scholarly journals September 2021 Pulmonary Case of the Month: A 45­-Year-Old Woman with Multiple Lung Cysts

2021 ◽  
Vol 23 (3) ◽  
pp. 64-72
Author(s):  
Lewis Wesselius ◽  
Keyword(s):  
Ovarian Cyst ◽  
Thoracoscopic Surgery ◽  
Tube Placement ◽  
Shortness Of Breath ◽  
Lung Cysts ◽  
Operative Note ◽  
History Of ◽  
The Right ◽  
Wedge Biopsy ◽  
Video Assisted Thoracoscopic Surgery

No abstract available. Article truncated after the first 150 words. History of Present Illness A 45-year-old woman presented with increasing dyspnea on exertion and a history of recurrent pneumothoraces. In March 2018 she had laparoscopic ovarian cyst removal and noted some subsequent shortness of breath. In August 2018 she developed a right pneumothorax requiring chest tube placement. In September 2018 she had recurrent right pneumothorax and had video-assisted thoracoscopic surgery (VATS) with a right pleurodesis. The operative note from the outside VATS indicates a RUL bleb was removed and a wedge biopsy was done from posterior segment of the RUL. Pathology from the wedge biopsy reported “minimal emphysematous disease without other diagnostic abnormality”. She continued to be short of breath after the operation. PMH, SH, and FH • In 1975 she reportedly had pulmonary tuberculosis. • In 2018 the pneumothoraces, pleurodesis and the right ovarian cyst resection noted above. She is a never smoker and has no family history…

scholarly journals A case of parasympathetic hyperactivity and associated Parry–Romberg syndrome

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110343
Author(s):  
Andrea N Clapp ◽  
Anna DePold Hohler
Keyword(s):  
Case Report ◽  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Thoracoscopic Surgery ◽  
History Of ◽  
Parry Romberg Syndrome ◽  
The Right ◽  
Facial Hemiatrophy ◽  
Video Assisted Thoracoscopic Surgery

This case report describes a 46-year-old female with a history of multiple endocrine neoplasia type 1 syndrome status post-parathyroidectomy, thymectomy via robotic video-assisted thoracoscopic surgery, and pituitary adenoma resection presenting with parasympathetic hyperactivity and Parry–Romberg syndrome. Parry–Romberg syndrome is a rare disorder that manifests as facial hemiatrophy. Reported symptoms include cognitive dysfunction, olfactory hallucinations, and parasympathetic hyperactivity: miosis of the right eye, anhidrosis, diarrhea, urinary incontinence, bowel incontinence, and orthostatic hypotension. Previous reports have noted associations between Parry–Romberg syndrome and sympathetic hyperactivity and dysregulation. This case report focuses on an association between Parry–Romberg syndrome and unopposed parasympathetic activity.

scholarly journals Lactobacillus gasseri Causing Bilateral Empyema

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Angela Esquibel ◽  
Ala S. Dababneh ◽  
Bharath Raj Palraj
Keyword(s):  
Thoracoscopic Surgery ◽  
Pleural Empyema ◽  
Complete Recovery ◽  
Tube Placement ◽  
Lactobacillus Gasseri ◽  
History Of ◽  
Severe Infections ◽  
Type Two Diabetes ◽  
Video Assisted Thoracoscopic Surgery

Lactobacilli are common commensal bacteria found in the gastrointestinal and genitourinary tract. Although they are usually thought to be nonpathogenic, there have been several cases that demonstrate severe infections caused by these microorganisms. This is a case of a 49-year-old male with previously undiagnosed type two diabetes mellitus who presented with a 3-month history of cough and was found to have right sided Lactobacillus gasseri empyema for which he underwent video-assisted thoracoscopic surgery (VATS) with chest tube placement. He subsequently developed a left sided pleural empyema for which the aspiration also grew out L. gasseri. The patient made a complete recovery and was seen for four months in follow-up after his initial presentation.

scholarly journals Non-smoking woman with adenocarcinoma of the lung, IV stage with ROS1 mutation and acquired thrombophilia

