Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple myeloma, which primarily affects the elderly, is rare in the head and neck. We report the case of a 71-year-old man who came to us with hoarseness, dysphagia, intermittent aspiration, and cervical lymphadenopathy. Our work-up included laboratory tests, radiographic examinations, analysis of bone marrow aspiration, and histopathologic evaluations. Cervical lymph node biopsy confirmed a diagnosis of multiple myeloma. Despite treatment with chemotherapy and radiation, the patient died of his disease 6 months later.
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PMID:Multiple myeloma in a patient with hoarseness, dysphagia, aspiration, and cervical lymphadenopathy. 1514

Primary malignant melanoma has been seen in virtually all sites and organ systems where neural crest cells migrate. Upper aero-digestive tract is the unusual site. We presented two cases of mucosal malignant melanoma. A 59-year-old female patient had been suffering from nasal airway obstruction and headache for three months, and was admitted to our clinic. There was an upper cervical lymphadenopathy 5 cm in diameter ipsilaterally. Computerized tomography presented a nasal mass originating from the left maxillary sinus, and extending into nasal cavity and the left lateral wall of nasopharynx. Left total maxillectomy and radical neck dissection was performed. Postoperative radiotherapy was applied. A 68-year-old male patient suffering from nasal airway obstruction, hypernasality, dysphagia, and oral bleeding was admitted to our clinic. Oral examination revealed the tumoral mass protruding downward through oropharynx. The second patient referred to medical oncology. There was no recurrence in the first patient 18 months later. And the second patient died one year later. We believe that nasal mucosal malignant melanoma was rare, and carefully evaluated since it may be amelanotic lesion. Nasopharyngeal mucosal malignant melanoma is very rare, and has worse prognosis.
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PMID:Mucosal malignant melanoma in upper aerodigestive tract: report of two cases. 1527 73

A 21-year-old white man in otherwise excellent general health was referred for a painful, progressive, facial eruption with associated fever, malaise, and cervicofacial lymphadenopathy. The patient reported that a vesicular eruption progressed from the left side of his face to also involve the right side of his face over the 48 hours preceding his clinic visit. He also reported some lesions in his throat and the back of his mouth causing pain and difficulty swallowing. Four to 7 days before presentation to us, the patient noted exposure to his girlfriend's cold sore. Additionally, he complained of a personal history of cold sores, but had no recent outbreaks. Physical examination revealed a somewhat ill man with numerous vesicles and donut-shaped, 2-4 mm, crusted erosions predominantly on the left side of the bearded facial skin. There were fewer, but similar-appearing lesions, on the right-bearded skin. The lesions appeared folliculocentric (Figure). Cervical and submandibular lymphadenopathy was present. Oral exam showed shallow erosions on the tonsillar pillars and soft palate. Genital examination was normal. The remainder of the physical exam was unremarkable. A Tzanck smear of vesicular lesions was positive for balloon cells and many multinucleated giant cells with nuclear molding. A viral culture was performed which, in several days, came back positive for herpes simplex virus. The complete blood cell count documented a white blood cell count of 8000/mm3 with 82.6% neutrophils and 9.0% lymphocytes. Based on the clinical presentation and the positive Tzanck smear, the patient was diagnosed with herpes simplex barbae, most likely spread by shaving. The patient was started on acyclovir 200 mg p.o. five times daily for 10 days. Oxycodone 5 mg in addition to acetaminophen 325 mg (Percocet; Endo Pharmaceuticals, Chadds Ford, PA) was prescribed for pain relief. A 1:1:1 suspension of viscous lidocaine (Xylocaine; AstraZeneca Pharmaceuticals LP, Wilmington, DE), diphenhydramine (Benadryl; Pfizer Inc., New York, NY), and attapulgite (Kaopectate; Pfizer Inc., New York, NY) was given as a swish and spit to relieve the oral discomfort. Good hygiene, no skin-to-skin contact with others, and no further shaving to prevent autoinoculation were stressed. He was advised to discard his old razor.
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PMID:Case study: inoculation herpes barbae. 1589 Dec 58

