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mediastinal adenopathy

Hyejin Cheon, Hye Jung Kim, Sang-Woo Lee, Do-Hoon Kim, Chang-Hee Lee, Seung Hyun Cho, Kyung Min Shin, So Mi Lee, Gab Chul Kim, Won Hwa Kim
PURPOSE: To evaluate the prevalence of and factors associated with internal mammary node (IMN) adenopathy on MRI and PET/CT used for initial staging in patients with operable breast cancer. METHODS: A total of 1320 patients diagnosed with invasive breast carcinoma between January 2011 and December 2015 underwent MRI and PET/CT for initial staging. The patients were considered to have IMN adenopathy when MRI revealed IMNs with the longest diameter of 5 mm or greater and a standardized uptake value greater than that of the mediastinal blood pool/contralateral parasternal area on PET/CT...
October 17, 2016: Breast Cancer Research and Treatment
Qing-Hua Liu, Sixto Arias, Ko-Pen Wang
The invaluable role of transbronchial needle aspiration (TBNA) in the diagnosis and staging of mediastinal adenopathy and lung cancer has been well established. Different lymph nodes regional nomenclatures and maps had been described over the years. The international association for the study of lung cancer (IASLC) and Wang's maps complement each other benefiting patients with lung cancer. In this article we briefly reviewed the roles of IALSC, Wang's maps and ROSE in TBNA.
September 2016: Journal of Thoracic Disease
Andrej Spec, Christopher R Barrios, Usama Ahmad, Laurie A Proia
Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. To determine if elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is specific to histoplasmosis or a non-specific marker for disseminated fungal infection or sepsis in general, we retrospectively examined records of all patients diagnosed with an endemic fungal infection (EFI) at Rush University Medical Center from January of 1997 to October of 2012, and a cohort of septic patients with elevated liver enzymes...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Scott R Silva, Murat Surucu, Jennifer Steber, Matthew M Harkenrider, Mehee Choi
OBJECTIVE: Radiation treatment planning for locally advanced lung cancer can be technically challenging, as delivery of ≥60 Gy to large volumes with concurrent chemotherapy is often associated with significant risk of normal tissue toxicity. We clinically implemented a novel hybrid RapidArc technique in patients with lung cancer and compared these plans with 3-dimensional conformal radiotherapy and RapidArc-only plans. MATERIALS/METHODS: Hybrid RapidArc was used to treat 11 patients with locally advanced lung cancer having bulky mediastinal adenopathy...
September 28, 2016: Technology in Cancer Research & Treatment
Yousef R Shweihat, James Perry, Yasser Etman, Ala Gabi, Yousef Hattab, Mohammad Al-Ourani, Prasanna Santhanam, Thaddeus Bartter
INTRODUCTION: Endosonography has improved our ability to reach thoracic lymph nodes and to diagnose pathologic conditions with nodal involvement and has lowered the threshold for biopsy. To avoid unnecessary procedures, it is important to recognize benign adenopathy. Congestive heart failure (CHF) is both common and a common cause of adenopathy. OBJECTIVE: To study the association between CHF and adenopathy and to describe the typical presentation of congestive adenopathy...
September 10, 2016: Journal of Bronchology & Interventional Pulmonology
Shakti K Bal, Balamugesh Thangakunam, Aparna Irodi, Mayank Gupta, Devasahayam J Christopher
Pulmonary venoocclusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) form a sinister subgroup of pulmonary arterial hypertension where the predominant pathology lies in the pulmonary veins and capillaries, thus making the use of pulmonary vasodilators potentially dangerous in these patients. Radiologically, the presence of centrilobular nodules, interlobular septal thickening, and significant mediastinal adenopathy are useful in identifying this subgroup from patients with pulmonary arterial hypertension...
September 10, 2016: Journal of Bronchology & Interventional Pulmonology
M Tetart, V Trosini-Désert, A Fekkar, C Chenivesse
INTRODUCTION: We report a case of pneumonia associated with necrotic mediastinal lymph nodes in an immunocompetent patient. The case report illustrates the difficulties in making a diagnosis in necrotic mediastinal lymph nodes and discusses strategies to optimize sampling. OBSERVATION: A 21-year-old immunocompetent woman was admitted to hospital with dyspnea and fever occurring ten days after delivery. Physical examination, biological results and chest X-ray led to the diagnosis of right upper lobe pneumonia...
