Pulmonary Nodular Lymphoid Hyperplasia in a 53-year-old Man With Malignant Sign: a Case Report and Literature Review

Abstract Background: Pulmonary nodular lymphoid hyperplasia (PNLH) is a rare benign illness. Due to atypical clinical and radiographic presentations, diagnosis largely depends on postoperative pathological examination. Thus, preoperative misdiagnosis is often occurred. Case presentation: We present a case of asymptomatic PNLH that was seen as ground-glass opacity (GGO) on computed tomography (CT). After 3-year observation, the diagnosis tends to adenocarcinoma owing to increasing density of the node and vessel convergence sign, which were signs of malignancy. Video-assisted segmentectomy (S10) was carried out. Histopathologic examination of postoperative specimen showed follicular lymphoid hyperplasia with interfollicular lymphoplasmacytosis, consistent with PNLH. The follow-up chest CT images showed no recurrence or metastasis.Conclusion: Although it is a benign disease, PNLH can exhibit malignant signs in the imaging examinations, which could lead to misdiagnosis. This reminds us of the uncertainty between imaging findings and diagnosis. The diagnosis depends on postoperative pathological examination. Surgical resection is not only diagnostic but also curative.

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Pulmonary nodular lymphoid hyperplasia in a 53-year-old man with malignant sign: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01672-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhen Yang ◽

Lianshuang Wei ◽

Xu Li ◽

Xin Liu

Keyword(s):

Ground Glass Opacity ◽

Lymphoid Hyperplasia ◽

Chest Ct ◽

Benign Disease ◽

Pathological Examination ◽

Case Presentation ◽

Volume Doubling Time ◽

Nodular Lymphoid Hyperplasia ◽

Volume Doubling

Abstract Background Pulmonary nodular lymphoid hyperplasia (PNLH) is a rare benign illness. Due to atypical clinical and radiographic presentations, diagnosis largely depends on postoperative pathological examination. Thus, preoperative misdiagnosis is often occurred. Case presentation We present a case of asymptomatic PNLH that was seen as ground-glass opacity (GGO) on computed tomography (CT). After 3-year observation, the diagnosis tends to adenocarcinoma owing to increasing density of the node and vessel convergence sign, which were signs of malignancy. Video-assisted segmentectomy (S10) was carried out. Histopathologic examination of postoperative specimen showed follicular lymphoid hyperplasia with interfollicular lymphoplasmacytosis, consistent with PNLH. The follow-up chest CT images showed no recurrence or metastasis. Conclusion Although it is a benign disease, PNLH can exhibit malignant signs in the imaging examinations, which could lead to misdiagnosis. This reminds us of the uncertainty between imaging findings and diagnosis. The diagnosis depends on postoperative pathological examination. Volume doubling time is a potential parameter to differentiate PNLH from lung cancer.

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The largest reported intrathoracic lipoma: a case report and current perspectives review

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1030-8 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Mohammed Aldahmashi ◽

Abdalmotaleb Elmadawy ◽

Mahmoud Mahdy ◽

Mohamed Alaa

Keyword(s):

Single Case ◽

Tumor Resection ◽

Pathological Examination ◽

Complete Excision ◽

Case Presentation ◽

Medical Checkup ◽

Excellent Outcome ◽

The Right ◽

Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

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Primary splenic hydatidosis: a case report

Journal of International Medical Research ◽

10.1177/0300060519845500 ◽

2019 ◽

Vol 48 (2) ◽

pp. 030006051984550

Author(s):

Qiang Wang ◽

Ming-quan Pang ◽

Ying-li Kang ◽

Zhi-xin Wang ◽

Dongzhi Cairang ◽

...

Keyword(s):

Case Report ◽

Laparoscopic Splenectomy ◽

Serological Test ◽

Chronic Atrophic Gastritis ◽

Pathological Examination ◽

Test Results ◽

Imaging Findings ◽

Pastoral Area ◽

History Of

We herein report a case of primary splenic hydatidosis to provide data regarding the diagnosis, treatment, and epidemiological statistics of this disease. The patient was from a pastoral area and was diagnosed with primary splenic hydatidosis with chronic atrophic gastritis. The patient had no history of surgical treatment of hydatidosis. The diagnosis was mainly based on possible exposure to endemic areas, imaging findings, serological test results, and operative and pathological examination findings. Laparoscopic splenectomy was performed, and regular albendazole therapy was given after the operation. The patient was admitted to the hospital for gastrointestinal bleeding 3 months postoperatively, and she was successfully treated and discharged. No recurrence of hydatid foci has been observed since the follow-up.

