Solitary fibrous tumour of mediastinum: an often asymptomatic neoplasm

2021 ◽  
Vol 14 (8) ◽  
pp. e241223
Author(s):  
Gerard Sexton ◽  
Joseph McLoughlin ◽  
Louise Burke ◽  
Kishore Doddakula
Keyword(s):  
Median Sternotomy ◽  
Mesenchymal Cell ◽  
Old Irish ◽  
Ct Guided ◽  
Solitary Fibrous Tumours ◽  
Effective Treatment Modality ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Thorax Ct

Solitary fibrous tumours (SFTs) are rare neoplasms derived from mesenchymal cell lines. They are often asymptomatic, follow an indolent growth pattern and are more often benign than malignant. Here, we present a case of a very large, asymptomatic mediastinal SFT in an otherwise healthy man. A 67-year-old Irish man was referred for workup of an asymptomatic murmur. Auscultation of the lung fields revealed diminished breath sounds on the right side. Chest X-ray identified a 20 cm mass localised within the thorax. CT of the thorax confirmed a pleural based, solid lesion with no local invasion. CT-guided core biopsies were reported as consistent with SFT. Primary excision of the lesion was undertaken via median sternotomy. Histological examination confirmed a diagnosis of SFT. The patient remains well at this time. Primary excisive surgery is a safe and effective treatment modality for SFTs.

scholarly journals Transmediastinal and Transcardiac Gunshot Wound with Hemodynamic Stability

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Leire Zarain Obrador ◽  
Yusef Mohamed Al-Lal ◽  
Jorge de Tomás Palacios ◽  
Iñaki Amunategui Prats ◽  
Fernando Turégano Fuentes
Keyword(s):  
Gunshot Wound ◽  
Median Sternotomy ◽  
Uneventful Recovery ◽  
Hemodynamic Stability ◽  
Group Iii ◽  
Entrance Wound ◽  
Group I ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Cardiac injuries caused by knives and firearms are slightly increasing in our environment. We report the case of a 43-year-old male patient with a transmediastinal gunshot wound (TGSW) and a through-and-through cardiac wound who was hemodynamically stable upon his admission. He had an entrance wound below the left clavicle, with no exit wound, and decreased breath sounds in the right hemithorax. Chest X-ray showed the bullet in the right hemithorax and large right hemothorax. The ultrasound revealed pericardial effusion, and a chest tube produced 1500 cc. of blood, but he remained hemodynamically stable. Considering these findings, a median sternotomy was carried out, the through-and-through cardiac wounds were suture-repaired, lung laceration was sutured, and a pacemaker was placed in the right ventricle. The patient had uneventful recovery and was discharged home on the twelfth postoperative day. The management and prognosis of these patients are determined by the hemodynamic situation upon arrival to the Emergency Department (ED), as well as a prompt surgical repair if needed. Patients with a TGSW have been divided into three groups according to the SBP: group I, with SBP>100 mmHg; group II, with SBP 60–100 mmHg; and group III, with SBP<60 mmHg. The diagnostic workup and management should be tailored accordingly, and several series have confirmed high chances of success with conservative management when these patients are hemodynamically stable.

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

scholarly journals Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

2020 ◽  
Vol 10 (1) ◽  
pp. 26743
Author(s):  
Khosrow Agin ◽  
Akram Sabkara ◽  
Farzaneh Sadat Mirsafai Rizi ‎ ◽  
Bita Dadpour ◽  
Maryam Vahabzadeh ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Diaphragmatic Paralysis ◽  
Recurrent Pneumonia ◽  
Emergency Center ◽  
Diabetes Mellitus Type Ii ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right

A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.

