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mediastinal pathology

Masaki Hashimoto, Shigeki Shimizu, Teruhisa Takuwa, Yoshitane Tsukamoto, Tohru Tsujimura, Seiki Hasegawa
BACKGROUND: An atypical type A thymoma variant was newly added to the WHO classification of type A thymoma family in 2015. CASE PRESENTATION: A 72-year-old female was present a large round mass in the anterior mediastinum. The radiological examination led to a preoperative diagnosis of non-invasive thymoma. Tumor resection was undertaken via median sternotomy. Complete removal of the mediastinal tumor was achieved. Pathological examination revealed that the tumor cells were spindle- and oval-shaped with atypia...
December 2016: Surgical Case Reports
Vidya Ramachandraiah, Wilbert Aronow, Dipak Chandy
Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. A recent development in establishing the diagnosis of pulmonary sarcoidosis is endobronchial ultrasound that increases the yield of transbronchial needle aspiration of hilar and/or mediastinal lymph nodes...
October 21, 2016: Postgraduate Medicine
Keiju Aokage, Junji Yoshida, Tomoyuki Hishida, Masahiro Tsuboi, Hisashi Saji, Morihito Okada, Kenji Suzuki, Syunichi Watanabe, Hisao Asamura
Since 'radical lobectomy' was reported by Cahan in 1960, the standard surgical care for lung cancer has been lobectomy, in which units of the lobe are excised with their specific regional hilar and mediastinal lymphatics. However, pulmonary function-preserving limited resection for lung cancer has gradually become more prevalent in the late 20th century. In 1995, Ginsberg et al. conducted a randomized controlled trial in which limited resection (segmentectomy and wide-wedge resection) and lobectomy for stage I lung cancer were compared and reported that limited resection should not be applied to healthy patients with clinical stage IA lung cancer...
October 20, 2016: Japanese Journal of Clinical Oncology
Clémentine Sarkozy, Thierry Molina, Hervé Ghesquières, Anne-Sophie Michallet, Jehan Dupuis, Diane Damotte, Franck Morsschauser, Marie Parrens, Laurent Martin, Peggy Dartigues, Aspasia Stamatoullas, Pierre Hirsch, Betina Fabiani, Krimo Bouabdallah, Maria Gomes da Silva, Marie Maerevoet, Camille Laurent, Bertrand Coiffier, Gilles Salles, Alexandra Traverse-Glehen
Mediastinal grey zone lymphoma, B cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B cell lymphoma, are not well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64.6%) with primary mediastinal B cell lymphoma immunophenotype, primary mediastinal B cell lymphoma-like morphology (30...
October 6, 2016: Haematologica
Frank O Velez-Cubian, Kathryn L Rodriguez, Matthew R Thau, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Eric M Toloza
BACKGROUND: We investigated whether robotic-assisted surgery improves mediastinal lymph node dissection (MLND). METHODS: We analyzed patients (pts) who underwent robotic-assisted video-assisted thoracoscopic surgery (R-VATS) lobectomy for non-small cell lung cancer (NSCLC) over 36 months. Perioperative outcomes, tumor histology, numbers, locations, and status of all lymph nodes (LNs), and TNM (tumor, nodal, and metastasis) stage changes were analyzed. RESULTS: One hundred fifty-nine pts had mean tumor size 3...
September 2016: Journal of Thoracic Disease
Anna Biernacka, Konstantinos D Linos, Peter A DeLong, Arief A Suriawinata, Vijayalakshmi Padmanabhan, Xiaoying Liu
When confronted with a metastatic poorly differentiated tumor of unknown origin, the initial workup includes the standard panel of immunostains to rule out carcinoma, sarcoma, lymphoma, and the greatest mimicker in pathology - malignant melanoma. Although not specific, the S-100 protein is expressed in over 95% of malignant melanomas. Herein, we present a case of multiorgan metastatic malignancy with a dominant hilar and mediastinal mass in a current smoker; clinically, highly suggestive of widespread primary lung cancer...
2016: CytoJournal
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Shigeru Yamada, Toshiaki Watanabe
BACKGROUND: The need for surveillance of rare late recurrence of rectal cancer has not yet been established. Local control of unresectable skeletal metastasis is important for palliation of symptoms and support for systemic chemotherapy. CASE PRESENTATION: A Japanese man underwent preoperative pelvic irradiation (50.4 Gy/28 Fr) and low anterior resection at the age of 57 years. The pathological stage was II (T3N0M0). Nine years after the surgery, his carcinoembryonic antigen (CEA) level showed rapid elevation, although he had no symptoms...