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Analysis of Chest CT Results of Coronavirus Disease 2019 (COVID-19) Patients at First Follow-Up

Canadian Respiratory Journal ◽

10.1155/2020/5328267 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Lingshan Zhong ◽

Shuo Zhang ◽

Jigang Wang ◽

Xinqian Zhao ◽

Kai Wang ◽

...

Keyword(s):

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Imaging Data ◽

Exclusion Criteria ◽

Pulmonary Lesions ◽

Normal Chest ◽

Time Of Admission ◽

Better Than

Objective. To investigate the dissipation and outcomes of pulmonary lesions at the first follow-up of patients who recovered from moderate and severe cases of COVID-19. Methods. From January 21 to March 3, 2020, a total of 136 patients with COVID-19 were admitted to our hospital. According to inclusion and exclusion criteria, 52 patients who recovered from COVID-19 were included in this study, including 33 moderate cases and 19 severe cases. Three senior radiologists independently and retrospectively analyzed the chest CT imaging data of 52 patients at the last time of admission and the first follow-up after discharge, including primary manifestations, concomitant manifestations, and degree of residual lesion dissipation. Results. At the first follow-up after discharge, 16 patients with COVID-19 recovered to normal chest CT appearance, while 36 patients still had residual pulmonary lesions, mainly including 33 cases of ground-glass opacity, 5 cases of consolidation, and 19 cases of fibrous strip shadow. The proportion of residual pulmonary lesions in severe cases (17/19) was statistically higher than in moderate cases (19/33) ( χ 2 = 5 . 759 , P < 0.05 ). At the first follow-up, residual pulmonary lesions were dissipated to varying degrees in 47 cases, and lesions remained unchanged in 5 cases. There were no cases of increased numbers of lesions, enlargement of lesions, or appearance of new lesions. The dissipation of residual pulmonary lesions in moderate patients was statistically better than in severe patients (Z = −2.538, P < 0.05 ). Conclusion. Clinically cured patients with COVID-19 had faster dissipation of residual pulmonary lesions after discharge, while moderate patients had better dissipation than severe patients. However, at the first follow-up, most patients still had residual pulmonary lesions, which were primarily ground-glass opacity and fibrous strip shadow. The proportion of residual pulmonary lesions was higher in severe cases of COVID-19, which required further follow-up.

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Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

10.21203/rs.3.rs-25791/v1 ◽

2020 ◽

Author(s):

Nian Liu ◽

Guanghong He ◽

Xiongxiong Yang ◽

Jianxin Chen ◽

Jie Wu ◽

...

Keyword(s):

Severity Score ◽

Ground Glass Opacity ◽

Chest Ct ◽

Critical Group ◽

Occurrence Rate ◽

Dynamic Changes ◽

Pleural Thickening ◽

The Third ◽

The Right

Abstract Background To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p < 0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2 = 0.137, p = 0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p > 0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p > 0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p < 0.05). Conclusions The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

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Retropharyngeal Abscess in an adult with Pneumonia during COVID-19 Outbreak in China

10.21203/rs.3.rs-58631/v1 ◽

2020 ◽

Author(s):

Tianyu Wang ◽

Haibin Liu ◽

Caiquan Liang ◽

Hang Zhang ◽

Jianchun Liao ◽

...

Keyword(s):