scholarly journals Rapidly Progressive Pulmonary Apical Fibrosis and Parenchymal Destruction in a Patient with Ankylosing Spondylitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hasan Ulusoy ◽  
Nazmiye Tibel Tuna ◽  
Aslı Tanrivermis Sayit
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Rare Complication ◽  
Granulomatous Inflammation ◽  
Pulmonary Involvement ◽  
High Resolution Computed Tomography ◽  
Thoracic Computed Tomography ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Pulmonary apical fibrosis is a rare complication of ankylosing spondylitis (AS). The essential characteristics of this lesion are its very slow progression and frequently asymptomatic nature. Herein, we are presenting a patient with AS who rapidly developed pulmonary apical fibrosis in a 3-year period despite decreased musculoskeletal pains. The 60-year-old male applied with complaints of progressively increasing cough in the recent two years, dyspnea, and fatigue. He had no chronic disease except AS. He had no continuous medication except nonsteroid anti-inflammatory drugs for 2-3 days monthly since his musculoskeletal pains decreased in the recent years. His physical examination revealed reduced breath sounds in the upper zones of the right lung. Chest X-ray revealed increased diffuse opacity in the upper zones of the right lung. Thoracic high-resolution computed tomography showed a consolidation accompanied with traction bronchiectases compatible with chronic fibrosis in the upper lobe of the right lung. However, thoracic computed tomography of the patient performed 3 years ago did not reveal pulmonary apical fibrosis and parenchymal destruction. Biopsy revealed no finding of malignancy, granulomatous inflammation, or vasculitis. The results of cultures were negative. So, the patient was diagnosed as pulmonary involvement of AS, which developed in a 3-year period. This case has shown that extra-articular complications may continue to develop in patients with AS even if their musculoskeletal complaints have subsided. So, patients with AS should be followed up regularly with systemic examinations.

scholarly journals Perplexing case of lung mass perfectly mimicking a malignancy

2019 ◽  
Vol 12 (7) ◽  
pp. e229273
Author(s):  
Eid Humaid Alqurashi ◽  
Ahmed Sayeed ◽  
Hasheema Hasheem Alsulami ◽  
Hadeel Mashhour Al-Qurashi
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Wedge Resection ◽  
Biopsy Result ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Histopathology Examination

A 35-year-old man, a known asthmatic and with a history of smoking presented with a history of recurrent episodes of mild haemoptysis. On examination, there was decreased intensity of breath sounds on the right infraclavicular area. The chest X-ray and CT chest showed a mass in right upper lobe with nodules in the other lobe. The VAT showed large heavily vascularised mass with surface laden with multiple nodules. The wedge resection of the mass was taken and sent for histopathology examination. The biopsy result showed picture suggestive of connective tissue disease associated follicular bronchiolitis. The patient did not have any signs or symptoms of connective tissue disease. However he was positive for Rheumatoid factor, ANA, anti-RO, anti-CCP antibodies. He was started on steroids and azathioprine. After 6 months of treatment, the size of the mass and nodules reduced by 50% and ESR was reduced to 5 from 75.

scholarly journals Kanker Paru: Laporan Kasus

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Junita Joseph ◽  
Linda W. A. Rotty
Keyword(s):  
Lung Cancer ◽  
Physical Examination ◽  
Ct Scan ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Bronchial Carcinoma ◽  
Bronchial Epithelium ◽  
Breath Sounds ◽  
The Right ◽  
Thorax Ct

