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https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#1
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643111/thymic-carcinoma-initially-presented-with-geographic-destruction-of-scapula-in-a-child
#2
Won-Jong Bahk, An-Hi Lee, Eun-Deok Chang, Dong-Wook Min, Yong-Koo Kang
As the conventional histopathologic examination of thymic carcinoma (TC) is nonspecific, immunohistochemical studies along with correlative radiographic investigations are needed for its correct diagnosis. TC commonly occurs in the late 5th to early 6th decades of life but is extremely rare in childhood. It may be incidentally detected from chest radiographs taken as routine or for other reasons. However, most patients present with symptoms such as chest pain, cough, shortness of breath, dysphagia and hoarseness, which are directly attributable to the mediastinal mass...
June 23, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28642455/diagnostic-value-of-video-assisted-mediastinoscopy-and-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-for-mediastinal-lymphadenectasis-without-pulmonary-abnormalities
#3
Feng Zhu, Dong-Chun Ma, Ning Xu, Xian-Quan Xu, Li-Ping Lv, Lei Tang, Xian-Kui Zha, Jian-Ping Xu, Xu-Hong Min
BACKGROUND Mediastinal diseases are difficult to diagnose due to diverse origins and complex anatomical structure of the mediastinal tissues. The prospective study aimed to compare the diagnostic efficiency of video-assisted mediastinoscopy (VAM) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lesions without pulmonary abnormalities. MATERIAL AND METHODS We divided 100 mediastinal lymphadenectasis patients without pulmonary abnormalities into a VAM group and an EBUS group...
June 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28635204/esophago-pulmonary-fistula-manifesting-as-recurrent-pneumonias-and-migrating-mediastinal-calcifications
#4
Jadd Kebbe, Sai Yendamuri, Charles Roche, Kassem Harris, Samjot Singh Dhillon
A 43-year old man presented with recurrent pneumonias, episodes of hemoptysis and an enlarging right lower lobe mass. A clear diagnosis was not previously established in spite of multiple radiological evaluations and biopsies. Meticulous review of his CT imaging showed that he had subcarinal calcification on his prior CT scans, which had decreased in size and now multiple new small areas of calcifications were seen in the right lower lobe lesion. An esophago-pulmonary fistula due to migration of mediastinal calcifications was suspected which was identified on careful review of the CT chest and confirmed by esophagogastroduodenoscopy...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634559/malignant-pleural-mesothelioma-with-marked-lymphatic-involvement-a-report-of-two-autopsy-cases
#5
Reiko Ideguchi, Kazuto Ashizawa, Saori Akashi, Michiko Shindo, Kazunori Minami, Toshio Fukuda, Junji Irie, Minoru Fukuda, Masataka Uetani
We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28624000/aneurysms-of-the-azygos-vein
#6
REVIEW
Maximilian Kreibich, Matthias Siepe, Jochen Grohmann, Gregor Pache, Friedhelm Beyersdorf
OBJECTIVE: Azygos vein aneurysms (AVAs) are uncommon and infrequently diagnosed. When confronted with a patient presenting with an AVA, physicians can rely on only a few case reports after an extensive literature search. To date, no guideline, no rule, and no review on the optimal treatment strategy for these patients exist. METHODS: A PubMed and MEDLINE database search for papers and case reports describing AVA was performed. Cases from our own institutions were also reviewed...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28616297/mediastinal-hemangioma-presenting-with-a-characteristic-feature-on-dynamic-computed-tomography-images
#7
Sheng-Min Li, Hsian-He Hsu, Shih-Chun Lee, Hong-Wei Gao, Kai-Hsiung Ko
Hemangiomas are uncommon benign tumors of the mediastinum. The definite diagnosis is sometimes difficult to make because of usually nonspecific features on single-phase contrast-enhanced computed tomography (CT) images. We described a 60-year-old woman suffering from a neck mass with progressive enlargement. On the dynamic CT study, the tumor showed peripheral nodular enhancement on early phase images and progressive centripetal fill-in on delayed phase images. Hemangioma was preoperatively diagnosed on the basis of this characteristic CT appearance...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28611161/follicular-dendritic-sarcoma-masquerading-as-fibrosing-mediastinitis
#8
Shashank Reddy Cingam, Majd Al Shaarani, Amol Takalkar, Prakash Peddi
