickening of the dura mater with enhancement and perilesional oedema, infiltrating the sphenoorbital fissure and an isointense mass with enhancement in the orbital region with dislocation of the optic nerve. Pathological and immunohistochemistry examination of the bioptical specimen was consistent with a diagnosis of RDD. Treatment with levetiracetam and steroids was started obtaining only remission of seizures. Because of the patient refusal of the surgical debulking, therapy with mercaptopurine was started, stopping disease progression. Conclusion. So far, very few cases of extranodal RDD with multiple CNS lesions involving the orbital region have been described. Our case is significant because it is the first case in which the efficacy of mercaptopurine treatment has been documented in an adult patient with isolated ocular and intracranial RDD. PMID:27840753

  11. Redefining Langerhans Cell Histiocytosis as a Myeloid Dysplasia and Identifying B | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): Redefining Langerhans Cell Histiocytosis as a Myeloid Dysplasia and Identifying Biomarkers for Early Detection and Risk Assessment. This application addresses Program Announcement PA-09-197: Biomarkers for Early Detection of Hematopoietic Malignancies (R01). The overall aim of this project is to identify novel biomarkers that may be used to diagnose and treat patients with Langerhans Cell Histiocytosis (LCH). LCH occurs with similar frequency as other rare malignancies including Hodgkin's lymphoma and AML. |

  12. [Growth retardation in histiocytosis X. Evaluation of anterior pituitary function (author's transl)].

    PubMed

    Calzada, L D; Chaussain, J L; Job, J C

    Among six patients with histiocytosis X of long duration and growth retardation of 3 to 4 standard deviations, three had a blunted growth hormone response to stimulation tests, associated to diabetes insipidus. In two of these three children there was a partial catchup of growth without treatment by human growth hormone. The causes and mechanisms of growth retardation in histiocytosis X, the influence of hydroelectrolytic disorders on growth in these patients and their need for treatment with human growth hormone are discussed.

  13. (18)F-FDG PET/CT in follow-up evaluation in pediatric patients with Langerhans histiocytosis.

    PubMed

    Garcia, J R; Riera, E; Bassa, P; Mourelo, S; Soler, M

    We evaluated the impact of (18)F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH). During 2007-2013, 13 (18)F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques. PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of (18)F-FDG bone uptake at 17 and 19 months. In our preliminar study, (18)F-FDG PET is a useful imaging procedure, along with other diagnostic tools, for identification of active lesions. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  14. Pulmonary Langerhans cell histiocytosis: a comprehensive analysis of 40 patients and literature review.

    PubMed

    Elia, Davide; Torre, Olga; Cassandro, Roberto; Caminati, Antonella; Harari, Sergio

    2015-06-01

    Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial disease affecting primarily young adult smokers. In order to highlight the clinical features of the disease, we conducted a retrospective analysis on clinical data of PLCH patients followed at our center; moreover, we reviewed the current literature on PLCH. Between January 2004 and July 2014, 40 patients with PLCH were evaluated at our Division. The average patients' age was 40 (± 14) years, and 22 of them were females. Diagnosis was based on search of CD1a+ cells in the bronchoalveolar lavage (10 patients), lung biopsy (8 patients), or cystic bone lesion's biopsy (2 patients); in 12 patients, diagnosis was achieved on the basis of the clinical-radiological data. The principal manifestation of PLCH was the presence of cysts involving upper lung zones with costophrenic sparing on chest CT scan (in 25 patients); micronodular pattern in the middle-upper zone and combination of the two radiological patterns were less frequently observed (in 9 and 6 patients, respectively). Pulmonary hypertension was found in 4 patients. Extra pulmonary manifestations were diabetes insipidus, bone lesions, and skin involvement (in 5, 7, and 1 patient, respectively). For 25 patients, smoking cessation was the only required therapy. Treatments with low dose of prednisolone, vinblastine and prednisolone, or 6-mercaptopurin were reserved for patients with major pulmonary or extra-pulmonary involvement (for 11, 4, and 5 patients, respectively). In conclusion, PLCH is a rare, multi-systemic disease; early diagnosis, accurate staging and smoking cessation are considered critical in PLCH management. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. Orbital Myiasis

    PubMed Central

    Khataminia, Gholamreza; Aghajanzadeh, Roja; Vazirianzadeh, Babak; Rahdar, Mahmoud

    2011-01-01

    Purpose To present a case of massive orbital myiasis. Case Report An 87-year-old debilitated woman suffering from left ocular pain of four days’ duration presented with a severely necrotized left orbit and several attached live larvae. The upper and lower eyelids and the eyeball were completely destroyed. She had history of eyelid surgery in the same eye due to a skin lesion, apparently some type of skin cancer, 15 years before. The larvae were identified as Chrysomya bezziana (Diptera: Calliphoridae) or old world screwworm fly. Conclusion Infestation of ocular and orbital tissues by fly larvae (ophthalmomyiasis) progresses rapidly and can completely destroy orbital tissues within days, especially in patients with poor general health. Treatment consists of removal of the larvae and surgical debridement. PMID:22454736

  16. Thyroid Langerhans cell histiocytosis and papillary thyroid carcinoma

    PubMed Central

    Algarni, Mohammed; Alhakami, Hadi; AlSubayea, Haia; Alfattani, Naif; Guler, Mohammet; Satti, Mohamed

    2016-01-01

    A 27-year-old female, married with two children, presented to our clinic with a 1-year history of thyroid swelling and pressure symptoms on lying backward and bilateral cervical lymphadenopathy. The patient was a known case of panhypopituitarism for 5 years. Comprehensive patient evaluation including FNAC with papillary thyroid cancer result then she underwent total thyroidectomy and bilateral neck dissection and final histologic examination confirmed papillary thyroid carcinoma in the background of lymphocytic thyroiditis, associated with Langerhans cell histiocytosis (LCH). The draining cervical lymph nodes were also involved by LCH and metastatic papillary thyroid carcinoma. Although the association of LCH with papillary thyroid carcinoma in the thyroid has been reported, their co-existence with LCH in the draining lymph nodes is very uncommon. PMID:27867869

  17. Langerhans cell histiocytosis in children under 2 years of age.

    PubMed

    Rivera-Luna, R; Alter-Molchadsky, N; Cardenas-Cardos, R; Martínez-Guerra, G

    1996-05-01

    This is a retrospective study of 55 children under the age of 2 years diagnosed with Langerhans cell histiocytosis (LCH). They were classified according to age and organ function and dysfunction following Lahey's criteria. The studied population was divided into four groups by age of diagnosis (0-6, 7-12, 13-18, and 19-24 months). Statistical analysis showed no significant difference in outcome between age groups, although the population under 6 months had a 81.3% fatality rate. The presence of organ dysfunction was a major cause of death in all age groups, being statistically significant in outcome (P > 0.005) compared with patients without organ dysfunction. The presence of thrombocytopenia and/or respiratory dysfunction was also highly associated with a fatal outcome. In the surviving population, no second malignancies have been reported. The late secondary effects of therapy include endocrine, orofacial, and osseous pathologies.

  18. Central nervous system imaging in childhood Langerhans cell histiocytosis – a reference center analysis

    PubMed Central

    Porto, Luciana; Schöning, Stefan; Hattingen, Elke; Sörensen, Jan; Jurcoane, Alina; Lehrnbecher, Thomas

    2015-01-01

    Background The aim of our study was (1) to describe central nervous system (CNS) manifestations in children with Langerhans cell histiocytosis (LCH) based on images sent to a reference center and meeting minimum requirements and (2) to assess the inter-rater agreement of CNS-MRI results, which represents the overall reproducibility of this investigation. Methods We retrospectively reviewed brain MRI examinations in children with LCH, for which MRI minimum requirements were met. Abnormalities were rated by two experienced neuroradiologists, and the inter-rater agreement was assessed. Results Out of a total of 94 imaging studies, only 31 MRIs met the minimum criteria, which included T2w, FLAIR, T1w images before/after contrast in at least two different section planes, and thin post contrast sagittal slices T1w through the sella. The most common changes were osseous abnormalities, followed by solid enlargement of the pineal gland, thickened enhancing stalk and signal changes of the dentate nucleus. Whereas inter-rater agreement in assessing most of the CNS lesions was relatively high (κ > 0.61), the application of minimum criteria often did not allow to evaluate the posterior pituitary. Conclusions The diversity of radiological protocols from different institutions leads to difficulties in the diagnosis of CNS abnormalities in children with LCH. Although the inter-rater agreement between neuroradiologists was high, not all the LCH manifestations could be completely ruled out when using the minimum criteria. Brain MRIs should therefore follow LCH guideline protocols and include T1 pre-gadolinium sagittal images, and be centrally reviewed in order to improve the comparison of clinical trials. PMID:26401129

  19. [Pulmonary Langerhans' cell histiocytosis (PLCH) revealed by pneumothorax: about a case].

    PubMed

    Sajiai, Hafsa; Rachidi, Mariam; Serhane, Hind; Aitbatahar, Salma; Amro, Lamyae

    2016-01-01

    Langerhans cell histiocytosis is a rare disease of unknown etiology characterized by the infiltration of Langerhans cells in one or more organs. It has a polymorphic clinical presentation. We report the case of Mr R.Y, age 22, with 8 pack year history of smoking, admitted to hospital with complete spontaneous right-sided pneumothorax. Chest drainage was performed with good evolution. Control chest CT scan showed multiple diffuse cyst formations, predominant in the upper lobes. Lab and imaging tests were performed in order to detect systemic histiocytosis with negative results. Patient's evolution was marked by pneumothorax recurrence; pleurodesis and lung biopsy were performed which confirmed the diagnosis. The diagnosis of Langerhans cell histiocytosis should be evoked in front of pneumothorax associated with lung cystic. The diagnosis is easy in front of a suggestive clinical and radiological picture. Nevertheless, therapeutic options are limited and pneumothorax recurrence is common.

  20. Morphological characterisation of malignant histiocytosis in a cat.

    PubMed

    Cortese, L; Paciello, O; Papparella, S

    2008-11-01

    Malignant histiocytosis (MH) is a progressive systemic neoplastic proliferation of morphologically atypical histiocytes, well characterised in humans and dogs but only recently identified in the cat. In all species, liver, lung, lymph nodes, spleen and bone marrow are infiltrated by atypical histiocytes, and the disease is rapidly fatal. The purpose of this study was to describe the clinical, histological, immunohistochemical and ultrastructural findings of MH in a cat, together with the diagnostic work-up and a list of differential diagnoses. Clinical evaluation included a complete blood-cell count, serum biochemistry, urinalysis, serology and ultrasound examination. The cat had clinical signs of depression, thinness, dehydration, pale mucous membranes and tachycardia. Abdominal ultrasonography revealed generalised splenomegaly and hepatomegaly. Necroscopy showed whitish nodules, randomly scattered throughout the parenchyma in the spleen and liver. The periportal lymph nodes were greatly enlarged and the cut surface was uniformly greyish-white and translucent. Histological examination revealed pleomorphic proliferation of large round tumour cells, with numerous phagocytic vacuoles containing erytrocytes, leukocytes and haemosiderin. By immunohistochemistry, positivity for lysozyme and alpha1-antitrypsin and a scattered positivity for Mac 387 were observed. Ultrastructural features of tumour cells included cytoplasmic lipid droplets, lysosomes and phagolysosomes. MH in the cat needs to be differentiated from diffuse granulomatous disease, non-Hodgkin's lymphoma and Hodgkin's-like disease. The morphological features of the tumour cells, combined with immunohistochemical and ultrastructural observation, are consistent with a diagnosis of MH in the cat.

  1. A case of Langerhans' cell histiocytosis following Hodgkin's disease

    PubMed Central

    LI, XIN; DENG, QI; LI, YU-MING

    2016-01-01

    Langerhans' cell histiocytosis (LCH) is a group of disorders in various tissues characterized by the proliferation of Langerhans cells. It is rarely observed in adults. Langerhans cells are dendritic cells that express cluster of differentiation 1a (CD1a) and S100 protein, and contain Birbeck granules. Its etiopathogenesis remains to be elucidated. One possible etiological cause is a reactive proliferation of Langerhans cells following chemotherapy or radiotherapy for Hodgkin's disease (HD). A number of cases of LCH associated with malignant lymphoma have been reported previously. It may follow after the malignant lymphoma, or occur with it. However, fewer cases have been reported where the LCH followed after HD. In the present case report, a patient was diagnosed with HD following chemotherapy for LCH. As LCH was diagnosed, the patient was treated with a combination of various chemotherapeutic agents in two cycles of cyclophosphamide, vincristine, and prednisolone (COP), and eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). The patient went into a successful clinical remission. One year later, computed tomographic (CT) scans of the thorax and abdomen revealed augmentation of the tumor mass in the mediastinum. An excisional biopsy of the right inguinal lymph node was performed. The patient was diagnosed with nodular sclerosing Hodgkin's disease. Following four cycles of doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy, a whole-body positron emission tomographic CT scan revealed a decrease in tumor mass in the mediastinum. At present, the patient remains in treatment, and the prognosis has yet to be fully determined. PMID:27330759

  2. Cutaneous crystal storing histiocytosis: a report of two cases.

    PubMed

    Li, Jing Jing; Henderson, Christopher

    2015-02-01

    Crystal storing histiocytosis (CSH) is a rare condition where crystals accumulate in the cytoplasm of macrophages and is usually associated with a lymphoplasmacytic neoplasm producing a monoclonal immunoglobulin with kappa light chain. CSH with primary manifestation in the skin is extraordinarily rare and limited to four case reports in the literature. Here we present two cases of cutaneous CSH. One case is that of an 80 year old woman who presented with bilateral periorbital oedema with yellow discolouration. Skin biopsy showed dermal CSH in association with a neoplastic lymphoplasmacytoid infiltrate showing IgM kappa light chain restriction. Subsequent work up led to the discovery of Waldenstrom's macroglobulinemia. She had an indolent clinical course but died 6 years later from transformation into a diffuse large B cell lymphoma in the bone marrow. The other case is that of a 52 year old man who was recently diagnosed with multiple myeloma and developed a pruritic rash on his back during chemotherapy. Skin biopsy showed Grover disease (transient acantholytic dermatosis) and crystal storing macrophages in the superficial dermis. He died 4 years later after a protracted clinical course involving multiple cycles of chemotherapy and numerous complications. In both patients cutaneous CSH occurred early in the course of their lymphoplasmacytic malignancy and its development did not herald rapid clinical decline.

  3. Bronchoscopic diagnosis of Langerhans cell histiocytosis and lymphangioleiomyomatosis.

    PubMed

    Harari, Sergio; Torre, Olga; Cassandro, Roberto; Taveira-DaSilva, Angelo M; Moss, Joel

    2012-09-01

    Limited data are available regarding the role of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) as diagnostic tools in pulmonary Langerhans' Cell Histiocytosis (LCH) and lymphangioleiomyomatosis (LAM). The aim of this study was to review our experience regarding the value of these two techniques in the diagnosis of these cystic lung diseases. Records of 452 patients with the presumptive diagnosis of interstitial lung disease were reviewed; 67 had a clinical-radiological diagnosis of either LCH (n = 27) or LAM (n = 40). Of 16 patients with LCH who underwent BAL, four specimens (25%) contained cells which had positive immunoreactivity for CD1a. Of three patients with negative BAL fluid who had TBB, only one had a positive tissue diagnosis. Ten LCH patients were diagnosed by surgical lung biopsy of which five had negative BAL fluid. The remaining 12 patients were diagnosed by clinical and radiologic features. Standard examination of BAL fluid was of no diagnostic value in LAM. TBB was performed in seven patients and was diagnostic in six, not resulting in complications. All 13 patients who underwent surgical lung biopsies had a positive histopathologic diagnosis The remaining 21 patients were diagnosed by clinical and radiologic features. We suggest that BAL may assist in the diagnosis of LCH whereas TBB may be useful in the diagnosis of LAM, thus avoiding the need for surgical biopsy. Copyright © 2012. Published by Elsevier Ltd.

  4. Pulmonary Langerhans cell histiocytosis and diabetes insipidus in pregnant women: our experience.

    PubMed

    Fuks, Leonardo; Kramer, Mordechai R; Shitrit, David; Raviv, Yael

    2014-04-01

    Pulmonary Langerhans cell histiocytosis (PLCH) occurs predominantly in young adult smokers. Diabetes insipidus occurs in up to 15 % patients with PLCH. Information on PLCH in pregnancy is sparse, especially associated with diabetes insipidus. We report three patients with these conditions and describe the disease history and pregnancy outcomes.

  5. The cognitive spectrum in neurodegenerative Langerhans cell histiocytosis.

    PubMed

    Le Guennec, Loïc; Decaix, Caroline; Donadieu, Jean; Santiago-Ribeiro, Maria; Martin-Duverneuil, Nadine; Levy, Richard; Delgadillo, Daniel; Kas, Aurélie; Drier, Aurélie; Magy, Laurent; Bayen, Eleonore; Hoang-Xuan, Khe; Idbaih, Ahmed

    2014-08-01

    Clinical spectrum of cognitive troubles complicating neurodegenerative Langerhans cell histiocytosis (ND-LCH) is poorly known. The aim of this study is to evaluate cognitive functions in ND-LCH. The cognitive functions of a series of eight adult patients (7 males and 1 female; mean age 26 years IQ 25-75; range 20-33) suffering from clinical and/or radiological ND-LCH were evaluated using the following tests: (1) forward/backward digit and spatial span tasks of the WAIS-R scale and the Corsi block task, (2) the French version of the free and cued selective reminding test, (3) verbal fluency tests, (4) the Frontal Assessment Battery (FAB), (5) backward measurement of the verbal and visuospatial memories of the WAIS-R scale, (6) the Rey complex figure test, (7) the trail making tests A and B, (8) digit symbol and symbol search of the WAIS-IV scale, and (9) the Stroop test. Episodic (i.e. autobiographical or personal) memory free recall, categorical verbal fluency, phonological verbal fluency, visuospatial processing skills, attention, speed of processing, and sensitivity to interference were impaired in ND-LCH patients. In contrast, verbal and visuospatial short-term memories (i.e. immediate memories or forward span tasks) were preserved in all patients. Adult ND-LCH patients suffer from a severe but dissociated dysexecutive syndrome, mostly affecting executive strategies and relatively sparing short-term memory. Our study supports the need of assessing executive functions using comprehensive cognitive evaluation in ND-LCH patients for early diagnosis.

  6. Differentiating skin-limited and multisystem Langerhans cell histiocytosis

    PubMed Central

    Simko, Stephen J.; Garmezy, Benjamin; Abhyankar, Harshal; Lupo, Philip J.; Chakraborty, Rikhia; Lim, Karen Phaik Har; Shih, Albert; Hicks, M. John; Wright, Teresa S.; Levy, Moise L.; McClain, Kenneth L.; Allen, Carl E.

    2014-01-01

    Objective To identify features associated with multisystem involvement and therapeutic failure in patients with skin Langerhans cell histiocytosis (LCH). Study design We reviewed medical records of 71 consecutive LCH patients with skin involvement evaluated at Texas Children’s Hospital and analyzed clinical features, laboratory results, and presence of circulating cells with the BRAF-V600E mutation, with respect to initial staging and clinical outcomes. Results Skin disease in patients older than 18 months at diagnosis was associated with presence of multisystem disease (OR 9.65, 95% CI 1.17–79.4). Forty percent of patients referred for presumed skin-limited LCH had underlying multisystem involvement, half of these with risk-organ involvement. Patients with skin-limited LCH had 3-year progression-free survival (PFS) of 89% after initial therapy, and none developed multisystem disease. Patients with skin/multisystem involvement had 3 year PFS of 44% with vinblastine/prednisone therapy, and risk-organ involvement did not correlate with failure to achieve non-active disease. Circulating cells with BRAF-V600E were detected at higher frequency in multisystem patients (8/11 skin/multisystem, 1/13 skin-limited, P=0.002). Conclusions Skin-limited LCH requires infrequent therapeutic intervention and has lower risk of progression relative to skin plus multisystem LCH. The less aggressive clinical course and lack of circulating cells with BRAF-V600E mutation in skin-limited LCH suggest a different mechanism of disease origin compared with multisystem or risk-organ disease. PMID:25441388

  7. Current understanding and management of pulmonary Langerhans cell histiocytosis.

    PubMed

    Vassallo, Robert; Harari, Sergio; Tazi, Abdellatif

    2017-10-01

    Pulmonary Langerhans cell histiocytosis (PLCH) is a diffuse lung disease that usually affects young adult smokers. PLCH affects different lung compartments; bronchiolar, interstitial and pulmonary vascular dysfunction may coexist to varying extents, resulting in diverse phenotypes. Analyses of PLCH tissues have identified activating mutations of specific mitogen-activated protein kinases (BRAF(V600E) and others). The current consensus is that PLCH represents a myeloid neoplasm with inflammatory properties: the myeloid tumour cells exhibit surface CD1a expression and up to 50% of the cells harbour activating BRAF or other MAPK mutations. PLCH may be associated with multisystem disease. The detection of disease outside of the thorax is facilitated by whole body positron emission tomography. The natural history of PLCH is unpredictable. In some patients, disease may remit or stabilise following smoking cessation. Others develop progressive lung disease, often associated with evidence of airflow limitation and pulmonary vascular dysfunction. Due to the inability to accurately predict the natural history, it is important that all patients undergo longitudinal follow-up at least twice a year for the first few years following diagnosis. The treatment of PLCH is challenging and should be individualised. While there is no general consensus regarding the role of immunosuppression or chemotherapy in management, selected patients may experience improvement in lung function with therapy. Determination of BRAF(V600E) or other mutations may assist with the development of an individualised approach to therapy. Patients with progressive disease should be referred to specialised centres and considered for a trial of pharmacotherapy or evaluated for transplantation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. DOR-1, A novel CD10+ stromal cell line derived from progressive Langerhans cell histiocytosis of bone.

    PubMed

    Gogusev, Jean; Telvi, Louise; Murakami, Ichiro; Lepelletier, Yves; Nezelof, Christian; Stojkoski, Alexandre; Glorion, Christophe; Jaubert, Francis

    2005-02-01

    Langerhans cell histiocytosis (LCH) is granulomatous proliferative disorder characterized by the presence of activated Langerhans cells admixed with macrophages, lymphocytes, and eosinophils. In an effort to obtain an LCH ex vivo model, we succeeded in establishing the DOR-1 cell line from an LCH lesion of bone in a 3-year-old girl. The DOR-1 cell line was established from a CD1a immunoreactive LCH lesion of bone maintained in long-term cell culture. The phenotypic characteristics were assessed by immuno-cytochemistry and fluorescence activated cell sorter (FACS) analysis. Cytogenetic analysis was performed by RHG-banding that was supplemented by fluorescence in situ hybridization (FISH). The DOR-1 cells grew in vitro as a poorly differentiated mesenchymal-like cells with a doubling time between 72 and 96 hr. The cells exhibited pleomorphism and consistent immuno-reactivity for CD10 (50%), CD13 (55%), CD68 (65%), and CD117 (70%) while CD1a, Langerin and HLA-DR were not detected. By RHG-banding, several aberrant chromosomes were detected including the t (9; 17) (p23; p13) translocation and a pair of long dicentric marker chromosomes indicating clonal abnormality. Functionally, exposure to 33 nM 12-O-tetradecanoyl phorbol mirystate-13-acetate (TPA) induced DOR-1 cell differentiation with appearance of cytoplasmic extensions. The DOR-1 cell line exhibits distinct immuno-cytochemical features and carries the t (9; 17) (p23; p13) translocation suggesting involvement of stromal-like cell lineage in LCH initiation and progression.

  9. Interleukin-1 loop model for pathogenesis of Langerhans cell histiocytosis.

    PubMed

    Murakami, Ichiro; Matsushita, Michiko; Iwasaki, Takeshi; Kuwamoto, Satoshi; Kato, Masako; Nagata, Keiko; Horie, Yasushi; Hayashi, Kazuhiko; Imamura, Toshihiko; Morimoto, Akira; Imashuku, Shinsaku; Gogusev, Jean; Jaubert, Francis; Takata, Katsuyoshi; Oka, Takashi; Yoshino, Tadashi

    2015-02-22

    We propose Langerhans cell histiocytosis (LCH) is an inflammatory process that is prolonged by mutations. We hypothesize that Merkel cell polyomavirus (MCPyV) infection triggers an interleukin-1 (IL-1) activation loop that underlies the pathogenesis of LCH. Langerhans cells (LCs) are antigen presenting cells in the skin. When LCs encounter exogenous antigens, they migrate from the epidermis into draining lymphoid tissues to initiate T-cell activity. It has been proposed that LC migration-related factors, including E-cadherin, matrix metalloproteinase, and Notch ligand induce LCH activity. We found that the tyrosine phosphatase SHP-1, which binds IL-1 receptor-associated kinase 1, is expressed at a significantly higher level in LCH affecting multiple organ systems (MS-LCH) than in LCH affecting a single organ system (SS-LCH). IL-1 stimulates T helper 17 cells and their signature cytokine IL-17 had been a matter of controversy. We detected higher levels of IL-17A receptor expression in MS-LCH than in SS-LCH and proposed an IL-17 endocrine model that could settle the controversy. IL-1 is the first cytokine secreted in response to sensitizers and promotes LC migration from sentinel tissues. Myeloid differentiation primary response 88 (MyD88), downstream of the IL-1 receptor, has functions in both RAS signaling and inflammation, leading to human cell transformation. In 2010, an activating mutation in the B-rapidly accelerated fibrosarcoma gene (BRAF) V600E was found in LCH. This BRAF mutation induces phosphorylation of the extracellular signal-regulated kinase (ERK) that may play an important role with MyD88 in LCH pathogenesis. However, phosphorylated ERK (pERK) is rapidly dephosphorylated by dual specificity phosphatase 6 (DUSP6), and limited proliferation is predicted in BRAF mutant cells. MyD88 binds pERK via its D-domain, thereby preventing pERK-DUSP6 interaction and maintaining ERK in an active, phosphorylated state. We detected MCPyV-DNA in the peripheral blood

  10. Primary orbital melanoma associated with orbital melanocytosis.

    PubMed

    Rice, C D; Brown, H H

    1990-08-01

    We report a case of primary orbital melanoma in a 17-year-old girl. The patient presented with painless proptosis during the first trimester of pregnancy. Computed tomography demonstrated a well-circumscribed mass located infra-temporally in the right orbit. The tumor was bluish-black, grossly encapsulated, and associated with orbital blue nevi. Histologic examination of the mass revealed a pigmented spindle-cell neoplasm. On electron microscopy, the presence of premelanosomes and the absence of basal lamina supported the diagnosis of melanoma. Malignant transformation of a preexisting nevus is postulated since perineural foci of benign dendritic melanocytes were seen within the melanoma. There has been no recurrence or metastasis in a 2-year follow-up. Of 30 primary orbital melanomas reviewed, 12 (40%) were associated with periorbital pigmentary disorders, such as oculodermal melanocytosis, blue nevus, and ocular melanocytosis. Our case is unique since the pigmentary lesions were limited to the orbital tissues.

  11. Diagnosis of Ocular Surface Lesions Using Ultra-High Resolution Optical Coherence Tomography

    PubMed Central

    Shousha, Mohamed Abou; Karp, Carol L.; Canto, Ana Paula; Hodson, Kelly; Oellers, Patrick; Kao, Andrew A.; Bielory, Brett; Matthews, Jared; Dubovy, Sander R.; Perez, Victor L.; Wang, Jianhua

    2012-01-01

    Purpose To assess the use of ultra high resolution optical coherence tomography (UHR-OCT) in the diagnosis of ocular surface lesions. Design Prospective, non-comparative, interventional case series. Participants Fifty four eyes of 53 consecutive patients with biopsy proven ocular surface lesions; 8 primary acquired melanosis, 5 amelanotic melanoma, 2 nevi, 19 ocular surface squamous neoplasia, 1 histiocytosis, 6 conjunctival lymphoma, 2 conjunctival amyloidosis, and 11 pterygia. Intervention UHR-OCT imaging of the ocular surface lesions. Main Outcome Measures Clinical course and photographs, UHR-OCT image and histopathological findings. Results UHR-OCT images of all examined ocular surface lesions showed close correlation with the obtained histopathological specimens. When clinical differential diagnosis of ocular surface lesions was broad, UHR-OCT images provided optical signs that guided towards a more specific diagnosis and management. In cases of amelanotic melanoma, conjunctival amyloidosis, and primary histiocytosis and in one case of ocular surface squamous neoplasia, UHR-OCT was instrumental in guiding the diagnosis. In those cases, UHR-OCT suggested that the presumed clinical diagnosis was incorrect and favored a diagnosis which was later confirmed by histopathological examination. Conclusions Correlations between UHR-OCT and histopathology confirm that UHR-OCT is an adjunctive diagnostic modality that can provide a non-invasive means to help and guide diagnosis and management of ocular surface lesions. PMID:23347984

  12. Malignant histiocytosis and other causes of death in Bernese mountain dogs in Denmark.

    PubMed

    Nielsen, L; Andreasen, S N; Andersen, S D; Kristensen, A T

    2010-02-13

    To determine the causes of death in Bernese mountain dogs, to assess the prevalence of malignant histiocytosis in the Danish Bernese mountain dog population, and to assess whether a hereditary pattern for this disease exists, 756 questionnaires were sent to members of the Danish Bernese Mountain Dog Club requesting information regarding the life span and causes of death of their dogs. A response rate of 57.7 per cent was achieved, giving information for 812 dogs, of which 290 had died. The average life span was 7.1 years. The most prevalent causes of death were neoplasia (42.1 per cent), old age (10.3 per cent), kidney disease (6.9 per cent), infection (5.9 per cent), skeletal problems (5.2 per cent), heart disease (3.8 per cent) and behavioural causes (3.5 per cent). Thirteen dogs were diagnosed with malignant histiocytosis, 11 of which were genealogically related.

  13. Laryngeal Langerhans Cell Histiocytosis Presenting with Neck Mass in an Adult Woman

    PubMed Central

    Jahandideh, Hesam; Nasoori, Yasser; Rostami, Sara; Safdarian, Mahdi

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a very rare condition that commonly affects the head and neck region. There are very few cases of isolated laryngeal involvement by LCH, mostly reported in pediatric patients. Here, we report a case of laryngeal LCH in a 62-year-old woman presenting with a neck mass several weeks ago. The clinical and histopathological findings are reported with a brief discussion about the disease. PMID:27127670

  14. Bilateral lacrimal caruncle lesions

    PubMed Central

    Okumura, Yuta; Takai, Yoshiko; Yasuda, Shunsuke; Terasaki, Hiroko

    2017-01-01

    ABSTRACT A 65-year-old man was referred to our hospital for the treatment of a lesion on the medial lacrimal canthus of both eyes. He had a history of perinuclear anti-neutrophil cytoplasmic antibodies, i.e., pANCA-positive interstitial pneumonia. Orbital magnetic resonance imaging excluded space occupying lesions, and laboratory testing excluded thyroid-related diseases. The masses were excised, and histopathological examinations showed sebaceous gland hyperplasia and inflammatory changes around the gland. In addition, the specimen from the left eye showed a retention cyst possibly caused by an infection. It was also possible that the use of steroid was involved in the development of the lesions. A relationship between the ANCA and the lesions was not completely eliminated. PMID:28303065

  15. The adverse prognostic hallmarks in identical twins with Langerhans cell histiocytosis: a clinical report and literature review.

    PubMed

    Chai, Damin; Tao, Yisheng; Bao, Zhengqi; Yang, Li; Feng, Zhenzhong; Ma, Li; Liang, Limei; Zhou, Xinwen

    2013-01-01

    Langerhans cell histiocytosis (LCH) is characterized by uncontrolled proliferation of Langerhans cells accompanying eosinophils. It often attacks children under 10 years of age. LCH in identical twins is very rare and its prognosis is different. Here we report identical-twin sisters with LCH. Computed tomography (CT) revealed osteolytic change in each twin's skull, and the elder exhibited poor eyesight. There were massive histiocyte-like cells surrounded by eosinophils in pathologic specimen of the abnormal lesions, which is typical pathologic finding in LCH. These pathologic cells were positive for S-100 and the cell surface protein CD1 antigen (CD1α), the known markers of LCH. After treating them with surgery, no symptoms were seen in the younger until now. While the older was found another soft mass (about 2.0 cm in diameter) in the left temporal area 18 months later. The same treatment was given to the older after admission, and she is healthy to date. To explore the relationship between hallmarks and the prognosis of identical-twin patients with LCH, we retrieved the 16 literatures (16 identical-twin pairs, 31 patients) listed in PubMed during the past 60 years. The data revealed all those patients who have disseminated to the bone marrow, spleen and liver with symptoms of fever and hepatosplenomegaly exhibited worse prognosis (9 out of the 31 patients). The other identical-twin subjects without infiltration of those organs recovered well. In conclusion, this study reveals the adverse hallmarks of prognosis in identical-twin patients with LCH by reviewing relevant literatures.

  16. Bone Langerhans cell histiocytosis with pulmonary involvement in an adult non-smoker: A case report and brief review of the literature

    PubMed Central

    Shen, Jie; Feng, Shicheng

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare disease of unknown cause, which encompasses a set of disorders of multiple organs with various clinical presentations that share the common characteristic of sizeable Langerhans cell infiltration. The clinical spectrum of LCH ranges from solitary bone lesions to involvement of other organs. lung involvement in LCH may be part of a multisystem disease, which almost exclusively occurs in adult smokers, while it is overlooked or misdiagnosed in the majority of non-smokers. High-resolution computed tomography (HRCT) of the chest is crucial for diagnosis; however, the treatment and prognosis of this disease have not been clearly determined. We herein present the case of a non-smoking adult patient who presented with lower limb pain and was diagnosed via biopsy with lch with multisystem involvement, including the bone and lungs. Lytic lesions in the corpus of the sacroiliac joint, sacrum, acetabulum and femoral head by a soft tissue mass were observed on diagnostic CT. In addition, chest HRCT revealed multiple cysts in the bilateral lungs, predominantly in the upper lobes. The final diagnosis of LCH was confirmed by histopathological examination and immunohistochemical staining for CD1a and S-100. Corticosteroid treatment alleviated lower limb pain and improved the patient's quality of life; thus, corticosteroids may be considered as a potential treatment option for patients with LCH. PMID:28123731

  17. Clinico-pathologic conference: case 4. Langerhans cell histiocytosis (LCH).

    PubMed

    Muramatsu, Takashi; Hall, Gillian L; Hashimoto, Sadamitsu; Miyauchi, Jun; Shimono, Masaki

    2010-12-01

    A 13-month-old Japanese boy presented with painless swelling in a left mandible and cheek. Intraoral examination revealed swelling in the left mandible and hemorrhage of oral mucosa due to biting. CT images revealed a wide osteolytic lesion of the left mandible with floating teeth. Biopsy was carried out and histopathological diagnosis was discussed.

  18. Congenital Orbital Teratoma.

    PubMed

    Pellerano, Fernando; Guillermo, Elvis; Garrido, Gloreley; Berges, Pedro

    2017-01-01

    We report a case of congenital orbital teratoma. A 3-day-old male, born at 39 weeks' gestation without relevant prenatal history, presented with a large vascularized proptotic mass distorting the left midface. Laboratory studies showed elevated serum alpha-fetoprotein (12,910 ng/ml). Computed tomography showed a multiloculated heterogeneous lesion composed of hypodense and hyperdense calcified areas encompassing the whole orbital cavity with expansion of the bony walls, as well as forward displacement and compression of the eyeball without extension to surrounding structures. Clinical, imaging and laboratory features were consistent with congenital orbital teratoma. Due to pronounced proptosis with exposure keratopathy and corneal perforation, no motility of the globe and no vision in the affected eye in a resource-limited setting, the patient underwent orbital exenteration. Histopathological examination confirmed the diagnosis of mature cystic teratoma. We describe the clinical course, radiographic and histopathological findings of this rare orbital tumor.

  19. Congenital Orbital Teratoma

    PubMed Central

    Pellerano, Fernando; Guillermo, Elvis; Garrido, Gloreley; Berges, Pedro

    2017-01-01

    We report a case of congenital orbital teratoma. A 3-day-old male, born at 39 weeks’ gestation without relevant prenatal history, presented with a large vascularized proptotic mass distorting the left midface. Laboratory studies showed elevated serum alpha-fetoprotein (12,910 ng/ml). Computed tomography showed a multiloculated heterogeneous lesion composed of hypodense and hyperdense calcified areas encompassing the whole orbital cavity with expansion of the bony walls, as well as forward displacement and compression of the eyeball without extension to surrounding structures. Clinical, imaging and laboratory features were consistent with congenital orbital teratoma. Due to pronounced proptosis with exposure keratopathy and corneal perforation, no motility of the globe and no vision in the affected eye in a resource-limited setting, the patient underwent orbital exenteration. Histopathological examination confirmed the diagnosis of mature cystic teratoma. We describe the clinical course, radiographic and histopathological findings of this rare orbital tumor. PMID:28275597

  20. Orbital endoscopic surgery.

    PubMed

    Prabhakaran, Venkatesh C; Selva, Dinesh

    2008-01-01

    Minimally invasive "keyhole" surgery performed using endoscopic visualization is increasing in popularity and is being used by almost all surgical subspecialties. Within ophthalmology, however, endoscopic surgery is not commonly performed and there is little literature on the use of the endoscope in orbital surgery. Transorbital use of the endoscope can greatly aid in visualizing orbital roof lesions and minimizing the need for bone removal. The endoscope is also useful during decompression procedures and as a teaching aid to train orbital surgeons. In this article, we review the history of endoscopic orbital surgery and provide an overview of the technique and describe situations where the endoscope can act as a useful adjunct to orbital surgery.

  1. Pulmonary lesions in cats with diabetes mellitus.

    PubMed

    Mexas, Angela M; Hess, Rebecka S; Hawkins, Eleanor C; Martin, Linda D

    2006-01-01

    Diabetes mellitus (DM) is a common endocrinopathy of cats and humans. Although few studies have examined the effects of DM on the pulmonary system, changes in pulmonary function and immunology in humans with type I and II diabetes, and pulmonary lesions in a murine diabetic model have been documented. Our objective was to determine whether pulmonary lesions occurred in cats with DM. Medical records and necropsy evaluations of 42 cats with DM were compared with those of 45 age-matched, nondiabetic cats for the presence of clinical evidence of respiratory disease and pulmonary histopathological findings at the time of necropsy. No statistical difference was noted in the presence of clinical evidence of respiratory disease between cats with diabetes and control cats. Nevertheless, there was a significant association between the presence of abnormal pulmonary histopathology and DM (P = .018, odds ratio = 3 inclusive of all cats; P = .005, odds ratio = 5 when non-DM cats with overt clinical evidence of respiratory disease were excluded). Pulmonary abnormalities detected by histopathological examination in cats with diabetes included congestion and edema, histiocytosis, pneumonia, smooth muscle hypertrophy, fibrosis, mineralization, neoplasia, and type II pneumocyte hyperplasia. The observed association between DM and pulmonary lesions in cats, independent of clinical evidence of respiratory disease, emphasizes the need for careful assessment of the respiratory tract in sick cats with diabetes.

  2. Retrospective analysis of nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions in a population of Taiwanese patients.

    PubMed

    Huang, Hsun-Yu; Chen, Yuk-Kwan; Ko, Edward Cheng-Chuan; Chuang, Fu-Hsiung; Chen, Ping-Ho; Chen, Ching-Yi; Wang, Wen-Chen

    2017-07-01

    We aimed to evaluate nonendodontic periapical lesions clinically misdiagnosed as endodontic periapical pathoses in a population of Taiwanese patients. Cases (2000-2014) of histopathological diagnoses of nonendodontic periapical lesions were retrieved from all cases with a clinical diagnosis of radicular cyst, apical granuloma, or apical periodontitis in the institution. These cases were regarded as misdiagnosed nonendodontic periapical lesions, of which the types and frequencies, in addition to the demographic data, were determined. Four thousand and four specimens were clinically diagnosed as endodontically associated pathoses, of which 118 cases (2.95%) received a histopathological diagnosis of a nonendodontic pathologic entity, the most frequent lesion being keratocystic odontogenic tumor (KCOT, n = 38, 32.20%), followed by fibro-osseous lesion (n = 18, 15.25%), and dentigerous cyst (n = 13, 11.02%). Nine malignant lesions in the periapical area [squamous cell carcinoma (n = 7, 5.93%), adenoid cystic carcinoma (n = 1, 0.85%), and Langerhans cell histiocytosis (n = 1, 0.85%)] were also noted. A wide variety of histopathological diagnoses, including benign odontogenic and non-odontogenic cystic and tumorous lesions and infectious diseases, as well as malignant lesions, was noted in these 118 cases of nonendodontic periapical lesions. Squamous cell carcinoma was the most predominant malignancy of nonendodontic periapical lesions misdiagnosed as apical periodontitis lesions from imaging examination overlooking the clinical findings. The current data form a useful basis for clinicopathological investigation and educational teaching regarding nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions.

