Oxford Medical Case Reports最新文献

{"title":"Pancreatic Pseudocyst-portal vein fistula with portal thrombosis and biliary obstruction: a rare complication of necrotising pancreatitis.","authors":"Sumanth Srinivasa Shetty, Dhanushan Gnanendran, Lavinia Onos, Rajashekar Gali","doi":"10.1093/omcr/omaf211","DOIUrl":"https://doi.org/10.1093/omcr/omaf211","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic pseudocyst fistulation into the portal venous system is rare. This may cause portal-vein thrombosis, portal hypertension, and biliary obstruction, complicating diagnosis and treatment.</p><p><strong>Case: </strong>A 45-year-old man with alcohol-induced necrotizing pancreatitis developed jaundice, pain, and abnormal liver tests. Imaging revealed a 6-cm pancreatic head pseudocyst connected to the portal confluence and thrombosed portal and splenic veins. CT showed cavernous transformation and bile duct compression. Pancreatic pseudocyst-portal vein fistula (PPVF) with portal hypertension-related biliary obstruction was diagnosed. The bile duct stricture was stented endoscopically; anticoagulation was withheld due to variceal risk. Symptoms and labs normalized within a week. At 3 months, the pseudocyst regressed, and the bile duct remained patent.</p><p><strong>Conclusion: </strong>PPVF should be considered when portal-vein thrombosis and pancreatic pseudocyst coexist. Characteristic imaging can often obviate invasive confirmation. Early multidisciplinary management, prioritizing endoscopic or percutaneous drainage and selective anticoagulation, allows for safe, effective treatment while avoiding high-risk surgery.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omaf211"},"PeriodicalIF":0.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbidopa/levodopa induced severe vitamin B6 deficiency leading to symptomatic transfusion dependent microcytic Anemia.","authors":"Byung K Lee, Jaime P Gastwirt","doi":"10.1093/omcr/omaf191","DOIUrl":"https://doi.org/10.1093/omcr/omaf191","url":null,"abstract":"<p><p>Parkinson's Disease is on the rise over the coming decades with expectations that more patients will be prescribed levodopa therapy. This case presents a patient with Parkinson's Disease who presented with severe symptomatic microcytic anemia. He was transfusion dependent during his extensive work up that occurred during both inpatient hospitalization and outpatient hematology visits. This was negative for iron deficiency, infectious etiology, hemolysis, active bleeding, bone marrow failure, myelodysplasia or hematologic malignancy. However, patient was found to have a critically low vitamin B6 level. Following initiation of vitamin B6 supplementation, patient's anemia resolved and was no longer transfusion dependent.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omaf191"},"PeriodicalIF":0.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nontranslocation follicular lymphoma mimicking infectious mononucleosis: a diagnostic challenge in a 39-year-old male.","authors":"Elinor Barsh, Jacob Keeling, Changlee S Pang, Ross Sattler, Kavanya Feustel, Alexander Enurah","doi":"10.1093/omcr/omag048","DOIUrl":"https://doi.org/10.1093/omcr/omag048","url":null,"abstract":"<p><p>Follicular lymphoma is an indolent B-cell non-Hodgkin lymphoma typically characterized by the t(14;18)(q32;q21) translocation resulting in B-cell lymphoma 2 (BCL2)/immunoglobulin heavy chain (IGH) fusion. Nontranslocation variants are rare and may present with atypical clinical features that complicate diagnosis. The patient's presentation initially resembled infectious mononucleosis due to a false-positive monospot test; however, subsequent workup revealed follicular lymphoma lacking the canonical BCL2/IGH translocation. Extensive infectious, autoimmune, and nutritional evaluation was unrevealing. Cervical lymph node biopsy demonstrated follicular lymphoma with uniform BCL2 expression but no detectable BCL2/IGH fusion by Fluorescence in Situ Hybridization (FISH), confirming nontranslocation follicular lymphoma. The patient achieved complete remission after six cycles of obinutuzumab, cyclophosphamide, vincristine, and prednisone. This case illustrates a rare presentation of nontranslocation follicular lymphoma mimicking infectious mononucleosis and emphasizes the importance of reconsidering hematologic malignancy in patients with persistent mucocutaneous inflammation and incongruent laboratory findings.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag048"},"PeriodicalIF":0.