... be an admixture of cells with more lipid-rich, vacuolated cytoplasm. Some nodules contain abundant lipid-rich cells that may show some “ballooning.” Nuclear hyperchromasia and pleomorphism are uncommon, although occasionally cells are binucleated or multinucleated, or have enlarged hyperchromatic nuclei...

... excludes lesions found during the workup for staging of known cancers ( 1 ). With current imaging technology, the prevalence of incidentalomas is estimated at approximately 4 percent. In a compilation of 25 autopsy studies it was 6 percent ( 1 ). Adrenal incidentalomas are uncommon below age 30...

... and round to oval, with one or two small, central to eccentric nucleoli ( fig. 2-16 ); occasionally, there is some nuclear enlargement. Mitotic figures are uncommon. Adjacent testicular parenchyma may appear almost normal or atrophic, with sclerosis and decreased spermatogenesis. There is a great...

.... Another pattern is diffuse or solid, which may be focal or predominant, and is typically associated with loss of the reticulin framework. A pseudopapillary arrangement of cells is an uncommon architectural pattern and may be artifactual due to inappropriate fixation. A storiform pattern is typical...

...–Schiff (PAS) positive and diastase resistant. Although reported in the majority of adrenal glands from adults, they may be difficult to find on casual inspection ( fig. 1-40 ). There appears to be no correlation with sex, race, or age, but in the authors’ experience, they are uncommon in the pediatric...

... distinctions, such as the presence of amyloid in medullary carcinoma or naked nuclei in paraganglioma, aid in distinguishing these entities ( 89 , 136 ), the first step is to be mindful of the possibility of paraganglioma in uncommon locations. REFERENCES REFERENCES 1. Kohn   A . Die paraganglien...

.... There is a marked male predilection and the majority of infected individuals are in their third to fifth decades. Eumycetoma is uncommon in children ( 24 , 30 ). Clinical Features Presentation is initially as a painless papule. This undergoes progressive enlargement, eventually evolving into a discharging nodule...

... as sleeping sickness (“maladie du sommeil”), is a now uncommon insect-borne infection caused by the flagellate protozoan Trypanosoma brucei (African or Old World trypanosome). Human infection is endemic to tropical Africa where this parasite’s insect vector, Glossina spp (the tsetse...

... of cases), and gastrointestinal (1 percent of cases). More recently, injectional anthrax has also been documented in intravenous (IV) drug users, but is uncommon. Cutaneous anthrax in humans occurs primarily in rural communities of Africa, Asia, Eastern Europe, the Middle East, and Central/South...

... after exposure Complications include sepsis and meningoencephalitis Other Hepatitis, biliary tract infection, peritonitis, and osteomyelitis Peripheral blood count typically reveals leukocytosis, with a predominance of neutrophils, and lymphopenia (in adult cases). Monocytosis is uncommon...

... other Francisella spp, F. hispaniensis and F. philomiragia, are also potential human pathogens but are extremely uncommon. The bacterium was first isolated in 1911 in Tulare county (hence the species name), California, from ground squirrels, and 3 years later, from humans ( 9...

.... tropica. Diffuse cutaneous disease presents as multiple papules, nodules, and extensive confluent plaques, which frequently develop on the face and limbs but can spread over the whole body. This form of skin disease is uncommon, more often seen in immunocompromised patients, and particularly...

... since the treatment is high-dose steroids, which reduces the T-cell inflammation in the CNS. Vacuolar Myelopathy of the Spinal Cord. This is a late process in HIV disease, uncommon now, presenting with leg weakness, spastic paraparesis, sensory ataxia, and incontinence. Histopathologically...

... associated with the intermittent relapse of acute symptoms. Ameboma (or amebic pseudotumor formation) is an uncommon complication that occurs in less than 5 percent of infected individuals. This is an inflammatory and often fibrotic colonic mass, which may be associated with stenosis...

... as reticuloendothelial cell and lymphoid hyperplasia. Rapid and pronounced splenic enlargement may be complicated by splenic rupture, particularly in acute primary disease. Chronic malaria leads to splenic fibrosis and perisplenitis. The uncommon tropical splenomegaly syndrome is associated with splenic...

..., thus enabling the fungal organisms to proliferate and infect tissues. Person-to-person transmission and nosocomial infection also occur, but are uncommon ( 4 ). Risk factors for infection include the extremities of age (which are associated with an immature or pathophysiologically senescent immune...

... Associations Epidemiology Clostridioides difficile Antibiotic-associated/pseudomembranous colitis Common Nosocomial setting and elderly individuals Clostridium perfringens Myonecrosis/gas gangrene Food poisoning Bacteremia Necrotizing enterocolitis (“pigbel”) Uncommon Worldwide...

... Skin and soft tissue bacterial infections that extend to multiple layers, are necrotizing, rapidly progressive, produce major toxic manifestations, and are uncommon when compared to the superficial and confined group of infections ( 2 ). It is the local environment that determines the conditions...

..., and penile mucosal involvement also occur ( 91 ). Disseminated disease is uncommon ( 92 ). Epidemiology Although the organism has a worldwide distribution, most cases have been reported from tropical and subtropical regions, especially India, Sri Lanka, Pakistan, and South America ( 91 - 93 ). Infection...