  3. Orbital Involvement by NUT Midline Carcinoma.

    PubMed

    D'Souza, Jill N; Notz, Gregory; Bogdasarian, Ronald N; Cognetti, David M; Curry, Joseph M; Rosen, Marc R; Tuluc, Madalina; Evans, James J; Bilyk, Jurij R

    2015-01-01

    A 32-year-old female presented with a sino-orbital lesion that proved to be a NUT midline carcinoma. This is only the third case of orbital involvement by this aggressive lesion. The clinical, radiographic, and histopathologic features of NUT midline carcinoma are discussed, as well as its management options.

  4. Morphoproteomics provides support for TGF-β pathway signaling in the osteoclastogenesis and immune dysregulation of osteolytic Langerhans cell histiocytosis

    PubMed Central

    Alexandrescu, Sanda; Tatevian, Nina; Czerniak, Bogdan A; Covinsky, Michael H; Burns, Nadja K; Brown, Robert E

    2012-01-01

    Langerhans cell histiocytosis (LCH) has a challenging and still unclear pathogenesis. A body of literature points to impaired maturation of the lesional dendritic cells, and to immune dysregulation in the form of increased FoxP3 cells. Various cytokine abnormalities such as expression of transforming growth factor (TGF)-β have been reported, as well as abnormalities in lipid content in LCH cells. Morphoproteomic techniques were applied to identify the signal transduction pathways that could influence histogenesis and immune regulation in osteolytic LCH. Five pediatric cases of osteolytic LCH were examined, using antibodies against CD1a, S100, CD68, CD8, FoxP3, phosphorylated (p)-STAT3 (Tyr705), protein kinase C (PKC)-α, phospholipase (PL)D1, fatty acid synthase (FASN), and zinc finger protein, Gli2. Positive and negative controls were performed. A FoxP3(+)/CD8(+) cell ratio was calculated by counting the FoxP3+ and CD8+ cells in 10 high power fields for each case. There is induction of sonic hedgehog (SHH) mediators consistent with TGF-β signaling pathway through Smad3-dependent activation of Gli2, findings supported by the plasmalemmal and cytoplasmic expression of PKC-α and PLD1, and nuclear expression of Gli2, in lesional cells. The FoxP3+/CD8+ cell ratio is increased, ranging from 1.7-7.94. There is moderate cytoplasmic expression of FASN in most of the Langerhans cells, a finding that supports previously published phospholipid abnormalities in LCH and is consistent with PKC-α/PLD1/TGF-β signaling. With our study, we strongly suggest that the TGF-β cell signaling pathway is a major player in the pathogenesis of LCH, leading to non-canonical induction of nuclear Gli2 expression, thereby contributing to osteoclastogenesis in LCH histiocytes. It could also cause a state of immune frustration in LCH, by inducing the transformation of CD4(+)CD25(-) cells into CD4(+)/FoxP3(+) cells. This coincides with the clinical evidence of a response to thalidomide in

  5. A longitudinal MRI study on lymph nodes histiocytosis of a xenograft cancer model

    PubMed Central

    Jiménez-González, María; Plaza-García, Sandra; Arizeta, Janire; Bianchessi, Silvia; Trigueros, César; Reese, Torsten

    2017-01-01

    Background Efforts are continuously made to detect and investigate the pivotal processes and interplay between the response of sentinel lymph node and malignant cells from a primary tumor. Conversely, some frequently used tumor animal models, such as human cancer xenografts, rarely feature metastasis. Therefore, lymph node alterations are seldom assessed. We consider that studying lymph node response could contribute to the understanding of host reaction to cancer. In the present study, we explored the presence of regional lymph node alterations in parallel with tumor growth using a pancreatic tumor xenograft model which does not develop metastasis. Methods and findings We established an animal cancer model by the subcutaneous inoculation of PANC-1 (a metastatic human pancreatic cancer cell line) in the left upper flank of athymic nude mice. Tumor animals, along with controls (n = 7 / group) were subjected to Magnetic Resonance Imaging (MRI) in order to follow tumor growth and brachial and axillary lymph nodes alterations over several weeks. Further histological analyses were performed at the end of the study. The individual average of the different lymph nodes sizes was 15–40% larger in the tumor animals compared to control animals at week 8 to week 20. The tumor size and lymph node size were not correlated. Histological analysis of the lymph nodes showed paracortical histiocytosis. No metastasis to lymph nodes could be detected by histology. In tumor bearing animals, histiocytosis was associated with isolated apoptotic bodies and migration of human tumoral cells was confirmed by specific immunostaining of human origin markers. Conclusions The lack of metastasis as well as the pathological manifestation of the lymph node alteration in this pre-clinical model established here parallels findings in patients with sinus histiocytosis that is correlated with improved survival. PMID:28704462

  6. Recognition and treatment of concurrent active and neurodegenerative langerhans cell histiocytosis: a case report.

    PubMed

    Ehrhardt, Matthew J; Karst, Jeffrey; Donohoue, Patricia A; Maheshwari, Mohit; McClain, Kenneth L; Bingen, Kristin; Kelly, Michael E

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a disorder of dendritic cell proliferation with subsequent tissue damage often requiring chemotherapy. Neurodegenerative LCH presents with neuromuscular, cognitive, and behavioral alterations typically occurring years after diagnosis of active LCH. We present a male child with a 4-year history of growth arrest, polyuria, polydipsia, recurrent otitis media, and seborrheic dermatitis. Cutaneous biopsies confirmed LCH and chemotherapy was initiated. During treatment for active LCH he developed neuropsychiatric decline. White matter changes on brain MRI were consistent with neurodegenerative LCH. Treatment was changed to cytarabine and intravenous immunoglobulin. After 1 year of therapy the patient experienced neuropsychological improvement.

  7. Rare case of unifocal Langerhans cell histiocytosis in four-month-old child.

    PubMed

    Martins, Marco Antonio T; Gheno, José Luis N; Sant'Ana Filho, Manoel; Pinto, Décio S; Tenis, Carlos Alberto; Martins, Manoela D

    2011-07-01

    Langerhans cell histiocytosis (LCH) comprises a group of disorders, the common feature of which is Langerhans cell proliferation. The clinical presentation is highly varied. The severity and prognosis of the disease are dependent on the type and extent of organ involvement. This paper reports a rare case of a four-month-old white male with unifocal LCH limited exclusively to the mandible, discussing the diagnosis, radiographic and immunohistochemical aspects, treatment and monitoring multidisciplinary of the case. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Diabetes insipidus and Langerhans cell histiocytosis: a case report of reversibility with 2-chlorodeoxyadenosine.

    PubMed

    Ottaviano, Fabio; Finlay, Jonathan L

    2003-07-01

    Diabetes insipidus (DI) is the most common manifestation of central nervous system involvement in Langerhans cell histiocytosis (LCH). Patients with LCH involving the head and neck region are reported to have about a 40% lifetime chance of developing DI. The clinical and biochemical diagnosis of DI is sometimes supported by the absence of the posterior pituitary bright signal on magnetic resonance images. Cladribine (2-chlorodeoxyadenosine, 2-CDA) has been reported as an active drug in children and adults with relapsed or refractory LCH. The authors report the successful reversal of DI in a 3-year-old child with established LCH using 2-CDA.

  9. Sporadic progressive mucinous histiocytosis in a Mexican patient.

    PubMed

    Narváez-Rosales, Verónica; Sáez-de-Ocariz, Marimar; Toussaint-Caire, Sonia; Ortiz-Hidalgo, Carlos; Espinosa-Rosales, Francisco

    2013-01-01

    A 33 year-old woman presented with numerous 3- to 5-mm red-brown and yellow-brown dome-shaped nodules, primarily located on the scalp, dorsal aspects of the forearms, and lower extremities (Figure 1 and Figure 2). Her lesions started to appear 5 years prior to her consultation with increasing number and without spontaneous regression. Findings from a previous biopsy revealed epithelioid dermatofibroma. The remainder of the physical examination was unremarkable. There were no familial cases of this condition (both the mother and two older sisters were examined).

  10. The presence of CXCR4+ CD1a+ cells at onset of Langerhans cell histiocytosis is associated with a less favorable outcome

    PubMed Central

    Quispel, Willemijn T.; Stegehuis-Kamp, Janine A.; Blijleven, Laura; Santos, Susy J.; Lourda, Magda; van den Bos, Cor; van Halteren, Astrid G.S.; Egeler, R. Maarten

    2016-01-01

    abstract Purpose: Langerhans Cell Histiocytosis (LCH) is a neoplastic disorder characterized by tissue accumulating CD1a+ histiocytes which frequently carry somatic mutations. Irrespective of mutation status, these LCH-cells display constitutively active kinases belonging to the MAPK pathway. We evaluated, in retrospect, the contribution of individual components of the MAPK-activating and chemotaxis-promoting TNF-CXCR4-CXCL12 axis to LCH manifestation and outcome. Experimental design: CXCR4, CXCL12 and TNF protein expression was immunohistochemically analyzed in 70 LCH-affected biopsies. The presence of CXCR4+CD1a+ cells in peripheral blood (PB) and/or bone marrow (BM) samples was evaluated by flowcytometry in 13 therapy-naive LCH-patients. Results: CXCL12 was detected in 68/70 (97%) biopsies. CXCR4+LCH-cells were present in 50/70 (71%) biopsies; their presence was associated with higher levels of intralesional TNF. Circulating CD1a+CXCR4+ cells were detected in 4/13 (31%) therapy-naïve LCH-patients which displayed BRAFV600E (2/4), MAP2K1 (1/4) or no (1/4) mutations in their tissues. These CD11c co-expressing CD1a+CXCR4+cells migrated to CXCL12 in chemotaxis assays. Lesional CXCR4+LCH-cells were detected in 18/20 cases who presented with LCH manifestation at multiple sites and in 5/23 (22%) patients who developed additional lesions after initially presenting with a single lesion. The CXCR4 status at onset proved to be an independent risk factor for LCH reactivation in multivariate analysis (odds ratio 10.4, p = 0.034). Conclusions: This study provides the first evidence that CXCR4 is involved in the homing and retention of LCH-cells in CXCL12-expressing tissues and qualifies CXCR4 as a candidate prognostic marker for less favorable disease outcome. PMID:28255525

  11. 18F-fluorodeoxyglucose positron emission tomography/computed tomography for primary thyroid langerhans histiocytosis: A case report and literature review

    PubMed Central

    Long, Qi; Shaoyan, Wang; Hui, Wang

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease, with an incidence rate of 4.0–5.4/1 million individuals. LCH encompasses a spectrum of disorders with diverse clinical presentations ranging from a single organ to multiple organ involvement. LCH rarely involves the thyroid gland. We presented a case with LCH of thyroid gland. The patient had painless progressive neck enlargement and then diabetes insipidus. Ultrasonic scan and magnetic resonance imaging scan revealed nodular goiter and pituitary stalk enlargement, respectively. Histopathological analysis revealed features of histiocytoid cells. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed in order to rule out the presence of whole body infiltration. 18F-FDG PET/CT also demonstrated increased uptake in the thickening pituitary stalk and maxillofacial skin lesion, in addition to the bilateral thyroid nodules, CT showed the left lung nodule and the skull destruction without 18F-FDG uptake. This report emphasizes the role of 18F-FDG PET/CT in multiple organs involvement of patients with LCH. PMID:26430317

  12. [Endoscopic approaches to the orbit].

    PubMed

    Cebula, H; Lahlou, A; De Battista, J C; Debry, C; Froelich, S

    2010-01-01

    During the last decade, the use of endoscopic endonasal approaches to the pituitary has increased considerably. The endoscopic endonasal and transantral approaches offer a minimally invasive alternative to the classic transcranial or transconjunctival approaches to the medial aspect of the orbit. The medial wall of the orbit, the orbital apex, and the optic canal can be exposed through a middle meatal antrostomy, an anterior and posterior ethmoidectomy, and a sphenoidotomy. The inferomedial wall of the orbit can be also perfectly visualized through a sublabial antrostomy or an inferior meatal antrostomy. Several reports have described the use of an endoscopic approach for the resection or the biopsy of lesions located on the medial extraconal aspect of the orbit and orbital apex. However, the resection of intraconal lesions is still limited by inadequate instrumentation. Other indications for the endoscopic approach to the orbit are the decompression of the orbit for Graves' ophthalmopathy and traumatic optic neuropathy. However, the optimal management of traumatic optic neuropathy remains very controversial. Endoscopic endonasal decompression of the optic nerve in case of tumor compression could be a more valid indication in combination with radiation therapy. Finally, the endoscopic transantral treatment of blowout fracture of the floor of the orbit is an interesting option that avoids the eyelid or conjunctive incision of traditional approaches. The collaboration between the neurosurgeon and the ENT surgeon is mandatory and reduces the morbidity of the approach. Progress in instrumentation and optical devices will certainly make this approach promising for intraconal tumor of the orbit.

  13. Isolated Langerhans Cell Histiocytosis of the Thyroid in an Adult Female: One-Year Followup

    PubMed Central

    Vilallonga, Ramon; Ciudin, Andrea; Fort, José Manuel; Baena, Juan Antonio; Gonzalez, Oscar; Armengol, Manuel; Mesa, Jordi; Ruiz Marcellán, Mari Carmen

    2011-01-01

    Thyroid gland involvement as the unique presentation of Langerhans cell histiocytosis is a rare phenomenon that can result in misdiagnosis. We report a case of Langerhans cell histiocytosis (LCH) presenting as a thyroid mass. It is a 52-year-old woman who presented an enlarged, diffusely firm, nontender, nonmobile, and not particularly nodular thyroid gland with mild compressive symptoms. Ultrasound and fine-needle aspiration showed a unique right node with benign signs. Patient was referred to our Ambulatory Surgery Department, where a hemithyroidectomy was performed. Histologic evaluation of the right thyroid gland revealed an involvement by LCH, confirmed by immunohistochemical analysis showing Langerhans cells that were positive for CD1a. LCH was a completely incidental occult finding apparent only after surgical resection and examination of the gland. Patient was evaluated, and no evidence of systemic affectation was found. LCH can rarely involve the thyroid gland in adults. Few cases have been reported in the literature. Most patients had evidence of LCH involving other anatomic sites. PMID:21461403

  14. Social/economic costs and health-related quality of life in patients with histiocytosis in Europe.

    PubMed

    Iskrov, Georgi; Astigarraga, Itziar; Stefanov, Rumen; López-Bastida, Julio; Linertová, Renata; Oliva-Moreno, Juan; Serrano-Aguilar, Pedro; Posada-de-la-Paz, Manuel; Schieppati, Arrigo; Taruscio, Domenica; Péntek, Márta; von der Schulenburg, Johann Matthias Graf; Kanavos, Panos; Chevreul, Karine; Persson, Ulf; Fattore, Giovanni

    2016-04-01

    The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with histiocytosis in Europe. We conducted a cross-sectional study of patients with histiocytosis from France, Germany, Italy, Spain, Bulgaria, the UK, and Sweden. Data on demographic characteristics, health resource utilisation, informal care, loss of labour productivity and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. A total of 134 patients (35 France, 32 Germany, 30 Italy, 24 Spain, 7 Bulgaria, 4 UK and 2 Sweden) completed the questionnaire. The average annual costs ranged from € 6832 to € 33,283 between countries, the year of reference being 2012. Estimated direct healthcare costs ranged from € 1698 to € 18,213; direct nonhealthcare costs ranged from € 2936 to € 17,622 and labour productivity losses ranged from € 1 to € 8855. The mean EQ-5D score for adult histiocytosis patients was estimated at between 0.32 and 0.85, and the mean EQ-5D visual analogue scale score was estimated at between 50.00 and 66.50. The main strengths of this study lie in our bottom-up approach to costing and in the evaluation of histiocytosis patients from a broad perspective (societal costs). This type of analysis is very scarce in international literature for rare diseases in comparison with other illnesses. We conclude that histiocytosis patients incur considerable societal costs and experience substantial deterioration in HRQOL.

  15. Isolated thymic Langerhans cell histiocytosis discovered on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT).

    PubMed

    Turpin, Sophie; Carret, Anne-Sophie; Dubois, Josée; Buteau, Chantal; Patey, Natalie

    2015-11-01

    The thymic infiltration in young patients with multisystemic Langerhans cell histiocytosis and its radiologic features are well known. However, isolated thymic disease has seldom been reported in the literature. We report the case of a 10-month-old child admitted for fever of unknown origin. Whole-body F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) was performed to identify a focus of infection. It demonstrated an unusual aspect of the thymus, which led to further investigation and revealed isolated infiltration of the thymus by Langerhans cell histiocytosis. The patient was treated accordingly and is now disease free. As evaluation of Langerhans cell histiocytosis patients with F-18 FDG PET/CT is becoming more frequent, it is important to be aware of the scintigraphical characteristics of thymic Langerhans cell histiocytosis.

  16. Concomitant orbital cavernous haemangioma and schwannoma in a patient.

    PubMed

    Gupta, Shweta; Kaliki, Swathi; Gowrishankar, Swarnalata

    2017-01-12

    A woman aged 39 years presented with right eye painless proptosis and decreased vision since 5 months. Right fundus examination revealed optic disc oedema. CT of the orbit revealed a well-defined homogeneous mass in the intraconal space in both orbits. Surgical excisional biopsy of the orbital lesions was performed. Histopathological examination of the right orbital lesion was suggestive of cavernous haemangioma and the left orbital lesion revealed schwannoma. The patient had an unremarkable postoperative course with improved visual acuity. This case illustrates benign orbital masses of 2 different tissues of origin in a single patient, which has not been described in the literature.

  17. Isolated Sphenoid Sinus Lesions: Experience with a Few Rare Pathologies

    PubMed Central

    Sadashiva, Nishanth; Nandeesh, B. N.; Shukla, Dhaval; Bhat, Dhananjaya; Somanna, Sampath; Devi, Bhagavatula Indira

    2017-01-01

    Introduction: The sphenoid sinus is often neglected because of its difficult access. The deep position of the sphenoid sinus hinders early diagnosis of pathologies in that location. Delayed diagnosis can cause serious complications due to proximity to many important structures. Objectives: The aim of this study is to demonstrate different pathologies which can affect the sphenoid sinus and elucidate the findings. Methods: Cases of isolated sphenoid sinus lesions encountered in the neurosurgical setting which had rare pathologies are discussed. Pathologies such as Langerhans cell histiocytosis, solitary plasmacytoma, chordoma, pituitary adenoma, leiomyosarcoma, fungal infection, and mucocele which appeared primarily in sphenoid sinus are discussed along with their imaging features and pathological findings. Conclusion: Multitude of different pathologies can occur in sphenoid sinus. Detailed preoperative imaging is very helpful, but transnasal biopsy and histological study are required often for definitive diagnosis. The possible advantages of early diagnosis before spread of pathology for prognosis cannot be overemphasized. PMID:28149092

  18. Kepler's Orbit

    NASA Image and Video Library

    Kepler does not orbit the Earth, rather it orbits the Sun in concert with the Earth, slowly drifting away from Earth. Every 61 Earth years, Kepler and Earth will pass by each other. Throughout the ...

  19. Orbital cellulitis

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001012.htm Orbital cellulitis To use the sharing features on this page, please enable JavaScript. Orbital cellulitis is an infection of the fat and muscles ...

  20. Rare Gastric Lesions Associated with Helicobacter pylori Infection: A Histopathological Review.

    PubMed

    Joo, Mee

    2017-07-01

    Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. However, some rare gastric lesions exhibiting distinctive histological features may also be associated with H. pylori infection, including lymphocytic gastritis, granulomatous gastritis, Russell body gastritis, or crystal-storing histiocytosis. Although diverse factors can contribute to their development, there is convincing evidence that H. pylori infection may play a pathogenic role. These findings are mainly based on studies in patients with these lesions who exhibited clinical and histological improvements after H. pylori eradication therapy. Thus, H. pylori eradication therapy might be indicated in patients with no other underlying disease, particularly in countries with a high prevalence of H. pylori infection. This review describes the characteristic histological features of these rare lesions and evaluates the evidence regarding a causative role for H. pylori infection in their pathogenesis.

  1. A Case of Orbital Histoplasmosis.

    PubMed

    Krakauer, Mark; Prendes, Mark Armando; Wilkes, Byron; Lee, Hui Bae Harold; Fraig, Mostafa; Nunery, William R

    2016-01-01

    Histoplasma capsulatum var capsulatum is a dimorphic fungus endemic to the Ohio and Mississippi River Valleys of the United States. In this case report, a 33-year-old woman who presented with a right orbital mass causing progressive vision loss, diplopia, and facial swelling is described. Lateral orbitotomy with lateral orbital wall bone flap was performed for excisional biopsy of the lesion. The 1.5 × 1.8 × 2.3 cm cicatricial mass demonstrated a granulomatous lesion with necrosis and positive staining consistent with Histoplasma capsulatum var capsulatum infection. To the authors' knowledge, this is the first case of orbital histoplasmosis to be reported in the United States and the first case worldwide of orbital histoplasmosis due to Histoplasma capsulatum var capsulatum.

  2. Sinus histiocytosis with massive lymphadenopathy. Is the lymph node enlargement always massive?

    PubMed

    Sachdev, Ritesh; Setia, Namrata; Jain, Shyama

    2007-05-01

    Sinus histiocytosis with massive lymphadenopathy (SHML) is a benign proliferating histiocytic disorder, predominantly of lymph nodes with extra-nodal involvement in some cases. It is a self-limiting disease and has a good prognosis; however some patients need steroid therapy. Therein lays a need to differentiate it from other lympho proliferative disorders of poorer prognosis. Clinically, it is suspected only when there is a significant lymph node enlargement in younger age group as the term signifies. Recently, we came across a case where a middle-aged female presented with a subtle swelling in submental region, clinically suspected of reactive or tubercular etiology. However on fine needle aspiration cytology, the smears showed many histiocytes, some of them showing lymphocytes and plasma cells in their cytoplasm, a morphological feature called as "emperipolesis" classically seen in SHML. The present case is reported because of unusual clinical presentation and possibly the need for a revision of existing terminology.

  3. Bisphosphonates Significantly Increase the Activity of Doxorubicin or Vincristine Against Canine Malignant Histiocytosis Cells

    PubMed Central

    Hafeman, S.D.; Varland, D.; Dow, S.W.

    2011-01-01

    Canine malignant histiocytosis (MH) is an aggressive neoplasm of macrophages and dendritic cells. It carries a poor prognosis due to the development of widespread metastasis and poor sensitivity to chemotherapy. Thus, there is a large need for new treatments for MH. We hypothesized that bisphosphonates might be useful to increase the effectiveness of cytotoxic chemotherapy against MH. To address this question, we conducted in vitro screening studies using MH cell lines and a panel of 6 chemotherapy and 5 bisphosphonate drugs. The combination of clodronate with vincristine was found to elicit synergistic killing which was associated with a significant increase in cell cycle arrest. Second, zoledronate combined with doxorubicin also significantly increased cell killing. Zoledronate significantly increased the uptake of doxorubicin by MH cells. Based on these findings, we conclude that certain bisphosphonate drugs may increase the overall effectiveness of chemotherapy for MH in dogs. PMID:22236140

  4. Pink lesions.

    PubMed

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  5. [Primary orbital squamous cell carcinoma].

    PubMed

    Campos Arbulú, Ana L; Sadava, Emmanuel E; Sánchez Ruiz, Alejandro; Fernández Vila, Juan M; Dillon, Horacio S; Mezzadri, Norberto A

    2017-01-01

    Primary orbital squamous cell carcinoma is a rare entity. There is little published literature. We report a case of primary squamous cell carcinoma of the orbital soft tissues. Surgical resection offered the best treatment for the patient. Complete resection of the lesion was achieved. The patient received adjuvant radiotherapy due to the proximity of the lesion to the surgical margins. Surgical treatment is feasible and should be considered as part of the surgeon's arsenal. However, therapeutic decisions must be made on a case-by-case basis.

  6. Nodular Fasciitis of the Orbit.

    PubMed

    Compton, Christopher J; Clark, Jeremy D; Thompson, Matthew P; Lee, Hui Bae H; Nunery, William R

    A 13-month-old boy was presented with new onset proptosis of the right eye. CT scan and MRI showed an enhancing mass in the right superior orbit with local bone remodeling and erosion. A craniotomy was performed for biopsy and sub-total resection. Histopathology and immunohistochemistry confirmed the lesion to be nodular fasciitis. Nodular fasciitis lesions are classically found in the anterior ocular adnexa, especially in pediatric patients. This is the first reported case of nodular fasciitis arising in the posterior orbit of a child younger than 16.

  7. Necrotic orbital melanoma arising de novo.

    PubMed Central

    Shields, J A; Shields, C L; Eagle, R C; De Potter, P; Oliver, G L

    1993-01-01

    A 76-year-old man with compressive optic neuropathy secondary to a retrobulbar mass was managed by orbitotomy and removal of the mass. The lesion proved histopathologically to be an unusual orbital melanoma with massive central necrosis. There was no histopathological evidence of congenital melanocytosis. Dermatological and systemic evaluation before and after orbital surgery revealed no evidence of primary melanoma elsewhere. The patient developed hepatic metastasis 2 years after excision of the orbital tumour. It appears that the melanoma was a primary orbital tumour and not a metastatic melanoma from an occult primary lesion. Images PMID:8457515

  8. Tumor pathology of the orbit.

    PubMed

    Héran, F; Bergès, O; Blustajn, J; Boucenna, M; Charbonneau, F; Koskas, P; Lafitte, F; Nau, E; Roux, P; Sadik, J C; Savatovsky, J; Williams, M

    2014-10-01

    The term orbital tumor covers a wide range of benign and malignant diseases affecting specific component of the orbit or developing in contact with them. They are found incidentally or may be investigated as part of the assessment of a systemic disorder or because of orbital signs (exophthalmos, pain, etc.). Computed tomography, MRI and Color Doppler Ultrasound (CDU), play a varying role depending on the clinical presentation and the disease being investigated. This article reflects long experience in a reference center but does not claim to be exhaustive. We have chosen to consider these tumors from the perspective of their usual presentation, emphasizing the most common causes and suggestive radiological and clinical presentations (progressive or sudden-onset exophthalmos, children or adults, lacrimal gland lesions, periorbital lesions and enophthalmos). We will describe in particular muscle involvement (thyrotoxicosis and tumors), vascular lesions (cavernous sinus hemangioma, orbital varix, cystic lymphangioma), childhood lesions and orbital hematomas. We offer straightforward useful protocols for simple investigation and differential diagnosis. Readers who wish to go further to extend their knowledge in this fascinating area can refer to the references in the bibliography.

  9. Physiologic Determinants of Exercise Capacity in Pulmonary Langerhans Cell Histiocytosis: A Multidimensional Analysis

    PubMed Central

    Fry, Stephanie; Giovannelli, Jonathan; Langlois, Carole; Bricout, Nicolas; Aguilaniu, Bernard; Bellocq, Agnes; Le Rouzic, Olivier; Dominique, Stephane; Delobbe, Alain; François, Geraldine; Tazi, Abdellatif; Wallaert, Benoit; Chenivesse, Cecile

    2017-01-01

    Background Reduced exercise capacity severely impacts quality of life in pulmonary Langerhans cell histiocytosis. Ascertaining mechanisms that impair exercise capacity is necessary to identify targets for symptomatic treatments. Methods Dyspnea, pulmonary function tests and cardiopulmonary exercise test were analysed in 62 study participants. Data were compared between subjects with impaired and normal aerobic capacity (V’O2 peak less than 84% versus 84% predicted or more). Data were reduced using a principal component analysis. Multivariate analysis included V’O2 peak as the dependent variable and principal components as covariates. Results V’O2 peak was reduced in 44 subjects (71%). Subjects with impaired aerobic capacity presented: (i) decreased FEV1, FVC, FEV1/FVC, DLCO and DLCO/VA and increased AaDO2, (ii) increased ventilatory equivalents at ventilatory threshold, VD/VT peak, AaDO2 peak and PaCO2 peak and decreased ventilatory reserve and PaO2 peak. There was no difference between groups in dyspnea scores. Principal component analysis extracted 4 principal components interpreted as follows: PC1: gas exchange; PC2: “pseudorestriction”; PC3: exercise-induced hyperpnea; PC4: air trapping. Multivariate analysis explained 65% of V’O2 peak. The 4 principal components were independently associated with V’O2 peak (βcoefficients: PC1: 9.3 [4.6; 14], PC2: 7.5 [3; 11.9], PC3: -5.3 [-9.6;-1.], PC4: -9.8 [-14,9;-4.7]). Conclusion Impaired exercise capacity is frequent in pulmonary Langerhans cell histiocytosis. It is mainly caused by pulmonary changes but is not associated with increased dyspnea intensity. Therefore, treating the lung represents a relevant approach for improving exercise capacity, even in patients experiencing mild dyspnea. PMID:28072848

  10. Sinus histiocytosis with massive lymphadenopathy Rosai-Dorfman disease: a unique case presentation.

    PubMed

    Kaltman, Jordan M; Best, Steven P; McClure, Shawn A

    2011-12-01

    Rosai and Dorfman first described sinus histiocytosis with massive lymphadenopathy (SHML) in 1969 with an article detailing 4 cases in which they differentiated this disease entity from the grouping of diseases categorized as histiocytosis X, where it was previously classified. Also known as Rosai-Dorfman disease (RDD), it is clinically characterized as massive, painless, bilateral, symmetric cervical lymphadenopathy, with fever and leukocytosis. An 11-year-old African American boy was referred to our clinic for extraction of a severely decayed tooth #30 and evaluation of a large right-sided neck mass. Initially, the patient had been seen by his general dentist who had diagnosed the mass as an odontogenic abscess. After 2 courses of different antibiotics, no changes in the mass were noted. Subsequently, the patient was sent to the emergency department where CT revealed multiple right-sided neck masses with the largest measuring 4 × 2 cm. The patient underwent an incisional biopsy by otolaryngology and a diagnosis of necrotic lymph tissue was made. Upon our examination, the carious tooth #30 was felt to be an incidental finding and fine-needle aspiration cytology of the largest mass was performed in 2 places. This also provided a diagnosis of necrotic lymph tissue. In concert with the patient and his mother, the decision was made to excise the mass because of psychosocial concerns. A massive right-sided lymph node attached to the submandibular gland was found and excised without complication. Histologic examination with S-100 stain confirmed a diagnosis of RDD. The patient healed well following surgery and has experienced no further lymphadenopathy. This case presentation and review of the literature is unique, as the patient presented with unilateral cervical lymphadenopathy only. Open biopsy and 2 fine-needle aspirations all returned as necrotic lymph tissue. Obtaining the correct diagnosis was additionally hampered by coincidental dental pathology on the

  11. Diagnosis of Langerhans cell histiocytosis on fine needle aspiration cytology: a case report and review of the cytology literature.

    PubMed

    Kumar, Neeta; Sayed, Shahin; Vinayak, Sudhir

    2011-01-20

    A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls.

  12. Orbital Chondroma: A rare mesenchymal tumor of orbit

    PubMed Central

    Kabra, Ruchi S; Patel, Sonal B; Shanbhag, Swapna S

    2015-01-01

    While relatively common in the skeletal system, cartilaginous tumors are rarely seen originating from the orbit. Here, we report a rare case of an orbital chondroma. A 27-year-old male patient presented with a painless hard mass in the superonasal quadrant (SNQ) of left orbit since 3 months. On examination, best-corrected visual acuity of both eyes was 20/20, with normal anterior and posterior segment with full movements of eyeballs and normal intraocular pressure. Computerized tomography scan revealed well defined soft tissue density lesion in SNQ of left orbit. Patient was operated for anteromedial orbitotomy under general anesthesia. Mass was excised intact and sent for histopathological examination (HPE). HPE report showed lobular aggregates of benign cartilaginous cells with mild atypia suggesting of benign cartilaginous tumor - chondroma. Very few cases of orbital chondroma have been reported in literature so far. PMID:26265654

  13. Proliferative Fasciitis of the Orbit.

    PubMed

    Bautista, Michael J; Perumal, Balaji; Jones, David M; Meyer, Dale R

    Proliferative fasciitis is a rare entity in the orbit. A 16-year-old boy presented with a growing right orbital mass, which was palpable just inferior to the medial right eyebrow. MRI demonstrated a 12 × 8 × 9 mm mass located medial to and slightly above the right globe within the subcutaneous soft tissues. An anterior orbitotomy with debulking of the lesion was performed. Histopathological examination confirmed a diagnosis of proliferative fasciitis. To the authors' knowledge, there is only one prior case in the literature demonstrating proliferative fasciitis of the orbit.

  14. A multicentre retrospective survey of Langerhans' cell histiocytosis: 348 cases observed between 1983 and 1993. The French Langerhans' Cell Histiocytosis Study Group.

    PubMed Central

    1996-01-01

    In a retrospective study involving 32 haematology/oncology departments in France, 348 cases of Langerhans' cell histiocytosis diagnosed between 1983 and 1993 were collated. The percentage of males was 56.4%. Median age at diagnosis was 30.2 months. The median follow up was 35.5 months. Initially, 108 patients (31%) had isolated unifocal or bifocal bone involvement, 67 (19%) had isolated multifocal bone involvement, 136 (39%) had soft tissue involvement without organ dysfunction, and 37 (11%) had organ dysfunction. Two thirds of the sites of involvement diagnosed throughout the course of the disease were present at diagnosis, while the remaining one third appeared during a relapse. Treatment was tailored to the individual patient and was extremely varied, hampering any comparison of regimens. Vinblastine with or without steroids was the most common regimen when systemic chemotherapy was used for the first episode (246/348). Twenty four of the 216 patients received VP 16 as first line treatment. Two patients with progressive multiorgan relapse, despite the use of several drugs, underwent bone marrow transplantation and are alive and disease free 60 and 22 months later. Altogether 21.9% of patients had sequelae, including diabetes insipidus in 17.5% of cases. The overall survival rate is 91.7% (confidence interval 90.7 to 95%) three years after diagnosis. In the univariate analysis, age less than 1 year, ear, nose, and throat, cutaneous, lymph node, liver, spleen, lung, marrow and intestinal involvement, male sex, progressive episodes, the absence of response, and partial responses, were associated with a poor vital prognosis. In a multivariate analysis of prognostic factors, poor early outcome emerged as the most important parameter, closely linked to other poor outcome features such as young age and organ dysfunction. It identified a small number of patients with a poor initial response to treatment, for whom intensive treatment should be assessed in a phase II

  15. Improved outcome in the treatment of pediatric multifocal Langerhans cell histiocytosis: Results from the Japan Langerhans Cell Histiocytosis Study Group-96 protocol study.

    PubMed

    Morimoto, Akira; Ikushima, Satoshi; Kinugawa, Naoko; Ishii, Eiichi; Kohdera, Urara; Sako, Masahiro; Fujimoto, Junichiro; Bessho, Fumio; Horibe, Keizo; Tsunematsu, Yukiko; Imashuku, Shinsaku

    2006-08-01

    The treatment outcome of multifocal childhood Langerhans cell histiocytosis (LCH) has not been satisfactory and has resulted in poor therapeutic responses with high mortality and a high incidence of reactivation with late sequelae. To overcome these issues, the Japan LCH Study Group-96 (JLSG-96) protocol was conducted prospectively from 1996 to 2001 in Japan. Newly diagnosed children with multifocal LCH were classified into 2 groups: a single-system multisite (SS-m) group and a multisystem (MS) group. All patients initially were treated on Protocol A, which consisted of 6 weeks of induction therapy with combined cytosine arabinoside, vincristine (VCR), and prednisolone (PSL) followed by 6 months of maintenance therapy. Patients who had a poor response to the induction of Protocol A were switched to a salvage regimen (Protocol B), which consisted of an intensive combination of doxorubicin, cyclophosphamide, VCR, and PSL. In total, 91 patients were treated, including 32 patients in the SS-m group and 59 patients in the MS group. At the median 5-year follow-up, 96.9% of patients in the SS-m group and 78.0% of patients in the MS group had good response status. Diabetes insipidus developed in 3.1% of patients in the SS-m group and in 8.9% of patients in the MS group. The overall survival rate at 5 years for the SS-m and MS groups was 100% and 94.4% +/- 3.2%, respectively. The JLSG-96 protocol attained very low mortality for pediatric patients with multifocal LCH. Copyright 2006 American Cancer Society.

  16. Orbital Granulomatosis With Polyangiitis (Wegener Granulomatosis)

    PubMed Central

    Muller, Karra; Lin, Jonathan H.

    2014-01-01

    The pathology of granulomatosis with polyangiitis (GPA), formerly Wegener granulomatosis, typically features a granulomatous and sometimes necrotizing vasculitis targeting the respiratory tract and kidneys. However, orbital involvement occurs in up to 60% of patients and is frequently the first or only clinical presentation in patients with systemic or limited forms of GPA. Orbital GPA can cause significant morbidity and potentially lead to complete loss of vision and permanent facial deformity. Fortunately, GPA is highly responsive to medical treatment with corticosteroids combined with cyclophosphamide or, more recently, rituximab. Therefore, it is imperative for this disease to be accurately diagnosed on orbital biopsy and distinguished from other histologically similar orbital lesions. Herein, we review the clinical and pathologic findings of orbital GPA, focusing on the differentiation of this disease from other inflammatory orbital lesions. PMID:25076302

  17. The Hot Orbit: Orbital Cellulitis

    PubMed Central

    Chaudhry, Imtiaz A.; Al-Rashed, Waleed; Arat, Yonca O.

    2012-01-01

    Orbital cellulitis is an uncommon condition previously associated with severe complications. If untreated, orbital cellulitis can be potentially sight and life threatening. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. The infection most commonly originates from sinuses, eyelids or face, retained foreign bodies, or distant soources by hematogenous spread. It is characterized by eyelid edema, erythema, chemosis, proptosis, blurred vision, fever, headache, and double vision. A history of upper respiratory tract infection prior to the onset is very common especially in children. In the era prior to antibiotics, vision loss from orbital cellulitis was a dreaded complication. Currently, imaging studies for detection of orbital abcess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention. PMID:22346113

  18. Inflammation of the Orbit

    MedlinePlus

    ... Cavernous Sinus Thrombosis Inflammation of the Orbit Orbital Cellulitis Preseptal Cellulitis Tumors of the Orbit Any or all of ... Cavernous Sinus Thrombosis Inflammation of the Orbit Orbital Cellulitis Preseptal Cellulitis Tumors of the Orbit NOTE: This ...

  19. Orbital Eccrine Hidrocystoma

    PubMed Central

    Marangoz, Deniz; Doğan Ekici, Işın; Çiftçi, Ferda

    2016-01-01

    A 29-year-old female patient presented with a painless mass on her upper eyelid medially. She noticed the mass 4 years earlier and it had increased in size over time. She had no diplopia, eyelid swelling, skin lesion overlying the mass, or visual disturbances. On ocular examination, eye movements and funduscopy were normal. The mass was movable and painless with palpation. Magnetic resonance imaging with contrast showed a 12x8x7 mm well-circumscribed cystic lesion with no contrast dye appearance. Surgical removal was performed delicately and no capsular rupture occured. Pathological examination revealed an eccrine hidrocystoma. Our aim is to underline that eccrine hidrocystoma should be included in differential diagnosis of orbital masses. PMID:28058171

  20. Computed tomography of the eye and orbit

    SciTech Connect

    Hammerschlag, S.B.; Hesselink, J.R.; Weber, A.L.

    1982-01-01

    This book is the product of the evolution of computed tomography (CT) into subspecialization and the need for one source of information for the busy radiologist. The authors have succeeded in providing a readable overview of orbital CT as well as a reference book. The book is divided into seven major catagories of pathology (Neurofibromatosis, Primary Orbital Neoplasms, Secondary and Metastic Tumors of the Orbit, Vascular Disorders, Inflammatory Disease, Occular Lesions, and Trauma) after separate discussions of anatomy and technique.

