scholarly journals Miliary Tuberculosis with Mediastinal and Cervical Lymph Node Involvement Complicated by an Eso- Mediastinal Fistula

Author(s):  
Guglielmi S ◽  
Guglielmi G ◽  
Mönig S ◽  
Janssens JP ◽  
Spahr L

Esophageal involvement in tuberculosis is rare even in highly endemic areas for tuberculosis and is most often secondary to concomitant mediastinal lymph node infection. Endoscopy and imaging are essential for diagnosis. Conservative treatment is possible but the major risk is mediastinitis secondary to an eso-mediastinal fistula.

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
An Wang ◽  
Lu Lu ◽  
Jie Fan ◽  
Shaohua Wang ◽  
Xiaofeng Chen

Abstract Background and objectives The optimal therapeutic method for patients with superficial esophageal squamous cell carcinoma (sESCC) remains to be established. Methods Clinical data of all the patients from 2002 to 2014 who underwent curative esophagectomy and three-field lymphadenectomy for thoracic sESCC were collected based on a prospectively-maintained database. The pattern of lymph node metastasis was analyzed based on the depth of tumor invasion, tumor location and surgical fields. Results The involved lymph node region was associated to the tumor location, however, upper mediastinal and perigastric region was the most vulnerable region. The incidence of lymph node metastasis increased with the depth of tumor invasion. No lymph node involvement was found in tumors invading proper mucosa (M2), while the pattern of positive lymph nodes in tumors invading the deepest 1/3 submucosa was similar to that in advanced ESCC. Lymphatic invasion, tumor location and upper mediastinal lymph node involvement were independent predictors for cervical lymph node metastasis. For patients without lymphatic invasion, the positive predictive value of upper mediastinal lymph node metastasis for positive cervical lymph node was low (0 ~ 25%), while the negative predictive value was extremely high, wherever the tumor located (93.8 ~ 100%). Conclusions Tumors invading till proper mucosa was the best indication for endoscopic mucosa resection. Mediastinal-abdominal lymphadenectomy was essential for sESCC invading beyond proper mucosa. For those without lymphatic invasion, cervical lymphadenectomy might be avoided in case of negative upper mediastinal lymph node.


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ahmed M. Habib ◽  
Xenophon Kassianides ◽  
Samuel Chan ◽  
Mahmoud Loubani ◽  
Syed Qadri

Colorectal carcinoma is the second biggest cancer responsible for mortality. Lung metastasis is the commonest, following the liver. It is not uncommon to perform pulmonary metastasectomy and identify mediastinal metastasis. Previous studies have identified incidental lymph node involvement following routine mediastinal lymph node clearance in 20–50% of cases. However, solitary intrathoracic lymph node metastasis is exceedingly rare. Even when present, it is usually metachronous. In our case, we present an exceedingly rare case whereby the intrathoracic lymph node metastasis is solitary, not accompanying pulmonary disease and with no liver metastasis. We also review the evidence for mediastinal lymphadenectomy in the literature.


2005 ◽  
Vol 446 (5) ◽  
pp. 546-554 ◽  
Author(s):  
Ömer Uluoğlu ◽  
Nalan Akyürek ◽  
Aytuğ Üner ◽  
Uğur Coşkun ◽  
Ayşegul Özdemir ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
A. Bahar Ceyran ◽  
Serkan Şenol ◽  
Barış Bayraktar ◽  
Şeyma Özkanlı ◽  
Z. Leyla Cinel ◽  
...  

A 37-year-old male case was admitted with goiter. Ultrasonography of thyroid showed a 5 cm cystic nodule in the left lobe with a 1.5 cm solid component. Fine needle aspiration biopsy revealed atypia of undetermined significance or follicular lesion. The patient was operated on. The pathological diagnosis was reported as papillary thyroid carcinoma. The immunohistochemical examination showed multiple foci of Langerhans cell histiocytosis involving both lobes. The patient died due to cardiac arrest with respiratory causes in the early postoperative period. Langerhans cell histiocytosis is a rare primary condition which involves abnormal clonal proliferation of Langerhans cells in various tissues and organs. Thyroid involvement is infrequently seen. Although the etiology is unknown, genetic components may be linked to the disease. It is also associated with a family history of thyroid disease. Papillary thyroid carcinoma is the most common malignant epithelial tumor of the thyroid gland. Langerhans cell histiocytosis presenting with papillary thyroid carcinoma is rare. The privilege of our case is langerhans cell histiocytosis of the thyroid with multiple cervical lymph node involvement accompanying cervical lymph node metastatic thyroid papillary carcinoma.


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