2021 ◽  
Vol 5 (1) ◽  
pp. 064-072
Author(s):  
Taivans Immanuels ◽  
Senterjakova Natalja ◽  
Kozirovskis Viktors ◽  
Strazda Gunta ◽  
Nazarovs Jurijs ◽  
...  
Keyword(s):  
Protein Tyrosine Kinase ◽  
Kinase Inhibitors ◽  
Palliative Chemotherapy ◽  
Thoracoscopic Surgery ◽  
Lower Lobe ◽  
Adenocarcinoma Of The Lung ◽  
Supraclavicular Lymph Nodes ◽  
History Of ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery

Despite the fact, that lung cancer is more common among older smoking men, however it may also develop among young women without a smoking anamnesis. We report here a history of a non-smoking woman, 40 years old, with a diagnosis of lung adenocarcinoma at IV stage. Despite the fact, the woman received three lines of palliative chemotherapy, the disease progressed. After the sample of the tumor was tested by genetic approach, ROS1 mutation was detected, and the patient was treated with a ROS1 inhibitor, Crizotinib. Sharp improvement was observed already after the first week of treatment. After one-month adenocarcinoma shrink, and specific supraclavicular lymph nodes disappeared. Unfortunately, due to problems with financing the treatment was stopped, after what the disease began to progress rapidly, and the patient died after a month due to brain metastasis. This case is noteworthy also because the patient was first diagnosed a thrombophilia with thrombi present in deep calf veins, left heart ventricle and lungs Adenocarcinoma was discovered occasionally when during video-assisted thoracoscopic surgery biopsy specimen was taken from suspicious mass in the lower lobe of the right lung. This story reminds us that lung carcinoma may start with a paraneoplastic syndrome, like thrombophilia as in this case and finding of adenocarcinoma of the lung in young, non-smoking persons is indicative for possible ROS1 gene mutation. In such cases early treatment with ROS1 protein-tyrosine kinase inhibitors should be started as soon as possible.

scholarly journals Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Dong ◽  
Chun-Li Wu ◽  
Yin-liang Sheng ◽  
Bin Wu ◽  
Guan-Chao Ye ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Lung Lesion ◽  
Parietal Pleura ◽  
Catamenial Pneumothorax ◽  
Endometrial Cells ◽  
Retrograde Menstruation ◽  
History Of ◽  
The Right ◽  
Thoracic Endometriosis

Abstract Background Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. Case presentation A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. Conclusion We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium.

scholarly journals Diagnostic and Therapeutic Performance of Video-Assisted Thoracoscopic Surgery (Vats) in Investigation and Management of Pleural Exudates

2008 ◽  
Vol 90 (7) ◽  
pp. 597-600 ◽  
Author(s):  
ARL Medford ◽  
YM Awan ◽  
A Marchbank ◽  
J Rahamim ◽  
J Unsworth-White ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Thoracoscopic Surgery ◽  
Good Practice ◽  
National Standards ◽  
Postoperative Fever ◽  
Video Assisted ◽  
The Right ◽  
Culture Negative ◽  
Video Assisted Thoracoscopic Surgery ◽  
Fluid Culture

INTRODUCTION Video-assisted thoracoscopic surgery (VATS) is the gold standard investigation for diagnosis of pleural exudates. It is invasive and it is important to ensure that it is performed to acceptable national standards. We assumed that VATS empyema fluid culture would not contribute further to microbiological diagnosis in referred culture-negative empyemas. PATIENTS AND METHODS Eighty-six consecutive external referrals for VATS for diagnosis of a cytology-negative pleural exudate (or for further management of the exudate) were studied retrospectively. Diagnostic yield, pleurodesis efficacy and complications were compared to national standards and good practice recommendations. VATS empyema fluid microbiological culture results were compared to pre-VATS empyema fluid culture results. RESULTS VATS was performed well within national standards with a diagnostic yield of 82.3% for cytology-negative exudates, 100% pleurodesis efficacy, 5.8% postoperative fever, with only one significant complication (1.2% rate) and no deaths. Compliance with good practice pleural fluid documentation points was greater than 70%. VATS empyema fluid culture positivity (84.6%) was significantly higher than pre-VATS fluid culture (35%). CONCLUSIONS VATS was performed to acceptable standards. These data confirm the utility and safety of VATS in the right context but also suggest the potential diagnostic utility of VATS empyema fluid culture. Further studies are required to investigate this latter possibility further.