Abstract: In general, lung cancer is all kinds of malignancy of the lung. It consists of malignancy derived from the lung itself (primary) and from out of the lung (metastasis). Clinically, primary lung cancers are malignant tumors derived from bronchial epithelium (bronchial carcinoma). Lung cancer is the main cause of death due to malignancy worldwide. We reported a male of 55-year-old male diagnosed as lung cancer. Diagnosis was based on anamnesis, physical examination, and supporting investigations. Anamnesis included smoking for 10 years ±15 cigarettes/day and complaints of shortness of breath, coughing, chest pain radiating to the back, and significant weight loss. Physical examination revealed enlargement of the right supraclavicular gland and decreased breath sounds in the right lung at the fifth intercostal space. Thorax photo, thorax CT-scan, and histopathological examination confirmed the diagnosis of lung cancer (adeno-carcinoma). Chemotherapy was administered with a combination of gemcitabine-cisplatin regimens for 12 cycles. The prognosis of this patient was poor because the disease had reached stage 4. However, the patient felt some clinical improvement after one month of chemotherapy.Keywords: lung cancer Abstrak: Kanker paru dalam arti luas adalah semua penyakit keganasan di paru, mencakup keganasan yang berasal dari paru sendiri (primer) maupun keganasan dari luar paru (metastasis). Dalam pengertian klinis yang dimaksud dengan kanker paru primer adalah tumor ganas yang berasal dari epitel bronkus (karsinoma bronkus). Kanker paru merupakan penyebab utama kematian akibat keganasan di dunia Kami melaporkan sebuah kasus kanker paru pada seorang laki-laki berusia 55 tahun. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang yang meliputi adanya riwayat merokok (sigaret) selama 10 tahun sebanyak ±15 batang rokok/hari, dengan sesak nafas, batuk, nyeri dada menjalar sampai ke punggung, dan penurunan berat badan yang nyata. Pada pemeriksaan fisik didapatkan pembesaran kelenjar supraklavikular kanan dan suara nafas menurun pada paru kanan setinggi sela iga V. Pada pemeriksaan penunjang foto toraks, thorax CT-scan, dan histopatologik didapatkan hasil yang menyokong diagnosis kanker paru (adenokarsinoma). Pada pasien ini, telah diberikan penata-laksanaan kemoterapi dengan kombinasi regimen gemcitabine-cisplatin selama 12 siklus. Progno-sis pasien ini buruk karena sudah sampai pada stadium 4, namun dengan kemoterapi yang dijalani sampai saat ini selama 1 bulan, pasien merasakan adanya perbaikan secara klinis.Kata kunci: kanker paru

Bullet Embolus to the Heart after Gunshot Wound to the Neck: A Case Report

2007 ◽  
Vol 73 (12) ◽  
pp. 1245-1246 ◽  
Author(s):  
Jacob M. Breeding ◽  
R. Stephen Smith ◽  
Jonathan M. Dort
Keyword(s):  
Foreign Body ◽  
Femoral Vein ◽  
Median Sternotomy ◽  
Gunshot Wounds ◽  
Intravenous Contrast ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Chest X Ray ◽  
Intracardiac Foreign Body ◽  
The Right

A 43-year-old woman presented with gunshot wounds to the neck, chest, and left thigh. Computed tomography of the neck and chest with intravenous contrast revealed a left common carotid pseudoaneurysm and a foreign body in the right atrium. Preoperative chest x-ray and CT scan confirmed a metallic foreign body in the right heart. At median sternotomy, the intracardiac foreign body could not be located using fluoroscopy. The foreign body (bullet) was subsequently removed in the cardiac catheterization laboratory using a percutaneous transvenous basket extraction through a right femoral vein cutdown.

scholarly journals Right lung complete atelectasis: an endotracheal tube displacement complication

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Apostolos Dimos ◽  
Andrew Xanthopoulos ◽  
Filippos Triposkiadis
Keyword(s):  
Emergency Treatment ◽  
Main Bronchus ◽  
Left Main Bronchus ◽  
Left Main ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
Post Intubation ◽  
The Right

ABSTRACT A 78-year-old, overweight woman with a severe individual history of the cardiovascular system was admitted in the intensive care unit with acute pulmonary edema. Despite appropriate emergency treatment, the patient did not show any clinical improvement and emergency intubation was decided. Post-intubation physical examination revealed dullness to percussion, absent breath sounds and reduced chest excursion of the right hemithorax combined with a gradual drop in blood pressure and oxygen saturation. An emergency chest X-ray showed opacification of the entire right lung and an ipsilateral shift of the mediastinum. Improvement of the patient’s respiratory and hemodynamic status was observed immediately after the partial withdrawal of the tube. Tube displacement is a relative frequent complication and concerns mainly the right main bronchus due to anatomical procedures. However, the above case is a rare case of tube displacement in the left main bronchus, which led to total atelectasis of the rightlung.