Fibrosing mediastinitis (FM) is a rare disorder resulting from abnormal immunological-mediated fibro-proliferative reaction in the mediastinum. Here, we describe a case of a 46-year-old female with an incidentally found 11×9 cm posterior mediastinal mass. Multiple biopsies of this unresectable, 18-fluorodeoxyglucose avid mass revealed marked fibrosis without any evidence of malignancy, suggesting idiopathic fibrosing mediastinitis as our initial diagnosis. Multiple interventions including a trial of steroids, fluconazole, and azathioprine to target fibrosing mediastinitis were not successful...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28605955/solitary-thymic-metastasis-of-breast-cancer-13-years-after-surgery
#9
Akira Fukunaga, Yuji Sasamura, Akio Takada, Yoshihiro Murakami, Hirotake Abe, Mamoru Miyasaka
A 59-year-old woman was noted to have an anterior mediastinal mass on computed tomography at a regular follow-up 13 years after initial surgery for left breast cancer. Magnetic resonance imaging showed an anterior mediastinal mass. A total thymectomy with excision of surrounding lymphoid tissue was performed. Pathological examination of the resected tumor confirmed the diagnosis of thymic metastasis from breast cancer. The patient has been alive for 6 years after thymectomy. Metastases to the thymus are rare, but long-term survival can be expected with appropriate treatment...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28603653/is-bronchodilator-the-correct-treatment-for-copd-subjects-before-ebus
#10
REVIEW
Veronica Leoni, Patrizia Pignatti, Dina Visca, Antonio Spanevello
Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a reliable and commonly established technique, enabling real-time guidance of transbronchial needle aspiration of mediastinal and hilar structures and parabronchial lung masses. As EBUS-TBNA became more available and adopted by clinicians, questions emerged about the optimal performance of the procedure. Although EBUS is considered safe, there are few complications that could occur during the test, correlated with both the procedure itself and the patient's characteristics...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28603645/understanding-local-performance-data-for-ebus-tbna-insights-from-an-unselected-case-series-at-a-high-volume-uk-center
#11
Vandana Jeebun, Richard Neil Harrison
BACKGROUND: We reviewed the diagnostic performance of endobronchial ultrasound transbronchial aspiration (EBUS-TBNA) on an unselected large cohort of patients who underwent the procedure in our institution in the past 3 years and to compare against published standards and existing literature. METHODS: All consecutive patients who underwent EBUS from January 2013 to December 2015 were included in the retrospective analysis, with a minimum of 6 months of clinico-radiological follow up...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602157/thymic-large-cell-neuroendocrine-carcinoma-a-rare-and-aggressive-tumor-a-case-report
#12
Efared Boubacar, Gabrielle Atsame-Ebang, Sani Rabiou, Ammor Fatimazahra, Asmae Mazti, Ibrahim S Sidibé, Layla Tahiri, Nawal Hammas, Ouadnouni Yassine, Smahi Mohamed, Chbani Laila, El Fatemi Hinde
BACKGROUND: Neuroendocrine tumors are a large group of tumors with a wide spectrum of behavior, affecting mainly the digestive system and the lung. The thymus is very rarely affected. CASE PRESENTATION: A 28-year-old Arab woman presented with chronic chest pain and dyspnea. A computed tomography scan showed a huge anterior mediastinal mass invading neighboring structures. A mediastinotomy was performed with biopsies of the mass. Pathological findings were consistent with a thymic large cell neuroendocrine carcinoma...
June 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28596199/mediastinal-seminoma-presenting-with-superior-vena-cava-syndrome
#13
Amanda Wanous, Ian R McPhail, J Fernando Quevedo, Nicole P Sandhu
We present a rare cause of superior vena cava syndrome (SVC) in a previously healthy male aged 31 years. Malignancy was suspected due to unintentional weight loss and childhood exposure to radioactive fallout from a nuclear facility accident. A very large anterior mediastinal mass was identified and demonstrated to be an extragonadal seminoma. Extragonadal germ cell tumours are rare tumours with a high potential for cardiovascular, pulmonary and vascular sequelae. Studies have documented an increased risk of developing seminoma in patients with radioactive exposure...
June 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28593398/localization-of-angiosarcoma-by-peri-operative-transesophageal-echocardiography
#14
Yi-Chun Chen
Transthoracic echocardiography (TTE), computed tomography (CT) and magnetic resonance (MR) cannot always clearly identify angiosarcoma. A 22 year old woman presented with dyspnea. Preoperative TTE showed no tumor, and CT and MR both gave the impression that an extra-cardiac, mediastinal tumor was present. Transesophageal echocardiography (TEE), performed during surgery showed an intra-cardiac tumor, which was a well-delineated mass at the intra-ventricular groove of the right heart and surrounding the superior vena cava...
