scholarly journals Medical Image of the Month: Buffalo Chest Identified at the Time of Lung Nodule Biopsy

2020 ◽  
Vol 21 (5) ◽  
pp. 121-123
Author(s):  
Phillip Belone ◽  
◽  
Jason Lee ◽  
Michael Larson
Keyword(s):  
New Left ◽  
Lung Nodule ◽  
Chest Ct ◽  
Tumor Board ◽  
Post Surgery ◽  
History Of ◽  
Lateral Decubitus ◽  
Touch Preparation ◽  
Intraprocedural Imaging ◽  
The Right

No abstract available. Manuscript truncated after 150 words. A gentleman in his late 50s with a past medical history of squamous cell carcinoma at the base of the tongue had numerous slowly-growing pneumocyst-like lesions despite clinical remission status post surgery and chemoradiation. Biopsy of one of these lesions was recommended by a multidisciplinary tumor board. An outpatient pre-procedural supine chest CT revealed a right pneumothorax above the lesion targeted for biopsy. A subsequent pre-procedural right lateral decubitus chest CT three weeks later demonstrated a left-sided pneumothorax, raising concern for buffalo chest. (A less likely possibility would be spontaneous resolution of the right pneumothorax and development of a new left pneumothorax in the less than 4-week interval.) Intraprocedural imaging continued to demonstrate the left-sided pneumothorax. A biopsy touch preparation of the first sample obtained did not demonstrate malignancy. Therefore, an attempt was made at obtaining another sample. However, the patient developed a brief but forceful coughing fit, resulting in …

Lung Nodule with Increasing Fluorodeoxyglucose Uptake in a Patient with a History of Lung Carcinoma and Talc Pleurodesis Evaluated by EBUS-TBNA On-Site Assessment

2017 ◽  
Vol 61 (1) ◽  
pp. 84-86 ◽  
Author(s):  
Elizabeth M. Kurian
Keyword(s):  
New Left ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Talc Pleurodesis ◽  
Site Assessment ◽  
Fdg Uptake ◽  
Positron Emission ◽  
History Of ◽  
Site Evaluation

Background: Fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan is an indicator of potential malignancy or infection. Patients with a history of talc pleurodesis can develop pleural or lung parenchymal nodules/talcomas. In these patients, talc-associated (non-malignancy-related) FDG uptake may occur over years. Case Report: A 66-year-old female presented with a past medical history significant for resected non-small-cell lung cancer and was treated with chemotherapy/radiation. The referring physician indicated that she subsequently developed benign pleural effusions and had talc pleurodesis to limit recurrence. The patient was referred to our institution for endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) due to a new left upper lobe nodule with increasing FDG uptake on follow-up interval PET performed at the referring institution. On-site cytologic evaluation showed no evidence of malignancy, but found refractile foreign material, consistent with the presence of talc particles. Conclusion: This case presents the importance of cytologic recognition of talc particles during on-site evaluation and discusses the phenomenon of increasing PET-FDG uptake associated with talc pleurodesis.

scholarly journals LUNG NODULE 25 YEARS AFTER LOBECTOMY – RECURRENCE OF BRONCHIAL CARCINOID

2020 ◽  
Vol 73 (10) ◽  
pp. 2309-2312
Author(s):  
Aleksandra Bełz ◽  
Violetta Rosiek ◽  
Joanna Głogowska- Szeląg ◽  
Katarzyna Stęplewska ◽  
Beata Kos-Kudła
Keyword(s):  
Positive Family History ◽  
Lung Nodule ◽  
Typical Carcinoid ◽  
Thoracic Computed Tomography ◽  
Pathological Result ◽  
Second Tumors ◽  
History Of ◽  
Distant Spread ◽  
The Right