scholarly journals Lung Abscess Carcinomatous

2021 ◽  
Vol 5 (7) ◽  
pp. 664-669
Author(s):  
Upi Puspita ◽  
Fauzar ◽  
Roza Kurniati
Keyword(s):  
Lung Cancer ◽  
Rare Case ◽  
Clinical Presentation ◽  
Needle Aspiration ◽  
Lung Abscess ◽  
Bronchial Obstruction ◽  
Fluid Level ◽  
Breath Sounds ◽  
The Right ◽  
Thorax Ct

Introduction: Pulmonary malignancies may easily be overlooked and valuable time may be lost. Lung cancer is sometimes diagnosed as a tuberculous cavity or an abscess. Abscess formation can appear in several different ways. Carcinoma that occurs in medium-sized bronchi causes partial bronchial obstruction, atelectasis, and infection due to retention. Inflammation can progress to damage to lung tissue, resulting the formation of multiple suppurative foci or more localized lung abscess. The link between lung abscess and lung cancer has been known, but the presence of malignancy in lung abscesses often undiagnosed. Obstruction from lung cancer can predispose to the development of a lung abscess. Case of a 54 year old man with increased pain at the right chest when breathing in since two months. On physical examination, it was found decreased of fremitus at the right hemithorax, deafness and decreased breath sounds as high as the II - V thoracic right hemithorax. Thorax CT-scan showed a round, homogeneous (HU: 17-30), with a cavity-like image with air fluid level, size: 7,88 cm x 8,2 cm x 9,29 cm and honey comb appearance around it. On the examination of TTNA (Transthoracic Needle Aspiration) results obtained Squamous Cell Carcinoma. A lobectomy is planned for the patient. Conclusion: We reported a rare case, a 54 year old male patient, with the diagnosis of Carcinomatous Lung Abscess. This case report was prepared with the aim of increasing awareness of malignancy in patients with a clinical presentation of abscesses, especially in old age.

scholarly journals Immunocytochemistry as a Diagnostic Procedure of Pleural Mesothelioma

2020 ◽  
Vol 2 (2) ◽  
pp. 68-73
Author(s):  
Asih Trimurtini ◽  
◽  
Triwahju Astuti ◽  
Hendy Yudhanto ◽  
Dini Erawati ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lung Tumor ◽  
Asbestos Exposure ◽  
Stage Iv ◽  
Pleural Mesothelioma ◽  
Cytologic Examination ◽  
Breath Sounds ◽  
History Of ◽  
The Right ◽  
Thorax Ct

Background: Mesothelioma is a primary malignant tumor arising from the mesothelial surface of the pleura, peritoneal, tunica vaginalis, and pericardium. Most cases of mesothelioma originate from the pleura. Most patients have a history of asbestos exposure. A common diagnostic problem is distinguishing mesothelioma from adenocarcinoma since both tumors invade the pleura. Immunocytochemistry of calretinin and TTF-1 can be used to establish the diagnosis of mesothelioma. Case: Male, 56 years old presented with chest pain, shortness of breath, cough, and weight loss since 5 months before hospitalization. The patient had a history of occupational exposure to asbestos for 30 years. The movement and breath sounds were decreased as well as dull upon percussion at the right chest. A chest X-ray revealed a right lung tumor with pleural effusion. Thorax CT scan suggested pleural mass in right hemithorax, infiltration to intercostal muscles, and destruction of the 7th right rib, right perihilar lymphadenopathy, right pleural effusion, and liver nodules according to mesothelioma T4N1M1 Stage IV. Infiltrative stenting of the right and inferior lobe of the right lung, infiltrative and obstructive stenting of the medius lobe suggestive of a chronic malignancy and inflammation were found on FOB. Cytologic examination of pleural fluid, sputum, and Washing-and-brushing of FOB were a class II (no malignant cells). USG-guided transthoracic FNAB revealed adenocarcinoma with differential diagnosis of mesothelioma. Immunocytochemistry with calretinin showed positive results and TTF-1 showed a negative result. These confirmed the diagnosis of pleural mesothelioma T4N1M1 Stage IV. The patient showed a stable response from carboplatin/gemcitabine treatment.

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