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Simone B S P Terra, Scott W Aesif, Joseph J Maleszewski, Andrew L Folpe, Jennifer M Boland
Synovial sarcoma (SS), a translocation-associated sarcoma characterized by SS18-SSX1/2 fusion, presents most often in the extremities of young adults. While SS regularly occurs in the pleuropulmonary parenchyma, the mediastinum is an exceedingly rare primary site; the literature on this subject is predominantly composed of case reports and small series, mostly without molecular confirmation. Cases of mediastinal SS were selected from our institutional and consultation archives. Diagnoses were confirmed by either SS18 fluorescence in situ hybridization (n=6) or reverse transcription polymerase chain reaction for SS18-SSX1/2 (n=15)...
March 14, 2018: American Journal of Surgical Pathology
Edson Marchiori, Bruno Hochhegger, Gláucia Zanetti
No abstract text is available yet for this article.
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Lauren A Bruns, Sarah Isbey, Melisa Tanverdi, Ian Kane
Although there are several reports of intracranial hemorrhage associated with vitamin K deficient bleeding, there are few reported cases of extracranial manifestations, specifically involving the thymus. Here, we discuss the unique case of a 4-week-old infant presenting with scrotal discoloration, respiratory distress, and widened mediastinum, found to have thymic hemorrhage related to confirmed coagulopathy secondary to late-onset vitamin K deficiency bleeding of the newborn.
March 12, 2018: Pediatric Emergency Care
Jirka Grosse, Karin Menhart, Benedikt Schmidbauer, Dirk Hellwig
Sarcoidosis, a granulomatous T-cell-mediated multisystem disease with a yearly incidence of 10.9 to 35.5 cases per 100,000 in the United States, affects a variety of organ systems. Although the characteristic radiological finding of a bihilar lymphadenopathy still plays a diagnostic key role, FDG PET/CT is more sensitive in detecting and monitoring various manifestations. We present a rare case of a 37-year-old woman with bihilar, mediastinal, and abdominal lymphadenopathy in conjunction with a histologically proven cutaneous manifestation of sarcoidosis in a tattoo of the lower back exhibiting an increased uptake of FDG...
March 13, 2018: Clinical Nuclear Medicine
Léopoldine Bricaire, Capucine Richard, Mathieu Gauthé, Béatrix Cochand-Priollet, Sébastien Gaujoux
We present the case of a severe familial primary hyperparathyroidism related to a germline deletion in the HRPT2 (CDC73) gene. Morphological explorations revealed 2 potential hyperfunctioning parathyroid glands: a left cervical lesion on the neck ultrasound, and an ectopic mediastinal lesion on the parathyroid scintigraphy using Tc-methoxyisobutylisonitrile and on F-fluorocholine PET/CT. Surgery removal and histopathological examination determined that the mediastinal mass corresponded to a thymoma and the cervical lesion to a parathyroid adenoma...
March 13, 2018: Clinical Nuclear Medicine
Sun-Ju Choi, Young Woo Do, Tak-Hyuk Oh, Hoseok Lee, Hyejin Cheon, Jae-Kwang Lim, Sang Yub Lee
INTRODUCTION: Central venous catheterization-induced central vein pseudoaneurysm is rare. Several treatment options have been recommended. We describe a case of central venous catheterization-induced right brachiocephalic vein pseudoaneurysm successfully treated with an uncovered self-expandable stent-assisted coil embolization and discuss the imaging findings, treatment strategy, and review of literature associated with thoracic venous pseudoaneurysm. CASE REPORT: A 77-year-old woman was referred to our trauma center to undergo treatment for central venous catheterization-induced central vein pseudoaneurysm...
March 1, 2018: Journal of Vascular Access
Karin Gasser
A 10-year-old female Australian Cattle Dog was referred for investigation of a mediastinal mass. During clinical examination, a mandarin- sized mass was detected ventrally of the trachea. According to computed tomographic (CT) findings and cytology of a fine-needle aspirate, thyroid neoplasia was suspected. The assumed tumour affected the left thyroid gland and was staged as stadium II because of enlargement of the ipsilateral cervical and retropharyngeal lymph nodes. The left thyroid, including the parathyroid gland, was removed surgically with a guarded prognosis...
