• klebsiella rhinoscleromatis
• mikulicz cell
• rhinoscleroma

and importance: this case report aimed at an unusual case of extensive rhinoscleroma with a literature review, We report this case to bring attention to the patients with immunodeficiency problem regardless of presenting symptoms. Case presentation: a 70 -year-old patient with diabetes and hypertension, consulted for chronic median and posterior headaches have not improved with symptomatic treatment. She reported cacosmia without rhinorrhea and right otalgia. The examination of the nasal cavity showed a bleeding lesion on the lateral wall of the nasopharynx. CT-scan of the facial showed tissue lesion on the posterior and lateral walls of the nasopharynx, with infiltration of the parapharyngeal space and bone lysis right edge of the clivus. The biopsy confirmed the diagnosis of rhinoscleroma. The patient started the ciprofloxacin for 3 months, and the evolvement has noticed with the disappearance of the lesion during the first month of treatment. The patient started the ciprofloxacin for 3 months, and the evolvement was noticed with the disappearance of the lesion during the first month of treatment. Cilinical discussion: rhinoscleroma is a chronic and progressive granulomatous disease of the nasal cavities. The diagnosis is confirmed by the search for bacteria and an anatomopathological assessment of MIKULICZ cells. The medical treatment of choice has a high concentration in macrophages such as rifampicin and fluoroquinolone. Conclusion: rhinoscleroma is a granulomatous disease caused by klebsiella rhinoscleromatis, you must think about in front a nasopharyngeal lesion imitating a malignant pathology.

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A rebellious headache may be indicate an extensive rhinoscleroma.

• Clivus
• Headache
• Klebsiella rhinoscleromatis
• Rhinoscleroma
• ciprofloxacin.case report

• CT
• MR
• Nasal
• Organized hematoma
• Sinus

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Diffusion Magnetic Resonance Imaging
• Female
• Hematoma/diagnostic imaging
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Retrospective Studies
• Tomography, X-Ray Computed
• Young Adult

Sarcoidosis is a granulomatous disease of unknown etiology that most often impacts the lungs. Cutaneous manifestations of sarcoidosis are seen among 9%-37% of patients. Subcutaneous sarcoidosis is a rare presentation of cutaneous sarcoidosis with estimates of frequency ranging from 1.4%-16%. To date, very few articles and case reports have been written about this subject. In this paper, we describe a case of subcutaneous sarcoidosis and perform a review of the literature to determine if there are commonalities among patients who present with subcutaneous sarcoidosis.

A 38-year-old female, with a past medical history of arthritis and recurrent nephrolithiasis, presents with an 8-mo history of 4 firm, asymptomatic, skin-colored nodules on her left and right upper extremities and neck. Needle biopsy and post-excisional pathology report both revealed well-formed, dense, non-caseating granulomas localized to the subcutaneous tissue. Chest computed tomography revealed mild mediastinal lymphadenopathy. A diagnosis of subcutaneous sarcoidosis was made, and the lesions were surgically removed.

Commonalities among patients presenting with subcutaneous sarcoidosis include: middle-aged female, lesions localizing to the upper or lower limbs, lymphadenopathy or pulmonary infiltration on chest imaging, elevated serum angiotensin-converting enzyme.

• Subcutaneous sarcoidosis
• Upper extremity
• Granulomatous disease
• Case report

Rhinoscleroma is a chronic granulomatous bacterial infection caused by the gram-negative bacillus Klebsiella rhinoscleromatis. It predominately involves the nasal cavities but it can also involve the rest of the upper respiratory tract. Hypertrophic stage of rhinoscleroma may cause large tumor masses which could mimic neoplasm. Radiological imaging is essential for differentiation of rhinoscleroma from other granulomatous and malignant lesions. Imaging is also an important tool for detection of disease extensions and follow up post therapy. We illustrate the radiographic features of a patient with a giant rhinoscleroma using CT, MRI and CT virtual bronchoscopy for prompt diagnosis, assessment of disease extensions before therapy and follow up after therapy. The diagnosis was confirmed by tissue biopsy and culture. The patient received medical antibiotic treatment for 3 months after surgical excision of the lesion.

Rhinoscleroma is a chronic granulomatous disease caused by Klebsiella rhinoscleromatis. It commonly affects the nasal cavity and nasopharynx, but it can also involve the larynx, trachea, bronchi, middle ear, and orbit. We are reporting a rare presentation of rhinoscleroma in a middle-aged female patient involving the lips and gums.

• Gums
• lips
• rhinoscleroma

• Rhinoscleroma
• diagnosis
• granulomatous disease
• histology

To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings.

We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease. MDCT was performed in all cases. Multiplanar and volume-rendering reconstructions were obtained when necessary. Virtual endoscopy was obtained from the CT with dedicated software.

Pathological conditions affecting the central airways are a heterogeneous group of diseases. Focal alterations include benign neoplasms, malignant neoplasms, and non-neoplastic conditions. Diffuse abnormalities are divided into those that produce dilation and those that produce stenosis and tracheobronchomalacia. Direct bronchoscopy (DB) visualises the mucosal layer and is an important diagnostic and therapeutic weapon. However, assessing the deep layers or the adjacent tissue is not possible. MDCT and post-processing techniques such as virtual bronchoscopy (VB) provide an excellent evaluation of the airway wall.

This review presents the complete spectrum of the central airway pathology with its clinical, pathological and radiological features.

• Dividing diseases into diffuse and focal lesions helps narrow the differential diagnosis.

• Focal lesions with nodularity are more likely to correspond to tumours.

• Focal lesions with stenosis are more likely to correspond to inflammatory disease.

• Posterior wall involvement is the main feature in diffuse lesions with stenosis.

• Relapsing polychondritis
• Respiratory tract diseases
• Tracheal diseases
• Tracheobronchomegaly
• Tuberculosis

• Parotid
• Sjögren’s
• salivary
• sialadenitis
• stone
• submandibular

• nose
• orphan disease
• paranasal sinuses
• rare disease