  1. Orbital pseudotumor

    MedlinePlus

    ... Goodlick TA, Kay MD, Glaser JS, Tse DT, Chang WJ. Orbital disease and neuro-ophthalmology. In: Tasman ... 423. Review Date 8/20/2016 Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La ...

  2. Orbiter's Skeleton

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The structure of NASA's Mars Reconnaissance Orbiter spacecraft is constructed from composite panels of carbon layers over aluminum honeycomb, lightweight yet strong. This forms a basic structure or skeleton on which the instruments, electronics, propulsion and power systems can be mounted. The propellant tank is contained in the center of the orbiter's structure. This photo was taken at Lockheed Martin Space Systems, Denver, during construction of the spacecraft.

  3. Severe sclerosing cholangitis after Langerhans cell histiocytosis treated by liver transplantation

    PubMed Central

    Tang, Yunhua; Zhang, Zhiheng; Chen, Maogen; Ju, Weiqiang; Wang, Dongping; Ji, Fei; Ren, Qingqi; Guo, Zhiyong; He, Xiaoshun

    2017-01-01

    Abstract Background: Langerhans cell histiocytosis (LCH) is a rare hematopoietic disorder of unknown pathogenesis. LCH diseases may occur in a single organ or multisystem organ. The patients with multisystem involvement usually have a poor prognosis. Liver involvement in multisystem LCH results in severe complications, such as obvious sclerosing cholangitis (SC) with jaundice. Methods: We reported a 31-year-old man developed severe SC due to multisystem LCH and was successfully treated by liver transplantation (LT). In addition, we firstly used tacrolimus and mycofenolate mofetil as immunosuppressants to treat LCH after LT. Results: We performed the immunosuppressants to deal with the LCH after LT, now the patient is currently well with normal liver function and no evidence of recurrence of LCH for 4 and a half years follow-up. Conclusion: LT should be recommended as an effective treatment for these adults with severe SC due to multisystem LCH. Finally, using tacrolimus and mycofenolate mofetil as immunosuppressants to treat LCH might be favorable to prevent LCH recurrence. PMID:28248858

  4. Hypopituitarism and goitre as endocrine manifestation of Langerhans cell histiocytosis (LCH). Case Report.

    PubMed

    Skowronska-Jozwiak, Elzbieta; Sporny, Stanislaw; Szymanska-Duda, Joanna; Baranska, Dobromila; Lewinski, Andrzej

    2016-07-01

    Langerhans cell histiocytosis (LCH) in adults is a rare disorder of unknown etiology characterized by monoclonal proliferation of Langerhans cells. It belongs to dendritic cell disorders and occurs in 1-2 adults per million. The most common endocrine manifestation of classical LCH is associated with the posterior pituitary, with clinical symptoms of diabetes insipidus. Less than 80 reported cases of LCH involving the thyroid gland have been published so far. We present the case of a 39 years old woman with 10 years history of diabetes insipidus and secondary amenorrhoea, which appeared after second delivery. She was suspected for lymphocytic inflammation of pituitary and she was administered steroid treatment. She was also treated symptomatically with desmopressin, L-thyroxine, estrogen and progestagen replacement therapy due to diabetes insipidus, secondary hypothyroidism and hypogonadotropic hypogonadism. In September 2014, she noticed a painless, firm tumour of the neck. Ultrasound (US) examination demonstrated bilateral, solid, hypoechogenic thyroid nodules. The result of fine-needle aspiration biopsy (FNAB) was not diagnostic. Due to rapid progression and US image of the tumour, she was referred for surgery. In postoperative histopathology tumour cells were positive for CD1a and S-100 protein, therefore diagnosis of LCH was established. Postoperatively, the results of thoracic computed tomography scan, abdominal US and bone scintigraphy revealed no evidence of multifocal disease. We have not observed any disease recurrence in the patient after a year of follow-up in postoperative course. This case illustrates diagnostic and therapeutic difficulties in patient with LCH.

  5. A confusing case report of pulmonary langerhans cell histiocytosis and literature review

    PubMed Central

    Zhen, Wang; Costable, Ulrich; Jun, Xu; Zhe, Ren; YuPing, Mao

    2016-01-01

    Abstract Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare disease. From the insidious onset and nonspecific manifestations, it is difficult to diagnose PLCH. To help improve the diagnosis and therapy options of adult PLCH, we present this case report and literature review about a confusing case of PLCH. In this report, we present a 37-year-old male PLCH case that was negative for CD1a and S100 expression. Smoking cessation and use of prescribed Spiriva appeared to improve the patient’s symptoms. To the best of our knowledge, this is the first reported case of PLCH in which improved symptoms were seen with the use of Spiriva alone.The mechanism is not clear, but potentially has some relationship with dilating the airway, decreasing the mucous hypersecretion and promoting anti-inflammatory pathways. From this patient’s case, we may be able to find more cases to then find other first line therapies for PLCH patients. PMID:28352790

  6. Molecular analysis of BRAF V600E mutation in multiple nodules of pulmonary Langerhans cell histiocytosis.

    PubMed

    Dimmler, Arno; Geddert, Helene; Werner, Martin; Faller, Gerhard

    2017-02-20

    Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, smoking-related histiocytic disorder with variable clinical symptoms. Like in other non-pulmonary Langerhans cell proliferations, PLCH has recently been shown to harbour BRAF V600E mutations in a significant subset of cases, thus challenging the concept of PLCH being a reactive disorder. Here, we analysed 38 formalin-fixed and paraffin-embedded PLCH nodules of nine patients for BRAF mutation using two different molecular methods. Using pyrosequencing and allele-specific quantitative PCR (AS-PCR), BRAF V600E mutations were found in 16/38 (42%) and 31/37 (84%) nodules, respectively. Analysing different nodules of the same patients with pyrosequencing 3/6 patients showed a concordant BRAF mutation status. When allele-specific quantitative PCR was used, condordant results were found in 5/6 patients. Our findings clearly indicate that (a) the sensitivity of the method used is crucial in analysing BRAF mutation status, (b) AS-PCR is more sensitive in detecting BRAF V600E mutations than pyrosequencing,

  7. Myths in the Diagnosis and Management of Orbital Tumors.

    PubMed

    Gündüz, Kaan; Yanık, Özge

    2015-01-01

    Orbital tumors constitute a group of diverse lesions with a low incidence in the population. Tumors affecting the eye and ocular adnexa may also secondarily invade the orbit. Lack of accumulation of a sufficient number of cases with a specific diagnosis at various orbital centers, the paucity of prospective randomized studies, animal model studies, tissue bank, and genetic studies led to the development of various myths regarding the diagnosis and treatment of orbital lesions in the past. These myths continue to influence the diagnosis and treatment of orbital lesions by orbital specialists. This manuscript discusses some of the more common myths through case summaries and a review of the literature. Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future. This will enable targeted treatments even for diseases with the same histopathologic diagnosis. Phenotypic variability within the same disease will be addressed using targeted treatments.

  8. From idiopathic diabetes insipidus to neurodegenerative Langerhans cell histiocytosis--an unusual presentation and progression of disease.

    PubMed

    Hayward, Rachel M; Nicolin, Gary; Kennedy, Charles; Joy, Harriet; Davies, Justin H

    2011-01-01

    Diabetes insipidus (DI) is rare in childhood and has a wide-ranging aetiology including the involvement of uncontrolled proliferation of dendritic cells in the hypothalamic-pituitary axis, characteristic of Langerhans cell histiocytosis (LCH). DI may manifest as a sequela of multisystem LCH disease involving skin, bone, liver, spleen and lymph nodes. In very rare cases patients diagnosed with LCH exhibit neurodegenerative changes, such as severe ataxia, tremor, dysarthria and intellectual impairment. We report a 2 1/2-year-old boy who presented initially with apparent idiopathic DI, developed anterior pituitary hormone deficiency and progressive neurological deterioration secondary to neurodegenerative LCH.

  9. Primary pancreatic sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): an unusual extranodal manifestation clinically simulating malignancy.

    PubMed

    Podberezin, Mark; Angeles, Ronald; Guzman, Grace; Peace, David; Gaitonde, Sujata

    2010-02-01

    Abstract Sinus histiocytosis with massive lymphadenopathy (SHML), also called Rosai-Dorfman disease, is a rare entity. Its etiology and pathogenesis are still essentially unclear. The histologic hallmark of this disease is proliferation of distinctive histiocytes within lymph node sinuses and in extranodal sites. Approximately 23% of patients with SHML, documented in the SHML Registry, presented with disease primarily in extranodal sites, and very few cases of SHML (<1%) involving the gastrointestinal system have been described in the literature. We report an unusual case of primary pancreatic SHML with infiltration of the process into peripancreatic, perinephric, and perisplenic adipose tissue, simulating malignancy.

  10. Orbital Debris

    NASA Technical Reports Server (NTRS)

    Kessler, D. J. (Compiler); Su, S. Y. (Compiler)

    1985-01-01

    Earth orbital debris issues and recommended future activities are discussed. The workshop addressed the areas of environment definition, hazards to spacecraft, and space object management. It concluded that orbital debris is a potential problem for future space operations. However, before recommending any major efforts to control the environment, more data are required. The most significant required data are on the population of debris smaller than 4 cm in diameter. New damage criteria are also required. When these data are obtained, they can be combined with hypervelocity data to evaluate the hazards to future spacecraft. After these hazards are understood, then techniques to control the environment can be evaluated.

  11. Nuclear orbiting

    SciTech Connect

    Shapira, D.

    1988-01-01

    Nuclear orbiting following collisions between sd and p shell nuclei is discussed. The dependence of this process on the real and imaginary parts of the nucleus-nucleus potential is discussed, as well as the evolution of the dinucleus toward a fully equilibrated fused system. 26 refs., 15 figs.

  12. Case report: Orbital epithelioid haemangioendothelioma.

    PubMed

    Zaragoza-Herrera, A; Morales-Baños, D R; Velasco-Ramos, P; Garrido-Sánchez, G A; López-Hernández, C M; Borbolla-Pertierra, A M

    2017-04-01

    A 13-year-old boy presented with right eye proptosis and lateral dystopia. A soft non-pulsatile mass was found in the superomedial orbital region. An excisional biopsy was performed, for which the histopathology reported an epithelioid haemangioendothelioma. Haemangioendothelioma is a borderline vascular lesion within the spectrum of clinically benign and malignant tumours. These can arise from soft tissue or bone. There are few reports of these tumours located in the orbit. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Periapical lesions are not always a sequelae of pulpal necrosis: a retrospective study of 1521 biopsies.

    PubMed

    Kontogiannis, T G; Tosios, K I; Kerezoudis, N P; Krithinakis, S; Christopoulos, P; Sklavounou, A

    2015-01-01

    To record the incidence of lesions that were not the sequelae of pulpal necrosis (non-SPN) amongst 1521 biopsies of periapical lesions submitted with a clinical diagnosis of a sequelae of pulpal necrosis (SPN). A retrospective study of 1521 biopsy request forms of specimens submitted for histopathological examination with a clinical diagnosis 'periapical inflammation', 'periapical abscess', 'periapical granuloma' or 'periapical cyst' during an arbitrarily selected 14-year period was undertaken. Gender and age of the patient, site and maximum diameter of the lesion, symptoms, inclusion of the final diagnosis in the differential diagnosis and specialty of the clinician submitting the biopsy material were recorded in each case. The final diagnosis for each case was extracted from the pathology report, and two groups were formed, SPN and non-SPN lesions. Differences between the respective features of SPN and non-SPN cases were analysed with Yate's chi-square test and t-test (significance level P < 0.05) RESULTS: In 52 of the 1521 cases examined (3.42%), the histological diagnosis was not consistent with a SPN. In most non-SPN cases, the histopathological diagnosis was not included in the differential diagnosis. The keratocystic odontogenic tumour [odontogenic keratocyst (OKC)] was the most frequent non-SPN lesion (34.62%). Other, yet less frequent, non-SPN lesions included glandular odontogenic cysts, lateral periodontal cysts, central ossifying fibromas as well as malignancies (metastatic carcinomas and Langerhans cell histiocytosis). Non-SPN lesions appeared in the periapical region mimicking a SPN, although rarely. Most of them were developmental cysts, in particular OKCs, but odontogenic tumours, such as ameloblastoma, or malignant lesions were also diagnosed. Histological examination of tissue harvested from periapical lesions should be performed, in particular when those lesions are large. © 2014 International Endodontic Journal. Published by John Wiley & Sons

  14. Insights into the pathogenesis of Langerhans cell histiocytosis: the development of targeted therapies

    PubMed Central

    Hutter, Caroline; Minkov, Milen

    2016-01-01

    More than a century after its first description, Langerhans cell histiocytosis (LCH) still remains an intriguing disease. Considerable progress in understanding its biology has been achieved recently. Description of the V600E BRAF mutation in samples of LCH tissue in 2010 was followed by description of additional mutations, all leading to constitutive ERK activation. Current experimental data suggest that LCH is a myeloid neoplasia with inflammatory properties, yet the exact pathophysiology remains poorly understood. Disease management paradigms have changed over time, closely reflecting the evolving view of the nature of the disease. The international Histiocyte Society have conducted three prospective clinical studies on multisystem LCH since the early 1990s. The standard frontline therapy for patients with multisystem LCH based on the cumulative knowledge of those trials consists of 6–12 weeks of initial therapy (daily oral steroids and weekly vinblastine injections), followed by pulses of prednisolone/vinblastine every 3 weeks, for a total treatment duration of 12 months. A currently ongoing study (LCH-IV) with a complex design (five interventional and two observational strata) targets further reduction of mortality and morbidity by tailoring treatment intensity depending on expected risk, as well as by exploring treatment regimens for special locations. Current knowledge on LCH pathobiology opens opportunities for improvement in the patient outcome. The activating BRAF and MAP2K1 mutations collectively accounting for about 75% of the LCH population as well as the resulting constitutive activation of downstream ERK offer an opportunity for targeted treatment. Related issues (eg, finding most effective and less toxic drugs or combinations, appropriate dosage, and optimal treatment duration) must be addressed in controlled prospective trials. Additional mechanisms, such as the interactions of the mutated dendritic cell clone with other inflammatory cells and

  15. [Rosai-Dorfman's disease (sinus histiocytosis with massive lymphadenopathy): a report of a case and bibliographic review].

    PubMed

    Pérez, Enrique Quezada; Garibay, Gabriela Escobar; Vázquez, Maria Isabel Castrejón; de la Mora, Maria Teresa Gorraez; Bayardo, Ricardo Guido; Camaño, María Eugenia Vargas

    2008-01-01

    Rosai-Dorfman's illness, also denominated sinus histiocytosis with massive lymphadenopathy is considered benign entity of unknown etiology; although it is believed it may be due to alterations of immune system. It was described in 1969 by Rosai and Dorfman and there are nearly 500 cases worldwide reported. The most frequent clinical manifestation is massive lymph node enlargement, mainly cervical, but almost in the fifth percent of cases any lymph node may be affected. Diagnosis is pathological, without treatment of choice, evolution is often spontaneous resolution. In extraganglionar compromise, illness may be progressive and fatal. A45 year-old woman with cervical and nasal lymphadenopathy and fever is presented. Biopsy report: histiocytosis with emperipolesis phenomenon and immunohistochemical markers S-100, CD48, and CD45, positives. Encountering total T lymphopenia, mainly CD4+ diminished relationship CD4/CD8 and polyclonal gammopathy. Relevant in this case, clinical presentation multiple lymph nodes, distinct of other reported in our country whose presentation was mainly cutaneous plus association among Rosai-Dorfman with immunological changes and good clinical response to immunomodulator treatment, not previously seen, as in this patient.

  16. Cholesteatoma as a complication of Langerhans Cell Histiocytosis of the temporal bone: A nationwide cross-sectional analysis.

    PubMed

    Simmonds, Jonathan C; Vecchiotti, Mark

    2017-09-01

    To determine if patients with Langerhans Cell Histiocytosis (LCH) of the temporal bone have a higher risk of developing cholesteatoma. Review of literature and cross-sectional weighted analysis of patients under 19 with a diagnosis of LCH from the National Inpatient Sample (NIS) and Kids' Inpatient Database (KID) from 2000 to 2013. ICD-9 codes and demographics were analyzed; pairwise comparisons and multivariate analyses were performed. Only seven cases of cholesteatoma after the treatment for LCH of the temporal bone have been documented in the literature. No significant association between cholesteatoma and LCH was seen (OR 0.747 [0.149-3.751]). Patients with LCH did have a higher incidence of chronic otitis media, chronic otitis externa, chronic sinusitis, hearing loss, and otitis media with effusion. Our results show that patients with Langerhans Cell Histiocytosis do not appear to have a higher risk of developing cholesteatoma. However they are more likely to be diagnosed with chronic otitis externa which should be differentiated from cholesteatoma or recurrence of LCH. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Pulmonary Langerhans Histiocytosis: an uncommon cause of interstitial pneumonia in a patient with Sjögren syndrome.

    PubMed

    González García, Andrés; Callejas Rubio, José Luis; Ríos Fernández, Raquel; Ortego Centeno, Norberto

    2016-03-01

    Sjögren syndrome is a chronic, systemic, and autoimmune disorder that targets exocrine glands by remarkable B cell hyperactivity. Eventually, it is associated with extra-glandular clinical manifestations that affect essentially any organ system, including pulmonary involvement. Interstitial lung disease is one of the most serious pulmonary complications, and the early diagnosis is essential to initiate a prompt therapy. On the other hand, Sjögren syndrome could present concomitantly with several rheumatologic diseases such as systemic lupus erythematosus or rheumatoid arthritis. Pulmonary Langerhans Histiocytosis is a rare clonal proliferative disease characterized by pulmonary involvement by cells phenotypically similar to Langerhans cells. We describe the case of a nonsmoker 62-year-old woman with Sjögren syndrome who presented concomitantly a Pulmonary Langerhans Histiocytosis mimicking a pulmonary complication of its Sjögren. Fortunately, she had a well response to corticosteroids and azathioprine regimen. The aim of the paper is to emphasize the importance of the good differential diagnosis related to the pulmonary involvement. To the best of our knowledge, this is the first description of these two entities in the literature.

  18. Eye and orbit ultrasound

    MedlinePlus

    Echography - eye orbit; Ultrasound - eye orbit; Ocular ultrasonography; Orbital ultrasonography ... ophthalmology department of a hospital or clinic. Your eye is numbed with medicine (anesthetic drops). The ultrasound ...

  19. Microsurgical Anatomy of the Orbit: The Rule of Seven

    PubMed Central

    Martins, Carolina; Costa e Silva, Isabel Eugênia; Campero, Alvaro; Yasuda, Alexandre; Aguiar, Luiz Roberto; Tatagiba, Marcos; Rhoton, Albert

    2011-01-01

    The orbits are paired structures, located on the anterior part of the face. Morphologically, each orbit is a four sided pyramid with a posterior apex and anterior base. In the orbit, all openings are arranged around the base, apex or between the orbital walls. An anatomical characteristic of the orbit is that structures are arranged in groups of seven: there are seven bones, seven intraorbital muscles and seven nerves in the orbit. Tumors confined within the periorbita in the anterior two thirds of the orbit can often be approached extracranially, but those located in the apical area, and especially those on the medial side of the optic nerve, often require a transcranial approach. Thus, knowledge of orbital osteology is paramount in adequately choosing and performing an orbital approach. Understanding the critical topographical elements in this area helps to classify an orbital lesion and provides for a solid basis in choosing the most adequate intraorbital route for its treatment. PMID:22567293

  20. Orbit analysis

    SciTech Connect

    Michelotti, L.

    1995-01-01

    The past fifteen years have witnessed a remarkable development of methods for analyzing single particle orbit dynamics in accelerators. Unlike their more classic counterparts, which act upon differential equations, these methods proceed by manipulating Poincare maps directly. This attribute makes them well matched for studying accelerators whose physics is most naturally modelled in terms of maps, an observation that has been championed most vigorously by Forest. In the following sections the author sketchs a little background, explains some of the physics underlying these techniques, and discusses the best computing strategy for implementing them in conjunction with modeling accelerators.

  1. Secondary mucoepidermoid carcinoma of the orbit

    PubMed Central

    Siuw, Chin Pei; Tan, Siow W; Abdul Wahid, Adrena B; Vasudevan, Suresh

    2016-01-01

    A 40-year-old man presented with right eye axial proptosis and ophthalmoplegia for 3 months. Imaging study showed a right intraconal mass with the erosion of the orbital floor. Incisional biopsy revealed mucoepidermoid carcinoma. Nasal endoscopy was normal and systemic tumor screening was negative for a primary source. The patient underwent right orbital exenteration, uncinectomy, nasal and maxillary mucosal biopsy. Malignant cells were found present in the mucosa of maxillary sinus roof and uncinate bone. The postoperative positron emission tomography scan showed residual active lesion in right orbital apex and maxilla but no primary lesion elsewhere. The patient subsequently underwent 35 cycles of postoperative radiotherapy. Primary mucoepidermoid carcinoma of the orbit is rare and typically arises from the lacrimal gland or sac. Those tumors not arising from lacrimal apparatus should be presumed metastatic in origin, and the thorough systemic survey should be undertaken in the search for the primary tumor. PMID:27146939

  2. Secondary mucoepidermoid carcinoma of the orbit.

    PubMed

    Siuw, Chin Pei; Tan, Siow W; Abdul Wahid, Adrena B; Vasudevan, Suresh

    2016-03-01

    A 40-year-old man presented with right eye axial proptosis and ophthalmoplegia for 3 months. Imaging study showed a right intraconal mass with the erosion of the orbital floor. Incisional biopsy revealed mucoepidermoid carcinoma. Nasal endoscopy was normal and systemic tumor screening was negative for a primary source. The patient underwent right orbital exenteration, uncinectomy, nasal and maxillary mucosal biopsy. Malignant cells were found present in the mucosa of maxillary sinus roof and uncinate bone. The postoperative positron emission tomography scan showed residual active lesion in right orbital apex and maxilla but no primary lesion elsewhere. The patient subsequently underwent 35 cycles of postoperative radiotherapy. Primary mucoepidermoid carcinoma of the orbit is rare and typically arises from the lacrimal gland or sac. Those tumors not arising from lacrimal apparatus should be presumed metastatic in origin, and the thorough systemic survey should be undertaken in the search for the primary tumor.

  3. Orbital floor dermoid: An unusual presentation

    PubMed Central

    Yeola (Pate), Meenakshi; Joharapurkar, S R; Bhole, A M; Chawla, Manisha; Chopra, Sumit; Paliwal, Anup

    2009-01-01

    Dermoid cysts are developmental abnormal arrangement of tissues and are often evident soon after birth. Its occurrence in the orbit is relatively rare. We report a case of orbital floor dermoid in an 18-year-old female patient who presented with progressive, painless swelling in the lower eyelid associated with mild proptosis of three months duration. The lesion was excised completely, and histopathology confirmed the diagnosis of dermoid cyst. PMID:19075411

  4. Vellus Hair Cyst of the Orbit.

    PubMed

    Choi, Rene; MacLean, Kyle D; Davidson, Hans C; Patel, Bhupendra C K

    Eruptive vellus hair cysts are a developmental abnormality of vellus hair follicles that result in small cystic papules occurring most frequently on the chest and proximal extremities. Lesions of the ocular adnexa are extremely rare, and to the best of the authors knowledge, involvement of the orbit has never been reported. The authors describe a patient with an eruptive vellus hair cyst involving the orbit.

  5. The pituitary gland in patients with Langerhans cell histiocytosis: a clinical and radiological evaluation.

    PubMed

    Kurtulmus, Neslihan; Mert, Meral; Tanakol, Refik; Yarman, Sema

    2015-04-01

    Langerhans cell histiocytosis (LCH) is a rare disease in which the most common endocrine manifestation is diabetes insipidus (DI). Data on anterior pituitary function in patients with LCH are limited. Thus, the present study investigated anterior pituitary function in LCH patients with DI via the evaluation of clinical and radiological findings at disease onset and during follow-up. The present study retrospectively evaluated nine patients with LCH (five males and four females). All diagnoses of LCH were made following histological and/or immunophenotypic analyses of tissue biopsies, bronchoalveolar lavage, or cerebrospinal fluid (CSF). Basal and, if necessary, dynamic pituitary function tests were used to assess anterior pituitary function, and magnetic resonance imaging (MRI) scans were used to image the pituitary. The LCH treatment modality was based on organ involvement. The mean age at onset of DI was 27.6 years (range 15-60 years). One patient (11%) exhibited single organ involvement, while eight patients (89%) displayed multisystem organ involvement. On admittance, one patient had hypogonadotropic hypogonadism, one patient exhibited panhypopituitarism [hypogonadotropic hypogonadism, central hypothyroidism, hypocortisolism, and growth hormone (GH) deficiency], and four patients (44%) displayed hyperprolactinemia. The MRI data revealed infundibular enlargement in seven patients (78%), a thalamic mass in one patient (11%), and the absence of the bright spot in all patients. A single patient (11%) showed a mass in the pons that had a partially empty sella. The patients were treated with radiation therapy (RT), chemotherapy (CT), or a combination of both (RT+CT) and were followed up for a median of 91.8 months (range 2-318 months). Seven patients were assessed during the follow-up period, of whom four patients (57.1%) developed anterior pituitary hormone deficiency, three (43%) were diagnosed with GH deficiency, and one (14%) exhibited gonadotropin deficiency

  6. Chronic subperiosteal hematic cyst formation twelve years after orbital fracture repair with alloplastic orbital floor implant.

    PubMed

    Glavas, Ioannis; Lissauer, Boaz; Hornblass, Albert

    2005-03-01

    An 89-year-old female patient with a history of a left orbital floor fracture repair with synthetic implant 12 years prior, presented with a three-week history of blurry vision, inferior conjunctival chemosis and proptosis of the left eye. CT scan revealed a well-circumscribed subperiosteal lesion with superior elevation of the orbital floor implant. The patient underwent transconjunctival orbital surgery with removal of the implant and drainage of the subperiosteal hemorrhagic cyst. The patient had an uncomplicated postoperative course, with resolution of the proptosis, chemosis, and return of normal vision. This case represents an unusual late complication of orbital fracture repair with associated reduced visual acuity.

  7. Nontraumatic Lesions of the Clavicle in a Paediatric Population: Incidence and Management

    PubMed Central

    Clement, N. D.; Nicol, G.; Porter, D. E.

    2014-01-01

    Background. The incidence of paediatric nontraumatic clavicle lesions is unknown and there is limited literature regarding the management of such patients. Methods. A review of a prospectively complied radiological database held at the study was conducted for a defined 10-year period. The study centre is the only paediatric service available for a defined catchment population. The case notes of all patients with nontraumatic lesions were reviewed, and the mode of presentation, the diagnostic dilemmas, and the management were recorded. Results. A total of 2133 clavicle radiographs were performed during the study period, with only five having a nontraumatic history. The overall incidence of paediatric nontraumatic clavicle lesions was 0.38 per 100,000 per year. Three patients were diagnosed with chronic recurrent osteomyelitis, one with chronic bifocal osteomyelitis, and one with Langerhans cell histiocytosis. All patients with osteomyelitis demonstrated a typical natural history of a chronic relapsing remitting infection. Three underwent bone biopsy; however, no organism was identified. Conclusion. This study demonstrated that the incidence of nontraumatic clavicle lesions is small, and those patients presenting with osteomyelitis should not routinely undergo a bone biopsy and close observation with the appropriate antibiotic therapy is advised. PMID:27355009

  8. Real-time contrast enhanced ultrasound imaging of focal splenic lesions.

    PubMed

    Li, Wei; Liu, Guangjian; Wang, Wei; Wang, Zhu; Huang, Yang; Xu, ZuoFeng; Xie, XiaoYan; Lu, MingDe

    2014-04-01

    To investigate the imaging features of focal splenic lesions (FSLs) on contrast-enhanced ultrasound (CEUS). Thirty two patients with FSLs proved by pathology were retrospectively analyzed. CEUS was performed using intravenous bolus injection of 2.4 ml sulfur hexafluoride-filled microbubble contrast agent and real time scanning. There were hemangioma (n=7), lymphoma (n=8), true cyst (n=3), infarction (n=4), hematolymphangioma (n=2), metastasis tumor (n=2), and one for each of the following entities extramedullary hemopoiesis, hamartoma, tuberculosis, Langerhans' cell histiocytosis, inflammatory pseudotumor and myxofibrosarcoma. Among 21 benign lesions, 4 infarctions and 3 cysts presented non-enhancement throughout CEUS scanning, and the other 14 lesions displayed various enhancement levels with 6 (42.9%) hyper-enhancement, 2 (14.3%) iso-enhancement and 6 (42.9%) hypo-enhancement in arterial phase and 11 (78.6%) hypo-enhancement, 1 (7.1%) iso-enhancement and 2 (14.3%) hyper-enhancement in late phase, respectively. The enhancement pattern included 9 (64.3%) homogeneous, 4 (28.6%) heterogeneous and 1 (7.1%) rim-like enhancement. As for the malignant FSLs, all the lesions became completely or extensively hypo-enhancement during the late phase no matter their vascularity during arterial phase. The CEUS features reported in this series may enrich the knowledge for CEUS characterization of FSLs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. [Benign vocal fold lesions].

    PubMed

    Pickhard, A; Reiter, R

    2013-05-01

    Benign vocal fold lesions are grouped in lesions arising from the epithelium like papillomas, lesions affecting the Reinke's space (nodules, polyps, cysts, Reinkes's edema as a form of chronic laryngitis) and lesions affecting the arytenoid (granulomas). A multifactorial genesis is assumed. Main symptoms are dysphonia and hyperfunctional vocal behavior that might also be a cause of these lesions. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Rethinking orbital imaging establishing guidelines for interpreting orbital imaging studies and evaluating their predictive value in patients with orbital tumors.

    PubMed

    Ben Simon, Guy J; Annunziata, Christine C; Fink, James; Villablanca, Pablo; McCann, John D; Goldberg, Robert A

    2005-12-01

    To establish guidelines for interpretation of orbital imaging by magnetic resonance imaging (MRI) and/or computed tomography (CT), and to apply these guidelines and examine their predictive value in 131 patients with biopsy-proven orbital tumors. Prospective evaluation of imaging studies. Imaging studies (CT and/or MRI) from 131 cases with biopsy-proven orbital tumors. Guidelines for reviewing orbital imaging studies (MRI and/or CT) were established based on 5 major characteristics: (1) anatomic location, (2) bone and paranasal sinuses involvement, (3) content, (4) shape, and (5) associated features. In total, 84 features were established by an experienced orbital surgeon and a neuroradiologist. Applying these 84 features, imaging studies of 131 biopsy-proven orbital tumors were evaluated by 3 physicians. Imaging features: characteristics, sensitivity, specificity, and positive and negative predictive values in various groups of orbital tumors and kappa values. One hundred thirty-one cases of biopsy-proven orbital tumors were evaluated. Benign lesions were more likely to be smaller in size, round or oval in shape (29% of all benign tumors, 0% in malignant and inflammatory, P<0.001), and associated with hyperostosis (22% of all benign lesions, P<0.001). They were also more likely to be hyperdense or hypodense on CT imaging (15% and 11%, respectively; P<0.05 in comparison with inflammatory and malignant tumors). Inflammatory processes showed panorbital involvement (23% vs. 3%, and 0% in benign and malignant tumors, respectively; P<0.001). Orbital fat involvement and fat stranding were noticed only in inflammatory lesions (19% and 16%, respectively; P<0.001). None of the features occurred only in malignant tumors, but they tend to involve the anterior orbit more commonly (54% vs. 20%, and 29% in benign and malignant; P = 0.002), and were more likely to show bone erosion (31% vs. 6%, and 16% in benign and inflammatory tumors, respectively; P = 0.004) and molding around

  11. Orbital Winch

    NASA Technical Reports Server (NTRS)

    Hoyt, Robert (Inventor); Slostad, Jeffrey T. (Inventor); Frank, Scott (Inventor); Barnes, Ian M. (Inventor)

    2016-01-01

    Orbital winch having: lower and upper frames; spool having upper and lower flanges with lower flange attached to lower frame; axial tether guide mounted to upper frame; secondary slewing ring coaxial with spool and rotatably mounted to upper frame, wherein secondary slewing ring's outer surface has gearing; upper tether guide mounted to inner surface of secondary slewing ring; linear translation means having upper end mounted to upper frame and lower end mounted on lower frame; primary slewing ring rotatably mounted within linear translation means allowing translation axially between flanges, wherein primary slewing ring's outer surface has gearing; lower tether guide mounted on primary slewing ring's inner surface; pinion rod having upper end mounted to upper frame and lower end mounted to lower frame, wherein pinion rod's teeth engage primary and secondary slewing rings' outer surface teeth; and tether passing through axial, upper, and lower tether guides and winding around spool.

  12. Orbital liposarcoma.

    PubMed

    Borbolla-Pertierra, A M; Morales-Baños, D R; Martínez-Nava, L R; Garrido-Sánchez, G A; López-Hernández, C M; Velasco-Ramos, P

    2017-02-01

    The case is presented of a 46-year-old male with right eye proptosis and conjunctival hyperaemia, of 18 months onset. A well-defined intraconal mass was found in the computed tomography. In magnetic resonance this was hypo-intense on T1, enhanced with gadolinium and hyperintense on T2. Excisional biopsy was performed, which was reported as a well-differentiated liposarcoma in the histopathology study. Liposarcoma is a malignant adipose tissue tumour. It is very rare in the orbit, with 5 histological types, the most common being myxoid. The treatment of choice is wide surgical excision and may be accompanied with radiotherapy. As it is an infiltrative tumour, It has a high rate of recurrence. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Central diabetes insipidus as a very late relapse limited to the pituitary stalk in Langerhans cell histiocytosis.

    PubMed

    Nakagawa, Shunsuke; Shinkoda, Yuichi; Hazeki, Daisuke; Imamura, Mari; Okamoto, Yasuhiro; Kawakami, Kiyoshi; Kawano, Yoshifumi

    2016-07-01

    Central diabetes insipidus (CDI) and relapse are frequently seen in multifocal Langerhans cell histiocytosis (LCH). We present two females with multifocal LCH who developed CDI 9 and 5 years after the initial diagnosis, respectively, as a relapse limited to the pituitary stalk. Combination chemotherapy with cytarabine reduced the mass in the pituitary stalk. Although CDI did not improve, there has been no anterior pituitary hormone deficiency (APHD), neurodegenerative disease in the central nervous system (ND-CNS) or additional relapse for 2 years after therapy. It was difficult to predict the development of CDI in these cases. CDI might develop very late in patients with multifocal LCH, and therefore strict follow-up is necessary, especially with regard to symptoms of CDI such as polydipsia and polyuria. For new-onset CDI with LCH, chemotherapy with cytarabine might be useful for preventing APHD and ND-CNS.

  14. Surgical approach to the superior mid-orbit.

    PubMed

    Krohn-Hansen, Dag; Nicolaissen, Bjørn; Meling, Torstein R; Haaskjold, Erling

    2013-09-01

    Access to the superior mid-orbit is required for procedures on the levator muscle in the correction of upper eyelid ptosis and in surgery aimed at local lesions in this region. The purpose with this human cadaver study was to clarify the anatomical substrate for a surgical approach to the levator muscle and the upper mid-orbit structures, in which the orbital septum and the retroseptal fat pad is not harmed during surgery. Macro-anatomical dissections and histological examinations were performed on five human orbits from three formalin embalmed cadaver heads. It was found that the orbital septum extends posteriorly from its junction with the levator aponeurosis. This posterior continuation of the orbital septum encloses the superior orbital fat pad and separates this from the anterior surface of the levator muscle. In between the orbital septum and the levator, there is a dissection space that provides a minimal invasive access corridor to the structures in the upper mid-orbit.

  15. Atherectomy in complex infrainguinal lesions: a review.

    PubMed

    Engelberger, S; van den Berg, J C

    2015-02-01

    In the femoropopliteal segment, endovascular revascularization techniques have gained the role as a first line treatment strategy. Nitinol stent placement has improved the short- and mid-term primary patency rates in most lesion types and is therefore widely applied. Stenting has several shortcomings as in-stent restenosis, stent fractures and foreign material being left behind in the vessel. The concept of atherectomy is plaque debulking. This results in a potential reduction of inflation pressure requirements in angioplasty. Stent placement and consecutive in-stent restenosis may be avoided. In this non systematic literature review, the performance of different atherectomy techniques, such as direct atherectomy, orbital atherectomy, laser debulking and rotational atherectomy in the treatment of complex femoropopliteal lesions, including long lesions, moderately to heavily calcified lesions as well as occlusions and in-stent restenosis, has been analyzed.

  16. Neuro-ophthalmology of orbital disease.

    PubMed

    Rose, Geoffrey E; Verity, David H

    2011-01-01

    In this chapter the presentation and management of common orbital diseases are discussed. An accurate clinical history and assessment are essential, with computed tomography being the imaging of choice. Magnetic resonance imaging provides detail of intrinsic optic nerve disease and orbital apical or intracranial pathology, and ultrasonography is valuable in assessing anterior orbital masses, in particular vascular lesions. Inflammatory lesions require a tissue biopsy before immunosuppression is instituted. Exceptions to this principle are scleritis, myositis, thyroid eye disease, and characteristic orbital apex syndrome, in which delay in immune suppression may jeopardize visual outcome. The term "orbital pseudotumor" is now obsolete. The management of active thyroid eye disease includes immunosuppression and low-dose orbital radiotherapy. Urgent orbital decompression is indicated in the presence of nonresponsive optic neuropathy, and inactive disease is managed by decompression for exophthalmos, and correction of muscle imbalance and lid retraction. Subacute lacrimal gland inflammation, unresponsive to a few weeks of nonsteroidal treatment, may be due to underlying carcinoma and a specialist opinion should be sought without delay. Pleomorphic adenoma, with typical features on imaging, should always be excised intact to avoid subsequent pervasive malignant disease. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Orbiter/launch system

    NASA Technical Reports Server (NTRS)

    Jackson, L. R.; Weidner, J. P.; Small, W. J.; Martin, J. A. (Inventor)

    1981-01-01

    The system includes reusable turbojet propelled booster vehicles releasably connected to a reusable rocket powered orbit vehicle. The coupled orbiter-booster combination takes off horizontally and ascends to staging altitude and speed under booster power with both orbiter and booster wings providing lift. After staging, the booster vehicles fly back to Earth for horizontal landing and the orbiter vehicle continues ascending to orbit.

  18. Skin lesion of blastomycosis

    MedlinePlus

    ... gov/ency/article/000865.htm Skin lesion of blastomycosis To use the sharing features on this page, please enable JavaScript. A skin lesion of blastomycosis is a symptom of an infection with the ...

  19. Example based lesion segmentation

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

    2014-03-01

    Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

  20. Rare Form of Erdheim-Chester Disease Presenting with Isolated Central Skeletal Lesions Treated with a Combination of Alfa-Interferon and Zoledronic Acid

    PubMed Central

    Bulycheva, E. N.; Baykov, V. V.; Zaraĭskiĭ, M. I.; Salogub, G. N.

    2015-01-01

    Erdheim-Chester disease (ECD) represents a clonal non-Langerhans histiocytosis, which manifests under an extensive variety of clinical symptoms. This creates a challenge for the physician, who is required to recognize and diagnose the disease in the early stages. Despite this considerable challenge, in the last decade there has been a dramatic increase in ECD diagnoses, in most part due to an increasing awareness of this rare disorder. Involvement of the axial skeleton is exclusively uncommon with no official recommendations for the treatment of the bone lesions. Here, we present a case report of a young male patient with isolated lesions of the spine, ribs, and pelvis, who was successfully treated with a combination therapy of alfa-interferon and zoledronic acid. PMID:25949835

  1. Management of Orbital and Periorbital Venous Malformation.

    PubMed

    Benoiton, Lara A; Chan, Kenneth; Steiner, Frederica; FitzJohn, Trevor; Tan, Swee T

    2017-01-01

    To review our management of common venous malformation (VM) affecting the orbit and/or periorbital area. Consecutive patients with orbital and/or periorbital VM were identified from our vascular anomalies database. Demographic details of the patients, anatomic site(s) affected, symptoms and signs, presence of a family history of VM, and types of treatment(s) were collected, supplemented by chart review. A total of 24 patients' age 1-68 (mean, 30) years with orbital and/or periorbital VM presented with cosmetic concerns (n = 17, 71%), distensibility (n = 15, 63%), pain (n = 9, 38%), diplopia (n = 4, 17%), and spontaneous thrombosis (n = 1, 8%). The VM caused globe dystopia (n = 13, 54%), enophthalmos (n = 6, 25%), proptosis (n = 3, 12%), exotropia (n = 3, 12%), and pseudoptosis with visual obstruction (n = 3, 13%). A total of 11 (46%) patients were managed conservatively. 13 (54%) patients underwent active treatment. Ethanol sclerotherapy (ES) was performed in six patients with extensive facial VM associated with orbital/periorbital involvement, resulting in symptomatic improvement in five patients, one of whom developed skin necrosis and another patient developed reduced infraorbital nerve sensation. Surgery was performed for localized lesion (n = 3, 23%), for extensive lesions (n = 4, 31%) and as an adjunct to ES (n = 6, 46%) resulting in symptomatic improvement in all patients. One patient required correction of lower lid ectropion. Orbital and/or periorbital VMs are heterogeneous, and management needs to be individualized. Surgery is used for localized lesions aiming for complete excision, as a debulking procedure for extensive orbital/periorbital VM when ES was not possible, or following ES for extensive facial VM with orbital and/or periorbital involvement.