Introduction: Bronchopulmonary (BP) carcinoids are low and intermediate grade tumors, seen in adults between fourth to sixth decade, where no clear association with tobacco smoking is established. Most often they are sporadic lesions (95%). Half of patients have no symptoms and the tumor is incidentally found on a chest x- ray. BP carcinoids have a good prognostic, however there is a risk of distant metastasis and the recurrences are frequent. Therefore a crucial role of vigilant follow- up, extending far beyond 5 years. Case presentation: We report a case of 73 years old women, with history of recurrent pulmonary infections, and positive family history for lung cancer. Patient underwent left inferior lobectomy for BP carcinoid 25 years before and completed a 5 years long follow- up. On a thoracic computed tomography scan a nodule in the right lung was detected. Patient benefited from surgery and the pathological result was typical carcinoid with Ki67<1%. Follow- up CT scans showed stable images, with no signs of spread or recurrence. Conclusions: Although there is a low risk of distant spread in such tumors, the recurrences are frequent. Moreover, patients may exhibit a higher risk of development of second tumors and there is a risk of metachronous tumors. The post-operative follow-up should be prolonged.

scholarly journals Risk factors for the conversion of laparoscopic to open cholecystectomy

2018 ◽  
Vol 5 (7) ◽  
pp. 2470
Author(s):  
Kiran Kumar Paidipelly ◽  
Sangamitra .
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Previous History ◽  
Normal Activity ◽  
Post Surgery ◽  
History Of ◽  
The Right ◽  
Hospital Days ◽  
Lower Morbidity

Background: Gall stones is one of the most common diseases in man. Laparoscopic cholecystectomy is the preferred procedure, mainly due to lower morbidity and mortality, thus returning to the normal activity sooner, lesser number of hospital days and lesser pain post-surgery. However, around 2-15% of the patients need to convert from laparoscopic to open surgery due to different reasons.Methods: 357 patients who came in for laparoscopic cholecystectomy were included into the study. Details such as age, height, weight, BMI, mode of surgery i.e. emergency or elective, physical and clinical examination including Ultrasound, lab results, previous history of surgery and other co morbidities were noted.Results: Out of the 357 patients, 31(8.7%) were converted to open cholecystectomies, of which, 61.3% females and 38.7% males. 58% in the open cholecystectomy group were above 60 years. 67.7% of the patients who converted to open surgery had a BMI of over 25, while it was 39.6%   in case of laparoscopic surgery. 74.2% among the patients who had undergone conversion to the open surgery had pain in the right hypochondrium, 67.7% had increased WBC levels.Conclusions: Increased age, obesity, tenderness in the RHC, increased WBC levels, acute cholecystitis are the predisposing factors for the conversion of laparoscopic cholecystectomy to open cystectomy.

Peran Computed Tomography (CT) Toraks dalam Diagnosis Abses yang Menyerupai Massa Mediastinum

2016 ◽  
Vol 1 (3) ◽  
pp. 178-184
Author(s):  
Krishna P. Wicaksono ◽  
Aziza G. Icksan
Keyword(s):  
Clinical History ◽  
Chest Ct ◽  
X Ray ◽  
Precise Diagnosis ◽  
Life Threatening ◽  
History Of ◽  
Facial Edema ◽  
Chest X Ray ◽  
The Right ◽  
Peripheral Enhancement

Mediastnal abscess is rare, yet it could be a life threatening infecton. A precise diagnosis followed by adequate treatments need to be quickly established. Clinical informaton is usually not diagnostc. Therefore, radiological examinatons have important role.We report a ffy-one years old female with clinical history of sore throat, cough and neck-facial edema since fve days before admission. Laboratory examinatons revealed leukocytosis and ESR elevaton. Chest x-ray depicted a homogenous consolidaton in the right paratracheal region which deviated trachea to the lef. On enhanced chest CT examinaton, we found a cystc mass in the right paratracheal region, extending to the right supero-anterior mediastnum, with peripheral enhancement, air-?uid level and minimal right pleural e?usion, suggestve for mediastnal abscess. Bronchoscopy found no abnormality.Several days later, mediastnal abscess was confrmed surgically and drained through thoracotomy. Although culture of pus failed to grow any bacteria, histopathological examinaton confrmed a non-specifc chronic in?ammaton with no sign of malignancy. The main purpose of this report is to emphasize the importance of enhanced chest CT in evaluatng patent with tumor mimicking mediastnal abscess.

