Журнал клинических случаев

Cystic lesions are very common in the body, in particular in the ENT field. However, reports of cysts involving the Eustachian tube are very rare.  We present in this report a case of a 49-years-old man who presented for unilateral chronic otitis media with effusion. A rigid endoscopy was done revealing no nasopharyngeal mass. An MRI showed the presence of a cystic lesion in the cartilaginous portion of the left Eustachian tube measuring 10 × 6 mm.  The decision was made to do a left myringotomy with a PE tube insertion, followed by an endoscopic endonasal marsupialisation of the cyst. The cyst was sent to pathology. The pathologist confirmed the presence of a cyst with absence of signs of malignancy. In this article we will review the literature concerning Eustachian tube benign tumors; in particularly benign cysts, and we will discuss the pathology, symptoms, treatment and outcome. 

A mucocele is a mucous-filled cavity in the paranasal sinuses due to obstruction or compression of neighboring structures by inflammatory processes, trauma, or prior surgery. It can be indolent, locally expanding, and destructive. Mucoceles are extremely rare in children. We report a nine-year-old boy with sudden-onset left orbital pain and proptosis. Computed tomography showed a well-defined soft tissue lesion originating in the left ethmoid sinuses, suggestive of a mucocele. The mass was marsupialized by endoscopic sinus surgery. Mucoceles should be a part of the differential diagnosis of a child presenting with proptosis. Imaging studies are helpful in establishing the diagnosis. 

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???????????: ????????????????? ??????????? ?????????????? ?????? — ???????????????? ???????????, ?????????? ?????? ?? ???? ????, ??????? ????? ??????? ????????????? ?????????? ????????. ??????? ??????? ????? ??? ????????? ????????? ?????? ???????? ?? ????????? ??????????? ???????????, ??? ???????? ? ??????? ?????????????????? ?????????????. ?????? ?????????? — ???? ?? ???????? ? ???????? ?????????????, ???????? ???? ????????? ??????????? ?????????????? ??? ?????? ?? ???????? ??????. ??????? ???????: 68-??????? ??????? ? ???????? ??????? ????????????????? ??????????? ?????????????? ??????, ????????? ?????????, ???????????????, ??????? ???????????? ?????????????, ????????, ?????? ???????? ????? ???? ? ????????? ???? ????????? ????????? ????????, ??????? ?????????? ? ??????????. ??????????? ????????? ???????, ??? ???????? ????????? ??? ??????? ??????? ????????????????? ??????????? ?????????????? ?????? ? 2015 ????. ????? ?????? ???????????? ??????????? ????????? ????????? ???????? ?????????? ?????-????????? ??-?? ?????????? ????????, ??????? ???????????? ?????????????; ????????????? ???? ???????? ???????? ?????????? ?????????????? ?????????? ??????????; ? ??????? ?????????????. ????? ????????? ???????????? ??????? ?? ??????? ? ??????? ???????? ????????? ?? ??????? ?????? ????????????? ????? ? ?????? ????????????? ?? ???????????. ??????????: ? ????????? ? ?????????????? ?????????? ?????? ????????? ????? ???? ???????????? ????????????. ? ?????? ????????????????? ??????????? ?????????????? ?????? ????????, ?????????? ?? ????? ?? ?????????? ??????? ??????? ???????, ????? ?????????????? ??? ????????? ? ??????? ??????????? ??????????? 5-?????-?????????. ???? ????? ??????????, ??? ??????????, ????????? ??????????? ???????????????? ???????????, ??????? ???? ?????? ???????? ???? ? ??????????? ? ?????????? ???????, ? ????? ???????? ???????? ??????????? ? ??????????. ?????????? ??????????? ????? ?????? ?????????? ???????? ?????? ???? ?????? ???????? ?? ??????? ???????????????? ??????? ? ?????? ???????????? ???????. 

