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 An Accidental Discovery of Tracheobronchomegaly: a Case Report

2020 ◽  
Author(s):  
Weijiang Ma ◽  
Aihua Liu ◽  
Xin Liu ◽  
Fukai Bao
Keyword(s):  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Image Features ◽  
Surgical Measures ◽  
The Right ◽  
Chest Ct Scan ◽  
Video Assisted Thoracoscopic Surgery ◽  
Accidental Discovery

Abstract Tracheobronchomegaly is a rare disease with congenital abnormal change in respiratory tract; its image features are also very special. In this case, we described a 57-year-old male with cough, expectoration, chest pain, and dyspnea. In our institution, the result of chest CT scan is highly extraordinary, which showed obvious dilation of the trachea and main bronchi, emphysema, and a number of pulmonary bullae, and there was a big bulla with air-fluid level on the lower lobe of the right lung. Fortunately, after wedge resection for the big bulla on the lower lobe of right lung under video-assisted thoracoscopic surgery, this patient’s symptoms were significantly relieved. The clinical manifestations of tracheobronchomegaly lack specificity; this disease has freakish image features. At present, there are no effective treatments for tracheobronchomegaly, which just was an accidental discovery in this patient; we just mainly take surgical measures to treat the big bulla for relieving symptoms.

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.

Postoperative cavitating infarction following lobectomy: the importance of variant pulmonary anatomy

2020 ◽  
Vol 13 (12) ◽  
pp. e238138
Author(s):  
William John Hunter Brown ◽  
Vidan Masani ◽  
Tim Batchelor ◽  
Jonathan C L Rodrigues
Keyword(s):  
Pulmonary Artery ◽  
Thoracoscopic Surgery ◽  
Vascular Complications ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Preoperative Imaging ◽  
Pulmonary Vasculature ◽  
The Right ◽  
Video Assisted Thoracoscopic Surgery ◽  
Safe Working

A 75-year-old woman was admitted to hospital with haemoptysis, fever and shortness of breath. She had undergone a right video-assisted thoracoscopic surgery upper lobectomy for an apical lung cancer 4 weeks earlier, and had been treated with antibiotics for 1 week prior to admission for a suspected postoperative lung abscess. Review of preoperative imaging found that she possessed a lobar pulmonary artery variant, with postoperative imaging confirming that the right lower lobe segmental pulmonary artery had been divided alongside the upper lobe vessels. The diagnosis of a lung abscess was thus revised to a cavitating pulmonary infarct. There are numerous variations of the pulmonary vasculature, all of which have the potential to cause a range of serious vascular complications if not appreciated preoperatively. