Esophageal Microperforation due to Calcified Mediastinal Lymph Node Leading to Tracheoesophageal Fistula

A 42-year-old male presented with worsening gastroesophageal reflux disease symptoms and cough. The clinical symptoms during the early course of illness were striking for aspiration pneumonia. He was given a prescription of proton pump inhibitors and antibiotics. Rapid decline in the clinical condition with worsening respiratory status was noted. Worsening symptoms of fever, cough, and chest pain prompted further diagnostic work-up suggesting esophageal microperforation. Esophagogram was found to be suggestive of tracheoesophageal fistula. The tracheoesophageal fistula was due to subcarinal lymph node of nontuberculous origin.

Download Full-text

Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma: Adding Ultrasound in Clinically Lymph Node Negative Patients May Improve Diagnostic Work-Up

PLoS ONE ◽

10.1371/journal.pone.0090360 ◽

2014 ◽

Vol 9 (3) ◽

pp. e90360 ◽

Cited By ~ 16

Author(s):

Rikke Norling ◽

Birgitte Marie Due Buron ◽

Marianne Hamilton Therkildsen ◽

Birthe Merete Henriksen ◽

Christian von Buchwald ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Cervical Lymph Nodes ◽

Node Negative ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

Download Full-text

Bronchial Carcinoid Tumor in the Era of Covid-19 Pandemic: A Case Report

10.21203/rs.3.rs-179070/v1 ◽

2021 ◽

Author(s):

Esubalew T. Mindaye ◽

Mulugeta Kassahun ◽

Gulilat Tigiye

Keyword(s):

Lymph Node ◽

Carcinoid Tumor ◽

Neuroendocrine Tumors ◽

Low Grade ◽

Bronchial Carcinoid ◽

Typical Carcinoid ◽

Bronchial Carcinoids ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

Abstract Introduction: Bronchial carcinoid tumors are rare, slow growing, malignant neuroendocrine tumors which arise from Enterochromaffin (Kulchitsky) cells. Early diagnosis is extremely important as the main stay of treatment is surgical excision. Presentation of case: We present a rare case of bronchial typical carcinoid tumor in a 27-year-old male who presented with a complaint of intermittent dry cough of 2 weeks’ duration associated with shortness of breath, low grade intermittent fever and loss of appetite. He was initially misdiagnosed as covid-19 pneumonia and was admitted to covid-19 treatment center. Right lung bi-lobectomy with regional lymph node resection was done and he was discharged home in good condition.Discussion: Majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, wheezing and hemoptysis. Due to such nonspecific presentation most patients are misdiagnosed or diagnosed late. In the era of covid-19 pandemic, in addition to the wide spread anxiety on the health care workers access to diagnostic work up of patients with rare diseases like bronchial carcinoids is very challenging especially in resource limited areas as invasive diagnostic procedures like bronchoscopy are usually avoided in covid-19 suspected patients during the pandemic. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids most lymphadenopathies are caused by a reactive inflammatory reaction.Conclusion: Bronchial carcinoids are rare, malignant neuroendocrine tumors with complete surgical resection being the only curative management. Although the world is over burdened by Covid-19 pandemic crisis, other lung pathologies are also still present in communities. In such challenging circumstance diagnosing rare pulmonary diseases like bronchial carcinoids need high index of suspicion and meticulous diagnostic work up. The outcome of typical carcinoids with lymph node metastasis is excellent with complete resection but close follow up is mandatory when dealing with larger tumors.

Download Full-text

Ganglioneurofibroma Arising Within the Extralobar Pulmonary Sequestration

10.21203/rs.3.rs-37474/v1 ◽

2020 ◽

Author(s):

Yuanyuan Liu ◽

Wenbin Wu ◽

Longbo Gong ◽

Miao Zhang

Keyword(s):

Mediastinal Lymph Node ◽

Three Dimensional ◽

Pulmonary Sequestration ◽

Whole Body ◽

Case Presentation ◽

Lymph Node Sampling ◽

Diagnostic Work ◽

Work Up ◽

Aberrant Vessels

Abstract Background: Neurogenic tumor arising within the pulmonary sequestration (PS) is rare.Case Presentation: A 42-year-old asymptomatic female was referred to our hospital for work-up of extralobar PS. The independent feeding artery from the thoracic aorta was confirmed by three-dimensional computed tomography angiography (3D-CTA). Extrapulmonary lesions were excluded by whole-body radiographical examinations. Uniportal thoracoscopic resection of the sequestrated lung and mediastinal lymph node sampling was performed successfully. Finally, ganglioneurofibroma within the PS was confirmed by pathological staining. The patient was discharged from the hospital on the 3rd postoperative day without tumor recurrence a year after surgery.Conclusion: Preoperative 3D-CTA is useful to verify the aberrant vessels of PS; whereas an elaborate diagnostic work-up after a timely resection is necessary for possible subsequent management and follow-up plan.