A 50-year-old woman lost about 10 kg of body weight within two months. Thereafter, she developed dysphagia and dysphonia. She visited our hospital and presented with a weak elevation of the soft palate, fasciculation of the tongue, hoarseness of voice, muscle weakness of the neck and extremities, and a decrement in vital capacity. She was admitted with a provisional diagnosis of motor neuron disease. The results of laboratory examinations showed an elevation in serum lysozyme and liquor protein levels, and pleocytosis in the liquor. Needle electromyography showed neurogenic changes, and bilateral hilar lymphadenopathy was revealed by computerized tomography. A biopsy specimen was excised from lymph nodes near the right anterior scalene muscle, which showed noncaseating granulomas consistent with sarcoidosis. All her symptoms improved after steroid administration. Such patients can be treatable with steroids. Moreover, the differential diagnosis from motor neuron disease is important.
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PMID:[A patient with sarcoidosis needed differential diagnosis from motor neuron disease]. 1611 29

A 32-year-old black female was started on phenytoin for seizure prophylaxis following the clipping of an aneurysm. This was stopped after 3 weeks when she developed a generalized skin rash. Over the next week she developed fever, sore throat, dysphagia, and headache. She had an erythematous throat with white exudates on the right tonsil and 1 to 3 cm firm, tender lymphadenopathy in multiple regions. Blood, throat swab and cerebrospinal fluid studies were negative for bacterial or viral infections, except for elevated liver enzymes. CT scan of chest, abdomen, and pelvis showed no lymphadenopathy. Lymph node biopsy suggested necrosis but no evidence of infection, granuloma, or lymphoma. Her lymphadenopathy resolved spontaneously and liver enzymes normalized in 3 weeks. Hypersensitivity syndrome due to antiepileptics manifests as fever, rash, generalized lymphadenopathy, and probably represents a T-cell mediated drug reaction. This reaction may persist despite cessation of the drug, and it may engender expensive evaluation. Careful observation up to 3 weeks after drug cessation may be the best management.
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PMID:Necrotizing lymphadenitis associated with the phenytoin-induced hypersensitivity syndrome. 1621 91

The prevalence of thyroid metastases in colorectal cancer (CRC) patients is unknown. We retrieved the records of all patients with CRC and pathologically proved thyroid metastasis for the period 1993-2004. Among 5,862 consecutive patients with CRC, 6 (0.1%) were diagnosed with thyroid metastases, a median of 61 months after the diagnosis of primary tumour, and a median of 19 months after the last surgical resection or radiofrequency ablation of other metastases (which were present in all cases). Signs and symptoms, when present (n=3), consisted of cervical pain, cervical adenopathy, goitre, dysphagia, and/or dysphonia. In other cases, the diagnosis was made by positron emission tomography scanning. Thyroidectomy was performed in the 5 patients with isolated thyroid metastases, with cervical lymph node dissection being required in all cases. The only patient treated conservatively because of concomitant liver and lung metastases developed life-threatening dyspnoea, which required emergent tracheal stenting. Median overall survival was 77 months, 58 months, and 12 months after the diagnosis of primary CRC, initial metastases, and thyroid metastasis, respectively. It is concluded that thyroid metastases are rare and occur late in the course of CRC. Thyroidectomy (with cervical lymph node dissection) may result in prevention or improvement of life-threatening symptoms and prolonged survival.
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PMID:Thyroid metastases from colorectal cancer: the Institut Gustave Roussy experience. 1676 42