December 2016: Surgical Case Reports
Damien Desbuquoit, Stijn Van Hecke, Pjotr Even, Paul M Parizel, Jan P van Meerbeeck, Annemie Snoeckx
The authors report a case of thoracic splenosis, which is the autotransplantation of splenic tissue into the pleural cavity. Splenosis in the chest is a rare entity and most often an incidental finding on chest computed tomography, typically showing solitary or multiple well-defined, noncalcified pleural nodules of variable size in the left hemithorax. It is important to include this benign pathology in the differential diagnosis among other, generally malignant, pleural lesions. Imaging clues to the diagnosis are absence of the spleen and/or associated rib fractures...
May 2016: Case Reports in Oncology
Robert M Hermann, Manoutschehr Djannatian, Norbert Czech, Mirko Nitsche
We report on a 72-year-old male patient who developed sarcoidosis of the mediastinal lymph nodes, the liver, and the prostate 11 years ago. Seven years later, he underwent transurethral resection of the prostate by laser due to hematuria. Pathology of the resected chips showed a 'granulomatous prostatitis with epitheloid cells'. Malignancy was histologically excluded at that time. Four years later, he was diagnosed with an undifferentiated prostate carcinoma, with a Gleason score of 5 + 4 = 9. After initiation of antihormonal therapy, he underwent radical prostatectomy and pelvic lymphadenectomy, which revealed a pT3b pN1 carcinoma with infiltrated resection margins...
May 2016: Case Reports in Oncology
Dawei Guo, Yiming Ni, Xiayi Lv, Zhihao Zhang, Peng Ye
BACKGROUND AND OBJECTIVE: With the popularity of minimally invasive techniques, preoperatively determining whether mediastinal lymph node dissection (MLD) is necessary for patients with cN1/2 nonsmall cell lung cancer (NSCLC) has sparked controversy once again. This study aims to analyze whether different primary sites are associated with the distribution of mediastinal lymph node metastases and to investigate the necessity of lymph node dissection and the factors influencing prognosis...
October 2016: Journal of Cancer Research and Therapeutics
Naomi E Verstegen, Alexander P W M Maat, Frank J Lagerwaard, Marinus A Paul, Michel I Versteegh, Joris J Joosten, Willem Lastdrager, Egbert F Smit, Ben J Slotman, Joost J M E Nuyttens, Suresh Senan
INTRODUCTION: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). METHODS: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases...
October 3, 2016: Radiation Oncology
Fumihiro Tanaka, Seiki Hasegawa, Nobuyuki Kondo, Ryo Miyahara, Hiroshi Date, Shinji Atagi, Masaaki Kawahara, Takeharu Yamanaka, Toshiaki Manabe, Hiromi Wada
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for the pathological evaluation of the mediastinal nodal (N2) status of lung cancer; however, its feasibility in potentially operable patients with suspicion of minimal N2 disease remains unestablished. PATIENTS AND METHODS: A prospective multicenter study was conducted to assess the feasibility of EBUS-TBNA in this setting. Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) and mediastinal nodal enlargement on computed tomography (CT) were eligible; patients were ineligible when CT revealed bulky (> 3 cm in the long-axis diameter) N2 or multiple (≥ 3) station N2...
2016: Oncology Research and Treatment
Bin Liu, Yuliang Li, Yongzheng Wang, Wujie Wang, Lili Wang, Yancu Hertzanu, Junjie Wang, Fujun Zhang
AIM: Certain metastasis-containing middle mediastinal lymph nodes cannot be approached by standard CT-guided brachytherapy. We here describe a novel trans-superior vena cava approach for such nodes. The aim of this prospective study was to assess the safety and clinical value of (125) iodine (I) brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes. METHODS: From February 2008 to October 2011, 32 patients with 43 pathologically confirmed metastasis-containing mediastinal middle lymph nodes underwent CT-guided percutaneous (125) I brachytherapy via a trans-superior vena cava approach...