??????? ??????????? ?????? (FICB) —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 

????????????? ???????, ????????? ? NLRP12, ????? ?????????? ???????? ????????? ?????????????????? ?????????-2 (FCAS2), ???????? ?????????? ?????????????????? ????????????, ????????? ????????? ???? NLRP12 ? ????????????????? ?????????????? ????????? ?????????, ????? ????? ??????????? ?????? ??? ??????????? ???????, ? ????????? ? ???????????/????????, ?????????, ????????? ??????, ????????? ??????, ???????????????, ?????? ? ??????, ?????????, ?????????? ? ???????????. ??????? ????? ??????? ????????? ???? ? ????? ???? ????? ?????????????????. ? ????????? ???? ???? ???????????????? ????????? ??????? NLRP12, ??????????? ??????????? ?????????????? ? ?????? ??????? ?? ???????. ????? ?? ????????? ?????? 24-??????? ???????, ??????????? FCAS2 ? ????? ????????????? ???????? ???? NLRP12, ? ???????? ?????????? ??? ??????? ????? ?? ?????????? ???????, ? ????? ?? ??????? ????-??-1 ????.

?????? ????????????: ????? ? ?????? ???????? ??????-????? (???), ??????????????? ? ???????? ? ??????? ???????????? ????? ????????? ??????? ?????? ???????? ????? (C3-C6). ????: ????????????????? ??????????? ??????? ??? ? ???????? ? ????????????. ????? ??????????: ???????? ???????? ?????????? ????????????, ?????, ?????. ???????? ??????: ? 55-??????? ??????? ? ??????? ?????????? ???????? ????? ?? ?????? C3-C6 ????? ?????????? ?????? ?????? ?????????????? ? ???????????? ? ????????????? ??? ????????? C3-C6 ??? ????? ???????? ????????? ?????????? ???? ? ???????? ???????????, ? ?? ??? ???????????????? ? ???? ?????????? ? ????????????. ????? ??? ?????? ????? ??????????? ? ???????? ???????? ????????? ??????????? (T40.0C), ??? ???? ??? ?????? ????? ?????, ? ??? ???????? ??????????? ???? ????????? ???????????. ????? ????????? ???? ????? ?????????? ???????? ? ???????? ?????????. ???? ????????? ???????????? ??????? ????????????, ??????? ??????? ??????? ??????????? ??????????????, ?????????? ???????????? ? ?????????????? ??????? ???????, ??? ???????? ????????? ??????? ?????? ???????-????????? ??????????? ?????????? (??????? ???????? ??????-?????). ?????? ???????????????? (???) ???????? ?????????? ?????????? ?????????? ?? ???? ?????? ???????????. ???? ????????? ?????????? ?????????? ??????? (??), ??????? ??????? ???????????? ??????? ??????????????????????? ??????????? ?????????????? ????????. ??? ?????????????? ???, ?? ????????? ? ???????? ??? ???? ???????????, ???????????? ?????????? ? ?? ????????? ?? ????????????? ?????????? ??????, ??????? ??? ??????? ?, ? ?????????, ????????. ??? ?? ?????, ???? ?????? ?????? ??????? ??? ???????????, ??? ? ???. ???? ???????? ???????????? ????????? ?? ???? ???????????, ?? ???????????? ???????? ????????? ?????? ?????? ??????????? ???????????. ?????? ??????? ????????? ?? ????????? ?? ? ??? ??????? ????? ??? ?????? ? ???????? ??????????? ??????????. ??????????: ?????????? ??????????????? ?????? ????????? ??????????????? ?????? ?????????????????????? ? ???????????? ???????? ? ????????????. ??? ?????????????, ??? ? ???? ????????? ? ????????? ????????? ??????? GBS ????? ???? ????? ????????. ????? ???????? ????????? ??????? ? ????????????? ???????????? ???????????????? ????????????? ??? ???????????? ??????? ??? ????? ?????????? ?????????????? ???? ???????? ? ??????? ???? ?????????. 

???????????: ?????????????? ?????????? ????? ?? ??? ???????? ?????? ???????? ??? ???????????????? ????. ????????????? ???????????????? ???? ????? ??????????? ? ????????? ? ??????????? ????????. ???????-??????? ???????????? ?????????? (????) — ??? ?????????? ?????????? ????????????, ??????? ????? ?????????? ?????? ???????????? ??????. ????? ?????? ?????? ???????? ????????????? ??????? ?????? ??????? ?????????????? ? ????? ????????? ? ???????????? ???? ????? ? ??????? ???????-??????? ???????????? ?????????? (????).