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed presentation of IgA nephropathy and malignant hypertension with histological thrombotic Microangiopathy.","authors":"Michael Isaacs, Uzzal K Talukdar, Krishna Gokula, Clyson Mutatiri","doi":"10.1093/omcr/omag047","DOIUrl":"https://doi.org/10.1093/omcr/omag047","url":null,"abstract":"<p><p>IgA Nephropathy (IgAN) is one of the most common causes of glomerulonephritis. Biopsy is necessary for definitive diagnosis, though due to variability in severity and progression patients may forego biopsy initially. However, certain clinical presentations and histopathological findings may be significant predictors of poor prognosis. We describe a case of IgAN initially presenting as malignant hypertension. Retrospective chart review suggested previous hospital encounters with features of IgAN, before loss to follow up. Subsequent biopsy evidence of co-occurrent IgA deposition and thrombotic microangiopathy were identified. The occurrence of severe hypertension and the aforementioned biopsy findings in IgAN are rare, and strong predictors of rapid progression to end-stage kidney disease. We briefly review the literature supporting this prognosis.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag047"},"PeriodicalIF":0.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Polyarticular gout mimicking sepsis after acute kidney injury: a case report.","authors":"Leon Schönfeld, Marko Stuhr, Lars Klinkert, Gritt Braunegger, Birte Diekmeyer, Bastian Schön, Nihal Wilde","doi":"10.1093/omcr/omag046","DOIUrl":"https://doi.org/10.1093/omcr/omag046","url":null,"abstract":"<p><strong>Background: </strong>Severe gout flares may rarely present as systemic inflammatory syndromes, closely mimicking sepsis. Milk-of-urate bullae are an uncommon manifestation of extensive crystal burden and are typically described in chronic tophaceous gout. The combination of polyarticular involvement, extreme inflammatory markers, acute kidney injury (AKI), and bullous lesions represents a diagnostic challenge.</p><p><strong>Case presentation: </strong>A 69-year-old man presented with generalized weakness and incapacitating migratory joint pain after lying on the floor for three days. Laboratory evaluation revealed acute prerenal kidney injury and a fulminant inflammatory response (CRP 47.7 mg/dl, leukocytes 16.8 × 10³/μl, procalcitonin 4.05 ng/ml), prompting a sepsis work-up and empiric broad-spectrum antibiotics. No infectious focus was identified. 18F-FDG PET-CT demonstrated intense tracer uptake in multiple finger and toe joints, particularly in both first metatarsophalangeal joints. Over subsequent days, the patient developed erythema, swelling, and painful limitation of these joints, followed by bullous skin lesions containing milky fluid. Serum uric acid was elevated at 9.61 mg/dl. Polyarticular gout was diagnosed. After partial renal recovery, anti-inflammatory therapy with naproxen and colchicine was initiated, resulting in rapid clinical improvement and spontaneous ulceration of the urate bullae. Inflammatory markers normalized. Urate-lowering therapy with allopurinol was started prior to discharge.</p><p><strong>Conclusion: </strong>This case illustrates how severe polyarticular gout can mimic fulminant sepsis with extreme inflammatory markers and FDG-PET hypermetabolism. Acute kidney injury acted as a trigger for catastrophic crystal inflammation. Milk-of-urate bullae reflected extensive systemic urate burden. Recognition of this pattern is essential to avoid diagnostic delay and unnecessary antimicrobial therapy.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag046"},"PeriodicalIF":0.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pulmonary Edema following Myometrial pituitrin injection during laparoscopic myomectomy.","authors":"Zhao Wang, Shan Song, Jing Zhang","doi":"10.1093/omcr/omag038","DOIUrl":"https://doi.org/10.1093/omcr/omag038","url":null,"abstract":"","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag038"},"PeriodicalIF":0.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign mixed epithelial ovarian tumor with mucinous, serous, and transitional components: a rare case report.","authors":"Banan Muhsen Ali, Loui Hasan, Ali Daoud, Moatasem Ali Hussein Al-Janabi","doi":"10.1093/omcr/omag040","DOIUrl":"https://doi.org/10.1093/omcr/omag040","url":null,"abstract":"<p><p>Benign epithelial ovarian tumors are among the most common ovarian neoplasms, with mucinous, serous, and transitional types representing major subgroups. However, the coexistence of multiple epithelial components within a single ovarian lesion is exceedingly rare. We report the case of a multiparous woman presenting with progressive abdominal distension caused by a large ovarian cyst. Imaging revealed a giant, well-circumscribed cystic mass, which was surgically excised. Histopathological evaluation demonstrated a predominantly mucinous cystadenoma with foci of serous and transitional (Brenner-like) epithelial differentiation, without borderline or malignant features. This case represents a rare example of a benign mixed epithelial ovarian tumor and highlights the importance of thorough histopathological examination to avoid misdiagnosis and to better understand mixed Müllerian epithelial differentiation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag040"},"PeriodicalIF":0.