scholarly journals Acute presentation of ruptured ovarian cyst secondary to torsion with ipsislateral concomitant ectopic pregnancy: A case report

2014 ◽  
Vol 3 (2) ◽  
pp. 54-56
Author(s):  
Mahendra R Pandey ◽  
Neeva Ojha
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Emergency Laparotomy ◽  
Hospital Emergency ◽  
Obstetrics And Gynaecology ◽  
History Of ◽  
Gestational Sac ◽  
One Year ◽  
The Right ◽  
Urine Pregnancy Test

Twenty-one year unmarried regularly menstruating lady without history of amenorrhea presented with acute abdomen in TU Teaching Hospital –Emergency Department. On evaluation urine pregnancy test was positive. Urgent ultrasound revealed multiloculated cystic lesion measuring 8.5 x 8 x 6.7 cms in the right adnexa anterolateral to the uterus with no intrauterine gestational sac. She underwent emergency laparotomy with right salpingo-oophorectomy. On laparotomy there was twisted and ruptured right ovarian cyst with unruptured ampullary pregnancy on the same side. There was coexistence of these two conditions which presented as acute abdomen. DOI: http://dx.doi.org/10.3126/njog.v3i2.10834 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 54-56

Introduction of the video-assisted thoracoscopic surgery (VATS) port through the subcostal incision to the right pleural cavity

ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 503-503
Author(s):  
Marcin Zieliński ◽  
Mariusz Rybak ◽  
Katarzyna Solarczyk-Bombik ◽  
Michal Wilkoj ◽  
Wojciech Czajkowski ◽  
...  
Keyword(s):  
Pleural Cavity ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery ◽  
Subcostal Incision

scholarly journals P1829 A middle aged man with pericardial cyst

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Kandil ◽  
R Nata ◽  
P Felix
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Maximum Diameter ◽  
Heavy Smoker ◽  
X Rays ◽  
Shortness Of Breath ◽  
Pericardial Cyst ◽  
History Of ◽  
Pericardial Cysts ◽  
The Right

Abstract Introduction Pericardial cysts are rare benign congenital anomaly that are usually accidentally discovered as a mass obliterating the costophrenic angle. The reported incidence is one to 100,000 with males are equally affected as females. They are usually asymptomatic; however, they can cause chest pain, shortness of breath and dry cough. Case report We present a 62 years old gentleman who presented with increasing shortness of breath. He was a heavy smoker and was known to have COPD. He was also known to have chronic heart failure with an EF of 40% and had a previous history of pericardial cyst that was initially discovered when he was investigated for shortness of breath. The patient had a one-month history of feeling more dyspneic than usual. His chest auscultation revealed scattered rhonchi and no murmurs were heard on auscultation of the heart. His ECG showed no new abnormality and his chest x-ray showed abnormal right cardio mediastinal silhouette with large opaque area adjacent to the right heart border and the size of the opacity the same compared to his previous x rays. An Echocardiography was done and this showed moderate to severe impairment of left ventricular systolic function with an EF of 30-35%, mild to moderate mitral regurgitation and showed a cystic lesion anterior to the right ventricle. A CT chest was done for evaluation of the pericardial cyst and showed centrilobular emphysema and a mass in the rt lung abutting the right border of the heart with a maximum diameter of 8.7 cm. The patient was non-compliant to his medications and repeatedly missed his follow up appointments. He also continued to smoke despite progression of his COPD. The cause of his shortness of breath was likely due to progression of heart failure and COPD with the pericardial cyst probably has no or minimal rule. Conclusion Pericardial cysts are rarely symptomatic and usually has a benign course. We aimed at increasing awareness of this rare benign animally. Abstract P1829 Figure.

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