mediastinal shift

BACKGROUND: Open fetal resection for large lung lesions has virtually been replaced by maternal steroid administration. Despite this paradigm shift, little is known about the effects steroids have on lung lesion growth in utero. METHODS: A 10-year retrospective review of all prenatally diagnosed lung lesions cared for at our fetal care center was performed. We evaluated the effects of prenatal steroids on congenital pulmonary airway malformation (CPAM)-volume-ratio (CVR), distinguishing change in CVR among CPAMs, bronchopulmonary sequestrations (BPS), and bronchial atresias...

Lymphoid cancers are among the most frequent cancers diagnosed in adolescents and young adults (AYA), ranging from approximately 30%-35% of cancer diagnoses in adolescent patients (age 10-19) to approximately 10% in patients aged 30-39 years. Moreover, the specific distribution of lymphoid cancer types varies by age with substantial shifts in the subtype distributions between pediatric, AYA, adult, and older adult patients. Currently, biology studies specific to AYA lymphomas are rare and therefore insight into age-related pathogenesis is incomplete...

Minimally invasive surgery is increasingly indicated in the management of malignant disease. Although oesophagectomy is a difficult operation, with a long learning curve, there is actually a shift towards the laparoscopic/thoracoscopic/ robotic approach, due to the advantages of visualization, surgeon comfort (robotic surgery) and the possibility of the whole team to see the operation as well as and the operating surgeon. Although currently there are still many controversial topics, about the surgical treatment of patients with gastro-oesophageal junction (GOJ) adenocarcinoma, such as the type of open or minimally invasive surgical approach, the type of oesophago-gastric resection, the type of lymph node dissection and others, the minimally invasive approach has proven to be a way to reduce postoperative complications of resection, especially by decreasing pulmonary complications...

Platypnoea-orthodeoxia syndrome is characterised by dyspnoea and oxygen desaturation in the upright position usually caused by an extracardiac shunt and less often due to dynamic factors that accentuate an intracardiac right-to-left shunt. In our patient, the collapse of lower lobe of left lung secondary to bronchial stenosis due to endobronchial tuberculosis and resultant mediastinal shift was the factor that led to an otherwise unrecognised intracardiac right-to-left shunt leading to platypnoea-orthodeoxia...

BACKGROUND: Diaphragmatic hernia (DH) is extremely rarely described during pregnancy. Due to the rarity, there is no diagnostic or treatment algorithm for DH in pregnancy. AIM: To summarize and define the most appropriate diagnostic methods and therapeutic options for DH in pregnancy based on scarce literature. METHODS: Literature search of English-, German-, Spanish-, and Italian-language articles were performed using PubMed (1946-2021), PubMed Central (1900-2021), and Google Scholar...

Background  The so-called nonintubated or awake video-assisted thoracoscopic surgery (NIVATS) is performed on spontaneously breathing patients, which was shown to reduce postoperative complications and shorten hospital stay. Case Description  Awake uniportal VATS was indicated for the evacuation of an extensive, superinfected hemothorax with symptomatic mediastinal shift in a patient with advanced mediastinal SMARCA4-deficient tumor and declined condition, who did not allow a general anesthetic procedure and was not a candidate for extensive surgery...

The emergence of immune checkpoint inhibitors (ICIs) has led to a dramatic paradigm shift within the landscape of cancer treatment, igniting significant interest in their potential application in treating hematologic malignancies. This comprehensive review critically has examined the existing body of literature to shed light on the evolving understanding of the efficacy and safety of ICIs, both as a single agent and in combination regimens in hematologic malignancies. Across distinct lymphoma subtypes, the observed treatment responses exhibit diversity, and conflicts...

Background Chest X-rays (CXRs) are widely used for cost-effective screening of active pulmonary tuberculosis despite their limitations in sensitivity and specificity when interpreted by clinicians or radiologists. To address this issue, computer-aided detection (CAD) algorithms, particularly deep learning architectures based on convolution, have been developed to automate the analysis of radiography imaging. Deep learning algorithms have shown promise in accurately classifying lung abnormalities using chest X-ray images...

INTRODUCTION: Congenital lung malformations (CLMs) are readily identified early in pregnancy with a variable natural history. Monitoring for lesion size and mediastinal shift (MS) is recommended following diagnosis. The purpose of this study is to propose a risk-stratified clinical algorithm for prenatal monitoring of CLM. METHODS: After ethical approval, all fetuses with CLMs evaluated at our fetal center from January 2015 to June 2022 were retrospectively reviewed...

PURPOSE/OBJECTIVE(S): Palliative radiation therapy (RT) can be a necessary element of treatment for hospitalized cancer patients who may be critically ill. We have implemented patient-free simulation machine starts using existing diagnostic imaging for treatment planning, eliminating the need for simulation. We hypothesize machine starts reduce time in the department without detriment to clinical outcomes. MATERIALS/METHODS: An IRB-approved database of patients receiving RT was queried for hospitalized patients treated with a machine start...