  2. Orbital dystopia due to orbital roof defect.

    PubMed

    Rha, Eun Young; Joo, Hong Sil; Byeon, Jun Hee

    2013-01-01

    We performed a retrospective review of patients who presented with delayed dystopia as a consequence of an orbital roof defect due to fractures and nontraumatic causes to search for a correlation between orbital roof defect size and surgical indications for the treatment thereof. Retrospective analyses were performed in 7 patients, all of whom presented with delayed dystopia due to orbital roof defects, between January 2001 and June 2011. The causes of orbital roof defects were displaced orbital roof fractures (5 cases), tumor (1 case), and congenital sphenoid dysplasia (1 case). All 7 patients had initially been treated conservatively and later presented with significant dystopia. The sizes of the defects were calculated on computed tomographic scans. Among the 7 patients, aspiration of cerebrospinal fluid, which caused ocular symptoms, in 1 patient with minimal displaced orbital roof and reconstruction with calvarial bone, titanium micromesh, or Medpor in 6 other patients were performed. The minimal size of the orbital roof in patients who underwent orbital roof reconstruction was 1.2 cm (defect height) x 1.0 cm (defect length), 0.94 cm(2). For all patients with orbital dystopia, displacement of the globe was corrected without any complications, regardless of whether the patient was evaluated grossly or by radiology. In this retrospective study, continuous monitoring of clinical signs and active surgical management should be considered for cases in which an orbital roof defect is detected, even if no definite symptoms are noted, to prevent delayed sequelae.

  3. Sclerosing idiopathic orbital inflammation.

    PubMed

    Brannan, Paul A; Kersten, Robert C; Kulwin, Dwight R

    2006-01-01

    A 5-year-old girl referred for orbital cellulitis was found to have a right orbital mass. Computed tomography revealed a mass occupying the inferotemporal orbit, extending into the maxillary sinus. Biopsy yielded a diagnosis of sclerosing idiopathic orbital inflammation. She was successfully treated with prednisone.

  4. C-scan ultrasonography in orbital diagnosis.

    PubMed Central

    Restori, M; Wright, J E

    1977-01-01

    A C-scan imaging facility has recently been added to the ultrasonic system in use at Moorfields Eye Hospital, London. The technique is explained and typical C-scans are presented to demonstrate the normal orbital fat and optic nerve, together with selected pathological conditions in the orbit. The C-scan facility permits imaging of the orbital contents in the coronal plane. This coronal plane imaging, together with high resolution and sensitivity, makes this a useful technique for demonstrating orbital lesions and it is hoped helps in the accurate measurement of the diameters of the optic nerve along its length. The problems associated with C-scanning are discussed. Images PMID:603781

  5. Intensified and prolonged therapy comprising cytarabine, vincristine and prednisolone improves outcome in patients with multisystem Langerhans cell histiocytosis: results of the Japan Langerhans Cell Histiocytosis Study Group-02 Protocol Study.

    PubMed

    Morimoto, Akira; Shioda, Yoko; Imamura, Toshihiko; Kudo, Kazuko; Kawaguchi, Hiroshi; Sakashita, Kazuo; Yasui, Masahiro; Koga, Yuhki; Kobayashi, Ryoji; Ishii, Eiichi; Fujimoto, Junichiro; Horibe, Keizo; Bessho, Fumio; Tsunematsu, Yukiko; Imashuku, Shinsaku

    2016-07-01

    The JLSG-96 study reported very low mortality rates for children newly diagnosed with multifocal Langerhans cell histiocytosis (LCH). The JLSG-02 study was performed to further improve the prognosis from 2002 to 2009. The present study compared the therapeutic results of these two studies in terms of multisystem disease. All patients were treated with 6 weeks of the Induction A regimen, comprising cytarabine, vincristine and prednisolone, followed by maintenance therapy. Poor responders to Induction A were switched to Induction B. JLSG-02 has been revised from JLSG-96 in the following respects: prednisolone dosage during Induction A increased; duration of maintenance therapy extended from 24 to 48 weeks; cyclosporine introduced to Induction B for progressive disease. One hundred forty-seven children with multisystem LCH were evaluated. Of these, 84 were positive for risk of organ involvement (RO) and 63 were RO-negative. At the 6-week point, 76.2 % of RO+ and 93.7 % of RO- patients responded to Induction A. Five-year event-free survival (EFS) was 46.2 % [95 % confidence (CI), 35.5-56.9] for RO+ and 69.7 % (58.4-81.1) for RO-, which was significantly superior to that in JLSG-96 [26.8 % (13.3-40.4) and 38.9 % (16.4-61.4), respectively]. The intensified induction and prolonged maintenance regimens in JLSG-02 improved EFS in patients with multisystem LCH.

  6. Orbital fractures: a review

    PubMed Central

    Joseph, Jeffrey M; Glavas, Ioannis P

    2011-01-01

    This review of orbital fractures has three goals: 1) to understand the clinically relevant orbital anatomy with regard to periorbital trauma and orbital fractures, 2) to explain how to assess and examine a patient after periorbital trauma, and 3) to understand the medical and surgical management of orbital fractures. The article aims to summarize the evaluation and management of commonly encountered orbital fractures from the ophthalmologic perspective and to provide an overview for all practicing ophthalmologists and ophthalmologists in training. PMID:21339801

  7. Aetiology of abfraction lesions.

    PubMed

    Lyons, K

    2001-09-01

    The aetiology of abfraction lesions is complex. Most evidence indicates that physical loading forces are a major contributing factor, although they are unlikely to be entirely responsible. Intraoral chemical influences and toothbrush abrasion, combined with the dynamics of inter-occlusal activity such as chewing, swallowing, and parafunction, lead to stress corrosion and may contribute to abfraction lesions. The multifactorial aetiology that operates in the initiation and progression of these lesions has made investigation difficult. Various theories have been proposed and numerous surveys and studies conducted, but the primary causal factor has yet to be definitively determined. This review concludes that occlusal loading is the initiating factor in the development of abfraction lesions.

  8. Transfer orbit determination accuracy for orbit maneuvers

    NASA Astrophysics Data System (ADS)

    Pinheiro, Mery Passos

    This work intends to show the accuracy of the orbital elements determined during transfer orbit as a function of data span, as well as the feasibility of performance maneuvers. The orbit estimator used is a weighted least squares algorithm. The observation vector is composed of angle data (azimuth and elevation) and range data and are from the Astra IC mission. The state vector is either propagated by Brower model or numerical integration (for small eccentricities and inclination). The complete software to determine the orbit has been developed by Hughes Aircraft and been used for all Hughes satellite mission.

  9. Lunar Reconnaissance Orbiter Orbit Determination Accuracy Analysis

    NASA Technical Reports Server (NTRS)

    Slojkowski, Steven E.

    2014-01-01

    Results from operational OD produced by the NASA Goddard Flight Dynamics Facility for the LRO nominal and extended mission are presented. During the LRO nominal mission, when LRO flew in a low circular orbit, orbit determination requirements were met nearly 100% of the time. When the extended mission began, LRO returned to a more elliptical frozen orbit where gravity and other modeling errors caused numerous violations of mission accuracy requirements. Prediction accuracy is particularly challenged during periods when LRO is in full-Sun. A series of improvements to LRO orbit determination are presented, including implementation of new lunar gravity models, improved spacecraft solar radiation pressure modeling using a dynamic multi-plate area model, a shorter orbit determination arc length, and a constrained plane method for estimation. The analysis presented in this paper shows that updated lunar gravity models improved accuracy in the frozen orbit, and a multiplate dynamic area model improves prediction accuracy during full-Sun orbit periods. Implementation of a 36-hour tracking data arc and plane constraints during edge-on orbit geometry also provide benefits. A comparison of the operational solutions to precision orbit determination solutions shows agreement on a 100- to 250-meter level in definitive accuracy.

  10. A case of Langerhans' cell histiocytosis associated with Hodgkin's lymphoma: Fine-needle aspiration cytologic and histopathological features.

    PubMed

    Das, Dilip K; Sheikh, Zafar A; Alansary, Taiba A; Amir, Thasneem; Al-Rabiy, Fatma N; Junaid, Thamradeen A

    2016-02-01

    Langerhans cell histiocytosis (LCH) can be associated with a variety of malignant neoplasms, the most common being malignant lymphoma, especially Hodgkin's lymphoma (HL). In this report, we describe the fine needle aspiration (FNA) cytologic features of a case with concurrent LCH and HL in a lymph node. A 20-year-old man presented with an enlarged left upper cervical lymph node. FNA smears from the swelling revealed numerous CD1a+ and S-100+ Langerhans-type cells (LCs) along with many eosinophils, neutrophils, and lymphocytes; there were also large atypical cells with enlarged nuclei having prominent nucleoli. The cytodiagnosis was LCH and the possibility of association with or trans-differentiation into a lymphoma was suggested. The histopathological diagnosis of the excised left cervical lymph node was classical HL-nodular sclerosis type (CHL-NS) with LCH. The lacunar type Reed-Sternberg (RS) cells were positive for CD30 and CD15, and the LCs were positive for CD1a and S-100 protein. PET/CT imaging demonstrated hypermetabolic lymph nodes in neck, abdomen, thorax and pelvis as well as pulmonary nodules and a splenic mass. The patient received 13 courses of chemotherapy and two years later, the enhanced CT revealed regressive course of the disease.

  11. Pseudo-Peritoneal Carcinomatosis Presentation of a Crystal-Storing Histiocytosis With an Unmutated Monoclonal κ Light Chain

    PubMed Central

    Aline-Fardin, Aude; Bender, Sebastien; Fabiani, Bettina; Buob, David; Brahimi, Said; Verpont, Marie Christine; Mothy, Mohamad; Ronco, Pierre; Boffa, Jean Jacques; Aucouturier, Pierre; Garderet, Laurent

    2015-01-01

    Abstract Crystal-storing histiocytosis (CSH) is a rare complication of monoclonal gammopathies caused by accumulation of crystalline material inside macrophages, and it may result in a variety of clinical manifestations depending on the involved organs. Although immunoglobulin κ light chains (LCs) seem to be the most frequent pathogenic component, very few molecular data are currently available. A 69-year-old man presented with a very poor performance status. Remarkable features were mesenteric lymph node enlargement and proteinuria, including a monoclonal κ LC. Light and electron microscopy studies revealed the presence of crystals within macrophages in the lymph nodes, bone marrow, and kidney, leading to the diagnosis of CSH. The pathogenic κ LC variable domain sequence was identical to the germline Vk3-20∗01/Jk2∗01 gene segments, without any somatic mutation, suggesting an extra-follicular B cell proliferation. The patient was successfully treated with 4 cycles of bortezomib and dexamethasone. After a 12-month follow-up, he remains in hematological and renal remission. CSH may present as pseudo-peritoneal carcinomatosis and relate to a monoclonal κ LC encoded by an unmutated gene. Bortezomib-based therapy proved efficacious in this case. PMID:26266355

  12. Secondary Sea-Blue Histiocytosis in a Patient with Transfusion Dependent HbE-Beta Thalassaemia and Osteosarcoma.

    PubMed

    Saad Eldeen Bakheet, Omayma; Yusof, Nurasyikin; Raja Zahratul, Azma; Ithnin, Azlin; Abdul Aziz, Suria; Alias, Hamidah

    2016-06-01

    Secondary sea-blue histiocytosis occurs more frequently than the primary form and occurs consequent to a wide range of metabolic and haematologic disorders including thalassaemia. We report an 18-year-old Chinese boy with transfusion-dependent HbE-beta thalassaemia who complained of pain and swelling at the left iliac crest region for 2 months duration. Physical examination revealed pallor with hepatosplenomegaly. Local examination revealed a huge swelling 12 cm × 12 cm in diameter, firm in consistency and tender. Histopathological examination of the mass revealed an osteosarcoma. His bone marrow aspirate showed numerous sea-blue histiocytes, the cytoplasm of which was closely packed with fine granules that stained blue with May-Grunwald-Giemsa. The nuclei were centrally located in some cells and displaced towards the periphery in other cells. There was no malignant cell infiltration in the marrow. The case is reported due to the co-incidental dual pathology in our patient (HbE-beta thalassaemia and osteosarcoma) and the unusual bone marrow finding of numerous sea-blue histiocytes.

  13. Fine-needle aspiration of primary Langerhans cell histiocytosis of the thyroid gland, a potential mimic of papillary thyroid carcinoma.

    PubMed

    Pusztaszeri, Marc P; Sauder, Kenan J; Cibas, Edmund S; Faquin, William C

    2013-01-01

    The clinical presentation of Langerhans cell histiocytosis (LCH) as a primary solitary nodule in the thyroid gland is rare. As a result, there are few reports of its cytologic features in thyroid aspirates where it can pose a diagnostic pitfall. CASE AND CONCLUSION: To foster familiarity with its cytomorphology, we report the fine-needle aspiration biopsy (FNAB) findings of 3 specimens from 2 patients with LCH presenting as a solitary thyroid nodule. All aspirates contained numerous dispersed cells with prominent nuclear grooves, and the background showed a mixed pattern of chronic inflammation including scattered eosinophils. The aspirate from patient 1 raised a differential diagnosis that included chronic lymphocytic thyroiditis and a thyroglossal duct cyst, while the aspirate from patient 2 was interpreted as 'suspicious for papillary thyroid carcinoma'. The diagnosis of LCH was confirmed in both patients after lobectomy and immunohistochemical studies that revealed positive reactivity for CD1a and S-100. LCH of the thyroid gland is rare and can pose significant diagnostic challenges, but increased familiarity with its characteristic cytomorphology can help in avoiding diagnostic pitfalls. Copyright © 2013 S. Karger AG, Basel.

  14. Management of adult patients with Langerhans cell histiocytosis: recommendations from an expert panel on behalf of Euro-Histio-Net

    PubMed Central

    2013-01-01

    Langerhans Cell Histiocytosis (LCH) is an orphan disease of clonal dendritic cells which may affect any organ of the body. Most of the knowledge about the diagnosis and therapy is based on pedriatic studies. Adult LCH patients are often evaluated by physicians who focus on only the most obviously affected organ without sufficient evaluation of other systems, resulting in patients being underdiagnosed and/or incompletely staged. Furthermore they may be treated with pediatric-based therapies which are less effective and sometimes more toxic for adults. The published literature on adult LCH cases lacks a comprehensive discussion on the differences between pediatric and adult patients and there are no recommendations for evaluation and comparative therapies. In order to fill this void, a number of experts in this field cooperated to develop the first recommendations for management of adult patients with LCH. Key questions were selected according to the clinical relevance focusing on diagnostic work up, therapy, and follow up. Based on the available literature up to December 2012, recommendations were established, drafts were commented by the entire group, and redrafted by the executive editor. The quality of evidence of the recommendations is predominantly attributed to the level of expert opinion. Final agreement was by consensus. PMID:23672541

  15. Orbits: Computer simulation

    NASA Technical Reports Server (NTRS)

    Muszynska, A.

    1985-01-01

    In rotating machinery dynamics an orbit (Lissajous curve) represents the dynamic path of the shaft centerline motion during shaft rotation and resulting precession. The orbit can be observed with an oscilloscope connected to XY promixity probes. The orbits can also be simulated by a computer. The software for HP computer simulates orbits for two cases: (1) Symmetric orbit with four frequency components with different radial amplitudes and relative phase angles; and (2) Nonsymmetric orbit with two frequency components with two different vertical/horizontal amplitudes and two different relative phase angles. Each orbit carries a Keyphasor mark (one-per-turn reference). The frequencies, amplitudes, and phase angles, as well as number of time steps for orbit computation, have to be chosen and introduced to the computer by the user. The orbit graphs can be observed on the computer screen.

  16. Neuro-Sweet Disease Causing Orbital Inflammation.

    PubMed

    Taravati, Parisa

    2015-02-01

    Neuro-Sweet disease is a rare condition causing encephalitis or meningitis in addition to the erythematous skin plaques of Sweet syndrome. Neuro-Sweet disease has been associated with several ocular manifestations, including ocular movement disorders, episcleritis, conjunctivitis, uveitis, and optic disc oedema. The author reports a patient with orbital inflammation, cranial neuropathies, and a skin rash in the setting of myelodysplastic syndrome. Biopsy of her skin lesion confirmed the diagnosis of neuro-Sweet disease. To the author's knowledge, this is the first reported case of neuro-Sweet disease causing orbital inflammation. Her ocular inflammation resolved with the use of systemic corticosteroid treatment.

  17. Preinvasive lesions

    Cancer.gov

    This definition is for allocation of lesions with preinvasive/borderline properties. It is currently aimed at newly identified neoplasms, which may be similar to those described in humans. In mouse pathology, many adenomas may be preinvasive/borderline lesions. However, their inclusion in the preinvasive category can be justified only upon development of better diagnostic criteria.

  18. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  19. Manned Venus Orbiting Mission

    NASA Technical Reports Server (NTRS)

    Willis, E. A., Jr.

    1967-01-01

    Manned orbiting stopover round trips to Venus are studied for departure dates between 1975 and 1986 over a range of trip times and stay times. The use of highly elliptic parking orbits at Venus leads to low initial weights in Earth orbit compared with circular orbits. For the elliptic parking orbit, the effect of constraints on the low altitude observation time on the initial weight is shown. The mission can be accomplished with the Apollo level of chemical propulsion, but advanced chemical or nuclear propulsion can give large weight reductions. The Venus orbiting mission weights than the corresponding Mars mission.

  20. Orbital Dermoid Cyst: Classification and its Impact on Surgical Management.

    PubMed

    Eldesouky, Mohammed Ashraf; Elbakary, Molham Abdelhafez

    2016-09-06

    Analysis of different clinical types of orbital dermoid cyst, and studying the impact of preoperative classification on the proposed surgical procedure. A retrospective study of orbital dermoid cyst cases. The clinical and imaging data were reviewed. The different types of dermoid were recorded as superficial or deep, lateral or medial, exophytic or endophytic. The deep dermoids were classified according to their site and continuity of the cyst wall. The operative approach, intraoperative, and/or postoperative complications were recorded. The study included 153 cases of orbital dermoid. The superficial lesions represented 68.6%, of which 74.3% were lateral and 61.0% were endophytic. Intraoperative cyst perforation was recorded in 56.3% of exophytic cases approached through crease incision, and recurrence occurred in 6.3%. Defective cyst wall was found in 31.25% of deep orbital dermoid. Surgery was complicated by cyst rupture when excision was attempted, and recurrence was recorded in one case. Exposure, intended evacuation, and dissection of the cyst wall were better surgical approaches for these cases without reported complications. Preoperative classification of orbital dermoid had an important effect on the surgical procedure. Endophytic superficial lesions were approached through crease incision without complications, while exophytic lesions were better approached through infrabrow incision. Deep orbital lesions with defective wall were better approached through exposure, intended evacuation, dissection, and excision of the remaining cyst wall.

  1. A new case of cervical intramedullary sinus histiocytosis causing paraplegia and review of the literature

    PubMed Central

    Rocha-Maguey, Jesús; Felix-Torrontegui, José-Angel; Cabrera-López, Myriam; Gutiérrez-Castro, Macrina; Montante-Montes de Oca, Daniel

    2016-01-01

    Background: Rosai–Dorfman disease (RDD) is an uncommon, benign histiocytic proliferative disorder of unknown origin. It predominantly affects the lymph nodes, but can also be found extranodal in different organs. Nervous system involvement is rare, and the most cases are intracranial. Surgical treatment is indicated when the central nervous system (CNS) in compromised. Case Description: We herein describe the management of a 27-year-old woman who presented progressive spinal cord symptoms, secondary to an isolated intramedullary lesion, which had a histological confirmation of RDD. To our knowledge, this is the 6th case reported in English written manuscripts. We review these cases and analyze some of the literature concerning the disease. Conclusions: RDD shows some variability in the involvement of the entire neuraxis, and because its ability to mimic meningeal and primary brain tumors, it is essential to be aware of this entity and consider RDD in the differential diagnosis of various lesions of the CNS. The conclusive diagnosis must be obtained by histological methods, so surgical approaches have to be discussed. Although it is not considered as a malignancy, options for postoperative medical treatment are variable and include radiation, chemotherapy or maybe monoclonal antibodies for refractory or recurrent cases. PMID:26862448

  2. MR Imaging of Orbital Inflammatory Pseudotumors with Extraorbital Extension

    PubMed Central

    Jung, So Lyung; Kim, Bum Soo; Ahn, Kook Jin; Kim, Young Joo; Jung, Ae Kyung; Park, Chan Sub; Song, Soon-Young; Park, Noh Hyuck; Kim, Mi Sung

    2005-01-01

    Objective To demonstrate a variety of MR imaging findings of orbital inflammatory pseudotumors with extraorbital extension. Materials and Methods We retrospectively reviewed the MR features of five patients, who were diagnosed clinically and radiologically as having an orbital inflammatory pseudotumor with extraorbital extension. Results The types of orbital pseudotumors were a mass in the orbital apex (n = 3), diffuse form (n = 2), and myositis (n = 1). The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. The orbital lesions extended into the following areas: the cavernous sinus (n = 4), the middle cranial fossa (n = 4), Meckel's cave (n = 2), the petrous apex (n = 2), the clivus (n = 2), the pterygopalatine fossa and infratemporal fossa (n = 2), the foramen rotundum (n = 1), the paranasal sinus (n = 1), and the infraorbital foramen (n = 1). On MR imaging, the lesions appeared as an isosignal intensity with gray matter on the T1-weighted images, as a low signal intensity on the T2-weighted images and showed a marked enhancement on the post-gadolinium-diethylene triamine pentaacetic acid (post-Gd-DTPA) T1-sequences. The symptoms of all of the patients improved when they were given high doses of steroids. Three of the five patients experienced a recurrence. Conclusion MR imaging is useful for demonstrating the presence of a variety of extraorbital extensions of orbital inflammatory pseudotumors. PMID:15968146

  3. Lunar orbiting prospector

    NASA Technical Reports Server (NTRS)

    1988-01-01

    One of the prime reasons for establishing a manned lunar presence is the possibility of using the potential lunar resources. The Lunar Orbital Prospector (LOP) is a lunar orbiting platform whose mission is to prospect and explore the Moon from orbit in support of early lunar colonization and exploitation efforts. The LOP mission is divided into three primary phases: transport from Earth to low lunar orbit (LLO), operation in lunar orbit, and platform servicing in lunar orbit. The platform alters its orbit to obtain the desired surface viewing, and the orbit can be changed periodically as needed. After completion of the inital remote sensing mission, more ambitious and/or complicated prospecting and exploration missions can be contemplated. A refueled propulsion module, updated instruments, or additional remote sensing packages can be flown up from the lunar base to the platform.

  4. Oral Lesions in Neonates

    PubMed Central

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  5. Multifocal vascular lesions.

    PubMed

    Levin, Laura E; Lauren, Christine T

    2016-09-01

    Multifocal vascular lesions are important to recognize and appropriately diagnose. Generally first noticed on the skin, multifocal vascular lesions may have systemic involvement. Distinguishing among the different types of multifocal vascular lesions is often based on clinical features; however, radiological imaging and/or biopsy are frequently needed to identify distinct features and guide treatment. Knowledge of the systemic associations that can occur with different vascular anomalies may reduce life-threatening complications, such as coagulopathy, bleeding, cardiac compromise, and neurologic sequelae. This review provides a synopsis of the epidemiology, pathogenesis, presentation, workup, and treatment of several well-recognized multifocal vascular tumors and malformations.

  6. Incidental vertebral lesions.

    PubMed

    Coumans, Jean-Valery C E; Walcott, Brian P

    2011-12-01

    Incidental vertebral lesions on imaging of the spine are commonly encountered in clinical practice. Contributing factors include the aging population, the increasing prevalence of back pain, and increased usage of MR imaging. Additionally, refinements in CT and MR imaging have increased the number of demonstrable lesions. The management of incidental findings varies among practitioners and commonly depends more on practice style than on data or guidelines. In this article we review incidental findings within the vertebral column and review management of these lesions, based on available Class III data.

  7. Low-Flow Arterialized Venous Malformations of the Orbit.

    PubMed

    Callahan, Alison B; Meyers, Philip M; Garrity, James A; Son, Jung H; Petris, Carisa; Kazim, Michael

    Orbital vascular malformations are classified by their hemodynamic properties, either high or low flow. Low-flow lesions may be simple venous, lymphatic, or combined lymphaticovenous malformations. The authors report a series of cases in which predominantly low flow, venous lesions were unexpectedly noted to have arterial feeders. A retrospective chart review of patients identified by the authors as having orbital varices with arterial components was conducted. The authors identified 7 such cases. After careful review, 2 cases were excluded due to inconclusive neuroradiographic findings. The authors review the clinical, radiologic, histopathologic, and surgical information from the remaining 5 cases and discuss their clinical significance. All 5 cases were most consistent with variceal lesions: 3 as clinically distensible lesions and 2 as thrombosed lesions. Additional arterial feeder vessels were noted by angiography (3) or intraoperative visualization (2). The arterial contribution varied from faint vessels to distinct branches of the ophthalmic artery. Ages ranged from 13 to 61 years without predilection for gender. Treatments consisted of excision, embolization, and observation. Two poignant cases are highlighted: the first illustrating that an angiogram in isolation of its clinical picture can be misleading and result in treatment intervention with undue risk, and the second illustrating that inadequate treatment of unrecognized arterial components may contribute to recurrences. Low-flow orbital variceal lesions may have less prominent, arterial components. This type of combined arterialized venous malformation is largely unrecognized in the ophthalmic literature. Correct identification of these lesions is critical in providing safe, effective, and durable treatment.

  8. Comprehensive Treatment of Primary Orbital Arteriovenous Malformation.

    PubMed

    Xie, Jizi; Xu, Shiqiong; Shi, Yinyun; Li, Tianyuan; Jia, Renbing; Fan, Xianqun

    2017-09-01

    Primary orbital arteriovenous malformations are a rare kind of vascular malformation lesions. The authors present a 17-year-old man presented with swelling and pulsation in the left upper eyelid. The angiogram of the left internal carotid artery showed that arteriovenous malformations at the left upper eyelid area were supplied with one of the branches of ophthalmic artery. In this report, the authors elaborated the comprehensive treatments of primary arteriovenous malformation.

  9. Image guided core needle biopsy of musculoskeletal lesions: are nondiagnostic results clinically useful?

    PubMed

    Didolkar, Manjiri M; Anderson, Megan E; Hochman, Mary G; Rissmiller, Julia G; Goldsmith, Jeffrey D; Gebhardt, Mark G; Wu, Jim S

    2013-11-01

    The clinical utility of nondiagnostic core needle biopsies is not fully understood. Understanding the clinical and radiologic factors associated with nondiagnostic core needle biopsies may help determine the utility of these nondiagnostic biopsies and guide clinical decision making. We asked (1) whether benign or malignant bone and soft tissue lesions have a higher rate of nondiagnostic core needle biopsy results, and which diagnoses have the lowest diagnostic yield; (2) how often nondiagnostic results affected clinical decision-making; and (3) what clinical factors are associated with nondiagnostic but useful core needle biopsies. A retrospective study was performed of 778 consecutive image-guided core needle biopsies of bone and soft tissue lesions referred to the musculoskeletal radiology department at a single institution. The reference standard was (1) the final diagnosis at surgery or (2) clinical followup. Diagnostic yield was calculated for the most common diagnoses. Clinical and imaging features related to each nondiagnostic core needle biopsy were assessed for their association with clinical usefulness. Useful nondiagnostic biopsies were defined as those that help guide treatment. Each lesion was assessed before biopsy by the orthopaedic oncologist as (1) "likely to be benign" or (2) "suspicious for malignancy." The overall diagnostic yield was 74%. Malignant lesions had higher diagnostic yield than benign lesions: 94% (323 of 345) versus 58% (252 of 433), yielding a relative risk (RR) of 1.61 and 95% CI of 1.48 to 1.75. Soft tissue lesions had a higher diagnostic yield than bone lesions: 82% (291 of 355) versus 67% (284 of 423); RR, 1.22; 95% CI, 1.22 (1.12-1.33). Ganglion cyst (36%, four of 11), myositis ossificans (40%, two of five), Langerhans cell histiocytosis (0%, 0 of four), and simple bone cyst 0%, 0 of six) had the lowest diagnostic yield. Of the nondiagnostic biopsies assessed for clinical usefulness by the orthopaedic oncologist, 60% (85 of

  10. CTO revascularization: Obstacles and options in balloon nonpenetrable lesions.

    PubMed

    Topaz, On

    2017-07-01

    CTO lesions resisting balloon crossing are located in moderate/severe tortuous coronary arteries contain more moderate/severe calcification burden and carry a higher J-CTO score as compared with balloon crossable CTO lesions. CTO lesions resisting balloon crossing do not constitute a homogenous group. In 25% of the patients, the resisting CTO was caused by stent restenosis and thrombus is an integral component of CTO in addition to calcium and fibrosis. The excimer laser and rotational/orbital atherectomy are among useful debulking technologies capable of creating a "pilot recanalization channel" in the CTO that enables completion of the revasularization. © 2017 Wiley Periodicals, Inc.

  11. Five Equivalent d Orbitals

    ERIC Educational Resources Information Center

    Pauling, Linus; McClure, Vance

    1970-01-01

    Amplifies and clarifies a previous paper on pyramidal d orbitals. Discusses two sets of pyramid d orbitals with respect to their maximum bond strength and their symmetry. Authors described the oblate and prolate pentagonal antiprisms arising from the two sets of five equivalent d orbitals. (RR)

  12. Introducing Earth's Orbital Eccentricity

    ERIC Educational Resources Information Center

    Oostra, Benjamin

    2015-01-01

    Most students know that planetary orbits, including Earth's, are elliptical; that is Kepler's first law, and it is found in many science textbooks. But quite a few are mistaken about the details, thinking that the orbit is very eccentric, or that this effect is somehow responsible for the seasons. In fact, the Earth's orbital eccentricity is…

  13. Introducing Earth's Orbital Eccentricity

    ERIC Educational Resources Information Center

    Oostra, Benjamin

    2015-01-01

    Most students know that planetary orbits, including Earth's, are elliptical; that is Kepler's first law, and it is found in many science textbooks. But quite a few are mistaken about the details, thinking that the orbit is very eccentric, or that this effect is somehow responsible for the seasons. In fact, the Earth's orbital eccentricity is…

  14. SEASAT B orbit synthesis

    NASA Technical Reports Server (NTRS)

    Rea, F. G.; Warmke, J. M.

    1976-01-01

    Addition were made to Battelle's Interactive Graphics Orbit Selection (IGOS) program; IGOS was exercised via telephone lines from JPL, and candidate SEASAT orbits were analyzed by Battelle. The additions to the program enable clear understanding of the implications of a specific orbit to the diverse desires of the SEASAT user community.

  15. Uterine Vascular Lesions

    PubMed Central

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  16. Talar Dome Lesion

    MedlinePlus

    ... the talus. During this period of immobilization, nonweightbearing range-of-motion exercises may be recommended. Oral medications. Nonsteroidal anti- ... in reducing the pain and inflammation. Physical therapy. Range-of-motion and strengthening exercises are beneficial once the lesion ...

  17. The transmaxillary endoscopic approach to the orbit.

    PubMed

    Schultheiß, Saskia; Petridis, Athanasios K; El Habony, Rashad; Maurer, Peter; Scholz, Martin

    2013-01-01

    In this surgical-anatomical cadaveric study we investigate the feasibility of the transmaxillary endoscopic approach to the intraorbital space. Anatomical landmarks are defined, the endoscopic view in the orbital space is studied and complications that can occur are discussed. Nine formalin-fixed heads were used to study the transmaxillary endoscopic approach to the orbit. The approach was used twice on each head (once for each maxilla). Therefore, we report our results on 18 transmaxillary intraorbital approaches. For better differentiation of anatomical structures, the veins and arteries were injected with blue and red plastic respectively in six cadaveric heads. The transmaxillary approach enables viewing the inferior intraconal structures without endangering the infraorbital nerve and its artery and without diversion of the inferior rectus muscle. The optic nerve was visualised more easily through the approach medial to the inferior rectus muscle instead of lateral to the muscle since the ciliary nerves are in the way in the lateral approach. The combination of the approaches medial and lateral to the inferior rectus muscle allows very good identification of all important anatomical structures in the inferior intraconal space. The transmaxillary endoscopic approach to the orbit is a useful new approach in the surgical armamentarium for orbital lesions. The overview of the inferior part of the orbit is excellent, and the lateral part of the optic nerve can be visualised. Careful anatomical dissection allows visualisation of important anatomical structures in the orbit without damaging nerves or arteries.

  18. Lunar Reconnaissance Orbiter Orbit Determination Accuracy Analysis

    NASA Technical Reports Server (NTRS)

    Slojkowski, Steven E.

    2014-01-01

    LRO definitive and predictive accuracy requirements were easily met in the nominal mission orbit, using the LP150Q lunar gravity model. center dot Accuracy of the LP150Q model is poorer in the extended mission elliptical orbit. center dot Later lunar gravity models, in particular GSFC-GRAIL-270, improve OD accuracy in the extended mission. center dot Implementation of a constrained plane when the orbit is within 45 degrees of the Earth-Moon line improves cross-track accuracy. center dot Prediction accuracy is still challenged during full-Sun periods due to coarse spacecraft area modeling - Implementation of a multi-plate area model with definitive attitude input can eliminate prediction violations. - The FDF is evaluating using analytic and predicted attitude modeling to improve full-Sun prediction accuracy. center dot Comparison of FDF ephemeris file to high-precision ephemeris files provides gross confirmation that overlap compares properly assess orbit accuracy.

  19. Orbital Plasmacytoma Mimicking an Orbital Abscess.

    PubMed

    Russell, David J; Seiff, Stuart R

    An 83-year-old male with a 15-month history of multiple myeloma presented with acute onset of swelling, redness, and pain around his right eye. CT scan was consistent with an orbital abscess. The patient was taken to the operating room for drainage of the orbital abscess. Abnormal tissue was encountered intraoperatively so biopsies were taken. His cultures grew only one colony of coagulase-negative Staphylococcus aureus. The histopathology from the biopsies showed a CD-138 positive plasma cell neoplasia consistent with a plasmacytoma. Plasmacytomas have been reported to present as orbital cellulitis and as abscesses in other locations in the body, but to our knowledge, this is the first case of a plasmacytoma presenting as an orbital abscess.

  20. Orbit Software Suite

    NASA Technical Reports Server (NTRS)

    Osgood, Cathy; Williams, Kevin; Gentry, Philip; Brownfield, Dana; Hallstrom, John; Stuit, Tim

    2012-01-01

    Orbit Software Suite is used to support a variety of NASA/DM (Dependable Multiprocessor) mission planning and analysis activities on the IPS (Intrusion Prevention System) platform. The suite of Orbit software tools (Orbit Design and Orbit Dynamics) resides on IPS/Linux workstations, and is used to perform mission design and analysis tasks corresponding to trajectory/ launch window, rendezvous, and proximity operations flight segments. A list of tools in Orbit Software Suite represents tool versions established during/after the Equipment Rehost-3 Project.

  1. IL-17A receptor expression differs between subclasses of Langerhans cell histiocytosis, which might settle the IL-17A controversy.

    PubMed

    Murakami, Ichiro; Morimoto, Akira; Oka, Takashi; Kuwamoto, Satoshi; Kato, Masako; Horie, Yasushi; Hayashi, Kazuhiko; Gogusev, Jean; Jaubert, Francis; Imashuku, Shinsaku; Al-Kadar, Lamia Abd; Takata, Katsuyoshi; Yoshino, Tadashi

    2013-02-01

    Langerhans cell histiocytosis (LCH) is a lymphoproliferative disorder consisting of abnormal Langerhans cell-like cells and other lymphoid cells. LCH presents as either a multisystem LCH (LCH-MS) or a single-system LCH (LCH-SS). Currently, neither the pathogeneses nor the factors that define these disease subclasses have been elucidated. The interleukin (IL)-17A autocrine LCH model and IL-17A-targeted therapies have been proposed and have engendered much controversy. Those authors showed high serum IL-17A levels in LCH and argued that serum IL-17A-dependent fusion activities in vitro, rather than serum IL-17A levels, correlated with LCH severity (i.e. the IL-17A paradox). In contrast, others could not confirm the IL-17A autocrine model. So began the controversy on IL-17A, which still continues. We approached the IL-17A controversy and the IL-17A paradox from a new perspective in considering the expression levels of IL-17A receptor (IL-17RA). We detected higher levels of IL-17RA protein expression in LCH-MS (n = 10) as compared to LCH-SS (n = 9) (P = 0.041) by immunofluorescence. We reconfirmed these data by re-analyzing GSE16395 mRNA data. We found that serum levels of IL-17A were higher in LCH (n = 38) as compared to controls (n = 20) (P = 0.005) with no significant difference between LCH subclasses. We propose an IL-17A endocrine model and stress that changes in IL-17RA expression levels are important for defining LCH subclasses. We hypothesize that these IL-17RA data could clarify the IL-17A controversy and the IL-17A paradox. As a potential treatment of LCH-MS, we indicate the possibility of an IL-17RA-targeted therapy.

  2. BRAF Mutation Correlates With High-Risk Langerhans Cell Histiocytosis and Increased Resistance to First-Line Therapy

    PubMed Central

    Emile, Jean-François; Barkaoui, Mohamed-Aziz; Thomas, Caroline; Fraitag, Sylvie; Boudjemaa, Sabah; Renaud, Florence; Moreau, Anne; Peuchmaur, Michel; Chassagne-Clément, Catherine; Dijoud, Frédérique; Rigau, Valérie; Moshous, Despina; Lambilliotte, Anne; Mazingue, Françoise; Kebaili, Kamila; Miron, Jean; Jeziorski, Eric; Plat, Geneviève; Aladjidi, Nathalie; Ferster, Alina; Pacquement, Hélène; Galambrun, Claire; Brugières, Laurence; Leverger, Guy; Mansuy, Ludovic; Paillard, Catherine; Deville, Anne; Armari-Alla, Corinne; Lutun, Anne; Gillibert-Yvert, Marion; Stephan, Jean-Louis; Cohen-Aubart, Fleur; Haroche, Julien; Pellier, Isabelle; Millot, Frédéric; Lescoeur, Brigitte; Gandemer, Virginie; Bodemer, Christine; Lacave, Roger; Hélias-Rodzewicz, Zofia; Taly, Valérie; Geissmann, Frédéric; Donadieu, Jean

    2016-01-01

    Purpose Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia with a broad spectrum of clinical manifestations and outcomes in children. The somatic BRAFV600E mutation occurs frequently, but clinical significance remains to be determined. Patients and Methods BRAFV600E mutation was investigated in a French LCH cohort. We analyzed associations between mutation status and clinical presentation, extent of disease, reactivation rate, response to therapy, and long-term permanent sequelae. Results Among 315 patients with successfully determined BRAF status, 173 (54.6%) carried a BRAFV600E mutation. Patients with BRAFV600E manifested more severe disease than did those with wild-type BRAF. Patients with BRAFV600E comprised 87.8% of patients (43 of 49) with multisystem LCH with risk organ involvement (liver, spleen, hematology), 68.6% of patients (35 of 51) with multisystem LCH without risk organ involvement, 43.9% of patients (86 of 196) with single-system LCH, and 42.1% of patients (8 of 19) with lung-involved LCH (P < .001). BRAFV600E mutation was also associated with organ involvement that could lead to permanent, irreversible damage, such as neurologic (75%) and pituitary (72.9%) injuries. Compared with patients with wild-type BRAF, patients with BRAFV600E more commonly displayed resistance to combined vinblastine and corticosteroid therapy (21.9% v 3.3%; P = .001), showed a higher reactivation rate (5-year reactivation rate, 42.8% v 28.1%; P = .006), and had more permanent, long-term consequences from disease or treatment (27.9% v 12.6%; P = .001). Conclusion In children with LCH, BRAFV600E mutation was associated with high-risk features, permanent injury, and poor short-term response to chemotherapy. Further population-based studies should be undertaken to confirm our observations and to assess the impact of BRAF inhibitors for this subgroup of patients who may benefit from targeted therapy. PMID:27382093

  3. Traditional lesion detection aids.

    PubMed

    Neuhaus, K W; Ellwood, R; Lussi, A; Pitts, N B

    2009-01-01

    Lesion detection aids ideally aim at increasing the sensitivity of visual caries detection without trading off too much in terms of specificity. The use of a dental probe (explorer), bitewing radiography and fibre-optic transillumination (FOTI) have long been recommended for this purpose. Today, probing of suspected lesions in the sense of checking the 'stickiness' is regarded as obsolete, since it achieves no gain of sensitivity and might cause irreversible tooth damage. Bitewing radiography helps to detect lesions that are otherwise hidden from visual examination, and it should therefore be applied to a new patient. The diagnostic performance of radiography at approximal and occlusal sites is different, as this relates to the 3-dimensional anatomy of the tooth at these sites. However, treatment decisions have to take more into account than just lesion extension. Bitewing radiography provides additional information for the decision-making process that mainly relies on the visual and clinical findings. FOTI is a quick and inexpensive method which can enhance visual examination of all tooth surfaces. Both radiography and FOTI can improve the sensitivity of caries detection, but require sufficient training and experience to interpret information correctly. Radiography also carries the burden of the risks and legislation associated with using ionizing radiation in a health setting and should be repeated at intervals guided by the individual patient's caries risk. Lesion detection aids can assist in the longitudinal monitoring of the behaviour of initial lesions. Copyright 2009 S. Karger AG, Basel

  4. [Juvenile nasopharyngeal angiofibroma with orbital extension].

