Clinical suspicion for Pott's disease should be high for any patient who presents with a destructive lesion
of the spine.
CT of the temporal bones revealed a destructive lesion
of the fight petrous apex, and MRI showed a 3.8 x 3.0 x 2.8-cm heterogenously enhancing mass of the right petrous apex.
The pathophysiology of cocaine-induced midline destructive lesions
is multifactorial and includes local ischemia secondary to vasoconstriction, chemical irritation from adulterants put in "cut" cocaine, and infection secondary to trauma, impaired mucociliary transport, and decreased humoral and cell-mediated immunity.
Interestingly, we showed that early successful eradication of bone marrow metastatic lesion by the systemic treatment precluded the development of destructive metastatic bone lesion as 24% of the observed BM lesions in our patients had disappeared without causing bone destructive lesions
Emphysema is defined by chronic abnormal inflammatory cell response resulting in destruction of small airway and alveolar walls, with coalescent destructive lesions
producing larger cavities resulting in bullous disease.(1) This alveolar destruction results in lung parenchymal distortion, making superimposed processes, particularly pulmonary edema, difficult to accurately identify.
(4,6) Gums are locally destructive lesions
in the skin, liver, bones, and other organs.
(10), three serologic profiles have been described in levamisole-induced vasculitis: no circulating autoantibodies in those with organ-limited disease, positive MPO and PR3 antibodies in patients with necrotizing systemic vasculitis, or positive cANCA and PR3 antibodies in cocaine-induced midline destructive lesions
. Other autoantibodies are commonly detected, such as antinuclear, anti-dsDNA, anticardiolipin, and antihuman neutrophil elastase antibodies, as well as lupus anticoagulant (6,8,10,15,17).
In SAPHO syndrome, destructive lesions
progress associated with marginal sclerosis explaining why destructive spondylodiscitis progresses slowly.
There were no bony erosions or destructive lesions
and joint spaces were normal.
Radiologic features vary from undefined destructive lesions
to a well-defined, multilocular appearance.
Previous reports showed also that cocaine by itself can be associated with an ANCA positive vasculitis and pseudovasculitis with special specificity for human neutrophil elastase (HNE-ANCA) in cocaine-induced midline destructive lesions
, as well as anticardiolipin antibody production [16-18].
Knowledge of the clinical and histological behavior of the odontogenic cyst is needed to ensure early detection and prompt treatment of these noncancerous but potentially destructive lesions