BACKGROUND: Systematic lymph node dissection in patients with gastric cancer could be sufficiently and reproducibly achieved along the outermost layer of the autonomic nerves and similar concept has been extensively used for robotic esophagectomy (RE) since 2018. This study aimed to determine the surgical and oncological safety of RE using the outermost layer-oriented approach for esophageal cancer (EC). METHODS: Sixty-six patients who underwent RE with total mediastinal lymphadenectomy for primary EC between April 2018 and December 2021 were retrospectively reviewed...

Superior vena cava syndrome (SVCS) is an obstruction of the venous return through the superior vena cava (SVC) or any other significant branches. The obstruction may be external, like thoracic mass compressing the SVC, or internal, like thrombosis or tumor, which directly invades the SVC. Patients experiencing a medical emergency after being initially stabilized require treatment for SVCS, including endovenous recanalization and the implantation of an SVC stent to reduce the risk of abrupt respiratory arrest and death...

Anterior mediastinal masses can be difficult to characterise on computed tomography (CT) due to the wide spectrum of normal appearances of thymic tissue as well as the challenge of differentiating between benign and malignant pathologies. Additionally, attenuation of cystic mediastinal lesions can be misinterpreted on CT due to varying attenuation values. Anecdotally, non-vascular magnetic resonance imaging (MRI) of the thorax is underutilised across radiology departments in the UK, but has been shown to improve diagnostic certainty and reduce unnecessary surgical intervention...

Multiple myeloma (MM) is a relatively common malignancy that primarily affects the bone marrow, while extramedullary disease (EMD) occurs in the skin and muscle, lung pleura, lymph nodes, liver, and CNS. Myelomatous pleural effusion (MPE) is a rare extramedullary manifestation of MM in which pleural fluid is composed almost entirely of abnormal plasma cells. MPE and other types of EMD are associated with poor prognosis, and MPE can present emergently due to tension physiology. We report a case of a patient with massive MPE presenting with contralateral midline shift...

Few reports of laser coagulation for foetal bronchopulmonary sequestration (BPS), a rare congenital malformation characterised by the absence of tracheobronchial connection and the presence of a systemic feeding artery, have been published. Additionally, very few of them focus also on the postnatal management, with results limited and controversial. Postnatal treatment of residual malformation remains debated, hence the need to share our experience of a combined pre- and postnatal approach to complicated extra-lobar BPS...

OBJECTIVES: To develop a mediastinal shift angle (MSA) measurement method applicable to right-sided congenital diaphragmatic hernia (RCDH) in fetal MRI and to validate the predictive value of MSA in RCDH. METHODS: Twenty-seven fetuses with isolated RCDH and 53 controls were included in our study. MSA was measured on MRI axial image at the level of four-chamber view of the fetal heart. The angle between the sagittal midline landmark line and the left boundary landmark line touching tangentially the lateral wall of the left ventricle was used to quantify MSA for RCDH...

Pulmonary agenesis is an uncommon congenital abnormality of the lungs that occurs either in isolation or in association with other anomalies in several organ systems. Right sided pulmonary agenesis is reported to have a worse prognosis owing to the more severe mediastinal shift and resultant compression of mediastinal structures. We present a case of right-side pulmonary agenesis with multiple associated anomalies found incidentally in a 19-year-old female patient.

Feline lymphoma is currently less commonly associated with retrovirus infections as the feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV). This is thought to have caused a shift in the distribution of anatomical subtypes and eventually have led to poorer treatment outcomes. The aim of this study was to evaluate whether this change was also notable in the Netherlands, a country historically known for its low prevalence of FeLV and FIV, and to determine its consequences on treatment response...

A few cases of primary liposarcoma of pleura have been reported worldwide. We report a young gentleman who was admitted with what was initially thought as coronavirus disease 2019 (COVID-19)-related pulmonary symptoms. His chest CT showed a large pleural effusion causing a mediastinal shift and compressing vital structures. He did not respond to conservative drainage intervention and subsequently underwent a left thoracotomy for his worsening clinical picture. He was found to have a large left pleural mass that was incompletely resected...

Mediastinal germ cell tumors (GCTs) are rare and aggressive cancers originating from the germ cells in the mediastinum. Early detection and treatment are vital due to their high potential for metastasis and recurrence. We present a case of a 28-year-old man who exhibited a cough and shortness of breath. Laboratory tests revealed elevated tumor markers, alpha-fetoprotein, and beta-human chorionic gonadotropin. Imaging studies displayed a large mediastinal mass, causing the right displacement of the mediastinum and cardiac tamponade...