scholarly journals The Differential Diagnosis of Bilateral Pleural Effusion and Multiple Mediastinal Lymphadenopathies Includes Kikuchi-Fujimoto Disease

2020 ◽  
Vol 8 ◽  
pp. 232470962093342
Author(s):  
Chienhsiu Huang
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Pleural Effusion ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Cervical Lymphadenopathy ◽  
Oral Prednisolone ◽  
Disease Diagnosis ◽  
Bilateral Pleural Effusion ◽  
Mediastinal Lymphadenopathy

Kikuchi-Fujimoto disease is an uncommon lymphohistiocytic disorder that frequently presents with acute or subacute clinical disease course. Cervical lymphadenopathy is the most common involved lymph node. Very rare cases of pathologic diagnosis of Kikuchi-Fujimoto disease with bilateral pleural effusion and multiple mediastinal lymphadenopathies have been reported in the literature. In this article, we report the case of a 60-year-old male presented with bilateral pleural effusion and multiple mediastinal lymphadenopathies. He received video-assisted thoracoscopic surgery of the right pleura and thoracoscopic excision of the mediastinal lymph node. The pathologic findings from the lymph node and pleura were compatible with Kikuchi-Fujimoto disease. He was treated with oral hydroxychloroquine and oral prednisolone. A computed tomography scan of the chest 4 months later showed regressive mediastinal lymphadenopathy and bilateral pleural effusion. Our case is a first reported case of Kikuchi-Fujimoto disease diagnosis by the pathology of the lymph node and pleura in the literature. Results from our case suggest that Kikuchi-Fujimoto disease should be included in the differential diagnosis of bilateral pleural effusion and multiple mediastinal lymphadenopathies.

Right Superior Mediastinal Lymph Node Dissection in Thoracoscopic Surgery Using a Bipolar Sealing Device

2013 ◽  
Vol 8 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Hitoshi Igai ◽  
Takashi Ibe ◽  
Natsuko Kawatani ◽  
Yoichi Ohtaki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection ◽  
Chest Drainage ◽  
Sealing Device

Objective This study investigated the use of a new bipolar sealing device (BSD) in right superior mediastinal lymph node dissection during thoracoscopic surgery. Methods The study population consisted of 42 consecutive patients undergoing lobectomy with right superior mediastinal lymph node dissection for primary lung cancer. Operative results were compared with those of conventional surgery in 42 background-matched controls. The primary endpoint for the present analysis was the success of right superior mediastinal lymph node dissection during thoracoscopic surgery using a BSD. The secondary endpoints included the duration of the operation, number of dissected lymph nodes, chest drainage volume and duration, postoperative hospital stay, morbidity, and mortality. Results The BSD was used successfully in 42 patients. No significant difference in duration of lymph node dissection, chest drainage volume, drainage duration, or number of dissected lymph nodes was observed between the study group and the controls. Because of a learning curve, the procedure initially took more than 20 minutes to complete, but surgical time was reduced to approximately 15 minutes after the procedure was performed in 15 patients. Conclusions Our method is safe and in no way inferior to the conventional procedure. The tendency of the learning curve suggests that a significantly shorter duration of lymph node dissection is possible using this method.

scholarly journals Ultrasound-Guided Cervical Lymph Node Sampling Performed by Respiratory Physicians

2019 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Mohammed Ahmed ◽  
Cyrus Daneshvar ◽  
David Breen
Keyword(s):  
Lymph Node ◽  
Cervical Lymph Node ◽  
Diagnostic Yield ◽  
Cervical Lymphadenopathy ◽  
Mediastinal Lymphadenopathy ◽  
Competency Assessment ◽  
Neck Lymph Node ◽  
Lymph Node Sampling ◽  
Significant Difference ◽  
Respiratory Physician

Background: A variety of disease processes investigated by respiratory physicians can lead to cervical lymphadenopathy. Ultrasound (US) has revolutionised respiratory investigations, and neck ultrasound (NUS) is increasingly recognised as an additional important skill for respiratory physicians. Objectives: We aimed to assess the feasibility of NUS performed by respiratory physicians in the workup of patients with mediastinal lymphadenopathy. Methods: This is a single-centre retrospective cohort study. All patients that underwent US-guided cervical lymph node sampling were included. The diagnostic yield is reported, and specimen adequacy is compared for respiratory physicians and radiologists. Results: Over 5 years, 106 patients underwent NUS-guided lymph node sampling by respiratory physicians compared to 35 cases performed by radiologists. There was no significant difference in the adequacy of sampling between the two groups (respiratory physicians 91.5% [95% CI 84.5–96%] compared to 82.9% [95% CI 66.4–93.4%] for radiologists [p = 0.2]). In the respiratory physician group, a diagnosis was achieved based on lymph node sampling in 89 cases (84%). Neck lymph node sampling was the only procedure performed to obtain tissue in 48 cases (45.3%). Conclusion: NUS and sampling performed by respiratory physicians are feasible and associated with an adequacy rate comparable to that of radiologists. It can reduce the number of invasive procedures performed in a selected group of patients. Guidelines for training and competency assessment are required.