    PubMed

    Hervás Ontiveros, A; España Gregori, E; Climent Vallano, L; Rivas Rodero, S; Alamar Velázquez, A; Simal Julián, J A

    2015-01-01

    The case is presented of a 21 year-old male with a history of left proptosis and diplopia of two weeks of onset. The MRI showed an ethmoid-orbital vascular lesion with anterior skull base invasion and orbital extension. Biopsy of the ethmoid confirmed fibrovascular tissue, which supported the diagnosis of angiofibroma. It is a benign neoplasm with local characteristics of malignancy due to its ability to invade adjacent areas. In this case, the debut presented with manifestations of orbital extension. A broad and multidisciplinary approach is needed in order to improve prognosis. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Painless orbital myositis.

    PubMed

    Chakor, Rahul T; Santhosh, N S

    2012-07-01

    Idiopathic orbital inflammation is the third most common orbital disease, following Graves orbitopathy and lymphoproliferative diseases. We present a 11 year old girl with 15 days history of painless diplopia. There was no history of fluctuation of symptoms, drooping of eye lids or diminished vision. She had near total restricted extra-ocular movements and mild proptosis of the right eye. There was no conjunctival injection, chemosis, or bulb pain. There was no eyelid retraction or lid lag. Rest of the neurological examination was unremarkable.Erythrocyte sedimentation rate was raised with eosinophilia. Antinuclear antibodies were positive. Liver, renal and thyroid functions were normal. Antithyroid, double stranded deoxyribonucleic acid and acetylcholine receptor antibodies were negative. Repetitive nerve stimulation was negative. Magnetic resonance imaging (MRI) of the orbit was typical of orbital myositis. The patient responded to oral steroids. Orbital myositis can present as painless diplopia. MRI of orbit is diagnostic in orbital myositis.

  6. Solar Sail Optimal Orbit Transfers to Synchronous Orbits

    NASA Technical Reports Server (NTRS)

    Powers, Robert B.; Coverstone, Victoria; Prussing, John E.; Lunney, Bryan C. (Technical Monitor)

    1999-01-01

    A constant outward radial thrust acceleration can be used to reduce the radius of a circular orbit of specified period. Heliocentric circular orbits are designed to match the orbital period of Earth or Mars for various radial thrust accelerations and are defined as synchronous orbits. Minimum-time solar sail orbit transfers to these synchronous heliocentric orbits are presented.

  7. Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis

    PubMed Central

    Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

    2009-01-01

    Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis. PMID:22470655

  8. Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis.

    PubMed

    Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

    2009-01-01

    Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.

  9. Monitoring pigmented skin lesions

    NASA Astrophysics Data System (ADS)

    Wallace, Vincent P.; Bamber, Jeffery C.; Ott, Robert J.; Crawford, Diane C.; Mortimer, Peter S.

    2002-06-01

    The rising incidence of skin cancer has led to an increase in the number of patients with skin lesions that require diagnosis, mostly using subjective visual examination. Successful treatment depends on early diagnosis. Unfortunately diagnostic accuracy, even by experts, can be as low as 56%; therefore, an accurate, objective diagnostic aid is greatly needed. Reflectance characteristics of pigmented skin lesions were documented to evaluate their diagnostic potential. Reflectance spectra in the wavelength range 320-1100nm were obtained from 260 lesions. Differences between spectra from benign and malignant lesions were utilized by extracting features with the best discriminating power. Discrimination was evaluated using two techniques: multivariate statistical analysis and artificial neural networks, using histology as the standard. Each technique was tested in a blind study and assessed in terms of its ability to diagnose new cases and compared to the clinical diagnosis. The artificial neural network achieved the best diagnostic performance for discriminating between malignant melanoma and benign nevi, having a sensitivity of 100% and a specificity of 65%. Utilization of visible and infrared techniques for monitoring skin lesions has lead to improvements in diagnostic accuracy. We conclude that these techniques are worthy of further development and evaluation in clinical practice as a screening tool.

  10. Meniscal Ramp Lesions

    PubMed Central

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  11. Nine-year-old girl with a respiratory epithelial cyst of the orbit.

    PubMed

    Weegerink, N; Van Goethem, J; De Schepper, S; Van de Velde, T; Schmelzer, B

    2016-01-01

    Here we describe the clinical and histopathological characteristics of a nine-year-old girl with an intraorbital mass of the left orbit, and review the relevant literature. Imaging data and surgical biopsy revealed an intraconal cystic lesion in the medial-inferior quadrant of the left orbit. The cyst was lined with ciliated pseudostratified epithelium, consistent with a respiratory epithelial cyst of the orbit. Cyst marsupialisation and partial mass removal alleviated symptoms, and no cyst recurrence was observed during follow-up. The literature suggests that this is an uncommon cause of a cystic orbital mass. Respiratory epithelial cysts of the orbit should be considered in the differential diagnosis of intraorbital masses. Surgical excision of such a lesion should be limited to avoid damaging orbital structures. Respiratory epithelial cysts of the orbit generally follow a benign course, and recurrence of ocular symptoms is rare.

  12. Orbit Determination of the Lunar Reconnaissance Orbiter

    NASA Technical Reports Server (NTRS)

    Mazarico, Erwan; Rowlands, D. D.; Neumann, G. A.; Smith, D. E.; Torrence, M. H.; Lemoine, F. G.; Zuber, M. T.

    2011-01-01

    We present the results on precision orbit determination from the radio science investigation of the Lunar Reconnaissance Orbiter (LRO) spacecraft. We describe the data, modeling and methods used to achieve position knowledge several times better than the required 50-100m (in total position), over the period from 13 July 2009 to 31 January 2011. In addition to the near-continuous radiometric tracking data, we include altimetric data from the Lunar Orbiter Laser Altimeter (LOLA) in the form of crossover measurements, and show that they strongly improve the accuracy of the orbit reconstruction (total position overlap differences decrease from approx.70m to approx.23 m). To refine the spacecraft trajectory further, we develop a lunar gravity field by combining the newly acquired LRO data with the historical data. The reprocessing of the spacecraft trajectory with that model shows significantly increased accuracy (approx.20m with only the radiometric data, and approx.14m with the addition of the altimetric crossovers). LOLA topographic maps and calibration data from the Lunar Reconnaissance Orbiter Camera were used to supplement the results of the overlap analysis and demonstrate the trajectory accuracy.

  13. Telescope in lunar orbit

    NASA Technical Reports Server (NTRS)

    Page, T.

    1985-01-01

    The use of a large telescope in high lunar orbit 4000 km above the Moon's equator is proposed. It is recognized that the Hubble Space Telescope (ST), will provide the necessary capabilities if it can be transferred to lunar orbit. The Orbital Transfer Vehicle (OTV), will be able to scan the lunar surface, locate small outcrops of minerals important to base development, support early base operations and undertake detailed geophysical exploration of the whole lunar surface.

  14. Saturn orbiter mission study

    NASA Technical Reports Server (NTRS)

    Wells, W. C.; Sullivan, R. J.

    1973-01-01

    A preliminary analysis of the important aspects of missions orbiting the planet Saturn is provided. Orbital missions to Saturn is given serious consideration for the 1980's, or after flybys by Pioneer 10/G and Mariner Jupiter-Saturn 1977. An attempt is made to characterize Saturn orbiters in detail so that comparisons with Jupiter missions can be made. The scientific objectives of Saturn exploration are grouped under four topics: (1) the atmosphere, (2) the magnetosphere, (3) the rings, and (4) the satellites.

  15. Orbital angioleiomyoma: A rare orbital neoplasm.

    PubMed

    Alam, Md Shahid; Subramanian, Nirmala; Koka, Kirthi; Subramanian, Krishnakumar

    2016-01-01

    A 44-year-old male patient presented with painless progressive proptosis of left eye for the last 20 years. Examination revealed a purplish vascular mass extending from the medial orbital region to the surface of the globe. He underwent complete excision of the mass via an anterior orbitotomy approach. Histopathology and immunohistochemistry revealed a diagnosis of angioleiomyoma. No recurrence was noted at 1 year of follow-up. Angioleiomyomas are benign smooth muscle tumors with an additional vascular component. Their occurrence in the orbit is extremely rare with only three cases reported in literature till date. We report a fourth case of angioleiomyoma of the orbit with the longest duration of presentation of 20 years.

  16. Intraventricular mass lesions

    SciTech Connect

    Morrison, G.; Sobel, D.F.; Kelley, W.M.; Norman, D.

    1984-11-01

    Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age, and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered.

  17. Magnetospheric Multiscale (MMS) Orbit

    NASA Image and Video Library

    This animation shows the orbits of Magnetospheric Multiscale (MMS) mission, a Solar-Terrestrial Probe mission comprising of four identically instrumented spacecraft that will study the Earth's magn...

  18. Orbital Debris: A Chronology

    NASA Technical Reports Server (NTRS)

    Portree, Davis S. F. (Editor); Loftus, Joseph P., Jr. (Editor)

    1999-01-01

    This chronology covers the 37-year history of orbital debris concerns. It tracks orbital debris hazard creation, research, observation, experimentation, management, mitigation, protection, and policy. Included are debris-producing, events; U.N. orbital debris treaties, Space Shuttle and space station orbital debris issues; ASAT tests; milestones in theory and modeling; uncontrolled reentries; detection system development; shielding development; geosynchronous debris issues, including reboost policies: returned surfaces studies, seminar papers reports, conferences, and studies; the increasing effect of space activities on astronomy; and growing international awareness of the near-Earth environment.

  19. Family of Orbiters

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image shows the paths of three spacecraft currently in orbit around Mars, as well as the path by which NASA's Phoenix Mars Lander will approach and land on the planet. The t-shaped crosses show where the orbiters will be when Phoenix enters the atmosphere, while the x-shaped crosses show their location at landing time.

    All three orbiters, NASA's Mars Reconnaissance Orbiter, NASA's Mars Odyssey and the European Space Agency's Mars Express, will be monitoring Phoenix during the final steps of its journey to the Red Planet.

    Phoenix will land just south of Mars's north polar ice cap.

  20. Introducing Earth's Orbital Eccentricity

    NASA Astrophysics Data System (ADS)

    Oostra, Benjamin

    2015-12-01

    Most students know that planetary orbits, including Earth's, are elliptical; that is Kepler's first law, and it is found in many science textbooks. But quite a few are mistaken about the details, thinking that the orbit is very eccentric, or that this effect is somehow responsible for the seasons. In fact, the Earth's orbital eccentricity is small, and its only effect on the seasons is their unequal durations. Here I show a pleasant way to guide students to the actual value of Earth's orbital eccentricity, starting from the durations of the four seasons. The date of perihelion is also found.

  1. Pituitary tumours: inflammatory and granulomatous expansive lesions of the pituitary.

    PubMed

    Carpinteri, R; Patelli, I; Casanueva, F F; Giustina, A

    2009-10-01

    Inflammatory and granulomatous diseases of the pituitary are rare causes of sellar masses. Lymphocytic hypophysitis is the most relevant of these disorders, and it is characterised by autoimmune pathogenesis with focal or diffuse inflammatory infiltration and varying degrees of pituitary gland destruction. Endocrine symptoms may include partial or total hypopituitarism, with adrenocorticotropic hormone (ACTH) deficiency being the earliest and most frequent alteration. Pituitary abscess is a rare but potentially life-threatening disease and, in 30-50% of patients, anterior pituitary hormone deficiencies or central diabetes insipidus (DI) at onset may be observed: the earliest manifestation being growth hormone deficiency (GHD), followed by follicle-stimulating hormone (FSH)/luteinising hormone (LH), thyroid-stimulating hormone (TSH) and ACTH deficiencies. Fungal infections of the pituitary are also very rare and include aspergillosis and coccidioidomycosis. Concerning pituitary involvement in systemic diseases, in sarcoidosis endocrine complications are rare, but the hypothalamus and pituitary are the glands most commonly affected. DI is reported in approximately 25-33 % of all neurosarcoidosis cases and is the most frequently observed endocrine disorder. Hyperprolactinaemia and anterior pituitary deficiencies may also occur. Rarely, partial or global anterior pituitary dysfunction may be present also in Wegener's granulomatosis, either at onset or in the course of the disease, resulting in deficiency of one or more of the pituitary axes. Other forms of granulomatous pituitary lesions include idiopathic giant cell granulomatous hypophysitis, Takayasu's disease, Cogan's syndrome and Crohn's disease. The hypotalamic-pituitary system is involved mainly in children with Langerhans' cells histiocytosis who develop DI, which is the most common endocrine manifestation. Anterior pituitary dysfunction is found more rarely and is almost invariably associated with DI

  2. The anatomical location and laterality of orbital cavernous haemangiomas.

    PubMed

    McNab, Alan A; Selva, Dinesh; Hardy, Thomas G; O'Donnell, Brett

    2014-10-01

    To determine the anatomical location and laterality of orbital cavernous haemangiomas (OCH). Retrospective case series. The records of 104 patients with OCH were analyzed. The anatomical location of each OCH defined by the location of a point at the centre of the lesion, and its laterality. There were 104 patients included in the study. No patient had more than one lesion. Sixteen (15.4%) were located in the anterior third of the orbit, 74 (71.2%) were in the middle third, and 14 (13.5%) in the posterior third. In the middle third, 10 of 74 (13.5%) were extraconal and 64 intraconal (86.5%), with 30 of 64 (46.9%) middle third intraconal lesions lying lateral to the optic nerve. Of 104 lesions, 56 (53.8%) were left sided, showing a trend towards a predilection for the left side (p = 0.065). If data from other published series which included data on laterality is added to our own data and analysed, 270 of 468 (57.7%) OCH occurred in the left orbit (p < 0.005). OCH may occur at almost any location within the orbit. The commonest location is the middle third of the orbit, in the intraconal space lateral to the optic nerve. This may reflect an origin of these lesions from the arterial side of the circulation, as there are more small arteries in the intraconal space lateral to the optic nerve than in other locations. A predilection for the left orbit remains unexplained.

  3. [Orbital leiomyoma. Case report and review of the literature].

    PubMed

    González-Martínez, Emilio; Robla Costales, Javier; Fernández Fernández, Javier; Viñuela Lobo, Jesús; Santamarta, David; Lomas García, Jesús; Iglesias, Elena; Ribas Ariño, Teresa; García-Cosamalón, José

    2014-01-01

    Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location has been reported in 25 cases. Histological findings and no recurrence after total resection support their benign behaviour. We report an intraconal orbital haemangioleiomyoma in a 55-year-old female treated by total resection through fronto-orbital craniotomy, with no recurrence after 15 months of follow-up. Radiological and pathological features are discussed, emphasising the prognostic role of the surgery. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  4. Orbital granulocytic sarcoma

    PubMed Central

    Stockl, F.; Dolmetsch, A.; Saornil, M; Font, R.; Burnier, M.

    1997-01-01

    AIM—Orbital granulocytic sarcoma is a localised tumour composed of cells of myeloid origin. Histological diagnosis can be difficult in patients with poorly differentiated orbital tumours and no evidence of systemic leukaemia. The naphthol AS-D chloracetate esterase (Leder stain) and immunohistochemical stains for lysozyme and MAC387 were used to determine the staining characteristics of these tumours. A case series of seven patients with orbital granulocytic sarcoma is presented.
METHODS—Seven patients with orbital granulocytic sarcoma were studied. Haematoxylin and eosin, Leder, and lysozyme stained sections were available in seven cases. Unstained formalin fixed paraffin embedded sections of seven cases were available for immunohistochemical evaluation using the avidin-biotin-complex technique for MAC387.
RESULTS—The mean age of presentation of the orbital tumour was 8.8 years. Four patients presented with an orbital tumour before any systemic manifestations of leukaemia. In two cases the diagnosis of the orbital tumour and systemic leukaemia was made simultaneously. There was one case of established systemic myeloid leukaemia in remission with the subsequent development of orbital granulocytic sarcoma. Six of seven cases (86%) were positive for the Leder stain. Five of seven cases (71%) showed positive immunoreactivity with lysozyme. The immunohistochemical stain for MAC387 was positive in all seven cases (100%) including one case that was negative for both lysozyme and Leder stains.
CONCLUSIONS—Orbital granulocytic sarcoma is a tumour that affects children and can present with rapidly progressive proptosis. This tumour may develop before, during, or after the occurrence of systemic leukaemia. The combination of Leder and lysozyme stains is useful in the diagnosis of orbital granulocytic sarcoma. MAC387 may be a more reliable marker for orbital granulocytic sarcoma.

 PMID:9497470

  5. Congenital orbital encephalocele, orbital dystopia, and exophthalmos.

    PubMed

    Hwang, Kun; Kim, Han Joon

    2012-07-01

    We present here an exceedingly rare variant of a nonmidline basal encephalocele of the spheno-orbital type, and this was accompanied with orbital dystopia in a 56-year-old man. On examination, his left eye was located more inferolaterally than his right eye, and the patient said this had been this way since his birth. The protrusion of his left eye was aggravated when he is tired. His naked visual acuity was 0.7/0.3, and the ocular pressure was 14/12 mm Hg. The exophthalmometry was 10/14 to 16 mm. His eyeball motion was not restricted, yet diplopia was present in all directions. The distance from the midline to the medial canthus was 20/15 mm. The distance from the midline to the midpupillary line was 35/22 mm. The vertical dimension of the palpebral fissure was 12/9 mm. The height difference of the upper eyelid margin was 11 mm, and the height difference of the lower eyelid margin was 8 mm. Facial computed tomography and magnetic resonance imaging showed left sphenoid wing hypoplasia and herniation of the left anterior temporal pole and dura mater into the orbit, and this resulted into left exophthalmos and encephalomalacia in the left anterior temporal pole. To the best of our knowledge, our case is the second case of basal encephalocele and orbital dystopia.

  6. Statistical initial orbit determination

    SciTech Connect

    Taff, L.G.; Belkin, B.; Schweiter, G.A.; Sommar, K. D.H. Wagner Associates, Inc., Paoli, PA )

    1992-02-01

    For the ballistic missile initial orbit determination problem in particular, the concept of 'launch folders' is extended. This allows to decouple the observational data from the initial orbit determination problem per se. The observational data is only used to select among the possible orbital element sets in the group of folders. Monte Carlo simulations using up to 7200 orbital element sets are described. The results are compared to the true orbital element set and the one a good radar would have been able to produce if collocated with the optical sensor. The simplest version of the new method routinely outperforms the radar initial orbital element set by a factor of two in future miss distance. In addition, not only can a differentially corrected orbital element set be produced via this approach - after only two measurements of direction - but also an updated, meaningful, six-dimensional covariance array for it can be calculated. This technique represents a significant advance in initial orbit determination for this problem, and the concept can easily be extended to minor planets and artificial satellites. 9 refs.

  7. Orbiting Rainbows Simulation

    NASA Image and Video Library

    2015-04-22

    This simulated image shows how a cloud of glitter in geostationary orbit would be illuminated and controlled by two laser beams. As the cloud orbits Earth, grains scatter the sun's light at different angles like many tiny prisms, similar to how rainbows are produced from light being dispersed by water droplets. That is why the project concept is called "Orbiting Rainbows." The cloud functions like a reflective surface, allowing the exoplanet (displayed in the bottom right) to be imaged. The orbit path is shown in the top right. On the bottom left, Earth's image is seen behind the cloud. To image an exoplanet, the cloud would need to have a diameter of nearly 98 feet (30 meters). This simulation confines the cloud to a 3.3 x 3.3 x 3.3 foot volume (1 x 1 x 1 meter volume) to simplify the computations. The elements of the orbiting telescope are not to scale. Orbiting Rainbows is currently in Phase II development through the NASA Innovative Advanced Concepts (NIAC) Program. It was one of five technology proposals chosen for continued study in 2014. In the current phase, Orbiting Rainbows researchers are conducting small-scale ground experiments to demonstrate how granular materials can be manipulated using lasers and simulations of how the imaging system would behave in orbit. http://photojournal.jpl.nasa.gov/catalog/PIA19318

  8. Titan Orbiter Aerorover Mission

    NASA Technical Reports Server (NTRS)

    Sittler Jr., E. C.; Acuna, M.; Burchell, M. J.; Coates, A.; Farrell, W.; Flasar, M.; Goldstein, B. E.; Gorevan, S.; Hartle, R. E.; Johnson, W. T. K.

    2001-01-01

    We propose a combined Titan orbiter and Titan Aerorover mission with an emphasis on both in situ and remote sensing measurements of Titan's surface, atmosphere, ionosphere, and magnetospheric interaction. The biological aspect of the Titan environment will be emphasized by the mission (i.e., search for organic materials which may include simple organics to 'amono' analogues of amino acids and possibly more complex, lightening detection and infrared, ultraviolet, and charged particle interactions with Titan's surface and atmosphere). An international mission is assumed to control costs. NASA will provide the orbiter, launch vehicle, DSN coverage and operations, while international partners will provide the Aerorover and up to 30% of the cost for the scientific instruments through collaborative efforts. To further reduce costs we propose a single PI for orbiter science instruments and a single PI for Aerorover science instruments. This approach will provide single command/data and power interface between spacecraft and orbiter instruments that will have redundant central DPU and power converter for their instruments. A similar approach could be used for the Aerorover. The mission profile will be constructed to minimize conflicts between Aerorover science, orbiter radar science, orbiter radio science, orbiter imaging science, and orbiter fields and particles (FP) science. Additional information is contained in the original extended abstract.

  9. Reticulohistiocytoma of the Orbit

    PubMed Central

    Weissman, Heather M.; Hayek, Brent R.; Grossniklaus, Hans E.

    2015-01-01

    Reticulohistiocytoma is a rare, benign histiocytic proliferation of the skin or soft tissue. While ocular involvement has been documented in the past, there have been no previously reported cases of reticulohistiocytoma of the orbit. In this report, the authors describe a reticulohistiocytoma of the orbit in a middle-aged woman. PMID:24807799

  10. Analyzing Shuttle Orbiter Trajectories

    NASA Technical Reports Server (NTRS)

    Lear, W. M.

    1986-01-01

    LRBET4 program best-estimated-of-trajectory (BET) calculation for post-flight trajectory analysis of Shuttle orbiter. Produces estimated measurements for comparing predicted and actual trajectory of Earth-orbiting spacecraft. Kalman filter and smoothing filter applied to input data to estimate state vector, reduce noise, and produce BET. LRBET4 written in FORTRAN IV for batch execution.

  11. Stability of halo orbits.

    PubMed

    Howard, J E; Dullin, H R; Horányi, M

    2000-04-10

    We predict new populations of trapped nonequatorial ("halo") orbits of charged dust grains about an arbitrary axisymmetric planet. Simple equilibrium and stability conditions are derived, revealing dramatic differences between positively and negatively charged grains in prograde or retrograde orbits. Implications for the Cassini mission to Saturn are discussed.

  12. Orbiting Carbon Observatory Briefing

    NASA Image and Video Library

    2009-01-29

    Anna Michalak, an Orbiting Carbon Observatory science team member from the University of Michigan, Ann Arbor, speaks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

  13. Orbital Shape Representations.

    ERIC Educational Resources Information Center

    Kikuchi, Osamu; Suzuki, Keizo

    1985-01-01

    Discusses the use of orbital shapes for instructional purposes, emphasizing that differences between polar, contour, and three-dimensional plots must be made clear to students or misconceptions will occur. Also presents three-dimensional contour surfaces for the seven 4f atomic orbitals of hydrogen and discusses their computer generation. (JN)

  14. Remote Controlled Orbiter Capability

    NASA Technical Reports Server (NTRS)

    Garske, Michael; delaTorre, Rafael

    2007-01-01

    The Remote Control Orbiter (RCO) capability allows a Space Shuttle Orbiter to perform an unmanned re-entry and landing. This low-cost capability employs existing and newly added functions to perform key activities typically performed by flight crews and controllers during manned re-entries. During an RCO landing attempt, these functions are triggered by automation resident in the on-board computers or uplinked commands from flight controllers on the ground. In order to properly route certain commands to the appropriate hardware, an In-Flight Maintenance (IFM) cable was developed. Currently, the RCO capability is reserved for the scenario where a safe return of the crew from orbit may not be possible. The flight crew would remain in orbit and await a rescue mission. After the crew is rescued, the RCO capability would be used on the unmanned Orbiter in an attempt to salvage this national asset.

  15. Mars Climate Orbiter

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The purpose of this mission is to study the climate history and the water distribution of Mars. Beautiful panoramic views of the shuttle on the launch pad, engine ignition, Rocket launch, and the separation and burnout of the Solid Rocket Boosters are shown. The footage also includes an animation of the mission. Detailed views of the path that the Orbiter traversed were shown. Once the Orbiter lands on the surface of Mars, it will dig a six to eight inch hole and collect samples from the planets' surface. The animation also included the prospective return of the Orbiter to Earth over the desert of Utah. The remote sensor on the Orbiter helps in finding the exact location of the Orbiter so that scientists may collect the sample and analyze it.

  16. Mars Climate Orbiter

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The purpose of this mission is to study the climate history and the water distribution of Mars. Beautiful panoramic views of the shuttle on the launch pad, engine ignition, Rocket launch, and the separation and burnout of the Solid Rocket Boosters are shown. The footage also includes an animation of the mission. Detailed views of the path that the Orbiter traversed were shown. Once the Orbiter lands on the surface of Mars, it will dig a six to eight inch hole and collect samples from the planets' surface. The animation also included the prospective return of the Orbiter to Earth over the desert of Utah. The remote sensor on the Orbiter helps in finding the exact location of the Orbiter so that scientists may collect the sample and analyze it.

  17. Orbital debris issues

    NASA Technical Reports Server (NTRS)

    Kessler, D. J.

    1985-01-01

    Man-made orbital debris, identified as a potential hazard to future space activities, is grouped into size categories. At least 79 satellites have broken up in orbit to date and, in combination with exploded rocket casings and antisatellite debris, threaten 10 km/sec collisions with other orbiting platforms. Only 5 percent of the debris is connected to payloads. The total population of orbiting objects over 4 cm in diameter could number as high as 15,000, and at 1 cm in diameter could be 32,000, based on NASA and NORAD studies. NASA has initiated the 10 yr Space Debris Assessment Program to characterize the hazards of orbiting debris, the potential damage to typical spacecraft components, and to identify means of controlling the damage.

  18. Orbital Plots Using Gnuplot

    NASA Astrophysics Data System (ADS)

    Moore, Brian G.

    2000-06-01

    The plotting program Gnuplot is freely available, general purpose, easy to use, and available on a variety of platforms. Complex three-dimensional surfaces, including the familiar angular parts of the hydrogen atom orbitals, are easily represented using Gnuplot. Contour plots allow viewing the radial and angular variation of the probability density in an orbital. Examples are given of how Gnuplot is used in an undergraduate physical chemistry class to view familiar atomic orbitals in new ways or to generate views of orbital functions that the student may have not seen before. Gnuplot may also be easily integrated into the environment of a Web page; an example of this is discussed (and is available at http://onsager.bd.psu.edu/~moore/orbitals_gnuplot). The plotting commands are entered with a form and a CGI script is used to run Gnuplot and display the result back to the browser.

  19. Orbital Debris Mitigation

    NASA Technical Reports Server (NTRS)

    Kelley, R. L.; Jarkey, D. R.; Stansbery, G.

    2014-01-01

    Policies on limiting orbital debris are found throughout the US Government, many foreign space agencies, and as adopted guidelines in the United Nations. The underlying purpose of these policies is to ensure the environment remains safe for the operation of robotic and human spacecraft in near- Earth orbit. For this reason, it is important to consider orbital debris mitigation during the design of all space vehicles. Documenting compliance with the debris mitigation guidelines occurs after the vehicle has already been designed and fabricated for many CubeSats, whereas larger satellites are evaluated throughout the design process. This paper will provide a brief explanation of the US Government Orbital Debris Mitigation Standard Practices, a discussion of international guidelines, as well as NASA's process for compliance evaluation. In addition, it will discuss the educational value of considering orbital debris mitigation requirements as a part of student built satellite design.

  20. Effective BRAF inhibitor vemurafenib therapy in a 2-year-old patient with sequentially diagnosed Langerhans cell histiocytosis and Erdheim–Chester disease

    PubMed Central

    Váradi, Zsófia; Bánusz, Rita; Csomor, Judit; Kállay, Krisztián; Varga, Edit; Kertész, Gabriella; Csóka, Monika

    2017-01-01

    Erdheim–Chester disease (ECD) is a rare histiocytic disorder, characterized by the xanthomatous infiltration of tissues by CD68-positive and CD1a-/CD100-negative foamy histiocytes. In childhood, ECD is exceptionally rare, and only a dozen cases have been published so far. The cooccurence of Langerhans cell histiocytosis (LCH) and ECD is even rarer. Here, we report a 2-year-old boy, the youngest patient in the literature so far, who was diagnosed with concomitant BRAF mutation-positive LCH and ECD. In his case, conventional LCH treatment proved to be ineffective, but he is the youngest patient who was successfully treated with the BRAF inhibitor vemurafenib. PMID:28182116

  1. Langerhans cell histiocytosis misdiagnosed as liver cancer and pituitary tumor in an adult: A case report and brief review of the literature

    PubMed Central

    MA, JING; JIANG, YONGFANG; CHEN, XIANGYU; GONG, GUOZHONG

    2014-01-01

    Langerhans cell histiocytosis (LCH) is a rare proliferative disorder in which pathological Langerhans cells accumulate in a variety of organs. LCH usually affects the bone, skin and lymph nodes of children; however, LCH occasionally affects vital organs, including the liver, spleen and pituitary gland. The present study reports a case of an adult LCH patient with marked liver damage, splenomegaly and pituitary damage treated using a new therapeutic strategy. This case was misdiagnosed as liver cancer and pituitary tumor on the basis of abdominal ultrasound, abdominal magnetic resonance imaging (MRI) and head MRI. The final diagnosis was established by identifying the proliferation of cluster of differentiation 1a-positive LCs in liver tissues. A new regimen of combined 12-week therapy of prednisolone/desmopressin/vincristine and 10 months of maintenance therapy of prednisolone/vinblastine/6-mercaptopurine improved symptoms, liver function and blood cell tests. PMID:24765185

  2. Chronic cutaneous lesions of sarcoidosis.

    PubMed

    Marchell, Richard M; Judson, Marc A

    2007-01-01

    Sarcoidosis involvement of the skin is common. The skin lesions of sarcoidosis may be nonspecific, showing a nondiagnostic inflammatory reaction pattern on histologic evaluation. Nonspecific skin lesions are often associated with an acute presentation of sarcoidosis and, in general, portend a good prognosis. Specific sarcoidosis skin lesions reveal typical sarcoid granulomas on histologic examination. These lesions tend to be chronic and require therapy for resolution. This article will review the epidemiology, diagnostic evaluation, and description of the various chronic skin lesions of sarcoidosis. Various images of these skin lesions will be demonstrated.

  3. Tumorous lesions of the hand.

    PubMed

    Johnson, J; Kilgore, E; Newmeyer, W

    1985-03-01

    A retrospective study was conducted of 543 tumorous lesions of the hand seen in a busy office practice for a 5-year period from April 1976 to April 1981. The lesions were grouped as benign lesions, of either the soft tissue or skeletal type, or as malignant lesions. The overall chance that a hand tumor was malignant was 2% (11 of 543). There was significant association of palmar radial ganglion and carpal tunnel syndrome (15%). Ganglions recur more often after aspiration than after surgery. Certain lesions, particularly a mucous cyst, have a high postoperative complication rate. A few of these unique lesions are described.

  4. Orbital Causes of Incomitant Strabismus

    PubMed Central

    Lueder, Gregg T.

    2015-01-01

    Strabismus may result from abnormal innervation, structure, or function of the extraocular muscles. Abnormalities of the orbital bones or masses within the orbit may also cause strabismus due to indirect effects on the extraocular muscles. This paper reviews some disorders of the orbit that are associated with strabismus, including craniofacial malformations, orbital masses, trauma, and anomalous orbital structures. PMID:26180465

  5. Skin lesions in psoriasis.

    PubMed

    Goodfield, M

    1994-05-01

    Psoriatic skin disease is common; it occurs at all ages and co-exists with joint disease in approximately 10% of cases. All areas of skin, scalp and nails may be involved. In the typical case, the skin lesions are easy to recognize. Atypical forms of skin involvement and lesions at unusual sites are less easily diagnosed by non-specialists. The cause is unknown, but there is a clear genetic element, with external factors being important in precipitation and exacerbations of the condition. Topical treatment is successful in most patients, but in resistant cases combinations of systemic therapy and ultraviolet radiation usually give good control. Although there is no cure, the majority of sufferers live normal lives and, with the exception of severe erythrodermic or generalized pustular psoriasis, there is no mortality. Morbidity, particularly social and occupational, is more of a problem than is often acknowledged.

  6. OL- ORBITAL LIFETIME PROGRAM

    NASA Technical Reports Server (NTRS)

    Orr, L. H.

    1994-01-01

    The Orbital Lifetime (OL) program analyzes the long-term motion of Earth-orbiting spacecraft at altitudes of up to 2500 kilometers. It models perturbations to the orbit caused by solar radiation pressure, atmospheric drag, and gravitational effects due to the sun, the moon, and Earth oblateness. OL can be used to predict the orbital lifetime and decay rate of a satellite. The atmospheric density models used in OL are the U.S. Standard Atmosphere for altitudes below 90 km and the Jacchia model for altitudes above 90 km. The Jacchia model requires solar flux and geomagnetic index for the date of orbit. An input file containing these values for 1984 to 1998 is supplied with the OL package. The solar radiation pressure calculations in OL will predict the amount of time a spacecraft is subjected to the Earth's shadow. Input to OL includes spacecraft physical characteristics, initial orbit parameters, and launch date/time. OL calculates time histories of the orbital elements, total lifetime, and decay rates. A spacecraft is considered 'down' at an altitude of 64 km. OL also generates a file of plot data which can be input to a user-supplied graphics program for lifetime plots of altitude against time. OL is written in FORTRAN 77 for interactive or batch execution and has been implemented on a DEC VAX series computer operating under VMS. This program was developed in 1985.

  7. Harmonically excited orbital variations

    SciTech Connect

    Morgan, T.

    1985-08-06

    Rephrasing the equations of motion for orbital maneuvers in terms of Lagrangian generalized coordinates instead of Newtonian rectangular cartesian coordinates can make certain harmonic terms in the orbital angular momentum vector more readily apparent. In this formulation the equations of motion adopt the form of a damped harmonic oscillator when torques are applied to the orbit in a variationally prescribed manner. The frequencies of the oscillator equation are in some ways unexpected but can nonetheless be exploited through resonant forcing functions to achieve large secular variations in the orbital elements. Two cases are discussed using a circular orbit as the control case: (1) large changes in orbital inclination achieved by harmonic excitation rather than one impulsive velocity change, and (2) periodic and secular changes to the longitude of the ascending node using both stable and unstable excitation strategies. The implications of these equations are also discussed for both artificial satellites and natural satellites. For the former, two utilitarian orbits are suggested, each exploiting a form of harmonic excitation. 5 refs.

  8. Orbital metastatic osteosarcoma.

    PubMed

    Rajabi, Mohammad Taher; Saeedi-Anari, Ghasem; Ramezani, Farshid; Tabatabaie, Seyed-Ziaeddin; Rajabi, Mohammad Bagher; Asadi Amoli, Fahimeh

    2015-02-01

    At an estimated incidence of 2 cases per million persons per year, osteosarcoma is the most common primary malignant bone tumor in children and adults, excluding hematopoietic intraosseous tumors. Orbital metastases of osteosarcoma are very rare. Only 5 cases of orbital metastasis of osteosarcoma previously reported in the literature. We report the case of a 19-year-old man with known history of osteosarcoma of right distal femur who presented with acute visual loss and progressive protrusion of his left eye. Orbital CT scan and MRI revealed orbital mass eroding orbital walls and intracranial invasion. He underwent superotemporal orbitotomy for debulking of orbital mass. Histopathological examination (HPE) of the specimen was reported as metastatic osteosarcoma with extensive tumor necrosis. Then he underwent adjuvant chemotherapy and palliative radiotherapy. Although orbital metastasis of osteosarcoma is a rare event, it seems it has had an increasing trend recently. so, making efforts to palliate the patient's symptoms by multidisciplinary teamwork and proper interaction among ophthalmologist, orthopedic surgeons and oncologists is necessary.

  9. Orbit Stabilization of Nanosat

    SciTech Connect

    JOHNSON,DAVID J.

    1999-12-01

    An algorithm is developed to control a pulsed {Delta}V thruster on a small satellite to allow it to fly in formation with a host satellite undergoing time dependent atmospheric drag deceleration. The algorithm uses four short thrusts per orbit to correct for differences in the average radii of the satellites due to differences in drag and one thrust to symmetrize the orbits. The radial difference between the orbits is the only input to the algorithm. The algorithm automatically stabilizes the orbits after ejection and includes provisions to allow azimuthal positional changes by modifying the drag compensation pulses. The algorithm gives radial and azimuthal deadbands of 50 cm and 3 m for a radial measurement accuracy of {+-} 5 cm and {+-} 60% period variation in the drag coefficient of the host. Approaches to further reduce the deadbands are described. The methodology of establishing a stable orbit after ejection is illustrated in an appendix. The results show the optimum ejection angle to minimize stabilization thrust is upward at 86{sup o} from the orbital velocity. At this angle the stabilization velocity that must be supplied by the thruster is half the ejection velocity. An ejection velocity of 0.02 m/sat 86{sup o} gives an azimuthal separation after ejection and orbit stabilization of 187 m. A description of liquid based gas thrusters suitable for the satellite control is included in an appendix.