???????? ??????: 28-?????? ?????????? ?????????? ? ????????????????? ??????? PNU. ??? ???? ? ??????? ?????????? ?????, ?? ????????? ?????????, ???????? ?? ????. ????????????? ?????? ?????? ??????? ???? ???????????????? ????? ? ??????? ????? ? 35 ? ? 36. ?????????????, ????????????? ? ??????? ?????????, ??? ?????????? ????? ? ?????. ??? ???????? ?????????, ?????? ???????????????? ?????????? ??????????, ?????? ????????? ?? ????? ????, ?? ?????? ???????? ? ??????????. ? ?????????? ??????????????? ?????????? ????? ? ???? ??????? ?????????? ????????? ???????????. ????????? ???????? ??????? ???????? ??????? ? ???????? ????????.

??????????: ???????? ??????? ????????????????? ???? ???? ????????? ????? ??????????????????? ??????? ? ?????????????? ????, ????? ?????????? ?????????? ??????? ??????? ???, ????????????? ??????????? ???? ? ????????? ?? ????????? ??????????? ?? ???????? ????. ???????? ???? ????????? ?????????, ?? ????????? ????????????? ?????????. ???????? ????????????? ????????? ????, ?? ??????????? ???? ??? ???????????? ????? ? ?????? ??????????? ???????? ?????. ???????? ??????????? ??? ??????? ??????????. ??????? ????????? ??? ??????????? ????? ????????, ??????? ?????????? ?? ???? ????????????????.

??????????: ? ????????????? ???????? ?????????? ??????? ??????????????? ????. ???? ????? ?????????? ??????????? ????????????? ???????????????? ???? ? ???????? ????????? ?????????? ???? ??????? ??? ??????????.

????????? ?????????????? ???????????????? ????????? ???????? ?????? (SCNCB) ??????????? ????? ? ?????????, ??? ??? ?? ?????????? ??????????? ???????. ?????????????? ????????? ???????? ???????? ?????????????? ???????????????? ????????? (SCNC) ? ????? ??????????? ? ??????. ?????? ???????? ?????????????? ????????? ? ???????? ?????? ?? ?????????????? ????????? ? ??????. ??????? ?????????? ???????????? ????? ????, ????? ????????? ????????? ?? ??????????? ?????????????? ????????? (EPSCC). ? ???? ?????? ??????????? ??? ???????? ? SCNCB ? ?????????? ????? ??????????????? ?????????? ??? ????????????? ?????????? ??????????? ? ??????? ????? ??????????? ? ???? ???? ???????. 

Dissecting esophagitis is a rare and benign form of chronic esophagitis, of diverse etiology, characterized by a typically whitish mucosa, with or without bleeding and presence of vertical circumferential fissures and cracks at endoscopy. Next, list a case of a young adult individual, who had a diagnosis of EDS with endoscopic diagnosis of EDS with probable cause of infection associated with loss of sub mucosal vascular component. After the diagnosis was made, therapeutic intervention was effectively possible. 

Sneddon’s Syndrome (SS) is a rare condition characterized by a non-inflammatory thrombotic vasculopathy, which involves small and medium vassels. Cerebrovascular disease and livedo racemosa are the main clinical manifestations of this syndrome. The incidence of SS has been estimated of 4 cases per 1 million/year in general population with a high prevalence in young women between 20-40 years of age. Three forms of the syndrome have been described: idiopathic, without a clear causative factor, related to primary Antiphospholipid Syndrome and related to Systemic Lupus Erythematosus (SLE) with or without anti-phospholipid antibodies. To date, there are very few indications for diagnosis and treatment. Skin biopsy and brain MRI are considered fundamental in the diagnostic process; however histologic samples could be negative or non-specific. Current treatment is based on oral anticoagulation and, in autoimmune-related SS, on immunosuppressant drugs, such as corticosteroids, cyclophosphamide, azathioprine, with unclear results. No data about the use of anti-CD20 monoclonal antibodies (Rituximab) in autoimmune-related SS are available so far. We report here, for the first time, the case of a 40 years old woman with SLErelated SS with anti-phospholipid antibodies, successfully treated with Rituximab.