September 9, 2016: Revue des Maladies Respiratoires
Hiren J Mehta, Tan-Lucien Mohammed, Michael A Jantz
Lung cancer screening using low dose CT scan reduces lung cancer specific and overall mortality in high risk patients. A significant limitation of lung cancer screening is the false positive rates. The American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS)was designed to standardize reporting of low dose lung cancer screening scans and also to decrease the false positive rates without significantly compromising on the sensitivity. Implementing Lung-RADS can also improve cost effectiveness...
August 10, 2016: Chest
L Vatin, D Rivière, P Podeur, O Cathelinaud, J Legodec, I Okremchouk, J B Morvan
OBJECTIVE: To present a case of thyroid sarcoidosis revealed by a multinodular goiter and cervical and mediastinal adenopathies. METHODS: We summarize the clinical presentation of a thyroid sarcoidosis. A review of literature regarding this topic is also presented. RESULTS: A 48-year-old woman presented dysphagia without dyspnea. Clinical and radiological explorations find a multinodular goiter with cervical and mediastinal adenopathies. The symptomatic side of the goiter and the association with adenopathies justify the surgery...
2015: Revue de Laryngologie—Otologie—Rhinologie
Takahiro Nakajima, Kazuhiro Yasufuku, Taiki Fujiwara, Ichiro Yoshino
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for sampling of mediastinal and hilar lymph nodes as well as pulmonary lesions adjacent to the airway. Guidelines for staging of lung cancer suggest that EBUS-TBNA should be considered the best first test of nodal staging for radiologically abnormal lymph nodes that are accessible by this approach. The application of EBUS-TBNA in pulmonary medicine and thoracic oncology is expanding with its role in the diagnosis of sarcoidosis, lymphoma, and tuberculosis...
July 2016: Respiratory Investigation
Swati Vishwanathan, Pritam Tayshetye, Farshaad Bilimoria, Gene Finley
A 62-year-old African-American man admitted to the emergency room with chest pain and exertional dyspnoea. He was found to be in rapid atrial fibrillation with pulmonary oedema. A transoesophageal echocardiogram performed prior to cardioversion showed a depressed left ventricular function (ejection fraction 30%) and an extracardiac heterogeneous echodensity compressing the right atrium and the superior vena cava. CT of the chest confirmed an anterior mediastinal mass measuring 13.5×6.6×10.1 cm, exerting a mass effect on the right atrium with mediastinal and right hilar adenopathy...
2016: BMJ Case Reports
Avradip Santra, Saumen Nandi, Saibal Mondal, Subhankar Chakraborty
Superior vena cava (SVC) syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e...
July 2016: Iranian Journal of Medical Sciences
Lingyi Yang, Wei Feng, Cheng Chen, Xiuqin Zhang, Yehan Zhu, Wei Lei, Jian-An Huang
Primary pulmonary T-cell lymphoma is an extremely rare neoplasm. The present study describes the case of an elderly male patient who was admitted to hospital with initial symptoms including a fever, coughing and dyspnea. A chest computed tomography scan detected pneumonia-like features, including multiple variable nodules, ground-glass opacities, patchy infiltration and subpleural consolidation, which progressed rapidly. No mediastinal or hilar adenopathy was noted. The patient was initially diagnosed with severe pneumonia; however, the patient developed severe respiratory failure and extensive progression in radiographic manifestation despite receiving a combination treatment of broad-spectrum antibiotics and antifungal agents...
July 2016: Experimental and Therapeutic Medicine
Mohini Pathria, Daniel Urbine, Marc Stuart Zumberg, Juan Guarderas
A 61-year-old woman presented with longstanding cough and progressive dyspnoea. She underwent an extensive evaluation and was diagnosed with common variable immunodeficiency (CVID) with granulomatous lymphocytic interstitial lung disease (GLILD). She was initially treated with subcutaneous immunoglobulin therapy, having declined intravenous immunoglobulin (IVIG) therapy. She also declined treatment with oral glucocorticoids. Over several months, she became increasingly symptomatic and developed increased pulmonary infiltrates, pleural effusions, mediastinal adenopathy, splenomegaly, pancytopenia and ascites...