  10. Tumefactive Fibroinflammatory Lesion: A Diagnostic Dilemma

    PubMed Central

    Jain, Promil; Sen, Rajeev; Sharma, Nisha; Bhargava, Shilpi; Singh, Virender

    2017-01-01

    Tumefactive fibroinflammatory lesions (TFLs) are rare idiopathic benign fibrosclerosing lesions that clinically simulate a malignancy. TFLs are seen more frequently in males between 10 and 74 years of age. The usual site of involvement is the head and neck region, but rarely the extremities may be involved. Coexisting fibrosclerotic processes have been reported including retroperitoneal fibrosis, sclerosing cholangitis, sclerosing mediastinal fibrosis, and orbital pseudotumors. The etiology of this poorly understood entity remains unknown. Possible suggestions include exaggerated responses or autoimmune reactions to any chronic infection. The clinical and radiological appearance of TFLs is that of malignancy, but histopathology reveals them to be a benign process broadly classified under non-neoplastic, fibroinflammatory proliferations. The treatment strategies for these lesions are not well defined and variable and include steroids, surgery, and radiotherapy either alone or in combination. TFLs, albeit not fatal, have a high recurrence rate; patients should, therefore, be kept on long-term follow-up. We describe a young female patient presenting with a rapidly developing cheek swelling, which was diagnosed histopathologically as a TFLs. PMID:28360448

  11. Discovery Orbiter Major Modifications

    NASA Image and Video Library

    2003-08-27

    During power-up of the orbiter Discovery in the Orbiter Processing Facility, a technician moves a circuit reset on the cockpit console. Discovery has been undergoing Orbiter Major Modifications in the past year, ranging from wiring, control panels and black boxes to gaseous and fluid systems tubing and components. These systems were deserviced, disassembled, inspected, modified, reassembled, checked out and reserviced, as were most other systems onboard. The work includes the installation of the Multifunction Electronic Display Subsystem (MEDS) - a state-of-the-art “glass cockpit.”

  12. Removal of orbital debris

    NASA Technical Reports Server (NTRS)

    Petro, Andrew J.; Talent, David L.

    1989-01-01

    The several methods presently identified for the reduction of orbital debris populations are broadly classifiable as either preventive or remedial, and fall within distinctive operational regimes. For all particles, (1) in the 250-2000-km altitude band, intelligent sweepers may be used; (2) for large objects, in the 80-250-km altitude band, orbital decay renders removal impractical; (3) for the 250-750-km altitude band, deorbit devices should be used; (4) for 750-2500-km altitude, OMV rendezvous for propulsive deorbit package attachment is foreseeable; and beyond 2500 km, (5) propulsive escape from earth orbit is required.

  13. Removal of orbital debris

    NASA Astrophysics Data System (ADS)

    Petro, Andrew J.; Talent, David L.

    The several methods presently identified for the reduction of orbital debris populations are broadly classifiable as either preventive or remedial, and fall within distinctive operational regimes. For all particles, (1) in the 250-2000-km altitude band, intelligent sweepers may be used; (2) for large objects, in the 80-250-km altitude band, orbital decay renders removal impractical; (3) for the 250-750-km altitude band, deorbit devices should be used; (4) for 750-2500-km altitude, OMV rendezvous for propulsive deorbit package attachment is foreseeable; and beyond 2500 km, (5) propulsive escape from earth orbit is required.

  14. Removal of orbital debris

    NASA Technical Reports Server (NTRS)

    Petro, Andrew J.; Talent, David L.

    1989-01-01

    The several methods presently identified for the reduction of orbital debris populations are broadly classifiable as either preventive or remedial, and fall within distinctive operational regimes. For all particles, (1) in the 250-2000-km altitude band, intelligent sweepers may be used; (2) for large objects, in the 80-250-km altitude band, orbital decay renders removal impractical; (3) for the 250-750-km altitude band, deorbit devices should be used; (4) for 750-2500-km altitude, OMV rendezvous for propulsive deorbit package attachment is foreseeable; and beyond 2500 km, (5) propulsive escape from earth orbit is required.

  15. Orbital-2 Mission

    NASA Image and Video Library

    2014-07-12

    The full Moon sets in the fog behind the Orbital Sciences Corporation Antares rocket, with the Cygnus spacecraft onboard, Saturday, July 12, 2014, launch Pad-0A, NASA's Wallops Flight Facility in Virginia. The Antares will launch with the Cygnus spacecraft filled with over 3,000 pounds of supplies for the International Space Station, including science experiments, experiment hardware, spare parts, and crew provisions. The Orbital-2 mission is Orbital Sciences' second contracted cargo delivery flight to the space station for NASA. Photo Credit: (NASA/Bill Ingalls)

  16. Orbital-2 Mission

    NASA Image and Video Library

    2014-07-12

    The Orbital Sciences Corporation Antares rocket, with the Cygnus spacecraft onboard, is seen during sunrise, Saturday, July 12, 2014, at launch Pad-0A of NASA's Wallops Flight Facility in Virginia. The Antares will launch with the Cygnus spacecraft filled with over 3,000 pounds of supplies for the International Space Station, including science experiments, experiment hardware, spare parts, and crew provisions. The Orbital-2 mission is Orbital Sciences' second contracted cargo delivery flight to the space station for NASA. Photo Credit: (NASA/Bill Ingalls)

  17. Orbital-2 Mission

    NASA Image and Video Library

    2014-07-11

    The Orbital Sciences Corporation Antares rocket, with the Cygnus spacecraft onboard, is seen on launch Pad-0A, Friday, July 11, 2014, at NASA's Wallops Flight Facility in Virginia. The Antares will launch with the Cygnus spacecraft filled with over 3,000 pounds of supplies for the International Space Station, including science experiments, experiment hardware, spare parts, and crew provisions. The Orbital-2 mission is Orbital Sciences' second contracted cargo delivery flight to the space station for NASA. Photo Credit: (NASA/Bill Ingalls)

  18. An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma

    PubMed Central

    Ribeiro, Sara Filipa Teixeira; Queirós, Tatiana; Amorim, José M.; Ferreira, Ana M.; Sales-Sanz, Marco

    2017-01-01

    Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications. PMID:28626414

  19. Orbit Determination Issues for Libration Point Orbits

    NASA Technical Reports Server (NTRS)

    Beckman, Mark; Bauer, Frank (Technical Monitor)

    2002-01-01

    Libration point mission designers require knowledge of orbital accuracy for a variety of analyses including station keeping control strategies, transfer trajectory design, and formation and constellation control. Past publications have detailed orbit determination (OD) results from individual libration point missions. This paper collects both published and unpublished results from four previous libration point missions (ISEE (International Sun-Earth Explorer) -3, SOHO (Solar and Heliospheric Observatory), ACE (Advanced Composition Explorer) and MAP (Microwave Anisotropy Probe)) supported by Goddard Space Flight Center's Guidance, Navigation & Control Center. The results of those missions are presented along with OD issues specific to each mission. All past missions have been limited to ground based tracking through NASA ground sites using standard range and Doppler measurement types. Advanced technology is enabling other OD options including onboard navigation using seaboard attitude sensors and the use of the Very Long Baseline Interferometry (VLBI) measurement Delta Differenced One-Way Range (DDOR). Both options potentially enable missions to reduce coherent dedicated tracking passes while maintaining orbital accuracy. With the increased projected loading of the DSN (Deep Space Network), missions must find alternatives to the standard OD scenario.

  20. Acute periodontal lesions.

    PubMed

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  1. Gram stain of skin lesion

    MedlinePlus

    ... Names Skin lesion gram stain Images Viral lesion culture References Hall GS, Woods GL. Medical bacteriology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier ...

  2. Respiratory epithelial cysts of the orbit.

    PubMed

    Goh, Rachel L Z; Hardy, Thomas G; Williams, Richard A; McNab, Alan A

    2016-10-01

    To describe post-traumatic and congenital respiratory epithelial cysts in the orbit, which are rare lesions with only 5 and 13 published cases, respectively. We reviewed all cases of respiratory epithelial cysts diagnosed at three institutions (two tertiary referral hospitals, one private clinic) between 1995 and 2015. We describe 10 cases of post-traumatic respiratory epithelial cyst (age range 23 - 82), presenting a mean of 17.4 years after their original trauma; and 3 congenital cases (age range 17-34). All but one case underwent surgical excision of the cyst and its lining, along with any surgical implant within the cyst. Two were recurrent after incomplete excision. Three presented with acute infection within the cyst. Respiratory epithelial orbital cysts are probably commoner than the paucity of published reports would suggest. Post-traumatic cysts often present many years after trauma, and may become secondarily infected. Complete surgical removal is recommended to prevent future recurrence.

  3. Indian Mars Orbiter Mission

    NASA Astrophysics Data System (ADS)

    Bhardwaj, Anil

    The Mars Orbiter Mission (MOM) is the first interplanetary mission of India launched by Indian Polar Satellite Launch Vehicle (PSLV-XL) on 5 November 2013. It departed from Earth's orbit on Dec. 1, 2013, on its 300-days journey to Mars. MOM will reach Mars on Sept. 24, 2014. The orbit of MOM around Mars is highly elliptical with periapsis ~370 km and apoapsis ~80000 km, inclination 151 degree, and orbital period 3.15 sols. The spacecraft mass is 1350 kg, with dry mass of 500 kg and science payload mass of 14 kg. The spacecraft carries five science payloads, namely: Methane Sensor for Mars (MSM), Mars Colour Camera (MCC), Lyman Alpha Photometer (LAP), Mars Exospheric Neutral Composition Analyzer (MENCA), TIR Imaging Spectrometer (TIS). This paper will present the details of the instruments, observation plan, and expected science.

  4. MMS Orbit Animation

    NASA Image and Video Library

    This animation shows the orbits of Magnetospheric Multiscale (MMS)mission, a Solar Terrestrial Probes mission comprising of fouridentically instrumented spacecraft that will study the Earth’sm...

  5. Report on orbital debris

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The success of space endeavors depends upon a space environment sufficiently free of debris to enable the safe and dependable operation of spacecraft. An environment overly cluttered with debris would threaten the ability to utilize space for a wide variety of scientific, technological, military, and commercial purposes. Man made space debris (orbital debris) differs from natural meteoroids because it remains in earth orbit during its lifetime and is not transient through the space around the Earth. The orbital debris environment is considered. The space environment is described along with sources of orbital debris. The current national space policy is examined, along with ways to minimize debris generation and ways to survive the debris environment. International efforts, legal issues and commercial regulations are also examined.

  6. ARTEMIS Orbits Magnetic Moon

    NASA Image and Video Library

    NASA's THEMIS spacecraft have completed their mission and are still working perfectly, so NASA is re-directing the outermost two spacecraft to special orbits around the Moon. Now called ARTEMIS, th...

  7. Space Shuttle Orbiter ECLSS.

    NASA Technical Reports Server (NTRS)

    Stoll, O. T.; Laubach, G. E.; Gibb, J. W.

    1973-01-01

    The Orbiter Environmental Control and Life Support System (ECLSS) provides the functions of atmosphere revitalization, crew life support, active thermal conditioning, and airlock support for EVA and docking activities. The ECLSS must satisfy the requirements of orbital missions with four to ten crewmembers and mission duration of a few hours to 30 days and the requirements associated with an atmospheric horizontal flight test program and ferry flight missions. The ECLSS development plan utilizes an ECLSS ground test article and thermal/vacuum testing to support the first horizontal flight test at the end of 1976. The ground testing and horizontal flight test program certify the Orbiter ECLSS for the first orbital flight in early 1978.

  8. Orbiter entry aerothermodynamics

    NASA Technical Reports Server (NTRS)

    Ried, R. C.

    1985-01-01

    The challenge in the definition of the entry aerothermodynamic environment arising from the challenge of a reliable and reusable Orbiter is reviewed in light of the existing technology. Select problems pertinent to the orbiter development are discussed with reference to comprehensive treatments. These problems include boundary layer transition, leeward-side heating, shock/shock interaction scaling, tile gap heating, and nonequilibrium effects such as surface catalysis. Sample measurements obtained from test flights of the Orbiter are presented with comparison to preflight expectations. Numerical and wind tunnel simulations gave efficient information for defining the entry environment and an adequate level of preflight confidence. The high quality flight data provide an opportunity to refine the operational capability of the orbiter and serve as a benchmark both for the development of aerothermodynamic technology and for use in meeting future entry heating challenges.

  9. Space Shuttle Orbiter ECLSS.

    NASA Technical Reports Server (NTRS)

    Stoll, O. T.; Laubach, G. E.; Gibb, J. W.

    1973-01-01

    The Orbiter Environmental Control and Life Support System (ECLSS) provides the functions of atmosphere revitalization, crew life support, active thermal conditioning, and airlock support for EVA and docking activities. The ECLSS must satisfy the requirements of orbital missions with four to ten crewmembers and mission duration of a few hours to 30 days and the requirements associated with an atmospheric horizontal flight test program and ferry flight missions. The ECLSS development plan utilizes an ECLSS ground test article and thermal/vacuum testing to support the first horizontal flight test at the end of 1976. The ground testing and horizontal flight test program certify the Orbiter ECLSS for the first orbital flight in early 1978.

  10. Optical orbital debris spotter

    NASA Astrophysics Data System (ADS)

    Englert, Christoph R.; Bays, J. Timothy; Marr, Kenneth D.; Brown, Charles M.; Nicholas, Andrew C.; Finne, Theodore T.

    2014-11-01

    The number of man-made debris objects orbiting the Earth, or orbital debris, is alarmingly increasing, resulting in the increased probability of degradation, damage, or destruction of operating spacecraft. In part, small objects (<10 cm) in Low Earth Orbit (LEO) are of concern because they are abundant and difficult to track or even to detect on a routine basis. Due to the increasing debris population it is reasonable to assume that improved capabilities for on-orbit damage attribution, in addition to increased capabilities to detect and track small objects are needed. Here we present a sensor concept to detect small debris with sizes between approximately 1.0 and 0.01 cm in the vicinity of a host spacecraft for near real time damage attribution and characterization of dense debris fields and potentially to provide additional data to existing debris models.

  11. Orbiting Carbon Observatory Briefing

    NASA Image and Video Library

    2009-01-29

    Charles Miller talks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

  12. Orbiting Carbon Observatory Briefing

    NASA Image and Video Library

    2009-01-29

    Panelists are seen during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

  13. Orbiting Carbon Observatory Briefing

    NASA Image and Video Library

    2009-01-29

    Ralph Basilio talks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

  14. Orbiting Carbon Observatory Briefing

    NASA Image and Video Library

    2009-01-29

    Eric Ianson speaks during a media briefing to discuss the upcoming Orbiting Carbon Observatory mission, the first NASA spacecraft dedicated to studying carbon dioxide, Thursday, Jan. 29, 2009, at NASA Headquarters in Washington. Photo Credit: (NASA/Paul E. Alers)

  15. Tethered orbital refueling study

    NASA Technical Reports Server (NTRS)

    Fester, Dale A.; Rudolph, L. Kevin; Kiefel, Erlinda R.; Abbott, Peter W.; Grossrode, Pat

    1986-01-01

    One of the major applications of the space station will be to act as a refueling depot for cryogenic-fueled space-based orbital transfer vehicles (OTV), Earth-storable fueled orbit maneuvering vehicles, and refurbishable satellite spacecraft using hydrazine. One alternative for fuel storage at the space station is a tethered orbital refueling facility (TORF), separated from the space station by a sufficient distance to induce a gravity gradient force that settles the stored fuels. The technical feasibility was examined with the primary focus on the refueling of LO2/LH2 orbital transfer vehicles. Also examined was the tethered facility on the space station. It was compared to a zero-gravity facility. A tethered refueling facility should be considered as a viable alternative to a zero-gravity facility if the zero-gravity fluid transfer technology, such as the propellant management device and no vent fill, proves to be difficult to develop with the required performance.

  16. Habitability study shuttle orbiter

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Habitability design concepts for the Shuttle Orbiter Program are provided for MSC. A variety of creative solutions for the stated tasks are presented. Sketches, mock-ups, mechanicals and models are included for establishing a foundation for future development.

  17. Altimetry, Orbits and Tides

    NASA Technical Reports Server (NTRS)

    Colombo, O. L.

    1984-01-01

    The nature of the orbit error and its effect on the sea surface heights calculated with satellite altimetry are explained. The elementary concepts of celestial mechanics required to follow a general discussion of the problem are included. Consideration of errors in the orbits of satellites with precisely repeating ground tracks (SEASAT, TOPEX, ERS-1, POSEIDON, amongst past and future altimeter satellites) are detailed. The theoretical conclusions are illustrated with the numerical results of computer simulations. The nature of the errors in this type of orbits is such that this error can be filtered out by using height differences along repeating (overlapping) passes. This makes them particularly valuable for the study and monitoring of changes in the sea surface, such as tides. Elements of tidal theory, showing how these principles can be combined with those pertinent to the orbit error to make direct maps of the tides using altimetry are presented.

  18. Orbiter thermal protection system

    NASA Technical Reports Server (NTRS)

    Dotts, R. L.; Curry, D. M.; Tillian, D. J.

    1985-01-01

    The major material and design challenges associated with the orbiter thermal protection system (TPS), the various TPS materials that are used, the different design approaches associated with each of the materials, and the performance during the flight test program are described. The first five flights of the Orbiter Columbia and the initial flight of the Orbiter Challenger provided the data necessary to verify the TPS thermal performance, structural integrity, and reusability. The flight performance characteristics of each TPS material are discussed, based on postflight inspections and postflight interpretation of the flight instrumentation data. Flights to date indicate that the thermal and structural design requirements for the orbiter TPS are met and that the overall performance is outstanding.

  19. A tapestry of orbits

    SciTech Connect

    King-Hele, D.

    1992-01-01

    In this book, the author describes how orbital research developed to yield a rich harvest of knowledge about the earth and its atmosphere. King-Hele relates a personal account of this research based on analysis of satellite orbits between 1957 and 1990 conducted from the Royal Aircraft Establishment in Farnborough England. The early research methods used before the launch of Sputnik in 1957 are discussed.

  20. The orbit of Earth

    NASA Astrophysics Data System (ADS)

    Karna, S.; Mallik, A. K.

    2015-12-01

    In our solar system, the Earth's orbital plane is known as the ecliptic plane. The perihelion and aphelion distances, which are the closest and the farthest points from the Sun lie on the ecliptic plane. The distance between the Earth and Sun is not same throughout the year, i.e. the orbit of Earth deviates a bit from the circle. However, the difference between perihelion and aphelion distance is very small. The goal of our research was to see if changing the shapes or inclination of the earth's orbital plane makes any difference in the; axial tilt of Earth and Sun, the time period taken for the Sun to move from vernal equinox to autumnal equinox, and then back to the vernal equinox. For this, we constructed a 3-D numerical model of the Earth-Sun geometry. Our model defines Earth's orbit as an inclined plane of the spherically symmetric system. We calculated the degree of the tilt of earth orbit to the ecliptic plane by converting from ecliptic frame of reference to the orbital frame of reference and then we made all the measurements. Initial inputs for our model are aphelion and perihelion parameters. It is interesting to examine that our results obtained from the Earth inclined orbit is same that observed value from Earth's circular orbit. In other words, values of the axial tilt of Earth and Sun, the time taken for the Sun to move from vernal equinox to autumnal equinox, and then back to the vernal equinox does not change. Moreover, we were also able to derive mathematical relations for finding the length of the apparent solar days throughout the year. Our mathematical relation provides new insight for the calculation of the time for the revolution of Sun around the Galactic center.

  1. New Heteroclinic Orbits Coined

    NASA Astrophysics Data System (ADS)

    Wang, Haijun; Li, Chang; Li, Xianyi

    We devote to studying the problem for the existence of homoclinic and heteroclinic orbits of Unified Lorenz-Type System (ULTS). Other than the known results that the ULTS has two homoclinic orbits to E0 = (0, 0, 0) for b = -2a1, d = -a1, a12 + a 2c > 0, e < 0 and two heteroclinic orbits to E1,2 = (±-2(a1 2+a2 c) e ,∓a1 a2 -2(a1 2+a2 c) e ,-a12+a2c a2e ) for b = -2a1, d = -a1, a12 + a 2c < 0, e > 0 on its invariant algebraic surface Q(x,y,z) = z - x2 2a2 = 0, formulated in the literature by Yang and Chen [2014], we seize two new heteroclinic orbits of this Unified Lorenz-Type System. Namely, we rigorously prove that this system has another two heteroclinic orbits to E0 and E± = (±b(a2 c-a1 d) a1e ,∓a1 a2 b(a2 c-a1 d) a1e , a1d-a2c a2e ) while no homoclinic orbit when a1 < 0, e < 0, a1 + d < 0, a2≠0, a2c - a1d > 0, b + 2a1 ≥ 0.

  2. The Lunar Orbital Prospector

    NASA Technical Reports Server (NTRS)

    Redd, Frank J.; Cantrell, James N.; Mccurdy, Greg

    1992-01-01

    The establishment of lunar bases will not end the need for remote sensing of the lunar surface by orbiting platforms. Human and robotic surface exploration will necessarily be limited to some proximate distance from the support base. Near real-time, high-resolution, global characterization of the lunar surface by orbiting sensing systems will continue to be essential to the understanding of the Moon's geophysical structure and the location of exploitable minerals and deposits of raw materials. The Lunar Orbital Prospector (LOP) is an orbiting sensing platform capable of supporting a variety of modular sensing packages. Serviced by a lunar-based shuttle, the LOP will permit the exchange of instrument packages to meet evolving mission needs. The ability to recover, modify, and rotate sensing packages allows their reuse in varying combinations. Combining this flexibility with robust orbit modification capabilities and near real-time telemetry links provides considerable system responsiveness. Maintenance and modification of the LOP orbit are accomplished through use of an onboard propulsion system that burns lunar-supplied oxygen and aluminum. The relatively low performance of such a system is more than compensated for by the elimination of the need for Earth-supplied propellants. The LOP concept envisions a continuous expansion of capability through the incorporation of new instrument technologies and the addition of platforms.

  3. The Exoplanet Orbit Database

    NASA Astrophysics Data System (ADS)

    Wright, J. T.; Fakhouri, O.; Marcy, G. W.; Han, E.; Feng, Y.; Johnson, John Asher; Howard, A. W.; Fischer, D. A.; Valenti, J. A.; Anderson, J.; Piskunov, N.

    2011-04-01

    We present a database of well-determined orbital parameters of exoplanets, and their host stars’ properties. This database comprises spectroscopic orbital elements measured for 427 planets orbiting 363 stars from radial velocity and transit measurements as reported in the literature. We have also compiled fundamental transit parameters, stellar parameters, and the method used for the planets discovery. This Exoplanet Orbit Database includes all planets with robust, well measured orbital parameters reported in peer-reviewed articles. The database is available in a searchable, filterable, and sortable form online through the Exoplanets Data Explorer table, and the data can be plotted and explored through the Exoplanet Data Explorer plotter. We use the Data Explorer to generate publication-ready plots, giving three examples of the signatures of exoplanet migration and dynamical evolution: We illustrate the character of the apparent correlation between mass and period in exoplanet orbits, the different selection biases between radial velocity and transit surveys, and that the multiplanet systems show a distinct semimajor-axis distribution from apparently singleton systems.

  4. Klatskin-Like Lesions

    PubMed Central

    Senthil Kumar, M. P.; Marudanayagam, R.

    2012-01-01

    Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5–15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature. PMID:22811587

  5. Cystic Lesions of the Mediastinum.

    PubMed

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  6. [Orbital complications of sinusitis].

    PubMed

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  7. Overall view of the Orbiter Servicing Structure within the Orbiter ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Overall view of the Orbiter Servicing Structure within the Orbiter Processing Facility at Kennedy Space Center. Can you see any hint of the Orbiter Discovery? It is in there. - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  8. Mars Geoscience Orbiter and Lunar Geoscience Orbiter

    NASA Technical Reports Server (NTRS)

    Fuldner, W. V.; Kaskiewicz, P. F.

    1983-01-01

    The feasibility of using the AE/DE Earth orbiting spacecraft design for the LGO and/or MGO missions was determined. Configurations were developed and subsystems analysis was carried out to optimize the suitability of the spacecraft to the missions. The primary conclusion is that the basic AE/DE spacecraft can readily be applied to the LGO mission with relatively minor, low risk modifications. The MGO mission poses a somewhat more complex problem, primarily due to the overall maneuvering hydrazine budget and power requirements of the sensors and their desired duty cycle. These considerations dictate a modification (scaling up) of the structure to support mission requirements.

  9. [Bony Bankart lesions].

    PubMed

    Spiegl, U J; Braun, S; Euler, S A; Warth, R J; Millett, P J

    2014-12-01

    Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Non-operative treatment can be successful for small, acute fractures, which are anatomically reduced after shoulder reduction. However, in patients with a high risk profile for recurrent instability initial Bankart repair is recommended. Additionally, bony fixation is recommended for acute fractures that involve more than 15-20% of the inferior glenoid diameter. On the other hand chronic fractures are generally managed on a case-by-case basis depending on the amount of fragment resorption and bony erosion of the anterior glenoid with high recurrence rates under conservative therapy. When significant bone loss of the anterior glenoid is present, anatomical (e.g. iliac crest bone graft and osteoarticular allograft) or non-anatomical (e.g. Latarjet and Bristow) reconstruction of the anterior glenoid is often indicated.

  10. Bullous lesions in scleroderma.

    PubMed

    Rencic, Adrienne; Goyal, Supriya; Mofid, Mona; Wigley, Frederick; Nousari, H Carlos

    2002-06-01

    The occurrence of bullous lesions in localized or systemic scleroderma is rare. Three histologic patterns have been reported: lichen sclerosus et atrophicus-like, lymphangiectatic blisters and autoimmune blistering diseases. To investigate the frequency, clinical, and immunopathologic features of patients with scleroderma and bullous eruptions and to review the literature regarding this rare condition. A retrospective study of 53 cases of scleroderma (localized, generalized, and systemic) in the dermatology and rheumatology clinics at one institution over an 8-year span. Clinical, serologic, and immunopathologic findings were analyzed in four cases. Four of 53 patients exhibited bullous lesions in association with scleroderma. The first case illustrates lymphangioma-like clinical and pathologic presentation. The second case demonstrates bullous lichen sclerosus et atrophicus-like pattern. The other two cases exemplify a superimposed autoimmune skin disease, epidermolysis bullosa acquisita and penicillamine induced pemphigus foliaceus after treatment for systemic scleroderma. Of the 53 original patients, we have described four cases of bullous scleroderma (7.5%) Illustrating several pathogenetic mechanisms of bulla formation. inflammatory (lichen sclerosus et atrophicus), fibrotic/obstructive (lymphangiomatous), autoimmune (epidermolysis bullosa acquisita), and pemphigus foliaceus. The final case illustrates bullae as a complication of therapy for the underlying scleroderma.

  11. Adult Xanthogranulomatous Disease of the Orbit: Clinical Presentations, Evaluation, and Management.

    PubMed

    Ortiz Salvador, J M; Subiabre Ferrer, D; Pérez Ferriols, A

    2017-06-01

    Adult xanthogranulomatous disease of the orbit refers to a heterogeneous group of clinical syndromes with differing degrees of systemic involvement and distinct prognoses. The different syndromes all present clinically with progressively enlarging, yellowish lesions of the orbit. Histologically, the lesions are characterized by an inflammatory infiltrate of foam cells and Touton-type multinucleated giant cells. The xanthomatized histiocytes are CD68(+), S100(-), and CD1a(-). There are 4 clinical forms of xanthogranulomatous disease of the orbit: adult xanthogranulomatous disease of the orbit, adult onset asthma and periocular xanthogranuloma, necrobiotic xanthogranuloma, and Erdheim-Chester disease. The treatment of local lesions are treated with systemic corticosteroids and other immunosuppressors. Vemurafenib, tocilizumab, and sirolimus have shown promising results in systemic disease. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Orbital Fluid Resupply Assessment

    NASA Technical Reports Server (NTRS)

    Eberhardt, Ralph N.

    1989-01-01

    Orbital fluid resupply can significantly increase the cost-effectiveness and operational flexibility of spacecraft, satellites, and orbiting platforms and observatories. Reusable tankers are currently being designed for transporting fluids to space. A number of options exist for transporting the fluids and propellant to the space-based user systems. The fluids can be transported to space either in the Shuttle cargo bay or using expendable launch vehicles (ELVs). Resupply can thus be accomplished either from the Shuttle bay, or the tanker can be removed from the Shuttle bay or launched on an ELV and attached to a carrier such as the Orbital Maneuvering Vehicle (OMV) or Orbital Transfer Vehicle (OTV) for transport to the user to be serviced. A third option involves locating the tanker at the space station or an unmanned platform as a quasi-permanent servicing facility or depot which returns to the ground for recycling once its tanks are depleted. Current modular tanker designs for monopropellants, bipropellants, and water for space station propulsion are discussed. Superfluid helium tankers are addressed, including trade-offs in tanker sizes, shapes to fit the range of ELVs currently available, and boil-off losses associated with longer-term (greater than 6-month) space-basing. It is concluded that the mixed fleet approach to on-orbit consumables resupply offers significant advantages to the overall logistics requirements.

  13. Sedna Orbit Comparisons

    NASA Technical Reports Server (NTRS)

    2004-01-01

    These four panels show the location of the newly discovered planet-like object, dubbed 'Sedna,' which lies in the farthest reaches of our solar system. Each panel, moving counterclockwise from the upper left, successively zooms out to place Sedna in context. The first panel shows the orbits of the inner planets, including Earth, and the asteroid belt that lies between Mars and Jupiter. In the second panel, Sedna is shown well outside the orbits of the outer planets and the more distant Kuiper Belt objects. Sedna's full orbit is illustrated in the third panel along with the object's current location. Sedna is nearing its closest approach to the Sun; its 10,000 year orbit typically takes it to far greater distances. The final panel zooms out much farther, showing that even this large elliptical orbit falls inside what was previously thought to be the inner edge of the Oort cloud. The Oort cloud is a spherical distribution of cold, icy bodies lying at the limits of the Sun's gravitational pull. Sedna's presence suggests that this Oort cloud is much closer than scientists believed.

  14. Sedna Orbit Comparisons

    NASA Image and Video Library

    2004-03-15

    These four panels show the location of the newly discovered planet-like object, dubbed "Sedna," which lies in the farthest reaches of our solar system. Each panel, moving counterclockwise from the upper left, successively zooms out to place Sedna in context. The first panel shows the orbits of the inner planets, including Earth, and the asteroid belt that lies between Mars and Jupiter. In the second panel, Sedna is shown well outside the orbits of the outer planets and the more distant Kuiper Belt objects. Sedna's full orbit is illustrated in the third panel along with the object's current location. Sedna is nearing its closest approach to the Sun; its 10,000 year orbit typically takes it to far greater distances. The final panel zooms out much farther, showing that even this large elliptical orbit falls inside what was previously thought to be the inner edge of the Oort cloud. The Oort cloud is a spherical distribution of cold, icy bodies lying at the limits of the Sun's gravitational pull. Sedna's presence suggests that this Oort cloud is much closer than scientists believed. http://photojournal.jpl.nasa.gov/catalog/PIA05569

  15. Sedna Orbit Comparisons

    NASA Technical Reports Server (NTRS)

    2004-01-01

    These four panels show the location of the newly discovered planet-like object, dubbed 'Sedna,' which lies in the farthest reaches of our solar system. Each panel, moving counterclockwise from the upper left, successively zooms out to place Sedna in context. The first panel shows the orbits of the inner planets, including Earth, and the asteroid belt that lies between Mars and Jupiter. In the second panel, Sedna is shown well outside the orbits of the outer planets and the more distant Kuiper Belt objects. Sedna's full orbit is illustrated in the third panel along with the object's current location. Sedna is nearing its closest approach to the Sun; its 10,000 year orbit typically takes it to far greater distances. The final panel zooms out much farther, showing that even this large elliptical orbit falls inside what was previously thought to be the inner edge of the Oort cloud. The Oort cloud is a spherical distribution of cold, icy bodies lying at the limits of the Sun's gravitational pull. Sedna's presence suggests that this Oort cloud is much closer than scientists believed.

  16. Orbital spacecraft resupply technology

    NASA Technical Reports Server (NTRS)

    Eberhardt, R. N.; Tracey, T. R.; Bailey, W. J.

    1986-01-01

    The resupplying of orbital spacecraft using the Space Shuttle, Orbital Maneuvering Vehicle, Orbital Transfer Vehicle or a depot supply at a Space Station is studied. The governing factor in fluid resupply designs is the system size with respect to fluid resupply quantities. Spacecraft propellant management for tankage via diaphragm or surface tension configurations is examined. The capabilities, operation, and application of adiabatic ullage compression, ullage exchange, vent/fill/repressurize, and drain/vent/no-vent fill/repressurize, which are proposed transfer methods for spacecraft utilizing tankage configurations, are described. Selection of the appropriate resupply method is dependent on the spacecraft design features. Hydrazine adiabatic compression/detonation, liquid-free vapor venting to prevent freezing, and a method for no-vent liquid filling are analyzed. Various procedures for accurate measurements of propellant mass in low gravity are evaluated; a system of flowmeters with a PVT system was selected as the pressurant solubility and quantity gaging technique. Monopropellant and bipropellant orbital spacecraft consumable resupply system tanks which resupply 3000 lb of hydrazine and 7000 lb of MMH/NTO to spacecraft on orbit are presented.

  17. Orbits For Sixteen Binaries

    NASA Astrophysics Data System (ADS)

    Cvetkovic, Z.; Novakovic, B.

    2006-12-01

    In this paper orbits for 13 binaries are recalculated and presented. The reason is that recent observations show higher residuals than the corresponding ephemerides calculated by using the orbital elements given in the Sixth Catalog of Orbits of Visual Binary Stars. The binaries studied were: WDS 00182+7257 = A 803, WDS 00335+4006 = HO 3, WDS 00583+2124 = BU 302, WDS 01011+6022 = A 926, WDS 01014+1155 = BU 867, WDS 01112+4113 = A 655, WDS 01361-2954 + HJ 3447, WDS 02333+5219 = STT 42 AB, WDS 04362+0814 = A 1840 AB, WDS 08017-0836 = A 1580, WDS 08277-0425 = A 550, WDS 17471+1742 = STF 2215 and WDS 18025+4414 = BU 1127 Aa-B. In addition, for three binaries - WDS 01532+1526 = BU 260, WDS 02563+7253 =STF 312 AB and WDS 05003+3924 = STT 92 AB - the orbital elements are calculated for the first time. In this paper the authors present not only the orbital elements, but the masses, dynamical parallaxes, absolute magnitudes and ephemerides for the next five years, as well.

  18. A respiratory epithelial choristomatous cyst of the orbit.

    PubMed

    Newton, C; Dutton, J J; Klintworth, G K

    1985-12-01

    A 23-year-old woman presented with a 19-year history of unilateral, intermittently painful, slowly progressive proptosis. Clinical examination disclosed decreased orbital resiliency and choroidal folds in the posterior pole. Orbital echography revealed an acoustically empty cystic lesion superotemporally. Computerized tomography demonstrated bony molding of the adjacent lateral orbital wall. At operation, a discrete, well-encapsulated mass was found adherent to the periorbita behind the lacrimal gland and extending into the muscle cone. There was no connection with the bony orbit. Histological examination disclosed the well-encapsulated cyst to be lined by pseudostratified ciliated columnar epithelium with goblet cells and filled with mucoid debris. We postulate that the cyst arose from respiratory epithelium sequestered during the intrauterine development of the paranasal sinuses.

  19. Human papillomavirus in oral lesions.

    PubMed

    González, Joaquín V; Gutiérrez, Rafael A; Keszler, Alicia; Colacino, Maria del Carmen; Alonio, Lidia V; Teyssie, Angelica R; Picconi, Maria Alejandra

    2007-01-01

    Growing evidence suggests a role for human papillomavirus (HPV) in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases); the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell samples from normal oral mucosa were used as controls. HPV detection and typing were performed by polymerase chain reaction (PCR) using primers MY09, 11, combined with RFLP or alternatively PCR using primers GP5+, 6+ combined with dot blot hybridization. HPV was detected in 91.0% of HPV- associated benign lesions, 14.3% of non-HPV associated benign lesions, 51.5% of preneoplasias and 60.0% of cancers. No control sample tested HPV positive. In benign HPV- associated lesions, 30.0% of HPV positive samples harbored high-risk types, while in preneoplastic lesions the value rose to 59.9%. In cancer lesions, HPV detection in verrucous carcinoma was 88.9% and in squamous cell carcinoma 43.8%, with high-risk type rates of 75.5% and 85.6%, respectively. The high HPV frequency detected in preneoplastic and neoplastic lesions supports an HPV etiological role in at least a subset of oral cancers.

  20. Imaging findings of vascular lesions in the head and neck

    PubMed Central

    Güneyli, Serkan; Ceylan, Naim; Bayraktaroğlu, Selen; Acar, Türker; Savaş, Recep

    2014-01-01

    Vascular lesions of the head and neck include vascular neoplasms, vascular malformations, and hypervascular lesions, derived from nonvascular soft-tissue elements. We retrospectively evaluated magnetic resonance imaging and computed tomography images of vascular lesions located in the head and neck. Twelve patients (seven males, five females) aged 1–68 years (mean age, 35.25 years) were included in this study. Most of the vascular lesions in our study were histologically diagnosed. The lesions were as follows: a hemangioma located in the parotid space (n=1); a hemangioendothelioma located in the parotid space (n=1); a hemangiopericytoma located in the larynx (n=1); a juvenile angiofibroma located in the nasopharynx (n=1); a glomus tumor located in the carotid bifurcation (n=1); venous malformations located in the parapharyngeal space, the pterygoid area, the orbital space, and the larynx (n=4); lymphatic malformations located in the parotid space and the supraclavicular area (n=2); and an arteriovenous malformation located in the infratemporal fossa (n=1). We present rare vascular lesions of the head and neck, which have typical radiological findings. PMID:25010372

  1. Mars Telecommunications Orbiter, Artist's Concept

    NASA Technical Reports Server (NTRS)

    2005-01-01

    This illustration depicts a concept for NASA's Mars Telecommunications Orbiter in flight around Mars. The orbiter is in development to be the first spacecraft with a primary function of providing communication links while orbiting a foreign planet. The project's plans call for launch in September 2009, arrival at Mars in August 2010 and a mission of six to 10 years while in orbit. Mars Telecommunication Orbiter would serve as the Mars hub for an interplanetery Internet, greatly increasing the information payoff from other future Mars missions. The mission is designed to orbit Mars more than 10 times farther from the planet than orbiters dedicated primarily to science. The high-orbit design minimizes the time that Mars itself blocks the orbiter from communicating with Earth and maximizes the time that the orbiter is above the horizon -- thus capable of communications relay -- for rovers and stationary landers on Mars' surface.

  2. Mars Telecommunications Orbiter, Artist's Concept

    NASA Technical Reports Server (NTRS)

    2005-01-01

    This illustration depicts a concept for NASA's Mars Telecommunications Orbiter in flight around Mars. The orbiter is in development to be the first spacecraft with a primary function of providing communication links while orbiting a foreign planet. The project's plans call for launch in September 2009, arrival at Mars in August 2010 and a mission of six to 10 years while in orbit. Mars Telecommunication Orbiter would serve as the Mars hub for an interplanetery Internet, greatly increasing the information payoff from other future Mars missions. The mission is designed to orbit Mars more than 10 times farther from the planet than orbiters dedicated primarily to science. The high-orbit design minimizes the time that Mars itself blocks the orbiter from communicating with Earth and maximizes the time that the orbiter is above the horizon -- thus capable of communications relay -- for rovers and stationary landers on Mars' surface.

  3. [Secondary orbital lymphoma].

    PubMed

    Basanta, I; Sevillano, C; Álvarez, M D

    2015-09-01

    A case is presented of an 85 year-old Caucasian female with lymphoma that recurred in the orbit (secondary ocular adnexal lymphoma). The orbital tumour was a diffuse large B-cell lymphoma according to the REAL classification (Revised European-American Lymphoma Classification). Orbital lymphomas are predominantly B-cell proliferations of a variety of histological types, and most are low-grade tumours. Patients are usually middle-aged or elderly, and it is slightly more common in women. A palpable mass, proptosis and blepharoptosis are the most common signs of presentation. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Antares Orbital-3 Mission

    NASA Image and Video Library

    2014-10-27

    The Orbital Sciences Corporation Antares rocket, with the Cygnus spacecraft onboard, is seen on launch Pad-0A after the launch attempt was scrubbed because of a boat down range in the trajectory Antares would have flown had it lifted off, Monday, Oct. 27, 2014, at NASA's Wallops Flight Facility in Virginia. The Antares will launch with the Cygnus spacecraft filled with over 5,000 pounds of supplies for the International Space Station, including science experiments, experiment hardware, spare parts, and crew provisions. The Orbital-3 mission is Orbital Sciences' third contracted cargo delivery flight to the space station for NASA. The next launch attempt will be made on Tuesday, Oct. 28 at 6:22 p.m. EDT. Photo Credit: (NASA/Joel Kowsky)

  5. Vertical orbital dystopia.

    PubMed

    Tan, S T; Ashworth, G; Czypionka, S; Poole, M D; Briggs, M

    1996-06-01

    Many pathologic processes may lead to vertical orbital dystopia. We reviewed 47 consecutive cases seen over a 13-year period. Twenty-nine patients underwent eye leveling procedures to improve cosmesis, 2 of these by camouflage procedures and 27 by orbital translocation. Ten patients had 16 secondary operations. There was one death, serious complications occurred in 3 patients, and nuisance complications occurred in 20 others. Seven patients developed diplopia postoperatively, and in 6 patients it was troublesome. In these, it resolved fully in 2 patients, improved to be of no consequence in 2, and in the remaining 2 troublesome symptoms persisted requiring inferior oblique muscle recession in 1. Binocular vision was never restored when not present preoperatively, and in 3 patients temporary loss occurred. There was an overall modest but significant improvement in appearance after surgery. It is concluded that vertical orbital translocation is rewarding and worthwhile.