February 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Tetyana Leinberger, Claudia Heilmann, Stefan Sorg, Matthias Mueller, Sami Kueri, Claudia Schmoor, Matthias Siepe, Friedhelm Beyersdorf
BACKGROUND:  Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. METHODS:  A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebrüder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 ± 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 ± 5 days; incidence of pneumonia during hospitalization within the first 30 (±5) days and chest pain intensity...
February 2, 2018: Thoracic and Cardiovascular Surgeon
John H Harris, William H Harris, Sanjay Jain, A Y Ferguson, David A Hill, Amy M Trahan
PURPOSE: CTA is routinely ordered on level II blunt thoraco-abdominally injured patients for assessment of injury to the thoracic aorta. The vast majority of such assessments are negative. The question being asked is, Does the accurate interpretation of the three mediastinal signs permit reliable determination of which patients need CTA for aortic assessment? The purpose of this investigation was to evaluate the role of three specifically selected mediastinal anatomic signs on the initial supine chest radiograph (CXR) of adult level II blunt thoraco-abdominally injured patients for the presence or absence of a mediastinal hematoma...
March 13, 2018: Emergency Radiology
Calvin Chao, Vijay Vanguri, Karl Uy
First described in 2005, the Mullerian derived cyst in the mediastinum is a rare finding with few subsequent reports. We report a case of Mullerian cyst occurring in the mediastinum of a 49-year-old female that was resected by robot-assisted thoracoscopic surgery. To our knowledge, this is the first report of robot-assisted resection of Hattori's cyst. Histopathologic analysis revealed ciliated Mullerian-type tubal epithelium positive for paired box gene 8 (PAX8), estrogen receptor (ER), and progesterone receptor (PR), confirming Mullerian differentiation...
2018: Case Reports in Pulmonology
Hiroaki Kuroda, Shnsuke Mori, Hirotaka Tanaka, Tatsuya Yoshida, Tetsuya Mizuno, Noriaki Sakakura, Yasushi Yatabe, Hiroshi Iwata, Yukinori Sakao
Background: We previously proposed measuring tumor size using mediastinal window setting on high-resolution computed tomography (CT) as a simple and useful modality for preoperative prognostication of small adenocarcinoma. Hence, the importance of tumor volume and positron emission tomography (PET) for preoperative prognostication of clinical stage IA (cIA) adenocarcinoma was studied. Materials and Methods: We retrospectively evaluated total 324 patients who underwent pulmonary resection of cIA adenocarcinoma between July 2008 and August 2015...
February 13, 2018: Oncotarget
Prudence Dy, Cristina Lajom, Josephino Sanchez
Neurogenic tumours of the mediastinum in adults occur most often at the posterior mediastinum, majority of which are benign of nerve sheath in origin. A 72-year-old woman, known asthmatic, presented with chronic symptoms of hoarseness, dysphagia, chest heaviness, easy fatigability, cough, epigastric pain, feeling of abdominal fullness and choking with food intake and at a supine position. Treated for other disorders, routine chest X-ray incidentally found a homogenous convex radiodensity at the right paratracheal area; mass which was also observed with CT and 18F-fludeoxyglucose-positron emission tomography/CT scan studies...
March 13, 2018: BMJ Case Reports
Meredith A Ray, Nicholas R Faris, Matthew P Smeltzer, Carrie Fehnel, Cheryl Houston-Harris, Paul Levy, Lynn Wiggins, Vishal Sachdev, Todd Robbins, David Spencer, Raymond U Osarogiagbon
BACKGROUND: Accurate pathologic nodal staging improves early-stage non-small-cell lung cancer survival. In an ongoing implementation study, we measured the impact of a surgical lymph node specimen collection kit and a more thorough pathologic gross dissection method, on attainment of guideline-recommended pathologic nodal staging quality. METHODS: We prospectively collected data on curative-intent non-small cell lung cancer resections from 2009-2016 from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions...