Foreign Body ◽

Chest Ct ◽

Retropharyngeal Abscess ◽

Surgical Drainage ◽

Case Presentation ◽

Raising Awareness ◽

Cervical Approach ◽

Anterior Cervical Approach ◽

Chest Ct Scan

Abstract Background: Retropharyngeal abscesses are rarely reported in adults and occur mostly in patients with immunocompromise or as a foreign body complication. Admittedly, the treatment of retropharyngeal abscesses frequently involves surgical drainage to achieve the best results. However, when retropharyngeal abscesses occurred in a highly suspected patient with COVID-19, the managements and treatments should be caution in order to prevent the spread of the virus. Case presentation: On Feb. 13, a 40-year-old male with retropharyngeal abscesses turned to our department complaining dyspnea and dysphagia. In addition, his chest CT scan shows a suspected COVID-19 infection, thus making out Multiple Disciplinary Team (MDT) determine to perform percutaneous drainage and catheterization through left anterior cervical approach under the guidance of B-ultrasound. Finally, the patient recovered and was discharged from the hospital on Feb. 27 after 14 days of isolation. There was no recurrence after half a year follow-up. Conclusions: By presenting this case, we aim at raising awareness of different surgical drainage methods and summarizing our experience in the management of retropharyngeal abscesses during the outbreak of COVID-19.

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Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

10.21203/rs.3.rs-25791/v2 ◽

2020 ◽

Author(s):

Nian Liu ◽

Guanghong He ◽

Xiongxiong Yang ◽

Jianxin Chen ◽

Jie Wu ◽

...

Keyword(s):

Severity Score ◽

Ground Glass Opacity ◽

Chest Ct ◽

Critical Group ◽

Occurrence Rate ◽

Dynamic Changes ◽

Pleural Thickening ◽

The Third ◽

The Right

Abstract Background: To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods: This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results: There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p <0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p >0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p >0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p <0.05). Conclusions: The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

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Pulmonary nodular lymphoid hyperplasia: a rare benign disease with malignant mask

Annals of Translational Medicine ◽

10.21037/atm.2018.12.59 ◽

2019 ◽

Vol 7 (3) ◽

pp. 43-43

Author(s):

Likui Fang ◽

Jinming Xu ◽

Luming Wang ◽

Zhehao He ◽

Wang Lv ◽

...

Keyword(s):

Lymphoid Hyperplasia ◽

Benign Disease ◽

Nodular Lymphoid Hyperplasia

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Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19

Insights into Imaging ◽

10.1186/s13244-020-00939-7 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Maxime Castelli ◽

Arnaud Maurin ◽

Axel Bartoli ◽

Michael Dassa ◽

Baptiste Marchi ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Low Dose ◽

High Sensitivity ◽

Chest Ct ◽

Lung Involvement ◽

Imaging Findings ◽

Asymptomatic Patients ◽

The Mean

Abstract Background Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. Methods For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score ≥ 10. Results A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 ± 6.5, and the mean score for patients with lung involvement was 8.1 ± 6.8 [1–31]. The mean age was 43 ± 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0–9.6] p < 0.001) and diabetes (4.7[1.0–22.1] p = 0.049) were risk factors for a score ≥ 10. Multivariate analysis including symptoms showed that only age > 54 years (4.1[1.7–10.0] p = 0.002) was a risk factor for a score ≥ 10. Rhinitis (0.3[0.1–0.7] p = 0.005) and anosmia (0.3[0.1–0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. Conclusion The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age ≥ 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.

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Overuse of Follow-up Chest Computed Tomography in Patients With Incidentally Identified Nodules Suspicious for Lung Cancer

10.21203/rs.3.rs-259864/v1 ◽

2021 ◽

Author(s):

Ran Guo ◽

Yang Zhang ◽

Zelin Ma ◽

Chaoqiang Deng ◽

Fangqiu Fu ◽

...

Keyword(s):

Lung Cancer ◽

Pulmonary Nodules ◽

Ground Glass Opacity ◽

Cost Effective ◽

Chest Ct ◽

Ground Glass ◽

Ct Screening ◽

Effective Care ◽

Mixed Ground

Abstract Purpose: Regardless of professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients undergo unnecessary chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients.Methods: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up time, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening.Results: Among 1853 patients in the study, 689 (37.2%) had overused Chest CT during follow-up of the lung cancer. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P<.001). 50.7% in the “age ≤40” group, 39.8% in the “41≤age ≤50” group, 38.7% in the “51≤age ≤60” group, 32.3% in the “61≤age ≤70” group, 27.8% in the “>70” group underwent unnecessary CT (P<.001). Female get more unnecessary CT than male (40.6% vs 32.8%, P<.001). Factors associated with a greater likelihood of Chest CT is the density of nodules (odds ratios [ORs] of 0.53 for mGGO; 0.15 for solid nodule, P<.0001, vs patients with pGGO).Conclusion: roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.

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