  6. Deceleration Orbit Improvements

    SciTech Connect

    Church, M.

    1991-04-26

    During the accelerator studies period of 12/90-1/91 much study time was dedicated to improving the E760 deceleration ramps. 4 general goals were in mind: (1) Reduce the relative orbit deviations from the nominal reference orbit as much as possible. This reduces the potential error in the orbit length calculation - which is the primary source of error in the beam energy calculation. (2) Maximize the transverse apertures. This minimizes beam loss during deceleration and during accidental beam blow-ups. (3) Measure and correct lattice parameters. Knowledge of {gamma}{sub T}, {eta}, Q{sub h}, Q{sub v}, and the dispersion in the straight sections allows for a more accurate energy calculation and reliable SYNCH calculations. (4) Minimize the coupling. This allows one to discern between horizontal and vertical tunes.

  7. Spiral Orbit Tribometer

    NASA Technical Reports Server (NTRS)

    Pepper, Stephen V.; Jones, William R., Jr.; Kingsbury, Edward; Jansen, Mark J.

    2007-01-01

    The spiral orbit tribometer (SOT) bridges the gap between full-scale life testing and typically unrealistic accelerated life testing of ball-bearing lubricants in conjunction with bearing ball and race materials. The SOT operates under realistic conditions and quickly produces results, thereby providing information that can guide the selection of lubricant, ball, and race materials early in a design process. The SOT is based upon a simplified, retainerless thrust bearing comprising one ball between flat races (see figure). The SOT measures lubricant consumption and degradation rates and friction coefficients in boundary lubricated rolling and pivoting contacts. The ball is pressed between the lower and upper races with a controlled force and the lower plate is rotated. The combination of load and rotation causes the ball to move in a nearly circular orbit that is, more precisely, an opening spiral. The spiral s pitch is directly related to the friction coefficient. At the end of the orbit, the ball contacts the guide plate, restoring the orbit to its original radius. The orbit is repeatable throughout the entire test. A force transducer, mounted in-line with the guide plate, measures the force between the ball and the guide plate, which directly relates to the friction coefficient. The SOT, shown in the figure, can operate in under ultra-high vacuum (10(exp -9) Torr) or in a variety of gases at atmospheric pressure. The load force can be adjusted between 45 and 450 N. By varying the load force and ball diameter, mean Hertzian stresses between 0.5 and 5.0 GPa can be obtained. The ball s orbital speed range is between 1 and 100 rpm.

  8. Satellite orbit predictor

    NASA Technical Reports Server (NTRS)

    Friedman, Morton l.; Garrett, James, Major

    An analog aid to determine satellite coverage of Emergency Locator Transmitters Emergency Position Indicating Radio Beacon (ELT/EPIRB) distress incidence is discussed. The satellite orbit predictor is a graphical aid for determining the relationship between the satellite orbit, antenna coverage of the spacecraft and coverage of the Local User Terminal. The predictor allows the user to quickly visualize if a selected position will probably be detected and is composed of a base map and a satellite track overlay for each satellite.A table of equator crossings for each satellite is included.

  9. Optical orbital angular momentum.

    PubMed

    Barnett, Stephen M; Babiker, Mohamed; Padgett, Miles J

    2017-02-28

    We present a brief introduction to the orbital angular momentum of light, the subject of our theme issue and, in particular, to the developments in the 13 years following the founding paper by Allen et al. (Allen et al. 1992 Phys. Rev. A 45, 8185 (doi:10.1103/PhysRevA.45.8185)). The papers by our invited authors serve to bring the field up to date and suggest where developments may take us next.This article is part of the themed issue 'Optical orbital angular momentum'.

  10. Passive orbital disconnect strut

    NASA Technical Reports Server (NTRS)

    Parmley, R. T.; Kittel, P.

    1984-01-01

    The design and test results with a third generation passive orbital disconnect strut (PODS) for space-based cryogenic He dewars are presented. Three pairs of PODS struts support a tank and change lengths in response to gas and temperature changes. A thin wall fiberglass tube is used on the cold disconnect end, which can be operated on the ground or in space. Tests were performed to characterize heat flows across the cold end to a liquid He sink and subsequent vacuum pressure within the He tank. Heat transfer was lower than predicted, suggesting that longer dewar in-orbit lifetimes can be expected with the new PODS.

  11. Optical orbital angular momentum

    PubMed Central

    Barnett, Stephen M.; Babiker, Mohamed; Padgett, Miles J.

    2017-01-01

    We present a brief introduction to the orbital angular momentum of light, the subject of our theme issue and, in particular, to the developments in the 13 years following the founding paper by Allen et al. (Allen et al. 1992 Phys. Rev. A 45, 8185 (doi:10.1103/PhysRevA.45.8185)). The papers by our invited authors serve to bring the field up to date and suggest where developments may take us next. This article is part of the themed issue ‘Optical orbital angular momentum’. PMID:28069775

  12. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  13. Optical orbital angular momentum

    NASA Astrophysics Data System (ADS)

    Barnett, Stephen M.; Babiker, Mohamed; Padgett, Miles J.

    2017-02-01

    We present a brief introduction to the orbital angular momentum of light, the subject of our theme issue and, in particular, to the developments in the 13 years following the founding paper by Allen et al. (Allen et al. 1992 Phys. Rev. A 45, 8185 (doi:10.1103/PhysRevA.45.8185)). The papers by our invited authors serve to bring the field up to date and suggest where developments may take us next. This article is part of the themed issue 'Optical orbital angular momentum'.

  14. [Managing focal incidental renal lesions].

    PubMed

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  15. Automated Estimation Of Lesion Size

    NASA Astrophysics Data System (ADS)

    Ruttimann, Urs E.; Webber, Richard L.; Groenhuis, Roelf A. J.; Troullos, Emanuel; Rethman, Michael T.

    1985-06-01

    Two methods were studied of estimating automatically the relative volume of local lesions in digital subtractions radiographs. The first method approximates the projected, lesion area by an equivalent circular area, and the second by an equivalent polygonal area. Lesion volume is estimated in both methods as equivalent area times the average gray-level difference between the detected area and the surrounding background. Regression results of the estimated relative volume versus the calibrated size of lesions induced in dry human mandibles showed the polygonal approximation to be superior. This method also permitted successful monitoring of bone remodelling during the healing process of surgically induced lesions in dogs. The quantitative results, as well as the examples from in vivo lesions demonstrate feasibility and clinically relavance of the methodology.

  16. Laser treatment of pigmented lesions.

    PubMed

    Goldberg, D J

    1997-07-01

    Several pigment-specific lasers can effectively treat epidermal and dermal pigmented lesions without complications using the basic principles of selective photothermolysis. Although such pigmented lesions as solar lentigines and nevi of Ota are relatively easy to treat using pigment-specific laser technology, café-au-lait macules and melasma show variable responses to treatment. New, long-pulsed pigment-specific lasers may prove to further enhance the clinical results obtained in resistant pigmented lesions and other conditions.

  17. ARTEMIS Lunar Orbit Insertion and Science Orbit Design Through 2013

    NASA Technical Reports Server (NTRS)

    Broschart, Stephen B.; Sweetser, Theodore H.; Angelopoulos, Vassilis; Folta, David; Woodard, Mark

    2015-01-01

    As of late-July 2011, the ARTEMIS mission is transferring two spacecraft from Lissajous orbits around Earth-Moon Lagrange Point #1 into highly-eccentric lunar science orbits. This paper presents the trajectory design for the transfer from Lissajous orbit to lunar orbit insertion, the period reduction maneuvers, and the science orbits through 2013. The design accommodates large perturbations from Earth's gravity and restrictive spacecraft capabilities to enable opportunities for a range of heliophysics and planetary science measurements. The process used to design the highly-eccentric ARTEMIS science orbits is outlined. The approach may inform the design of future planetary moon missions.

  18. ARTEMIS Lunar Orbit Insertion and Science Orbit Design Through 2013

    NASA Technical Reports Server (NTRS)

    Broschart, Stephen B.; Sweetser, Theodore H.; Angelopoulos, Vassilis; Folta, David; Woodard, Mark

    2015-01-01

    As of late-July 2011, the ARTEMIS mission is transferring two spacecraft from Lissajous orbits around Earth-Moon Lagrange Point #1 into highly-eccentric lunar science orbits. This paper presents the trajectory design for the transfer from Lissajous orbit to lunar orbit insertion, the period reduction maneuvers, and the science orbits through 2013. The design accommodates large perturbations from Earth's gravity and restrictive spacecraft capabilities to enable opportunities for a range of heliophysics and planetary science measurements. The process used to design the highly-eccentric ARTEMIS science orbits is outlined. The approach may inform the design of future planetary moon missions.

  19. Fuzzy description of skin lesions

    NASA Astrophysics Data System (ADS)

    Laskaris, Nikolaos; Ballerini, Lucia; Fisher, Robert B.; Aldridge, Ben; Rees, Jonathan

    2010-02-01

    We propose a system for describing skin lesions images based on a human perception model. Pigmented skin lesions including melanoma and other types of skin cancer as well as non-malignant lesions are used. Works on classification of skin lesions already exist but they mainly concentrate on melanoma. The novelty of our work is that our system gives to skin lesion images a semantic label in a manner similar to humans. This work consists of two parts: first we capture they way users perceive each lesion, second we train a machine learning system that simulates how people describe images. For the first part, we choose 5 attributes: colour (light to dark), colour uniformity (uniform to non-uniform), symmetry (symmetric to non-symmetric), border (regular to irregular), texture (smooth to rough). Using a web based form we asked people to pick a value of each attribute for each lesion. In the second part, we extract 93 features from each lesions and we trained a machine learning algorithm using such features as input and the values of the human attributes as output. Results are quite promising, especially for the colour related attributes, where our system classifies over 80% of the lesions into the same semantic classes as humans.

  20. Unusual case of traumatic neuroma of the orbit.

    PubMed

    Ulivieri, Simone; Muscas, Giovanni; Miracco, Clelia; Oliveri, Giuseppe; Galluzzi, Paolo; Giorgio, Antonio

    2016-01-01

    Traumatic or amputation neuromas are neoformations developing after damage to a peripheral nerve. They are not proper tumors but rather a reactive process or a frustrated attempt of nerve regeneration. Traumatic neuromas are potentially found in every sensory peripheral nerve and often at the site of past surgical intervention, including orbital surgery. A 29-year-old Northern African migrant presented progressive exophthalmos and progressive loss of acuity in left eye, which had started about 6 months before after a cranio-facial trauma caused by a violent assault. MRI of the orbits showed a massive intra-orbital, intra-conical lesion, clearly compressing and dislocating the optic nerve and extending posteriorly to the orbital apex. Surgery was performed through lateral approach of Kroenlein and led to complete excision of the lesion. Histology revealed fibrotic, adipose and striated muscle tissues, a disordered, non-neoplastic overgrowth of small and large fascicles of nerves, inflammatory infiltrates, and fibrosis with sparse calcifications were diffusely observed in a background of fat, scar and striated muscle tissued. Patient was discharged on the fifth day in good health condition, without deficit of eye motion but without recovery of visual acuity. In conclusion, this case demonstrates that traumatic neuromas may arise in the orbit in patients with minor direct trauma to nerves and without previous surgical treatment.

  1. Europa Orbiter Exploration Strategies

    NASA Technical Reports Server (NTRS)

    Johnson, T. V.

    2001-01-01

    The Europa Orbiter mission is planned as the next stage of Europa exploration. Its primary goals are to search for definitive evidence of a subsurface ocean, to characterize the ice crust and ice/water interface, and to prepare for future surface/sub-surface missions. Additional information is contained in the original extended abstract.

  2. A Neptune Orbiter Mission

    NASA Technical Reports Server (NTRS)

    Wallace, R. A.; Spilker, T. R.

    1998-01-01

    This paper describes the results of new analyses and mission/system designs for a low cost Neptune Orbiter mission. Science and measurement objectives, instrumentation, and mission/system design options are described and reflect an aggressive approach to the application of new advanced technologies expected to be available and developed over the next five to ten years.

  3. [Orbital neoplasms in children].

    PubMed

    Küchle, H J

    1989-04-01

    The incidence, diagnosis and clinical picture of the orbital tumors in children are discussed on the basis of 49 personal cases. Discovered was the preponderance of primary non-malignant tumors. The most frequently encountered tumors were angiomas (27 p.c.), dermatomas (19 p.c.) lymphomas (8 p.c.) and among the malignant tumors--rhabdomyosarcoma (6 p.c.).

  4. Electrostatic drops in orbit

    NASA Astrophysics Data System (ADS)

    Rodriguez, Isabel J.; Schmidt, Erin; Weislogel, Mark M.; Pettit, Donald

    2016-11-01

    We present what we think are the first intentional electrostatic orbits in the near-weightless environment of a drop tower. Classical physics problems involving Coulombic forces in orbital mechanics have traditionally been confined to thought experiments due to practical terrestrial experimental limitations, namely, the preponderance of gravity. However, the use of a drop tower as an experimental platform can overcome this challenge for brief periods. We demonstrate methanol-water droplets in orbit around a variety of charged objects- some of which can be used to validate special cases of N-body systems. Footage collected via a high-speed camera is analyzed and orbital trajectories are compared with existing theoretical predictions. Droplets of diameters 0.5 to 2mm in a variety of obits are observed. Due to the repeatability of drop tower initial conditions and effective low-g environment, such experiments may be used to construct empirical analogues and confirm analyses toward the benefit of other fields including space and planetary science. NASA Cooperative Agreement NNX12A047A, Portland State LSAMP, Robert E. McNair Scholars Program.

  5. Mars Climate Orbiter

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The Mars Surveyor '98 Climate Orbiter is shown here during acoustic tests that simulate launch conditions. The orbiter was to conduct a two year primary mission to profile the Martian atmosphere and map the surface. To carry out these scientific objectives, the spacecraft carried a rebuilt version of the pressure modulated infrared radiometer, lost with the Mars Observer spacecraft, and a miniaturized dual camera system the size of a pair of binoculars, provided by Malin Space Science Systems, Inc., San Diego, California. During its primary mission, the orbiter was to monitor Mars atmosphere and surface globally on a daily basis for one Martian year (two Earth years), observing the appearance and movement of atmospheric dust and water vapor, as well as characterizing seasonal changes of the planet's surface. Imaging of the surface morphology would also provide important clues about the planet's climate in its early history. The mission was part of NASA's Mars Surveyor program, a sustained program of robotic exploration of the red planet, managed by the Jet Propulsion Laboratory for NASA's Office of Space Science, Washington, DC. Lockheed Martin Astronautics was NASA's industrial partner in the mission. Unfortunately, Mars Climate Orbiter burned up in the Martian atmosphere on September 23, 1999, due to a metric conversion error that caused the spacecraft to be off course.

  6. Sedna Orbit Animation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This animation shows the location of the newly discovered planet-like object, dubbed 'Sedna,' in relation to the rest of the solar system. Starting at the inner solar system, which includes the orbits of Mercury, Venus, Earth, and Mars (all in yellow), the view pulls away through the asteroid belt and the orbits of the outer planets beyond (green). Pluto and the distant Kuiper Belt objects are seen next until finally Sedna comes into view. As the field widens the full orbit of Sedna can be seen along with its current location. Sedna is nearing its closest approach to the Sun; its 10,000 year orbit typically takes it to far greater distances. Moving past Sedna, what was previously thought to be the inner edge of the Oort cloud appears. The Oort cloud is a spherical distribution of cold, icy bodies lying at the limits of the Sun's gravitational pull. Sedna's presence suggests that this Oort cloud is much closer than scientists believed.

  7. Sedna Orbit Animation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This animation shows the location of the newly discovered planet-like object, dubbed 'Sedna,' in relation to the rest of the solar system. Starting at the inner solar system, which includes the orbits of Mercury, Venus, Earth, and Mars (all in yellow), the view pulls away through the asteroid belt and the orbits of the outer planets beyond (green). Pluto and the distant Kuiper Belt objects are seen next until finally Sedna comes into view. As the field widens the full orbit of Sedna can be seen along with its current location. Sedna is nearing its closest approach to the Sun; its 10,000 year orbit typically takes it to far greater distances. Moving past Sedna, what was previously thought to be the inner edge of the Oort cloud appears. The Oort cloud is a spherical distribution of cold, icy bodies lying at the limits of the Sun's gravitational pull. Sedna's presence suggests that this Oort cloud is much closer than scientists believed.

  8. Solar Orbiter Status Report

    NASA Astrophysics Data System (ADS)

    Gilbert, Holly; St. Cyr, Orville Chris; Mueller, Daniel; Zouganelis, Yannis; Velli, Marco

    2017-08-01

    With the delivery of the instruments to the spacecraft builder, the Solar Orbiter mission is in the midst of Integration & Testing phase at Airbus in Stevenage, U.K. This mission to “Explore the Sun-Heliosphere Connection” is the first medium-class mission of ESA’s Cosmic Vision 2015-2025 program and is being jointly implemented with NASA. The dedicated payload of 10 remote-sensing and in-situ instruments will orbit the Sun as close as 0.3 A.U. and will provide measurments from the photosphere into the solar wind. The three-axis stabilized spacecraft will use Venus gravity assists to increase the orbital inclination out of the ecliptic to solar latitudes as high as 34 degrees in the extended mission. The science team of Solar Orbiter has been working closely with the Solar Probe Plus scientists to coordinate observations between these two highly-complementary missions. This will be a status report on the mission development; the interested reader is referred to the recent summary by Müller et al., Solar Physics 285 (2013).

  9. Orbital Fluid Transfer System

    NASA Technical Reports Server (NTRS)

    Johnston, A. S., (Nick); Ryder, Mel; Tyler, Tony R.

    1998-01-01

    An automated fluid and power interface system needs to be developed for future space missions which require on orbit consumable replenishment. Current method of fluid transfer require manned vehicles and extravehicular activity. Currently the US does not have an automated capability for consumable transfer on-orbit. This technology would benefit both Space Station and long duration satellites. In order to provide this technology the Automated Fluid Interface System (AFIS) was developed. The AFIS project was an advanced development program aimed at developing a prototype satellite servicer for future space operations. This mechanism could transfer propellants, cryogens, fluids, gasses, electrical power, and communications from a tanker unit to the orbiting satellite. The development of this unit was a cooperative effort between Marshall Space Flight Center in Huntsville, Alabama, and Moog, Inc. in East Aurora, New York. An engineering model was built and underwent substantial development testing at Marshall Space Flight Center (MSFC). While the AFIS is not suitable for spaceflight, testing and evaluation of the AFIS provided significant experience which would be beneficial in building a flight unit. The lessons learned from testing the AFIS provided the foundation for the next generation fluid transfer mechanism, the Orbital Fluid Transfer System (OFTS). The OFTS project was a study contract with MSFC and Moog, Inc. The OFTS was designed for the International Space Station (ISS), but its flexible design could used for long duration satellite missions and other applications. The OFTS was designed to be used after docking. The primary function was to transfer bipropellants and high pressure gases. The other items addressed by this task included propellant storage, hardware integration, safety and control system issues. A new concept for high pressure couplings was also developed. The results of the AFIS testing provided an excellent basis for the OFTS design. The OFTS

  10. Orbital Fluid Transfer System

    NASA Technical Reports Server (NTRS)

    Johnston, A. S., (Nick); Ryder, Mel; Tyler, Tony R.

    1998-01-01

    An automated fluid and power interface system needs to be developed for future space missions which require on orbit consumable replenishment. Current method of fluid transfer require manned vehicles and extravehicular activity. Currently the US does not have an automated capability for consumable transfer on-orbit. This technology would benefit both Space Station and long duration satellites. In order to provide this technology the Automated Fluid Interface System (AFIS) was developed. The AFIS project was an advanced development program aimed at developing a prototype satellite servicer for future space operations. This mechanism could transfer propellants, cryogens, fluids, gasses, electrical power, and communications from a tanker unit to the orbiting satellite. The development of this unit was a cooperative effort between Marshall Space Flight Center in Huntsville, Alabama, and Moog, Inc. in East Aurora, New York. An engineering model was built and underwent substantial development testing at Marshall Space Flight Center (MSFC). While the AFIS is not suitable for spaceflight, testing and evaluation of the AFIS provided significant experience which would be beneficial in building a flight unit. The lessons learned from testing the AFIS provided the foundation for the next generation fluid transfer mechanism, the Orbital Fluid Transfer System (OFTS). The OFTS project was a study contract with MSFC and Moog, Inc. The OFTS was designed for the International Space Station (ISS), but its flexible design could used for long duration satellite missions and other applications. The OFTS was designed to be used after docking. The primary function was to transfer bipropellants and high pressure gases. The other items addressed by this task included propellant storage, hardware integration, safety and control system issues. A new concept for high pressure couplings was also developed. The results of the AFIS testing provided an excellent basis for the OFTS design. The OFTS

  11. CO-ORBITAL OLIGARCHY

    SciTech Connect

    Collins, Benjamin F.; Sari, Re'em

    2009-04-15

    We present a systematic examination of the changes in semimajor axis of a protoplanet as it interacts with other protoplanets in the presence of eccentricity dissipation. For parameters relevant to the oligarchic stage of planet formation, dynamical friction keeps the typical eccentricities small and prevents orbit crossing. Interactions at impact parameters greater than several Hill radii cause the protoplanets to repel each other; if the impact parameter is instead much less than the Hill radius, the protoplanets shift slightly in semimajor axis but remain otherwise unperturbed. If the orbits of two or more protoplanets are separated by less than a Hill radius, they are each pushed toward an equilibrium spacing between their neighbors and can exist as a stable co-orbital system. In the shear-dominated oligarchic phase of planet formation, we show that the feeding zones contain several oligarchs instead of only one. Growth of the protoplanets in the oligarchic phase drives the disk to an equilibrium configuration that depends on the mass ratio of protoplanets to planetesimals, {sigma}/{sigma}. Early in the oligarchic phase, when {sigma}/{sigma} is low, the spacing between rows of co-orbital oligarchs are about 5 Hill radii wide, rather than the 10 Hill radii cited in the literature. It is likely that at the end of oligarchy, the average number of co-orbital oligarchs is greater than unity. In the outer solar system, this raises the disk mass required to form the ice giants. In the inner solar system, this lowers the mass of the final oligarchs and requires more giant impacts than previously estimated. This result provides additional evidence that Mars is not an untouched leftover from the oligarchic phase, but must be composed of several oligarchs assembled through giant impacts.

  12. Co-Orbital Oligarchy

    NASA Astrophysics Data System (ADS)

    Collins, Benjamin F.; Sari, Re'em

    2009-04-01

    We present a systematic examination of the changes in semimajor axis of a protoplanet as it interacts with other protoplanets in the presence of eccentricity dissipation. For parameters relevant to the oligarchic stage of planet formation, dynamical friction keeps the typical eccentricities small and prevents orbit crossing. Interactions at impact parameters greater than several Hill radii cause the protoplanets to repel each other; if the impact parameter is instead much less than the Hill radius, the protoplanets shift slightly in semimajor axis but remain otherwise unperturbed. If the orbits of two or more protoplanets are separated by less than a Hill radius, they are each pushed toward an equilibrium spacing between their neighbors and can exist as a stable co-orbital system. In the shear-dominated oligarchic phase of planet formation, we show that the feeding zones contain several oligarchs instead of only one. Growth of the protoplanets in the oligarchic phase drives the disk to an equilibrium configuration that depends on the mass ratio of protoplanets to planetesimals, Σ/σ. Early in the oligarchic phase, when Σ/σ is low, the spacing between rows of co-orbital oligarchs are about 5 Hill radii wide, rather than the 10 Hill radii cited in the literature. It is likely that at the end of oligarchy, the average number of co-orbital oligarchs is greater than unity. In the outer solar system, this raises the disk mass required to form the ice giants. In the inner solar system, this lowers the mass of the final oligarchs and requires more giant impacts than previously estimated. This result provides additional evidence that Mars is not an untouched leftover from the oligarchic phase, but must be composed of several oligarchs assembled through giant impacts.

  13. Fortuitously discovered liver lesions

    PubMed Central

    Dietrich, Christoph F; Sharma, Malay; Gibson, Robert N; Schreiber-Dietrich, Dagmar; Jenssen, Christian

    2013-01-01

    The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible. PMID:23745019

  14. Comparison of Low Earth Orbit and Geosynchronous Earth Orbits

    NASA Technical Reports Server (NTRS)

    Drummond, J. E.

    1980-01-01

    The technological, environmental, social, and political ramifications of low Earth orbits as compared to geosynchronous Earth orbits for the solar power satellite (SPS) are assessed. The capital cost of the transmitting facilities is dependent on the areas of the antenna and rectenna relative to the requirement of high efficiency power transmission. The salient features of a low orbit Earth orbits are discussed in terms of cost reduction efforts.

  15. Shuttle on-orbit rendezvous targeting: Circular orbits

    NASA Technical Reports Server (NTRS)

    Bentley, E. L.

    1972-01-01

    The strategy and logic used in a space shuttle on-orbit rendezvous targeting program are described. The program generates ascent targeting conditions for boost to insertion into an intermediate parking orbit, and generates on-orbit targeting and timeline bases for each maneuver to effect rendezvous with a space station. Time of launch is determined so as to eliminate any plane change, and all work was performed for a near-circular space station orbit.

  16. Nonsurgical management of periapical lesions

    PubMed Central

    Fernandes, Marina; de Ataide, Ida

    2010-01-01

    Periapical lesions develop as sequelae to pulp disease. They often occur without any episode of acute pain and are discovered on routine radiographic examination. The incidence of cysts within periapical lesions varies between 6 and 55%. The occurrence of periapical granulomas ranges between 9.3 and 87.1%, and of abscesses between 28.7 and 70.07%. It is accepted that all inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. A review of literature was performed by using electronic and hand searching methods for the nonsurgical management of periapical lesions. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, Lesion Sterilization and Repair Therapy, and the Apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. PMID:21217952

  17. Helioseismology with Solar Orbiter

    NASA Astrophysics Data System (ADS)

    Löptien, Björn; Birch, Aaron C.; Gizon, Laurent; Schou, Jesper; Appourchaux, Thierry; Blanco Rodríguez, Julián; Cally, Paul S.; Dominguez-Tagle, Carlos; Gandorfer, Achim; Hill, Frank; Hirzberger, Johann; Scherrer, Philip H.; Solanki, Sami K.

    2015-12-01

    The Solar Orbiter mission, to be launched in July 2017, will carry a suite of remote sensing and in-situ instruments, including the Polarimetric and Helioseismic Imager (PHI). PHI will deliver high-cadence images of the Sun in intensity and Doppler velocity suitable for carrying out novel helioseismic studies. The orbit of the Solar Orbiter spacecraft will reach a solar latitude of up to 21∘ (up to 34∘ by the end of the extended mission) and thus will enable the first local helioseismology studies of the polar regions. Here we consider an array of science objectives to be addressed by helioseismology within the baseline telemetry allocation (51 Gbit per orbit, current baseline) and within the science observing windows (baseline 3×10 days per orbit). A particularly important objective is the measurement of large-scale flows at high latitudes (rotation and meridional flow), which are largely unknown but play an important role in flux transport dynamos. For both helioseismology and feature tracking methods convection is a source of noise in the measurement of longitudinally averaged large-scale flows, which decreases as T -1/2 where T is the total duration of the observations. Therefore, the detection of small amplitude signals (e.g., meridional circulation, flows in the deep solar interior) requires long observation times. As an example, one hundred days of observations at lower spatial resolution would provide a noise level of about three m/s on the meridional flow at 80∘ latitude. Longer time-series are also needed to study temporal variations with the solar cycle. The full range of Earth-Sun-spacecraft angles provided by the orbit will enable helioseismology from two vantage points by combining PHI with another instrument: stereoscopic helioseismology will allow the study of the deep solar interior and a better understanding of the physics of solar oscillations in both quiet Sun and sunspots. We have used a model of the PHI instrument to study its

  18. SPECS: Orbital debris removal

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The debris problem has reached a stage at which the risk to satellites and spacecraft has become substantial in low Earth orbit (LEO). This research discovered that small particles posed little threat to spacecraft because shielding can effectively prevent these particles from damaging the spacecraft. The research also showed that, even though collision with a large piece of debris could destroy the spacecraft, the large pieces of debris pose little danger because they can be tracked and the spacecraft can be maneuvered away from these pieces. Additionally, there are many current designs to capture and remove large debris particles from the space environment. From this analysis, it was decided to concentrate on the removal of medium-sized orbital debris, that is, those pieces ranging from 1 cm to 50 cm in size. The current design incorporates a transfer vehicle and a netting vehicle to capture the medium-sized debris. The system is based near an operational space station located at 28.5 deg inclination and 400 km altitude. The system uses ground-based tracking to determine the location of a satellite breakup or debris cloud. These data are uploaded to the transfer vehicle, which proceeds to rendezvous with the debris at a lower altitude parking orbit. Next, the netting vehicle is deployed, tracks the targeted debris, and captures it. After expending the available nets, the netting vehicle returns to the transfer vehicle for a new netting module and continues to capture more debris in the target area. Once all the netting modules are expended, the transfer vehicle returns to the space station's orbit where it is resupplied with new netting modules from a space shuttle load. The new modules are launched by the shuttle from the ground and the expended modules are taken back to Earth for removal of the captured debris, refueling, and repacking of the nets. Once the netting modules are refurbished, they are taken back into orbit for reuse. In a typical mission, the

  19. Close up view of the Orbiter Discovery in the Orbiter ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Close up view of the Orbiter Discovery in the Orbiter Processing Facility at Kennedy Space Center. The view is a detail of the aft, starboard landing gear and a general view of the Thermal Protection System tiles around the landing-gear housing. - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  20. Orbit Insertion by Mars Reconnaissance Orbiter (Artist's Concept)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    This is an artist's concept of NASA's Mars Reconnaissance Orbiter during the critical process of Mars orbit insertion. In order to be captured into orbit around Mars, the spacecraft must conduct a 25-minute rocket burn when it is just shy of reaching the planet. As pictured, it will pass under the red planet's southern hemisphere as it begins the insertion burn.

  1. Analysis of 43 cases of Langerhans cell histiocytosis (LCH)-induced central diabetes insipidus registered in the JLSG-96 and JLSG-02 studies in Japan.

    PubMed

    Shioda, Yoko; Adachi, Souichi; Imashuku, Shinsaku; Kudo, Kazuko; Imamura, Toshihiko; Morimoto, Akira

    2011-12-01

    To determine the ability of recent systemic chemotherapy protocols to reduce the incidence of central diabetes insipidus (CDI) in Langerhans cell histiocytosis (LCH), 43 CDI cases that belonged to a cohort of 348 pediatric patients with multi-focal LCH who were treated with the JLSG-96/-02 protocols were analyzed. The overall incidence of CDI was 12.4%, but in 24 cases CDI was already present at the time LCH was diagnosed. Thus, CDI developed during or after systemic chemotherapy over a follow-up period of 5.0 (0.2-14.7) years in only 19 patients (5.9%), with 7.4% at 5-year cumulative risk by Kaplan-Meier analysis. In two cases, complete resolution of CDI was noted. Anterior pituitary hormone deficiency was detected in 13 cases, while CDI-associated neurodegenerative disease was observed in six cases. The JLSG-96/-02 protocol appears to effectively reduce the occurrence of CDI. However, novel therapeutic measures are required to reverse pre-existing CDI and to prevent CDI-associated neurological complications.

  2. Predictor Variables of Developing Anterior Pituitary Deficiencies in a Group of Paediatric Patients with Central Diabetes Insipidus and Langerhans Cell Histiocytosis.

    PubMed

    Vaiani, Elisa; Malossetti, Carmen; Vega, Lina Margarita; Zubizarreta, Pedro; Braier, Jorge; Belgorosky, Alicia

    2017-01-01

    Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unknown etiopathogenesis. Central diabetes insipidus (CDI) is the most frequent endocrine manifestation and is a known risk factor for the development of further anterior pituitary hormone deficiencies (APD). However, not all CDI patients develop APD, as observed during prolonged periods of follow-up. To find predictors of developing APD in LCH children with CDI followed in our institution. We retrospectively analysed 44 patients over a median period (quartiles) of 12.3 years (8.79-14.24). Patients were subdivided into group 1 and group 2, according to absence or presence of APD, respectively. The main variables studied were: (1) chronological age (CA) at LCH diagnosis, (2) the primary site of LCH at diagnosis: low risk (LR) and multisystemic risk organs, and (3) the presence of reactivation. Multivariate Cox regression analysis showed that APD was positively associated with CA at LCH diagnosis [relative risk (RR) 1.14, p < 0.01], the LR clinical form (RR 8.6, p < 0.03), and negatively associated with the presence of reactivations (RR 0.3, p < 0.01). Patients with older CA at LCH diagnosis, LR clinical forms, and fewer reactivation episodes might represent a subgroup of paediatric LCH CDI patients with a higher risk of developing APD. © 2016 S. Karger AG, Basel.

  3. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature.

    PubMed

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not.

  4. Lunar Reconnaissance Orbiter Mission Highlights

    NASA Image and Video Library

    Since launch on June 18, 2009 as a precursor mission, the Lunar Reconnaissance Orbiter (LRO) has remained in orbit around the moon, collecting vast amounts of science data in support of NASA's expl...

  5. Diverse Orbits Around Mars Graphic

    NASA Image and Video Library

    2015-05-04

    This graphic depicts the relative shapes and distances from Mars for five active orbiter missions plus the planet's two natural satellites. It illustrates the potential for intersections of the spacecraft orbits. The number of active orbiter missions at Mars increased from three to five in 2014. With the increased traffic, NASA has augmented a process for anticipating orbit intersections and avoiding collisions. NASA's Mars Odyssey and MRO (Mars Reconnaissance Orbiter) travel near-circular orbits. The European Space Agency's Mars Express, NASA's MAVEN (Mars Atmosphere and Volatile Evolution) and India's MOM (Mars Orbiter Mission), travel more elliptical orbits. Phobos and Deimos are the two natural moons of Mars. http://photojournal.jpl.nasa.gov/catalog/PIA19396

  6. Diplopia secondary to orbital surgery.

    PubMed

    Silbert, David I; Matta, Noelle S; Singman, Eric L

    2012-01-01

    Diplopia may occur following any type of ocular or pericocular surgery. The surgeries most frequently associated with postoperative diplopia include: repair of orbital fracture, endoscopic sinus surgery (from inadvertent orbital penetration), and orbital decompression for thyroid-related immune orbitopathy (TRIO). Postoperative diplopia after orbital tumor resection has been reported--e.g., after excision of fibrous dysplasia and osteoma. However, a recent case series suggests diplopia after orbital tumor resection is uncommon and transient. Surgical intervention for orbital trauma carries the highest risk of postoperative diplopia and will be the focus of this review. We will also present a case report of worsening diplopia following repair of orbital floor fracture to highlight potential motility issues that can arise when implants are employed to treat orbital floor fractures.

  7. The Orbital Acceleration Research Experiment

    NASA Technical Reports Server (NTRS)

    Blanchard, R. C.; Hendrix, M. K.; Fox, J. C.; Thomas, D. J.; Nicholson, J.

    1986-01-01

    The hardware and software of NASA's proposed Orbital Acceleration Research Experiment (OARE) are described. The OARE is to provide aerodynamic acceleration measurements along the Orbiter's principal axis in the free-molecular flow-flight regime at orbital attitude and in the transition regime during reentry. Models considering the effects of electromagnetic effects, solar radiation pressure, orbiter mass attraction, gravity gradient, orbital centripetal acceleration, out-of-orbital-plane effects, orbiter angular velocity, structural noise, mass expulsion signal sources, crew motion, and bias on acceleration are examined. The experiment contains an electrostatically balanced cylindrical proofmass accelerometer sensor with three orthogonal sensing axis outputs. The components and functions of the experimental calibration system and signal processor and control subsystem are analyzed. The development of the OARE software is discussed. The experimental equipment will be enclosed in a cover assembly that will be mounted in the Orbiter close to the center of gravity.

  8. Orbiter based construction equipment

    NASA Technical Reports Server (NTRS)

    Goodwin, C. J.

    1982-01-01

    Many orbiter based activities need equipment to hold a payload steady while it is being worked on. This work may be construction, updating, repair, services, check out, or refueling operations in preparation for return to Earth. The Handling and Positioning Aid (HPA) is intended for use as general purpose equipment. The HPA provides a wide choice of work station positions, both immediately above the orbiter cargo bay and beyond. It can act in a primary docking role and, if required, can assist actively in the berthing process. From an analysis of ten reference missions, it was determined that two types of HPA mobility are needed; a tilt table, which simply swings out of the cargo bay, pivoting about an athwartships y axis, and an articulated arm. Illustration of the aid are provided.

  9. Orbital rhabdomyosarcomas: A review

    PubMed Central

    Jurdy, Lama; Merks, Johanus H.M.; Pieters, Bradly R.; Mourits, Maarten P.; Kloos, Roel J.H.M.; Strackee, Simone D.; Saeed, Peerooz

    2013-01-01

    Rhabdomyosarcoma (RMS) is a highly malignant tumor and is one of the few life-threatening diseases that present first to the ophthalmologist. It is the most common soft-tissue sarcoma of the head and neck in childhood with 10% of all cases occurring in the orbit. RMS has been reported from birth to the seventh decade, with the majority of cases presenting in early childhood. Survival has changed drastically over the years, from 30% in the 1960’s to 90% presently, with the advent of new diagnostic and therapeutic modalities. The purpose of this review is to provide a general overview of primary orbital RMS derived from a literature search of material published over the last 10 years, as well as to present two representative cases of patients that have been managed at our institute. PMID:24227982

  10. Mercury orbiter transport study

    NASA Technical Reports Server (NTRS)

    Friedlander, A. L.; Feingold, H.

    1977-01-01

    A data base and comparative performance analyses of alternative flight mode options for delivering a range of payload masses to Mercury orbit are provided. Launch opportunities over the period 1980-2000 are considered. Extensive data trades are developed for the ballistic flight mode option utilizing one or more swingbys of Venus. Advanced transport options studied include solar electric propulsion and solar sailing. Results show the significant performance tradeoffs among such key parameters as trip time, payload mass, propulsion system mass, orbit size, launch year sensitivity and relative cost-effectiveness. Handbook-type presentation formats, particularly in the case of ballistic mode data, provide planetary program planners with an easily used source of reference information essential in the preliminary steps of mission selection and planning.

  11. On-orbit coldwelding

    NASA Technical Reports Server (NTRS)

    Dursch, Harry; Spear, Steve

    1991-01-01

    Spacecraft mechanisms are required to operate in the space environment for extended periods of time. A significant concern to the spacecraft designer is the possibility of metal to metal coldwelding or significant increases in friction. Coldwelding can occur between atomically clean metal surfaces when carefully prepared in a vacuum chamber on earth. The question is whether coldwelding occurs in orbit service conditions. The results of the System Special Investigation Group's (SIG's) investigation into whether coldwelding had occurred on any Long Duration Exposure Facility (LDEF) hardware are presented. The results of a literature search into previous ground based anomalies is also presented. Results show that even though there have been no documented on-orbit coldwelding related failures, precautions should be taken to ensure that coldwelding does not occur in the space environment and that seizure does not occur in the prelaunch or launch environment.