March 10, 2018: Annals of Thoracic Surgery
Sara A Hayes, James Huang, Jennifer Golia Pernicka, Jane Cunningham, Junting Zheng, Chaya S Moskowitz, Michelle S Ginsberg
BACKGROUND: The aim of this study was to assess pre-operative computed tomography (CT) characteristics of thymic carcinomas and to investigate which features could predict an incomplete surgical resection. A secondary aim was to correlate pre-operative imaging features with Masaoka stage. METHODS: In this study, approved by our Institutional Review Board, two readers retrospectively reviewed pre-operative CTs at our tertiary referral oncology center between 1994 and 2014...
March 10, 2018: Annals of Thoracic Surgery
Lucas W Thornblade, Douglas E Wood, Michael S Mulligan, Alexander S Farivar, Michal Hubka, Kimberly E Costas, Bahirathan Krishnadasan, Farhood Farjah
OBJECTIVE: Prior studies have reported underuse of-but not variability in-invasive mediastinal staging in the pretreatment evaluation of patients with lung cancer. We sought to compare rates of invasive mediastinal staging for lung cancer across hospitals participating in a regional quality improvement and research collaborative. METHODS: We conducted a retrospective study (2011-2013) of patients undergoing resected lung cancer from the Surgical Clinical Outcomes and Assessment Program in Washington State...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Harry H Ching, Jacob B Kahane, Megan J Foggia, Annabel E Barber, Robert C Wang
BACKGROUND: Resection of massive goiters with suprahyoid, retropharyngeal, and substernal extension may not be amenable to standard approaches. This study evaluates a surgical approach allowing resection of massive goiters with minimal substernal and deep neck dissection. METHODS: Cases of thyroidectomy for goiters with substernal, retropharyngeal, or suprahyoid extension at a single institution from 2006 to 2017 were reviewed. The technique involves initial complete division of the medial thyroid tracheal attachments after identification of the RLN medial-inferiorly or superiorly...
March 12, 2018: World Journal of Surgery
Noman Lateef, Abdul Haseeb, Uzair K Ghori, Abubakar Tauseef, Mustafa Dawood, Syed M Hasan Kazmi
Rosai-Dorfman disease (RDD) is a rare, benign, and predominantly nodal disease that most commonly presents as bilateral, painless cervical lymphadenopathy; although inguinal, axillary, mediastinal, and hilar lymphadenopathy has also been reported. Apart from nodal involvement, RDD has extranodal manifestations involving bone, soft tissue, and liver as well as constitutional symptoms of fever, night sweats, and weight loss, which make it reasonable to rule out the infectious, autoimmune, and malignant conditions as the differential diagnosis...
January 2, 2018: Curēus
Alberto Testori, Emanuele Voulaz, Marco Alloisio, Valentina Errico, Umberto Cariboni, Matilde De Simone, Ugo Cioffi
A 67-year-old patient presented for persistent cough. Computed tomography showed right lower lung opacity associated with mediastinal adenopathy. On suspicion of metastatic pulmonary neoplasm, the patient was submitted to right lower lobectomy with lymphadenectomy. Postoperative histopathology led to the diagnosis of multicentric Castleman's disease.
March 2018: Clinical Case Reports
Brett W Carter, John P Lichtenberger, Marcelo K Benveniste, Patricia M de Groot, Carol C Wu, Jeremy J Erasmus, Mylene T Truong
Lung cancer remains the leading cause of cancer-related mortality worldwide. To formulate effective treatment strategies and optimize patient outcomes, accurate staging is essential. Lung cancer staging has traditionally relied on a TNM staging system, for which the International Association for the Study of Lung Cancer (IASLC) has recently proposed changes. The revised classification for this eighth edition of the TNM staging system (TNM-8) is based on detailed analysis of a new large international database of lung cancer cases assembled by the IASLC for the purposes of this project...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Lucyna Kepka, Joanna Socha
We greatly appreciate the recent publication of a Japan Lung Cancer Society and Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations (LNSs) for radiotherapy for lung cancer. This atlas is based on the International Association for the Study of Lung Cancer (IASLC) consensus lymph node map, which resolved differences between the Japanese and American classification and was incorporated into the seventh edition of the TNM staging system. The authors must be commended for providing a very clear, comprehensive presentation of the borders of the mediastinal and hilar LNSs, using a multidisciplinary approach...
March 8, 2018: Journal of Radiation Research
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