Case Number : Case 502 Posted By: Guest

[b]Richard Carr - Camponile Hotel (Malaga) Wrote:[/b]

Well congratulations to Sharmila then Mona for the correct diagnosis of "allergic granulomatosus nodules of the eyelid and conjuctiva" Ashton N, Cook C. Am J Ophthalmol. 1979 Jan;87(1):1-28. The described 22 cases. I quote from their abstract. "All cases showed the histologic features of the Splendore-Hoeppli phenomenon, that is, a giant cell and eosinophil granulomatous reaction to an antigen-antibody precipitate originally described in relation to parasites or fungi. In four of seven typical cases selected for detailed description unidentified nematodes were found to be the cause of the condition." In this case I must credit Dr David Snead for making the diagnosis. I had considered a limited form of Churg Strauss. This particular case does not appear to be related to nematode worms but related to the allergic status, IgE and RAST positive for grass pollens and cat dander. It is certainly a dramatic histology!! The lesions responded to predsol eye drops. Najla I will post a comment in yesterday's case in answer to your question. Regards to all

[size=2]Submitted on 12/05/2012 01:41[/size] [b]Najla - () Wrote:[/b]

May I ask a question please about yesterday's case. What about a predominantly exophytic tumour with typical morphological and immunohistochemical findings of AFX but with superficial, infiltrative (not just pushing)extension into subcutis? Do you still call it AFX or go further to diagnose undifferentiated pleomorphic sarcoma? Any highlights please.

[size=2]Submitted on 11/05/2012 21:01[/size] [b]Mario Fernando Dueñas A. - Oficina de Patología Doctor Mario Fernando Dueñas A. (Pasto. Nariño. Colombia. South America) Wrote:[/b]

It may be Basidiobolomycosis of the nose and face. This entity should be kept in mind in indolent infections of the nose and facial soft tissues.

[size=2]Submitted on 11/05/2012 19:11[/size] [b]Azza Mostafa - (Egypt) Wrote:[/b]

probably not fungus. more now with parasites could be loa loa, gnathostomiasis?? serology - blood smears?

[size=2]Submitted on 11/05/2012 18:41[/size] [b]Marie MD - () Wrote:[/b]

how about Mucocutaneous entomophthoramycosis (rhinoento-mophthoramycosis)?

[size=2]Submitted on 11/05/2012 18:31[/size] [b]Mona Abdel Halim - () Wrote:[/b]

Wao, that turned out to be very interesting, agree with allergic granulomatosis of the conjunctiva, mostly induced by trematodes,,,,

[size=2]Submitted on 11/05/2012 16:35[/size] [b]Sharmila Madhogaria - UHCW (UK) Wrote:[/b]

Addendum: ? Schistosoma, Philophthalmus, Loa loa, other parasites

[size=2]Submitted on 11/05/2012 16:21[/size] [b]Sharmila Madhogaria - UHCW (UK) Wrote:[/b]

Splendore-Hoeppli. ?Allergic conjunctival granuloma, ?Orbital pythiosis

[size=2]Submitted on 11/05/2012 15:48[/size] [b]Azza Mostafa - (Egypt) Wrote:[/b]

Splendore-Hoepli surounding?? fungal like red grain actinomycetoma caused by actinomadura pelletieri or red grain of eumycetoma caued by petriellium boydii but far clinically? If it is Rhinosporidiosis for the clinical polyps should we find sporangia? anyway for Grocott & PAS & Gram?

[size=2]Submitted on 11/05/2012 15:45[/size] [b]Richard Carr - Warwick (UK) Wrote:[/b]

Yes this is a fantastic example of Splendore-Hoepli but we need to do some research to find a clinicopathological best fit. I will leave this one hanging until someone comes up with a good suggestion!!

[size=2]Submitted on 11/05/2012 15:23[/size] [b]Engin Sezer - (Istanbul) Wrote:[/b]

Flame figures as a component of hypereosinophilic syndrome?

[size=2]Submitted on 11/05/2012 15:15[/size] [b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

?Splendore-Hoeppli phenomenon.

[size=2]Submitted on 11/05/2012 14:58[/size] [b]Richard Carr - Warwick (UK) Wrote:[/b]

Try something else - it is a rare clinicopathological case.

[size=2]Submitted on 11/05/2012 14:10[/size] [b]Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:[/b]

agree with all... Churg Strauss disease

[size=2]Submitted on 11/05/2012 13:34[/size] [b]Yüksel Okumuş - Bursa State Hospital (Turkey) Wrote:[/b]

Agree with CSD

[size=2]Submitted on 11/05/2012 13:05[/size] [b]Mona Abdel Halim - () Wrote:[/b]

Churg Strauss disease,,, lovely images

[size=2]Submitted on 11/05/2012 12:38[/size] [b]A Bansal - BCU HB (North Wales) Wrote:[/b]

Discrete necrotising granulomas with numerous eosinophils suggestive of Churg-Strauss syndrome.

[size=2]Submitted on 11/05/2012 11:08[/size] [b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

Churg–Strauss syndrome.

[size=2]Submitted on 11/05/2012 10:50[/size]