  12. Spectrum of prostatic lesions

    PubMed Central

    2013-01-01

    Background Prostate gland of male reproductive system is about the size of walnut and surrounds the urethra. Most frequently encountered diseases affecting prostate are Prostatitis, Benign prostatic hyperplasia and Prostatic cancer .Our objective of study was to evaluate the spectrum and correlation of prostatic lesions with presenting complaints of patient. Methods It was a cross-sectional study conducted in Pathology Department of Dow Medical College, Dow University of Health Sciences during the period of 1st January 2010 to December 2012. Pathology department of Dow Medical College collected specimens from both Civil Hospital and Lyari General Hospital Karachi, Pakistan. Specimens were taken through transurethral resection of prostate (TURP), simple prostatectomy and radical prostatectomy. A questionnaire was made and information including name, age, ward name of hospital, laboratory number, clinical diagnosis and symptoms were noted in it. Data was entered and analyzed through SPSS 19. Result During the targeted months, 48 prostatic specimens were received with a mean age of 65.7 + -7.6 years. Common presenting complains were urinary retention in 23(47.9%) patients, followed by dribbling in 12(25%). Out of 48 patients, 42 have Benign Prostatic Hyperplasia and 6 have Prostatic Adenocarcinoma. Both Benign Prostatic Hyperplasia and Prostatic Adenocarcinoma were more prevalent in the age group of 60-70 years. Conclusion Frequency of prostatic cancer is on the rise and measures should be taken for its early detection. Screening protocols and awareness programs need to be introduced. Screening programs should be focused on level of androgens and molecular pathogenesis. PMID:24063260

  13. STS-125 Orbital Debris

    NASA Image and Video Library

    2009-07-02

    JSC2010-E-054445 (2 July 2009) --- Members of the Orbital Debris Program Office and the Hypervelocity Impact Technology Facility at JSC record images of impact craters and other surface data on the returned Wide Field and Planetary Camera (WFPC-2) of the Hubble Space Telescope. Inspection took place at the Goddard Space Flight Center during the summer of 2009. Photo credit: NASA or National Aeronautics and Space Administration

  14. Orbital Debris Modeling

    NASA Technical Reports Server (NTRS)

    Liou, J. C.

    2012-01-01

    Presentation outlne: (1) The NASA Orbital Debris (OD) Engineering Model -- A mathematical model capable of predicting OD impact risks for the ISS and other critical space assets (2) The NASA OD Evolutionary Model -- A physical model capable of predicting future debris environment based on user-specified scenarios (3) The NASA Standard Satellite Breakup Model -- A model describing the outcome of a satellite breakup (explosion or collision)

  15. Small Mercury Relativity Orbiter

    NASA Technical Reports Server (NTRS)

    Bender, Peter L.; Vincent, Mark A.

    1989-01-01

    The accuracy of solar system tests of gravitational theory could be very much improved by range and Doppler measurements to a Small Mercury Relativity Orbiter. A nearly circular orbit at roughly 2400 km altitude is assumed in order to minimize problems with orbit determination and thermal radiation from the surface. The spacecraft is spin-stabilized and has a 30 cm diameter de-spun antenna. With K-band and X-band ranging systems using a 50 MHz offset sidetone at K-band, a range accuracy of 3 cm appears to be realistically achievable. The estimated spacecraft mass is 50 kg. A consider-covariance analysis was performed to determine how well the Earth-Mercury distance as a function of time could be determined with such a Relativity Orbiter. The minimum data set is assumed to be 40 independent 8-hour arcs of tracking data at selected times during a two year period. The gravity field of Mercury up through degree and order 10 is solved for, along with the initial conditions for each arc and the Earth-Mercury distance at the center of each arc. The considered parameters include the gravity field parameters of degree 11 and 12 plus the tracking station coordinates, the tropospheric delay, and two parameters in a crude radiation pressure model. The conclusion is that the Earth-Mercury distance can be determined to 6 cm accuracy or better. From a modified worst-case analysis, this would lead to roughly 2 orders of magnitude improvement in the knowledge of the precession of perihelion, the relativistic time delay, and the possible change in the gravitational constant with time.

  16. Small Mercury Relativity Orbiter

    NASA Astrophysics Data System (ADS)

    Bender, Peter L.; Vincent, Mark A.

    1989-08-01

    The accuracy of solar system tests of gravitational theory could be very much improved by range and Doppler measurements to a Small Mercury Relativity Orbiter. A nearly circular orbit at roughly 2400 km altitude is assumed in order to minimize problems with orbit determination and thermal radiation from the surface. The spacecraft is spin-stabilized and has a 30 cm diameter de-spun antenna. With K-band and X-band ranging systems using a 50 MHz offset sidetone at K-band, a range accuracy of 3 cm appears to be realistically achievable. The estimated spacecraft mass is 50 kg. A consider-covariance analysis was performed to determine how well the Earth-Mercury distance as a function of time could be determined with such a Relativity Orbiter. The minimum data set is assumed to be 40 independent 8-hour arcs of tracking data at selected times during a two year period. The gravity field of Mercury up through degree and order 10 is solved for, along with the initial conditions for each arc and the Earth-Mercury distance at the center of each arc. The considered parameters include the gravity field parameters of degree 11 and 12 plus the tracking station coordinates, the tropospheric delay, and two parameters in a crude radiation pressure model. The conclusion is that the Earth-Mercury distance can be determined to 6 cm accuracy or better. From a modified worst-case analysis, this would lead to roughly 2 orders of magnitude improvement in the knowledge of the precession of perihelion, the relativistic time delay, and the possible change in the gravitational constant with time.

  17. Spectrophotovoltaic orbital power generation

    NASA Technical Reports Server (NTRS)

    Onffroy, J. R.

    1980-01-01

    The feasibilty of a spectrophotovoltaic orbital power generation system that optically concentrates solar energy is demonstrated. A dichroic beam-splitting mirror is used to divide the solar spectrum into two wavebands. Absorption of these wavebands by GaAs and Si solar cell arrays with matched energy bandgaps increases the cell efficiency while decreasing the amount of heat that must be rejected. The projected cost per peak watt if this system is $2.50/W sub p.

  18. 'Spider' in Earth Orbit

    NASA Technical Reports Server (NTRS)

    1969-01-01

    View of the Apollo 9 Lunar Module 'Spider' in a lunar landing configuration photographed by Command Module pilot David Scott inside the Command/Service Module 'Gumdrop' on the fifth day of the Apollo 9 earth-orbital mission. The landing gear on 'Spider' has been deployed. lunar surface probes (sensors) extend out from the landing gear foot pads. Inside the 'Spider' were astronauts James A. McDivitt, Apollo 9 Commander; and Russell L. Schweickart, Lunar Module pilot.

  19. Prospecting from Orbit

    NASA Image and Video Library

    2017-09-04

    The combination of morphological and topographic information from stereo images from NASA's Mars Reconnaissance Orbiter, as well as compositional data from near-infrared spectroscopy has been proven to be a powerful tool for understanding the geology of Mars. Beginning with the OMEGA instrument on the European Space Agency's Mars Express orbiter in 2003, the surface of Mars has been examined at near-infrared wavelengths by imaging spectrometers that are capable of detecting specific minerals and mapping their spatial extent. The CRISM (Compact Reconnaissance Imaging Spectrometer for Mars) instrument on our orbiter is a visible/near-infrared imaging spectrometer, and the HiRISE camera works together with it to document the appearance of mineral deposits detected by this orbital prospecting. Mawrth Vallis is one of the regions on Mars that has attracted much attention because of the nature and diversity of the minerals identified by these spectrometers. It is a large, ancient outflow channel on the margin of the Southern highlands and Northern lowlands. Both the OMEGA and CRISM instruments have detected clay minerals here that must have been deposited in a water-rich environment, probably more than 4 billion years ago. For this reason, Mawrth Vallis is one of the two candidate landing sites for the future Mars Express Rover Mission planned by the European Space Agency. This image was targeted on a location where the CRISM instrument detected a specific mineral called alunite, KAl3(SO4)2(OH)6. Alunite is a hydrated aluminum potassium sulfate, a mineral that is notable because it must have been deposited in a wet acidic environment, rich in sulfuric acid. Our image shows that the deposit is bright and colorful, and extensively fractured. The width of the cutout is 1.2 kilometers. https://photojournal.jpl.nasa.gov/catalog/PIA21936

  20. Orbitals and orbital energies in DFT and TDDFT

    NASA Astrophysics Data System (ADS)

    Baerends, Evert Jan

    The status and meaning of orbitals and orbital energies in the Kohn-Sham one-electron model of DFT has been controversial, in contrast to Hartree-Fock orbitals and orbital energies. We will argue the opposite: the exact Kohn-Sham orbitals of DFT are ''better'' than HF orbitals and their orbital energies are much closer to ionization energies than HF orbital energies are. This follows from the relation between the KS potential and the wavefunction, which can be cast in the form vs =vc , kin +vH +vxchole +vresp, where each term depends on the KS orbitals and the wavefunction (the one- or two-particle density matrices). The response potential vresp (r) = ∑ j ∞|/dj(r) | 2 ρ (r) Ij - ∑ i H|/ψs , i(r) | 2 ρ (r) (-ɛi) (dj is the Dyson orbital corresponding to ion state ΨjN - 1 , ψs , i is a Kohn-Sham orbital) enables the connection between ionization energies Ii and orbital energies ɛi to be made. For virtual orbitals and orbital energies similar statements can be made: the shapes and energies of the (exact) KS orbitals are much more realistic than those of the Hartree-Fock model or hybrid functionals. The HOMO-LUMO gap in molecules is very close to the optical gap, and very different from the fundamental gap. In solids the situation is very different, which is the well-known ''KS gap problem''. Again the response potential vresp (a good approximation to it) helps to solve this problem, affording a straigtforward correction method of the KS gap to the fundamental gap.

  1. Plotting Orbital Trajectories For Maneuvers

    NASA Technical Reports Server (NTRS)

    Brody, Adam R.

    1991-01-01

    Interactive Orbital Trajectory Planning Tool (EIVAN) computer program is forward-looking interactive orbit-trajectory-plotting software tool for use with proximity operations (operations occurring within 1-km sphere of space station) and other maneuvers. Developed to plot resulting trajectories, to provide better comprehension of effects of orbital mechanics, and to help user develop heuristics for planning missions on orbit. Program runs with Microsoft's Excel for execution on MacIntosh computer running MacIntosh OS.

  2. Orbital shadowing for 3-flows

    NASA Astrophysics Data System (ADS)

    Gan, Shaobo; Li, Ming

    2017-05-01

    We call that a flow has the orbital shadowing property if for any ε > 0 there is d > 0 such that, for any d-pseudo orbit g (t) there exists an orbit Orb (x) satisfying distH (g (t) ‾ , Orb (x) ‾) < ε. In this paper, we show that the C1-interior of the set of 3-dimensional flows having the orbital shadowing property is contained in the set of Ω-stable 3-flows.

  3. Orbiter Autoland reliability analysis

    NASA Technical Reports Server (NTRS)

    Welch, D. Phillip

    1993-01-01

    The Space Shuttle Orbiter is the only space reentry vehicle in which the crew is seated upright. This position presents some physiological effects requiring countermeasures to prevent a crewmember from becoming incapacitated. This also introduces a potential need for automated vehicle landing capability. Autoland is a primary procedure that was identified as a requirement for landing following and extended duration orbiter mission. This report documents the results of the reliability analysis performed on the hardware required for an automated landing. A reliability block diagram was used to evaluate system reliability. The analysis considers the manual and automated landing modes currently available on the Orbiter. (Autoland is presently a backup system only.) Results of this study indicate a +/- 36 percent probability of successfully extending a nominal mission to 30 days. Enough variations were evaluated to verify that the reliability could be altered with missions planning and procedures. If the crew is modeled as being fully capable after 30 days, the probability of a successful manual landing is comparable to that of Autoland because much of the hardware is used for both manual and automated landing modes. The analysis indicates that the reliability for the manual mode is limited by the hardware and depends greatly on crew capability. Crew capability for a successful landing after 30 days has not been determined yet.

  4. Orbital spacecraft consumables resupply

    NASA Technical Reports Server (NTRS)

    Dominick, Sam M.; Eberhardt, Ralph N.; Tracey, Thomas R.

    1988-01-01

    The capability to replenish spacecraft, satellites, and laboratories on-orbit with consumable fluids provides significant increases in their cost and operational effectiveness. Tanker systems to perform on-orbit fluid resupply must be flexible enough to operate from the Space Transportation System (STS), Space Station, or the Orbital Maneuvering Vehicle (OMV), and to accommodate launch from both the Shuttle and Expendable Launch Vehicles (ELV's). Resupply systems for storable monopropellant hydrazine and bipropellants, and water have been developed. These studies have concluded that designing tankers capable of launch on both the Shuttle and ELV's was feasible and desirable. Design modifications and interfaces for an ELV launch of the tanker systems were identified. Additionally, it was determined that modularization of the tanker subsystems was necessary to provide the most versatile tanker and most efficient approach for use at the Space Station. The need to develop an automatic umbilical mating mechanism, capable of performing both docking and coupler mating functions was identified. Preliminary requirements for such a mechanism were defined. The study resulted in a modular tanker capable of resupplying monopropellants, bipropellants, and water with a single design.

  5. Laplacian Orbit Determination

    NASA Astrophysics Data System (ADS)

    Branham, R. L., Jr.

    2003-11-01

    Laplace's method is a standard for the calculation of a preliminary orbit. Certain modifications enhance its efficacy: reduce the observations, if necessary, by use of the L1 criterion; use a polynomial, whose order is determined by impersonal criteria, to calculate the first and second derivatives of observational quantities; combine the separate equations, one to determine the heliocentric distance of the object and the other its geocentric distance, into one polynomial equation for the heliocentric distance, whose roots are found by a standard algorithm; use recursion to calculate the f and g series. At least one differential correction is recommended to increase the accuracy of the computed orbital elements. Difficult problems, lack of convergence of the differential corrections, for example, can be handled by total least squares or ridge regression. The method is first applied to calculate a preliminary orbit of Comet P/ 1846 D1 (de Vico) from 59 observations made during five days in 1995 and then to a more difficult object, the Amor type minor planet 1982 DV (3288 Seleucus).

  6. An Orbit Plan toward AKATSUKI Venus Reencounter and Orbit Injection

    NASA Technical Reports Server (NTRS)

    Kawakatsu, Yasuhiro; Campagnola, Stefano; Hirose, Chikako; Ishii, Nobuaki

    2012-01-01

    On December 7, 2010, AKATSUKI, the Japanese Venus explorer reached its destination and tried to inject itself into Venus orbit. However, due to a malfunction of the propulsion system, the maneuver was interrupted and AKATSUKI again escaped out from the Venus into an interplanetary orbit. Telemetry data from AKATSUKI suggests the possibility to perform orbit maneuvers to reencounter the Venus and retry Venus orbit injection. Reported in this paper is an orbit plan investigated under this situation. The latest results reflecting the maneuvers conducted in the autumn 2011 is introduced as well.

  7. An Orbit Plan toward AKATSUKI Venus Reencounter and Orbit Injection

    NASA Technical Reports Server (NTRS)

    Kawakatsu, Yasuhiro; Campagnola, Stefano; Hirose, Chikako; Ishii, Nobuaki

    2012-01-01

    On December 7, 2010, AKATSUKI, the Japanese Venus explorer reached its destination and tried to inject itself into Venus orbit. However, due to a malfunction of the propulsion system, the maneuver was interrupted and AKATSUKI again escaped out from the Venus into an interplanetary orbit. Telemetry data from AKATSUKI suggests the possibility to perform orbit maneuvers to reencounter the Venus and retry Venus orbit injection. Reported in this paper is an orbit plan investigated under this situation. The latest results reflecting the maneuvers conducted in the autumn 2011 is introduced as well.

  8. Circular-Orbit Maintenance Strategies for Primitive Body Orbiters

    NASA Technical Reports Server (NTRS)

    Wallace, Mark S.; Broschart, Stephen

    2013-01-01

    For missions to smaller primitive bodies, solar radiation pressure (SRP) is a significant perturbation to Keplerian dynamics. For most orbits, SRP drives large oscillations in orbit eccentricity, which leads to large perturbations from the irregular gravity field at periapsis. Ultimately, chaotic motion results that often escapes or impacts that body. This paper presents an orbit maintenance strategy to keep the orbit eccentricity small, thus avoiding the destabilizing secondary interaction with the gravity field. An estimate of the frequency and magnitude of the required maneuvers as a function of the orbit and body parameters is derived from the analytic perturbation equations.

  9. Circular-Orbit Maintenance Strategies for Primitive Body Orbiters

    NASA Technical Reports Server (NTRS)

    Wallace, Mark S.; Broschart, Stephen

    2013-01-01

    For missions to smaller primitive bodies, solar radiation pressure (SRP) is a significant perturbation to Keplerian dynamics. For most orbits, SRP drives large oscillations in orbit eccentricity, which leads to large perturbations from the irregular gravity field at periapsis. Ultimately, chaotic motion results that often escapes or impacts that body. This paper presents an orbit maintenance strategy to keep the orbit eccentricity small, thus avoiding the destabilizing secondary interaction with the gravity field. An estimate of the frequency and magnitude of the required maneuvers as a function of the orbit and body parameters is derived from the analytic perturbation equations.

  10. Wobbly Planet Orbital Schematic Illustration

    NASA Image and Video Library

    2014-02-04

    This illustration shows the unusual orbit of planet Kepler-413b around a close pair of orange and red dwarf stars. The planet 66-day orbit is tilted 2.5 degrees with respect to the plane of the binary stars orbit.

  11. Orbiter KU-band transmitter

    NASA Technical Reports Server (NTRS)

    Halterman, R.

    1976-01-01

    The design, build, and test of an engineering breadboard Ku band quadraphase shift keyed and wideband frequency modulated transmitter are described. This orbiter Ku band transmitter drawer is to simulate the orbiter transmitter and meet the functional requirements of the orbiter communication link.

  12. Orbiter OMS and RCS technology

    NASA Technical Reports Server (NTRS)

    Boudreaux, R. A.

    1982-01-01

    Orbiter Orbital Maneuver Subsystem (OMS) and Reaction Control Subsystem (RCS) tankage has proved to be highly successful in shuttle flights on-orbit propellant transfer tests were done. Tank qualification tests along with flight demonstrations were carried out future uses of storable propellants are cited.

  13. Repair-Resistant DNA Lesions

    PubMed Central

    2017-01-01

    The eukaryotic global genomic nucleotide excision repair (GG-NER) pathway is the major mechanism that removes most bulky and some nonbulky lesions from cellular DNA. There is growing evidence that certain DNA lesions are repaired slowly or are entirely resistant to repair in cells, tissues, and in cell extract model assay systems. It is well established that the eukaryotic DNA lesion-sensing proteins do not detect the damaged nucleotide, but recognize the distortions/destabilizations in the native DNA structure caused by the damaged nucleotides. In this article, the nature of the structural features of certain bulky DNA lesions that render them resistant to NER, or cause them to be repaired slowly, is compared to that of those that are good-to-excellent NER substrates. Understanding the structural features that distinguish NER-resistant DNA lesions from good NER substrates may be useful for interpreting the biological significance of biomarkers of exposure of human populations to genotoxic environmental chemicals. NER-resistant lesions can survive to replication and cause mutations that can initiate cancer and other diseases. Furthermore, NER diminishes the efficacy of certain chemotherapeutic drugs, and the design of more potent pharmaceuticals that resist repair can be advanced through a better understanding of the structural properties of DNA lesions that engender repair-resistance. PMID:28750166

  14. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  15. Dermoscopy of pigmented skin lesions.

    PubMed

    Soyer, H P; Argenziano, G; Chimenti, S; Ruocco, V

    2001-01-01

    This paper describes the basic concepts of dermoscopy, the various dermoscopic equipments and the standard criteria for diagnosing pigmented skin lesions. In assessing dermoscopic images, both global and local features can be recognized. These features will be systematically described and illustrated in Part I of this article. First, we will focus on 8 morphologically rather distinctive global features that allow a quick, preliminary categorization of a given pigmented skin lesion. Second, we will describe various local features representing the letters of the dermoscopic alphabet. The local features permit a more detailed assessment of pigmented skin lesions.

  16. No carious cervical lesions: abfraction.

    PubMed

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-10-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5.

  17. Nerve lesioning with direct current

    NASA Astrophysics Data System (ADS)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  18. Orbital phase design of diradicals.

    PubMed

    Ma, Jing; Inagaki, Satoshi; Wang, Yong

    2010-01-01

    Over the last three decades the rational design of diradicals has been a challenging issue because of their special features and activities in organic reactions and biological processes. The orbital phase theory has been developed for understanding the properties of diradicals and designing new candidates for synthesis. The orbital phase is an important factor in promoting the cyclic orbital interaction. When all of the conditions: (1) the electron-donating orbitals are out of phase; (2) the accepting orbitals are in phase; and (3) the donating and accepting orbitals are in phase, are simultaneously satisfied, the system is stabilized by the effective delocalization and polarization. Otherwise, the system is less stable. According to the orbital phase continuity requirement, we can predict the spin preference of π-conjugated diradicals and relative stabilities of constitutional isomers. Effects of the intramolecular interaction of bonds and unpaired electrons on the spin preference, thermodynamic and kinetic stabilities of the singlet and triplet states of localized 1,3-diradicals were also investigated by orbital phase theory. Taking advantage of the ring strains, several monocyclic and bicyclic systems were designed with appreciable singlet preference and kinetic stabilities. Substitution effects on the ground state spin and relative stabilities of diradicals were rationalized by orbital interactions without loss of generality. Orbital phase predictions were supported by available experimental observations and sophisticated calculation results. In comparison with other topological models, the orbital phase theory has some advantages. Orbital phase theory can provide a general model for both π-conjugated and localized diradicals. The relative stabilities and spin preference of all kinds of diradicals can be uniformly rationalized by the orbital phase property. The orbital phase theory is applied to the conformations of diradicals and the geometry

  19. Leiomyosarcoma of the uterus with sphenoid bone and orbital metastases.

    PubMed

    Su, Grant W; Hong, Sang H

    2007-01-01

    A 55-year-old woman presented with a 1-week history of vision loss in the right eye associated with proptosis and diplopia. Past medical history was significant for high-grade leiomyosarcoma of the uterus status post total abdominal hysterectomy and bilateral salpingo-oophorectomy and postoperative pelvic radiation 18 months prior to presentation. Staging studies at the time of initial diagnosis of uterine leiomyosarcoma showed no evidence for metastatic disease. At presentation, CT and MRI showed a well-circumscribed 3.0 cm x 3.6 cm x 2.4 cm mass centered in the right greater sphenoid wing, extending into the middle cranial fossa and the superior and lateral orbital wall. Biopsy of the orbital mass revealed a poorly differentiated high-grade leiomyosarcoma, consistent with recurrent metastatic disease from the uterus. The patient subsequently underwent radiation treatment followed by a left orbital exenteration 6 months after the orbital biopsy. A left thoracostomy was performed 8 months after the orbital biopsy for a metastatic nodule in the left lower lobe of the lung. The clinicopathologic findings of this rare metastatic orbital lesion are presented.

  20. Bilateral ptosis: Lesion in the oculomotor nuclei or supranuclear lesion?

    PubMed

    Dimitriou, Julien; Montoute, Timothy; Levivier, Marc; Borruat, François-Xavier; Diserens, Karin

    2015-01-01

    Bilateral ptosis is a very interesting clinical challenge for doctors because of the multiple possible localizations of a lesion which can lead to this neurological sign. Through this case report, we aim to determine the difference between an apraxia of lid opening (ALO) with difficulty in initiating the act of lid elevation, in spite of adequate understanding, motor control and cranial nerve pathways, and a bilateral ptosis with a lesion in the oculomotor nucleus or blepharospasm. The case report of a 50-year-old patient presenting bilateral ptosis and multiple ischemic lesions in the brainstem and bilateral frontal lobe lesions after the emergency removal of a large frontal tumor. Our patient had an ALO according to the neurological follow-up and showed the ability, after a few weeks, of initiating the act of opening her eyes with her hand. The ophthalmic evaluation confirmed that in her case the ALO was associated with a nuclear lesion of the oculomotor nerve secondary to a midbrain lesion. Our case report confirms multiple differential diagnoses in bilateral ptosis and the importance of clinical examination in spite of good neurological imaging.

  1. [Malignant peripheric nerve sheath tumor of the orbit: first description of orbital location in a patient with NF1].

    PubMed

    Romero-Rojas, A E; Díaz-Pérez, J A; Lozano-Castillo, A

    2010-02-01

    The malignant peripheric nerve sheath tumor (MPNST), is a malignant neoplastic lesion originated in Schwann cells of the lining sheath of peripheral nerves. This neoplasia may appear with benign or malignant heterologous components, with divergent differentiation, as the glandular one. To describe for the first time in the literature, a case of a glandular MPNST, located at the orbit and to revise the literature on this tumoral lesion. Nine year old male, with a base diagnosis of NF1, who had exophthalmos, retro-ocular pain, headache, facial asymmetry and descent of the right eyeball, that started 1 year earlier. This patient showed in the Computed Tomography an Magnetic Resonance, a well delimited, lobulated, solid mass at the eyeball, which extended to the fontal and temporal brain parenchyma. A right Fronto-temporal craniotomy was made with fronto -orbital- zygomatic resection of the tumoral lesion. Later, a dural plasty and reconstruction with titanium mesh was made at the skull base. At present, the patient is asymptomatic after 4 months of follow up. A malignant biphasic neoplastic lesion was observed, reactive in the mesenchymal elements S100, PGP 9.5, neurofilaments and vimentin. The glandular component was positive for AE1/AE3, EMA, CEA and focally for CD57. There was also reactivity to cromogranin, synaptophysin, serotonin and somatostatin. The diagnosis of Glandular MPNST was made. For the first time in the literature a case of Glandular MPNST located at the orbit, which occurred in child with NF1, is described. This extremely uncommon neoplasia must be taken into account, in the study of biphasic malignant lesions, as its diagnosis is of great importance because of the bad prognosis of the affected patients.

  2. Orbital maneuvers and space rendezvous

    NASA Astrophysics Data System (ADS)

    Butikov, Eugene I.

    2015-12-01

    Several possibilities of launching a space vehicle from the orbital station are considered and compared. Orbital maneuvers discussed in the paper can be useful in designing a trajectory for a specific space mission. The relative motion of orbiting bodies is investigated on examples of spacecraft rendezvous with the space station that stays in a circular orbit around the Earth. An elementary approach is illustrated by an accompanying simulation computer program and supported by a mathematical treatment based on fundamental laws of physics and conservation laws. Material is appropriate for engineers and other personnel involved in space exploration, undergraduate and graduate students studying classical physics and orbital mechanics.

  3. Radar Surveys of Meteoroid Orbits

    NASA Astrophysics Data System (ADS)

    Baggaley, W. J.

    1995-01-01

    Radar facilities providing routine measurements of the heliocentric orbits of meteoroids are valuable in providing a data-base of the orbital characteristics of the solar system small body population in the mass range about 10-2 down to 10-6 g. Such an orbital information background is essential for an understanding of the evolutionary processes of this component. An outline is presented of orbit-finding systems; their inherent limitations and associated selection effects with some emphasis given to the on-going southern hemisphere routine survey provided by the AMOR facility which provides orbits down to a limiting magnitude ˜ +13.

  4. Global Orbit Feedback in RHIC

    SciTech Connect

    Minty, M.; Hulsart, R.; Marusic, A.; Michnoff, R.; Ptitsyn, V.; Robert-Demolaize, G.; Satogata, T.

    2010-05-23

    For improved reproducibility of good operating conditions and ramp commissioning efficiency, new dual-plane slow orbit feedback during the energy ramp was implemented during run-10 in the Relativistic Heavy Ion Collider (RHIC). The orbit feedback is based on steering the measured orbit, after subtraction of the dispersive component, to either a design orbit or to a previously saved reference orbit. Using multiple correctors and beam position monitors, an SVD-based algorithm is used for determination of the applied corrections. The online model is used as a basis for matrix computations. In this report we describe the feedback design, review the changes made to realize its implementation, and assess system performance.

  5. Management Strategies in Rosai-Dorfman Disease: To Do or Not To Do.

    PubMed

    Shrirao, Neha; Sethi, Aditya; Mukherjee, Bipasha

    2016-10-01

    Rosai-Dorfman disease or sinus histiocytosis with massive lymphadenopathy is an extremely rare non-Langerhans cell histiocytosis. Orbital involvement is even rarer and may be accompanied by lymph node involvement. Treatment options range from systemic steroids and immunosuppressants to radiation and debulking. We present a rare case of bilateral orbital sinus histiocytosis with massive lymphadenopathy with cervical and circumaortic lymphadenopathy.

  6. Lunar Prospector Orbit Determination Results

    NASA Technical Reports Server (NTRS)

    Beckman, Mark; Concha, Marco

    1998-01-01

    The orbit support for Lunar Prospector (LP) consists of three main areas: (1) cislunar orbit determination, (2) rapid maneuver assessment using Doppler residuals, and (3) routine mapping orbit determination. The cislunar phase consisted of two trajectory correction maneuvers during the translunar cruise followed by three lunar orbit insertion burns. This paper will detail the cislunar orbit determination accuracy and the real-time assessment of the cislunar trajectory correction and lunar orbit insertion maneuvers. The non-spherical gravity model of the Moon is the primary influence on the mapping orbit determination accuracy. During the first two months of the mission, the GLGM-2 lunar potential model was used. After one month in the mapping orbit, a new potential model was developed that incorporated LP Doppler data. This paper will compare and contrast the mapping orbit determination accuracy using these two models. LP orbit support also includes a new enhancement - a web page to disseminate all definitive and predictive trajectory and mission planning information. The web site provides definitive mapping orbit ephemerides including moon latitude and longitude, and four week predictive products including: ephemeris, moon latitude/longitude, earth shadow, moon shadow, and ground station view periods. This paper will discuss the specifics of this web site.

  7. Viking orbiter attitude control analysis

    NASA Technical Reports Server (NTRS)

    Rodriguez, G.

    1977-01-01

    Two Viking orbiters are currently in Mars orbit. In the nearly two years since they were launched, the orbiters have successfully performed many functions including transportation of the Viking landers to Mars. The orbiters have for the last year provided relay links for lander-earth communications, and they have carried out from orbit their own scientific exploration of the planet. Crucial to the success of the orbiters has been the performance of the on-board attitude control system, which has provided the required orbiter stabilization and orientation throughout the missions. A comprehensive spacecraft and attitude control system dynamic analysis was necessary to certify the control system before launch and to evaluate its flight performance. This paper contains an outline of the analysis and of some of its results.

  8. Orbital Debris: A Policy Perspective

    NASA Technical Reports Server (NTRS)

    Johnson, Nicholas L.

    2007-01-01

    A viewgraph presentation describing orbital debris from a policy perspective is shown. The contents include: 1) Voyage through near-Earth Space-animation; 2) What is Orbital Debris?; 3) Orbital Debris Detectors and Damage Potential; 4) Hubble Space Telescope; 5) Mir Space Station Solar Array; 6) International Space Station; 7) Space Shuttle; 8) Satellite Explosions; 9) Satellite Collisions; 10) NASA Orbital Debris Mitigation Guidelines; 11) International Space Station Jettison Policy; 12) Controlled/Uncontrolled Satellite Reentries; 13) Return of Space Objects; 14) Orbital Debris and U.S. National Space Policy; 15) U.S Government Policy Strategy; 16) Bankruptcy of the Iridium Satellite System; 17) Inter-Agency Space Debris Coordination Committee (IADC); 18) Orbital Debris at the United Nations; 19) Chinese Anti-satellite System; 20) Future Evolution of Satellite Population; and 21) Challenge of Orbital Debris

  9. Voxel-based lesion mapping of meningioma: a comprehensive lesion location mapping of 260 lesions.

    PubMed

    Hirayama, Ryuichi; Kinoshita, Manabu; Arita, Hideyuki; Kagawa, Naoki; Kishima, Haruhiko; Hashimoto, Naoya; Fujimoto, Yasunori; Yoshimine, Toshiki

    2017-09-01

    OBJECTIVE In the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques. METHODS Magnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D. RESULTS The 3D lesion frequency map clearly showed that skull base structures such as parasellar, sphenoid wing, and petroclival regions were commonly affected by the tumor. The middle one-third of the superior sagittal sinus was most commonly affected in parasagittal tumors. Substantial lesion accumulation was observed around the leptomeninges covering the central sulcus and the sylvian fissure, with very few lesions observed at the frontal, parietal, and occipital convexities. CONCLUSIONS Using an objective visualization method, meningiomas were shown to be located around the middle third of the superior sagittal sinus, the perisylvian convexity, and the skull base. These observations, which are in line with previous descriptive analyses, justify further use of voxel-based lesion mapping techniques to help understand the biological nature of this disease.

  10. Herpes viral culture of lesion

    MedlinePlus

    ... virus; Herpes simplex virus culture Images Viral lesion culture References Costello M, Sabatini LM, Yungbluth M. Viral infections. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier ...

  11. Electrocautery for Precancerous Anal Lesions

    Cancer.gov

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  12. Lesions of the avian pancreas.

    PubMed

    Schmidt, Robert E; Reavill, Drury R

    2014-01-01

    Although not well described, occasional reports of avian exocrine and endocrine pancreatic disease are available. This article describes the lesions associated with common diseases of the avian pancreas reported in the literature and/or seen by the authors.

  13. Biomagnetic activity in ovarian lesions.

    PubMed

    Anastasiadis, P; Anninos, P; Kotini, A; Limberis, B; Galazios, G

    1998-01-01

    BACKGROUND-MATERIALS: This study aimed to investigate biomagnetic activity in benign and malignant ovarian diseases using the biomagnetometer SQUID. Magnetic recordings were obtained from 40 patients with palpable ovarian lesions. 19 of these were invasive carcinomas, and 21 were benign ovarian lesions. We used a one channel biomagnetometer SQUID (superconducting quantum interference device), in order to measure the magnetic field from benign and malignant ovarian diseases. Interestingly, the ovarian lesion waveforms and the corresponding spectral densities were of high amplitude in most (96%) malignant ovarian lesions, and of low amplitude in most (95%) benign ovarian diseases. These findings were of statistical significance (students t-test p < 0.005). It is suggested that biomagnetic measurement of benign and malignant ovarian diseases, which is an entirely new application of SQUID technology, is a promising procedure for assessing ovarian tumors.

  14. [A case of primary intraosseous cavernous hemangioma extending from the orbital rim to the sphenoid wing: a case report].

    PubMed

    Inaka, Yasufumi; Otani, Naoki; Nishida, Sho; Kumagai, Kohsuke; Fujii, Kazuya; Ueno, Hideaki; Tomiyama, Arata; Tomura, Satoshi; Osada, Hideo; Wada, Kojiro; Mori, Kentaro

    2014-11-01

    A primary intraosseous cavernous hemangioma located at the sphenoid bone with extensive involvement of the orbital roof and the lateral wall of the orbit is very rare. A 48-year-old woman presented with progressive right exophthalmos and diplopia. CT showed a bony mass lesion in the right sphenoid bone extending to the orbital bone. MRI showed an abnormal lesion in the sphenoid bone, which was heterogeneously enhanced with gadolinium. All of the abnormal bone was surgically removed, and histological examination confirmed a cavernous angioma. We also present a brief clinical and radiological review of seven previously reported cases.

  15. Mass-forming primary angiitis of central nervous system with Rosai-Dorfmann disease-like massive histiocytosis with emperipolesis.

    PubMed

    Kim, Seong-Ik; Kim, Soo Hee; Cho, Hwa Jin; Kim, Hannah; Chung, Chun-Kee; Choi, Seung Hong; Park, Sung-Hye

    2015-08-01

    Primary angiitis of the central nervous system (PACNS) is a vasculitis restricted to the CNS without systemic involvement. We report a case of PACNS that was radiologically tumor-mimicking, and pathologically similar to the Rosai-Dorfmann disease. A 20-year-old woman presented with a focal facial motor seizure. Magnetic resonance image revealed heterogeneously enhanced well-demarcated solitary cerebral mass in the posterior frontal lobe. Histopathologically, the lesion showed lymphoplasmacytic vasculitis with massive parenchymal infiltration of large histiocytes with emperipolesis. Diffuse ischemic change, necrosis, hemorrhage of the brain parenchyma with neuronophagia, and extensive reactive gliosis by gemistocytic astrocytes were accompanying microscopic features. The patient was doing well for 3 years after complete resection of the lesion, except for occasional occurrence of alcohol- or sleep deprivation-associated seizure. We describe this unique case to provide evidence that mass formation can be developed in PACNS by accompanying parenchymal lymphohistiocytic infiltration, necrosis, and marked reactive gliosis. © 2015 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

  16. Hypervelocity Orbital Intercept Guidance

    DTIC Science & Technology

    1988-04-14

    Professor Charles E. Fosha, Jr. Terminal guidance of a hypervelocity exo-atmospheric orbital interceptor with free end-time is examined. The pursuer is...stochastic nonlinear systems with free end-time was developed by Tse and 29 Bar-Shalom [5]. This method differs from the optimal control formulation...Vol. AC-18, No. 2, April 1973, pp. 98-108. 5. Tse, E., and Y. Bar-Shalom, "Adaptive Dual Control For Stochastic Nonlinear Systems with Free End- Time

  17. Current orbital debris environment

    NASA Technical Reports Server (NTRS)

    Kessler, Donald J.

    1989-01-01

    NASA has instituted a plan for the definition of activities and resources required over the coming decade for the deepening of current understanding of anthropogenic orbital debris, and its effects on future mission operations. This understanding will be the basis of policy definition and policy implementation efforts. The most immediate requirement is the definition of the debris environment, with emphasis on data for debris sizes smaller than 4 cm. Systems-damage criteria and hypervelocity-impact theory will then be used to define the hazard to specific spacecraft.

  18. Orbiter door closure tools

    NASA Technical Reports Server (NTRS)

    Acres, W. R.

    1980-01-01

    Safe reentry of the shuttle orbiter requires that the payload bay doors be closed and securely latched. Since a malfunction in the door drive or bulkhead latch systems could make safe reentry impossible, the requirement to provide tools to manually close and secure the doors was implemented. The tools would disconnect a disabled door or latch closure system and close and secure the doors if the normal system failed. The tools required to perform these tasks have evolved into a set that consists of a tubing cutter, a winch, a latching tool, and a bolt extractor. The design, fabrication, and performance tests of each tool are described.

  19. Lunar Exploration Orbiter (LEO)

    NASA Astrophysics Data System (ADS)

    Jaumann, R.; Spohn, T.; Hiesinger, H.; Jessberger, E. K.; Neukum, G.; Oberst, J.; Helbert, J.; Christensen, U.; Keller, H. U.; Mall, U.; Böhnhardt, H.; Hartogh, P.; Glassmeier, K.-H.; Auster, H.-U.; Moreira, A.; Werner, M.; Pätzold, M.; Palme, H.; Wimmer-Schweingruber, R.; Mandea, M.; Lesur, V.; Häusler, B.; Hördt, A.; Eichentopf, K.; Hauber, E.; Hoffmann, H.; Köhler, U.; Kührt, E.; Michaelis, H.; Pauer, M.; Sohl, F.; Denk, T.; van Gasselt, S.

    2007-08-01

    The Moon is an integral part of the Earth-Moon system, it is a witness to more than 4.5 b. y. of solar system history, and it is the only planetary body except Earth for which we have samples from known locations. The Moon is our closest companion and can easily be reached from Earth at any time, even with a relatively modest financial budget. Consequently, the Moon was the first logical step in the exploration of our solar system before we pursued more distant targets such as Mars and beyond. The vast amount of knowledge gained from the Apollo and other lunar missions of the late 1960's and early 1970's demonstrates how valuable the Moon is for the understanding of our planetary system. Even today, the Moon remains an extremely interesting target scientifically and technologically, as ever since, new data have helped to address some of our questions about the Earth-Moon system, many questions remained. Therefore, returning to the Moon is the critical stepping-stone to further exploring our immediate planetary neighborhood. In this concept study, we present scientific and technological arguments for a national German lunar mission, the Lunar Explorations Orbiter (LEO). Numerous space-faring nations have realized and identified the unique opportunities related to lunar exploration and have planned missions to the Moon within the next few years. Among these missions, LEO will be unique, because it will globally explore the Moon in unprecedented spatial and spectral resolution. LEO will significantly improve our understanding of the lunar surface composition, surface ages, mineralogy, physical properties, interior, thermal history, gravity field, regolith structure, and magnetic field. The Lunar Explorations Orbiter will carry an entire suite of innovative, complementary technologies, including high-resolution camera systems, several spectrometers that cover previously unexplored parts of the electromagnetic spectrum over a broad range of wavelengths, microwave and

  20. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. Copyright © 2016 Elsevier Inc. All rights reserved.