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavitating mesenteric lymph node syndrome: a rare complication of celiac disease-case report and literature review.","authors":"Taha Yassine Aaboudech, Sabrine Derqaoui, Siham Mesmoudi, Manal Cherkaoui, Ahmed Jahid, Ikram Errabih, Zakia Bernoussi, Kaoutar Znati","doi":"10.1093/omcr/omag041","DOIUrl":"https://doi.org/10.1093/omcr/omag041","url":null,"abstract":"<p><strong>Background: </strong>Cavitating Mesenteric Lymph Node Syndrome (CMLNS) is an uncommon complication of celiac disease, characterized by cystic mesenteric lymph nodes and high morbidity.</p><p><strong>Case presentation: </strong>A 46-year-old male with chronic diarrhea, vomiting, and weight loss had hypoalbuminemia and elevated anti-TTG IgA. Duodenal biopsy confirmed celiac disease (Marsh IIIb). CT showed pseudocystic mesenteric lymph nodes and splenic atrophy, initially suggesting malignancy. Laparoscopic excision revealed cavitated lymph nodes with liquefactive necrosis and an inflammatory rim, excluding lymphoma or infection. The patient received a gluten-free diet, nutritional support, and corticosteroids, achieving clinical improvement and stable imaging at six months.</p><p><strong>Conclusion: </strong>CMLNS should be considered in celiac patients with refractory symptoms and atypical imaging. Early recognition through clinical, radiological, and pathological assessment, combined with a gluten-free diet and supportive care, is crucial to improve outcomes.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag041"},"PeriodicalIF":0.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follicular lymphoma within an ovarian teratoma.","authors":"Franceska Tchapdeu, Neha Bhardwaj, Jay Dhanapal, John Willan","doi":"10.1093/omcr/omag010","DOIUrl":"https://doi.org/10.1093/omcr/omag010","url":null,"abstract":"<p><p>We report an unusual case of a 46 year old diagnosed with follicular lymphoma within an ovarian teratoma. She sought medical attention due to menorrhagia, but was otherwise well. Positron Emission Tomography (PET) scanning demonstrated stage III disease, and she was treated with combination chemotherapy to complete metabolic remission on her end of treatment PET scan.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag010"},"PeriodicalIF":0.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of delayed post-radiofrequency ablation biopsy in a pulmonary nodule metastatic from breast carcinoma: a case report.","authors":"Shima Behzad, Amirhossein Shahsavani Asl, Hamidreza Rouientan, Shahram Akhlaghpoor","doi":"10.1093/omcr/omag036","DOIUrl":"https://doi.org/10.1093/omcr/omag036","url":null,"abstract":"<p><p>Thermal ablation is an established treatment for pulmonary nodules, conventionally performed after histopathologic confirmation of malignancy. We report the case of a 66-year-old woman with a history of left breast invasive ductal carcinoma (Bloom-Richardson grade II, score 7) with a 3-cm primary tumor and 3/19 axillary lymph nodes involved (pT2N1), and HER2 amplification detected by fluorescence in situ hybridization, who presented with a right lower lobe pulmonary nodule suspicious for metastasis. In contrast to standard practice, the lesion was first ablated under CT guidance, after which a coaxial core biopsy was obtained from the ablation zone. Histopathological analysis confirmed metastatic breast carcinoma, with preserved tissue architecture and immunohistochemical integrity (HER2 immunohistochemistry was 2+, and CISH confirmed HER2 amplification), despite a 4-hour interval between ablation and biopsy. No immediate procedural complications were observed. This case underscores the feasibility and diagnostic adequacy of delayed post-ablation biopsy and suggests that diagnostic integrity can be maintained even several hours after ablation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 4","pages":"omag036"},"PeriodicalIF":0.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}