scholarly journals Thoracic textilomas: CT findings

2014 ◽  
Vol 40 (5) ◽  
pp. 535-542 ◽  
Author(s):  
Dianne Melo Machado ◽  
Gláucia Zanetti ◽  
Cesar Augusto Araujo Neto ◽  
Luiz Felipe Nobre ◽  
Gustavo de Souza Portes Meirelles ◽  
...  
Keyword(s):  
Chest Pain ◽  
Early Identification ◽  
Heart Surgery ◽  
Chest Ct ◽  
Ct Scans ◽  
Radiopaque Marker ◽  
History Of ◽  
The Right ◽  
Pericardial Involvement ◽  
Pleural Involvement

OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

scholarly journals Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema

2019 ◽  
Vol 12 (5) ◽  
pp. e228849
Author(s):  
Joana Sofia Carvalho ◽  
Diogo Paixão Marques ◽  
Inês Oliveira ◽  
Ana Cláudia Vieira
Keyword(s):  
Bronchopleural Fistula ◽  
Final Diagnosis ◽  
Lung Abscess ◽  
Chest Ct ◽  
Appropriate Treatment ◽  
Ultrasound Findings ◽  
History Of ◽  
Respiratory Physiotherapy ◽  
The Right

We report the case of a 66-year-old man with dental infection who presented to our emergency department complaining of a 3-month medical history of chest pain and productive cough, in association with malaise, fever, weight loss and anaemia. His chest radiograph showed a nearly total opacification of the right hemithorax and chest ultrasound findings were suggestive of empyema, subsequently confirmed by a chest CT. The patient started appropriate treatment. A follow-up chest CT performed to rule out bronchopleural fistula revealed a large lung abscess. The patient had the final diagnosis of a giant lung abscess, which was initially thought to be an empyema because of the clinical and radiologic similarities with this entity. The initial misdiagnosis led to prompt percutaneous drainage of the lung abscess in addition to antibiotherapy and respiratory physiotherapy with a good final outcome, which suggests the efficacy of this approach in similar cases.

Surgically induced diffuse scleritis associated with choroidal detachment following phacoemulsification surgery

2021 ◽  
pp. 112067212110261
Author(s):  
Diego Alejandro Valera-Cornejo ◽  
Marlon García-Roa ◽  
Verónica Romero-Morales
Keyword(s):  
Early Recognition ◽  
Oral Prednisone ◽  
Choroidal Detachment ◽  
Rare Presentation ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
History Of ◽  
Pars Plana ◽  
The Right ◽  
Surgically Induced

Purpose: We present a case of a hemorrhagic choroidal detachment associated with a surgical induced diffuse scleritis (SIDS) following phacoemulsification surgery. Case report: A-49-year-old healthy male with history of high myopia and pars-plana vitrectomy associated with 360° encircling buckle surgery years ago, who underwent phacoemulsification surgery with in-the-bag intraocular lens implantation on the right eye and developed an important 360° hemorrhagic choroidal detachment on the first-day post-surgery, 10 days later, presented SIDS. First day after surgery, best-corrected visual acuity was hands movement in the affected eye. Ten days later, the patient presented with severe ocular pain and redness on the right eye, the right sclera showed active diffuse inflammation without thinning. A normal collagen vascular profile was found and systemic vasculitic disorders were discarded. The patient responded well to systemic therapy (oral prednisone, 0.5 mg/kg/day at the beginning and then 1 mg/kg/day when scleritis appeared) and 8 weeks later, fundus examination revealed complete resolution of the hemorrhagic choroidal detachment and inflammation. Conclusion: A rare presentation of a surgical induced diffuse scleritis associated with choroidal detachment as an acute complication due to phacoemulsification cataract surgery was presented. Early recognition and treatment led to visual improvement and resolution of the scleritis and choroidal detachment.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

Sign in / Sign up

Export Citation Format

Share Document