Download Full-text

Diagnosis and management of atypical pneumonia

10.1093/med/9780199600830.003.0118 ◽

2016 ◽

Author(s):

Martin Langer ◽

Edoardo Carretto

Keyword(s):

Legionella Pneumophila ◽

Clinical Presentation ◽

Clinical Symptoms ◽

Respiratory Infections ◽

Atypical Pneumonia ◽

Close Collaboration ◽

Antimicrobial Sensitivity ◽

Diagnostic Work ◽

Micro Organisms ◽

Work Up

‘Atypical pneumonia’ is an old, but successful term, which covers respiratory infections caused by different micro-organisms, causing similar clinical symptoms, and characterized by similar antimicrobial sensitivity/resistance. Out of specific epidemic contexts, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumonia are the micro-organisms involved, L. pneumophila being by far the most frequently involved in severe community-acquired ‘atypical’ pneumonia. It is important to suspect ‘atypical’ pneumonia on the basis of clinical presentation and the correlated extrapulmonary symptoms. Knowledge of symptoms leads to suspicion and, consequently, to timely and adequate empiric treatment and proper diagnostic work-up. Standard microbiological diagnosis is based on urinary antigen test for L. pneumophila and on serology for the other pathogens. A culture should be performed if legionellosis is suspected. NATs techniques could be the future diagnostic tests. Close collaboration with the microbiologist will improve the diagnosis.

Download Full-text

TRACHEOESOPHAGEAL FISTULA SECONDARY TO METASTATIC MEDIASTINAL LYMPH NODE FROM PROSTATE CANCER

The American Journal of Gastroenterology ◽

10.14309/00000434-200410001-00684 ◽

2004 ◽

Vol 99 ◽

pp. S222-S223

Author(s):

Charles H. Moore ◽

Jaymie H. Pennington ◽

Hemender Shah ◽

Dhiraj Yadav

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Tracheoesophageal Fistula ◽

Mediastinal Lymph Node

Download Full-text

Case Report: Hematoma Formation After Spontaneous Coronary Artery Rupture

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.801005 ◽

2022 ◽

Vol 8 ◽

Author(s):

Weitao Liang ◽

Honghua Yue ◽

Tailong Zhang ◽

Zhong Wu

Keyword(s):

Coronary Artery ◽

Clinical Symptoms ◽

Preoperative Evaluation ◽

Diagnostic Process ◽

Hematoma Formation ◽

Diagnostic Work ◽

The Right ◽

Multimodality Approach ◽

Work Up ◽

Coronary Artery Rupture

We report a case of hematoma formation in the right coronary artery after spontaneous rupture. A 48-year-old female patient was admitted with a suspected right cardiac mass. Despite diagnostic work-up, the dignity of the mass could not be determined. Due to acute clinical symptoms, explorative surgery was decided and performed. Hereby, the mass was partially incised, and thrombus-like tissue was detected without active bleeding. We described the challenges during the diagnostic process, and the diagnosis was finally made according to a multimodality approach. For further assessment, we reviewed related literature and highlighted the importance of coronary angiography in the preoperative evaluation of such patients. The therapy may vary according to the location and size of such lesions.

Download Full-text

Neurosarcoidosis Mimicking the Recurrence of Malignant Lymphoma

Case Reports in Neurology ◽

10.1159/000518378 ◽

2021 ◽

pp. 605-612

Author(s):

Keishu Murakami ◽

Jinsoo Koh ◽

Junko Taruya ◽

Hidefumi Ito

Keyword(s):

Lymph Node ◽

Malignant Lymphoma ◽

Clinical Symptoms ◽

Comprehensive Evaluation ◽

Mediastinal Lymph Node ◽

Interleukin 2 ◽

Cardiac Inflammation ◽

Positron Emission ◽

History Of ◽

Soluble Interleukin 2 Receptor

A 67-year-old woman with a recurrent history of malignant lymphoma (ML) presented with muscle weakness and paresthesia of the fingertips and feet. Due to the elevated level of serum soluble interleukin-2 receptor and increased <sup>18</sup>F-fluorodeoxyglucose uptake in a mediastinal lymph node, neurolymphomatosis was initially suspected. Neurological and electrophysiological examinations were consistent with mononeuropathy multiplex. A diagnosis of neurosarcoidosis was made based on the presence of noncaseating epithelioid granulomas in the mediastinal lymph node, along with the presence of the uveitis, cardiac inflammation, and mononeuropathy multiplex. She was treated with glucocorticoids and azathioprine, and her symptoms disappeared. Sarcoidosis following ML is rare, and since biopsy of nervous systems is often improbable, differentiating neurosarcoidosis and neurolymphomatosis can be difficult as their clinical symptoms can be similar. Clinicians should consider systemic pathological investigations based on <sup>18</sup>F-fluorodeoxyglucose positron emission tomography examination in addition to comprehensive evaluation to accurately diagnose neurosarcoidosis.