June 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28578595/thymic-hyperplasia-associated-with-graves-disease-pathophysiology-and-proposed-management-algorithm
#15
Uzma Haider, Patrick Richards, Andrew Gianoukakis
BACKGROUND: The association between Graves' disease (GD) and thymic hyperplasia was first described in 1912 and has been reported numerous times thereafter. Thymic hyperplasia associated with GD presents as an incidental mediastinal mass on chest X- ray or Computerized tomography (CT). The pathogenesis of thymic hyperplasia in the setting of GD is unclear but seems to involve a complex interplay of hormonal and immunological mechanisms. SUMMARY: Here we have reviewed the effect that thyroid hormones and autoimmunity have on thymic growth and size...
June 3, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28575247/endoscopic-ultrasound-in-diagnosis-of-esophageal-tuberculosis-10-year-experience-at-a-tertiary-care-center
#16
Y Tang, W Shi, X Sun, W Xi
Definite diagnosis of esophageal tuberculosis (ET) requires isolation of tubercle bacilli, which is challenging in clinical practice. Difficulty in differentiating ET from other esophageal diseases may well result in a delay in diagnosis. The literature on utility of endoscopic ultrasound (EUS) in diagnosis of ET is insufficient. This study aims to evaluate the role of EUS morphology combined with EUS-guided tissue acquisition in the diagnosis of ET. Data of the 35 patients diagnosed with ET from January 2006 to October 2015 were retrospectively analyzed...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28560833/use-of-microwave-ablation-in-the-treatment-of-patients-with-multiple-primary-malignant-tumors
#17
Yue Han, Na Shao, Xiaoming Xi, Xuezhi Hao
A 56-year-old man was admitted to our hospital in 2007, complaining of an irritating cough. Computed tomography examination demonstrated a mass in the right lung and enlargement of the hilar and mediastinal lymph nodes. Small cell lung cancer was confirmed by pathological examination after fibro-bronchoscope biopsy. The patient was treated with received sequential chemotherapy and radiotherapy. Preventive radiotherapy of the whole brain was performed after complete remission of the lung disease. Seven years after diagnosis, follow-up computed tomography revealed masses in both the liver and kidney...
May 31, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28556943/infected-mediastinal-bronchogenic-cyst-successfully-treated-by-eus-fna-drainage-via-esophagus
#18
I O Davarashvili, Yulia Epstein, Tawfik Khoury
A 61-year old female admitted with complaints of 10 days of productive cough and fever of 38 °C. She was started on antibiotics with oral cefuroxime 500 mg and azithromycin 500 mg. An X-Ray showed mediastinal mass with an air-fluid within. The patient was referred to our institution due to a suspicion of lung abscess. This article is protected by copyright. All rights reserved.
May 29, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28552534/an-epstein-barr-virus-positive-classical-hodgkin-lymphoma-with-exclusive-sinusoidal-growth-pattern-an-unusual-morphologic-variant
#19
Pu Su, Rachel Jug, Xin Liu, Endi Wang
Classical Hodgkin lymphoma (cHL) typically involves lymph node parenchyma, and a case with Hodgkin cells confined within nodal sinusoids is extremely rare. Herein we report a case of cHL with a sinusoidal growth pattern. This 15-year old patient presented with B symptoms and was found to have bilateral cervical lymphadenopathy and an anterior mediastinal mass. Biopsy of a cervical lymph node demonstrated cohesive clusters of Reed-Sternberg (RS)-like cells suggestive of sinusoidal growth with an extrasinusoidal mixed inflammatory cell infiltrate characteristic of the microenvironment seen in cHL...
June 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#20
REVIEW
C M McCarthy, J Unterscheider, C Burke, J Coulter
We describe a case of a 36-year-old woman presenting with vaginal bleeding and suboptimally rising serum human chorionic gonadotropin levels, who was investigated for a pregnancy of unknown location. Ultrasonography, laparoscopy and dilatation and curettage failed to reveal signs of an intra-uterine or intra-abdominal pregnancy. Following computed tomography imaging, a mediastinal mass was histologically determined to be a gestational choriocarcinoma. Following surgical resection and chemotherapy, the patient recovered and proceeded to have a successful intra-uterine pregnancy...
May 26, 2017: Irish Journal of Medical Science
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