scholarly journals A case report on expanding horizon of endobronchial ultrasound through esophagus

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Mario Tamburrini ◽  
Parikshit Thakare ◽  
Francesca Zampieri ◽  
Angelo Scarda ◽  
Alessandra Di Paolo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pleural Effusion ◽  
Squamous Carcinoma ◽  
Final Diagnosis ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Malignant Cells ◽  
Necrotic Tissue ◽  
Fluid Collections ◽  
Cytology Report

Endobronchial ultrasound has revolutionized the field of bronchoscopy and has become one of the most important tools for the diagnosis of intrathoracic lymphadenopathy and para-bronchial structures. The reach of this technique has not been limited to these structures and pleural lesions have been at times accessible. To our knowledge, pleural fluid collections have not been accessed with endobronchial ultrasound (EBUS) through oesophageal approach and rationale behind using this approach. We report a case of 70 years old man who has been referred from physician for the EBUS in view of hilar mass with mediastinal lymphadenopathy with pleural effusion. The endobronchial ultrasound through oesophagus (EUS-B) was done for thoracocentesis and lymph node cytology evaluation and ultimately endobronchial biopsy of hilar mass was done as rapid on-site (ROSE) analysis of lymph node was suggestive of necrotic tissue. The cytology report of lymph node and pleural effusion was positive for malignant cells. The final diagnosis was metastatic poorly differentiating adeno-squamous carcinoma.

Cervical lymphadenopathy secondary to atypical mycobacteria in children

1996 ◽  
Vol 110 (1) ◽  
pp. 48-51 ◽  
Author(s):  
R. Benson-Mitchell ◽  
G. Buchanan
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Malignant Disease ◽  
Cervical Lymphadenopathy ◽  
Surgical Excision ◽  
Definitive Diagnosis ◽  
Atypical Mycobacteria ◽  
Complete Surgical Excision ◽  
Immunocompromised Child

AbstractNon-tuberculous mycobacterial (NTM) infections usually present as an enlarged lymph node in the neck of a non-immunocompromised child. The differential diagnosis includes bacterial adenitis, malignant disease and tuberculosis. The definitive diagnosis relies upon isolating the organisms in culture. The treatment is complete surgical excision with, or without, anti-tuberculous chemotherapyTen cases of NTM infections are presented with a discussion of the aetiology and treatment of this condition.

Video-assisted thoracoscopic surgery for the treatment of mediastinal lymph node tuberculous abscesses

2017 ◽  
Vol 37 (6) ◽  
pp. 849-854
Author(s):  
Tao Zuo ◽  
Feng-yun Gong ◽  
Bao-jun Chen ◽  
Zheng-yi Ni ◽  
Ding-yu Zhang
Keyword(s):  
Lymph Node ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals A multidisciplinary collaborative model based on single-port thoracoscopy for the treatment of giant mediastinal lymph node hyperplasia: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110627
Author(s):  
Haihua Gu ◽  
Tianshu Liu ◽  
Ling Zhu ◽  
Lufeng Zhao ◽  
Junqiang Fan
Keyword(s):  
Lymph Node ◽  
Single Port ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Superior Vena ◽  
Vena Cava ◽  
Postoperative Recovery ◽  
Castleman Disease ◽  
Collaborative Model ◽  
Model Based

Mediastinal unicentric Castleman disease (UCD) frequently manifests as a hyper-enhancing lymph node mass and is often surgically curable. However, because of excessive vascularisation and adhesion to important surrounding structures, surgery is often associated with severe haemorrhage that is often difficult to control thoracoscopically. Therefore, thoracotomy is often preferred, which increases the trauma to the patient and affects postoperative recovery. Here, we describe the case of a 30-year-old male patient with a large upper mediastinal lymph node (7 × 5 × 4 cm) that was compressing his superior vena cava. The distribution of nutritive arteries of the mass was analysed in detail, and the main branches were embolised prior to surgery. With the assistance of preoperative isovolumetric haemodilution, we achieved complete resection through single-port thoracoscopy, with only minor haemorrhage, which enabled the patient to recover rapidly. This multidisciplinary collaborative model, based on single-port thoracoscopic surgery, may be of wide practical use for the treatment of mediastinal UCD.

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