Candida albicans, a medically important opportunistic yeast is described as the etiologic agent of stomatitis in dogs. The oral swabs collected from 34 dogs showing symptoms of stomatitis or gingivitis such as anorexia, halitosis, bleeding within the oral cavity, dysphagia, ptyalism (salivation) and submandibular lymphadenopathy were cultured for isolation of the causative agent. C. albicans was isolated from four (11.8%) dogs. The isolates were sensitive to clotrimazole, fluconazole and amphotericin-B but were resistant to nystatin. The routine application of Pal's sunflower seed medium and Narayan stain in microbiological laboratories is highly emphasized. It is recommended that the role of C. albicans, as the etiologic agent of canine stomatitis, should be carefully investigated in various clinical related disorders of dogs as well as in other animals.
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PMID:Canine mycotic stomatitis due to Candida albicans. 1738 48

Despite the increased incidence of tuberculosis related to human immunodeficiency virus (HIV) in recent decades, pancreatic tuberculosis has rarely been described. We report a case of pancreatic tuberculosis in a 39-year-old African man who presented with progressive dysphagia, vomiting, weight loss and productive cough, accompanied by localized epigastric pain and one episode of melena. HIV-1 testing was positive and lymphocyte subset profile showed CD(4) count of 9/mm(3). Abdominal computed tomography (CT) scan with contrast revealed a cystic mass in the body of the pancreas, significant portal and retroperitoneal cystic adenopathy, and multiple cystic lesions in the spleen and liver. CT guided cyst aspiration and node biopsy detected Mycobacterium tuberculosis. The patient responded well on antituberculosis and antiretroviral therapy. Tuberculosis rarely involves the pancreas, probably due to the presence of pancreatic enzymes which interfere with the seeding of Mycobacterium tuberculosis. Pancreatic tuberculosis is considered to be the result of dissemination of the infection from nearby lymphatic nodes. Endoscopic ultrasound or CT guided fine needle aspiration for cytology is the recommended diagnostic technique. Although the prognosis is good with anti-tuberculosis treatment, it could be fatal without correct diagnosis and treatment. The clinician's high index of suspicion of pancreatic tuberculosis and application of FNAB to obtain pathological evidence are extremely important to a correct diagnosis, especially in young HIV positive patients.
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PMID:Pancreatic tuberculosis in a human immunodeficiency virus positive patient: a case report. 1824 Mar 54

We report a case of liver sarcoidosis with dysphagia. Although akinesia of the soft palate, disappearance of the palatal reflex, and pyramidal signs indicated brainstem lesions, brain magnetic resonance imaging showed no lesion and the focus was obscure. Iritis, parotiditis, and hilar lymphadenopathy supported the diagnosis of sarcoidosis. However, lung biopsy was normal. Finally, sarcoidosis was diagnosed by liver biopsy. We speculated that microgranulomas in the brainstem that did not exhibit imaging abnormalities causing the neurological symptoms and that liver biopsy can be an effective diagnostic tool even for cases that presented with neurological signs, but no gastrointestinal symptom.
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PMID:Liver sarcoidosis that presented with dysphagia. 1907 55

Cardiac involvement as an initial presentation of malignant lymphoma is a rare occurrence. We describe the case of a 77-year-old man who had initially been diagnosed with a left atrial mass on an echocardiogram, presenting with progressive dyspnea, dysphagia, odynophagia and fevers. The cardiac mass had been managed as an outpatient with full anticoagulation for the suspicion of clot. On admission, cardiac magnetic resonance imaging revealed a large mediastinal mass invading the left atrium that originated from the oesophagus. A barium oesophagram revealed an apple core lesion involving the distal third of the oesophagus. A subsequent computed tomography scan demonstrated a large mediastinal soft tissue mass and paratracheal lymphadenopathy. A flexible upper endoscopy revealed an oesophageal mass that was approximately 10 cm in length, irregular at the margins, and with a very necrotic appearance. This was biopsied, revealing findings consistent with high grade diffuse large B cell lymphoma. This case illustrates lymphoma presenting with dyspnea, odynophagia and a left atrial mass. To our knowledge, there are no reported cases of diffuse large B cell lymphoma presenting as odynophagia and a cardiac mass.
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PMID:Diffuse large B cell lymphoma presenting as a cardiac mass and odynophagia. 1881 Jul 25


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