2016: BMJ Case Reports
Sumina R Goel, Munir Ghesani, E Gordon DePuey, Sugganth Daniel
Focal mediastinal F-18 FDG uptake may be from potential adenopathy requiring biopsy confirmation or benign active brown adipose tissue to be left untouched. Knowledge of this potential pitfall and precise localization with fusion PET/CT are important in preventing misinterpretation as malignancy. Our case report is important in the aspect that CT was not able to confirm the uptake as benign finding, which led to invasive biopsy and biopsy confirmed it to be a benign brown adipose tissue.
2008: Radiology case reports
David E Manson
The acceptance of applications for the use of chest MRI in children has been somewhat slow and selective. The use of MRI to image chest wall lesions is likely the most common and widely used indication, aside from the widespread and somewhat sophisticated use of MRI in imaging the cardiovascular structures of the chest. In this respect, fairly standard variations of T1-W, T2-W and contrast-enhanced imaging can be used, similar to the sequences used for musculoskeletal lesions elsewhere in the body. Imaging of the anterior mediastinal masses should be performed in conjunction with a detailed pre-test clinical examination to determine potential cardiovascular compromise...
May 2016: Pediatric Radiology
Ayako Hirai, Shuichi Shinohara, Taiji Kuwata, Masaru Takenaka, Yasuhiro Chikaishi, Soichi Oka, Koji Kuroda, Naoko Imanishi, Fumihiro Tanaka
BACKGROUND: Resection and reconstruction of the pulmonary artery during lobectomy is a safe and effective procedure for centrally located lung cancer. We usually choose a pericardial conduit to repair a large defect of the pulmonary artery. The use of an autologous pulmonary vein conduit for reconstruction was first described in 2009. CASE PRESENTATION: A 64-year-old woman with left upper lung adenocarcinoma with mediastinal and hilar adenopathy was referred to our hospital...
December 2016: Surgical Case Reports
A Rhanim, K Marc
INTRODUCTION: Vascular lesion of sarcoidosis is rare, it may precede, follow or occur with the symptoms of a Takayasu's disease. Many pathogenic mechanisms (infectious, genetic and immunological) participate in associating those two diseases. OBSERVATION: We describe the case of a 24-year-old female patient, hospitalized for a check up for mediastinal and cervical adenopathies, nasal obstruction with intermittent claudication in the upper limbs evolving over eight months the clinic examination shows an abolition of radial pulses...
August 2016: Revue de Pneumologie Clinique
Christina R Bellinger, Deepankar Sharma, Jimmy Ruiz, Graham Parks, Travis Dotson, Edward F Haponik
PURPOSE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic tool for lung cancer, sarcoidosis, and suspected metastatic extrathoracic malignancy. EBUS-TBNA carries a high diagnostic yield, but its negative predictive value (NPV) requires further clarification. METHODS: We reviewed EBUS-TBNA at our cancer center from 2008 to 2015. We identified negative diagnostic samples for adenopathy suspected to represent metastatic disease from extrathoracic malignancy...
June 2016: Lung
Dima Youssef, Wael E Shams, Yasmin Elshenawy, Adel El-Abbassi, Jonathan P Moorman
It is often difficult to discern true mycobacterial infection from colonization due to Mycobacterium gordonae (M. gordonae) since this organism is ubiquitous and is commonly an innocuous saprophyte. This study reports a rare case of caseating hilar adenopathy and pulmonary disease caused by M. gordonae in a patient with chronic obstructive pulmonary disease (COPD) and rheumatoid arthritis (RA) on maintenance steroids and methotrexate. Pathologic exam and cultures of lymph node excision biopsy and bronchoalveolar lavage (BAL) confirmed the diagnosis...
September 2014: International Journal of Mycobacteriology
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