September 29, 2016: Asia-Pacific Journal of Clinical Oncology
Zhenyang Zhang, Qiancheng Song, Jiangbo Lin, Mingqiang Kang
OBJECTIVE: To explore the application of mesoesophagus suspension technique to improve the upper mediastinal lymph node dissection during thoracoscopic esophagectomy in the treatment of esophageal cancer. METHODS: Clinical data of 164 thoracic esophageal cancer patients who underwent combined thoracoscopic and laparoscopic esophagectomy with two-field lymph node dissection in the Union Hospital of Fujian Medical University between October 2012 and June 2015 were retrospectively analyzed...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Shan Xian Guo, Yan Jian, Ying Lan Chen, Yun Cai, Qing Yuan Zhang, Fang Fang Tou
Neoadjuvant Chemotherapy has been used for the stage III of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, the survival benefits of radiation therapy added in induction regimens remains controversial. We therefore conducted a meta-analysis of the published clinical trials to quantitatively evaluate the benefit of preoperative chemoradiotherapy. After searching the database of Pubmed, CNKI, EMBASE, ESMO, The Cochrane Library databases, The American Society of Clinical Oncology and Clinical Trials...
September 28, 2016: Scientific Reports
Naohiro Nose, Kazuhiro Higuchi, Eiichi Chosa, Takanori Ayabe, Masaki Tomita, Kunihide Nakamura
A 60-year-old woman was referred to our hospital with an anterior mediastinal tumor measuring 3.5 cm in diameter on computed tomography (CT). We performed tumor resection by video-assisted thoracic surgery (VATS) with three ports. The final diagnosis was Type A Masaoka Stage I thymoma. On follow-up CT performed 36 months after the operation, two pleural tumors were detected at the port sites through which the forceps and ultrasonic scalpel had passed repeatedly during the operation. We therefore performed a second operation and enucleated the tumors while preserving the ribs...
2016: Journal of Surgical Case Reports
Mehreen Fatima, Muhammad Aslam Khan, Shahid Jamal, Jawad Khaliq Ansari, Muhammad Usman Ullah
OBJECTIVE: To determine the sensitivity, specificity, negative and positive predictive values, and diagnostic accuracy of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA). STUDY DESIGN: Across-sectional validation study. PLACE AND DURATION OF STUDY: Department of Histopathology, Army Medical College, in collaboration with Department of Pulmonology, Military Hospital Rawalpindi, from March 2014 to March 2015. METHODOLOGY: Cases of EBUS-TBNAcomprised of both TBNAs and cell block/biopsy of the same patients...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Kavian Toosi, Frank O Velez-Cubian, Jessica Glover, Emily P Ng, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Eric M Toloza
BACKGROUND: Mediastinal involvement in resected non-small-cell lung cancer mandates adjuvant therapy and affects survival. This study investigated lymph node dissection efficacy, lymph node metastasis detection, and survival after robotic-assisted lobectomy for non-small-cell lung cancer. METHODS: We retrospectively analyzed patients who underwent robotic-assisted lobectomy for non-small-cell lung cancer. Survival was assessed through chart reviews, Social Security Death Registry, and national obituary searches...
September 21, 2016: Surgery
Christopher Bell, Fernando Domingo, Ashley D Miller, Jeremiah S Smith, James R Headrick
We report a case of a posterior mediastinal mature cystic teratoma with rupture secondary to blunt chest trauma in a 20-year-old male involved in a motor-vehicle accident. Initial treatment was guided by Advanced Trauma Life Support and a tube thoracostomy was performed for presumed hemothorax. The heterogeneous collection within the thoracic cavity was discovered to be the result of a ruptured cystic mass. Pathologic findings confirmed the mass consistent with a mature cystic teratoma. As mediastinal teratomas are most commonly described arising from the anterior mediastinum, the posterior location of the teratoma described in this report is exceedingly rare...
2016: Case Reports in Surgery
Maxine Darke, Anil Dasyam, Matthew Then, Kavita Varma, Amir A Borhani, Rakesh Varma
Hibernomas, especially located in the mediastinum, are extremely rare benign tumors, which are important to consider in the differential diagnosis of a heterogeneously enhancing mass with areas of fat attenuation on imaging of an often incidentally discovered mass. Other common possibilities in the differential include malignant tumors, such as liposarcoma, hence histopathology is usually required to confirm the diagnosis. Hibernomas often follow the distribution of sites of persistence of brown fat in adults, and intrathoracic locations are unusual...
2016: Case Reports in Radiology
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