Download Full-text

Dietary hyperthyroidism in a Rottweiler

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v83i6.16629 ◽

2014 ◽

Vol 83 (6) ◽

pp. 306-311 ◽

Cited By ~ 3

Author(s):

S. Cornelissen ◽

K. De Roover ◽

D. Paepe ◽

M. Hesta ◽

E. Van der Meulen ◽

...

Keyword(s):

Clinical Case ◽

Bacterial Contamination ◽

Clinical Symptoms ◽

Clinical Signs ◽

Dietary History ◽

Total Thyroxine ◽

Diagnostic Work ◽

Work Up ◽

Complete History ◽

Diagnostic Work Up

In this report, a clinical case of dietary hyperthyroidism in a dog is described. An elevenmonth- old, male, intact Rottweiler was presented because of panting, weight loss and increased serum total thyroxine concentration. A complete history revealed that the dog was fed a bone and raw food diet, which made dietary induced hyperthyroidism very likely. Other possible differentials were excluded after a thorough diagnostic work-up. Finally, after changing towards a traditional commercial maintenance diet, the clinical symptoms resolved and thyroid blood values normalized. In every dog with an increased serum total thyroxine concentration, with or without clinical signs of hyperthyroidism, a thorough dietary history should be obtained. Owners should be informed that raw food diets tend to be nutritionally imbalanced, carry the risk of bacterial contamination, and have other safety problems. Therefore, veterinarians should recommend against feeding these diets.

Download Full-text

Prognostic Value of Lymphography in Cervical Cancer

Tumori Journal ◽

10.1177/030089167806400307 ◽

1978 ◽

Vol 64 (3) ◽

pp. 295-304 ◽

Cited By ~ 4

Author(s):

Fabio Volterrani ◽

Stefania Vona ◽

Sandro Barni ◽

Renato Musumeci

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Clinical Stage ◽

Stage I ◽

Clinical Classification ◽

Therapeutic Approaches ◽

Number Of Patients ◽

Node Metastases ◽

Diagnostic Work ◽

Work Up

This work is based on a review of 341 lymphographies carried out as a part of the initial diagnostic work-up performed on the same number of patients referred to our Institute for treatment from January 1961 to December 1976. As regards the distribution by clinical stage of the cases under consideration, there were 152 cases in Stage I (44.6%), 100 in Stage II (29.3%) and 89 in Stages III plus IV (26.1%). The positive lymphography incidence at the 2 extremes (Stage I a and Stages III plus IV) was 3.5 % and 46.0 %, respectively. The histologic type on its own did not seem to influence the incidence of lymph node metastases detectable by lymphography. For the negative cases, with all the stages mixed together, a 68.8 % 5-year survival rate free of disease was recorded, as compared with the 32.0 % found for the positive cases (P < 0.0001). A similar difference was recorded stage by stage. Our observations support the opinion that lymphography is valid in clinical practice to distinguish the minimum or nil lymph node invasion cases (negative) with favorable prognosis, from the cases having lymph node invasion of a certain importance or even at a maximum (positive), with a poor fate, independently of the initial clinical stage. Furthermore they suggest the advisability of reviewing the basic concepts of the clinical classification in cervical cancer, to be cautious in considering clinical reviews that do not report information of this importance, and to put under discussion different therapeutic approaches for cases presenting a lymphographic abnormality.

Download Full-text

Ganglioneurofibroma arising within the extralobar pulmonary sequestration

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01295-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Yuanyuan Liu ◽

Wenbin Wu ◽

Longbo Gong ◽

Miao Zhang

Keyword(s):

Mediastinal Lymph Node ◽

Three Dimensional ◽

Neuron Specific Enolase ◽

Pulmonary Sequestration ◽

Lymph Node Sampling ◽

S 100 ◽

Diagnostic Work ◽

Work Up ◽

Aberrant Vessels

Abstract Background Neurogenic tumor arising within the pulmonary sequestration (PS) is rare. Case presentation A 42-year-old asymptomatic female was referred to our hospital for work-up of extralobar PS. The independent feeding artery from the thoracic aorta was confirmed by three-dimensional computed tomography angiography (3D-CTA). Uniportal thoracoscopic resection of the sequestrated lung with mediastinal lymph node sampling was performed successfully. Ganglioneurofibroma within the PS was diagnosed as the specimen revealed positive expression of SRY-related HMG-box 10 protein, neuron-specific enolase, S-100, chromogranin A and synuclein. Tumor recurrence was not recorded 1 year after the surgery. Conclusion Preoperative 3D-CTA is useful to identify the aberrant vessels of PS. An elaborate diagnostic work-up after a timely resection is necessary for subsequent management and follow-up plan.

Download Full-text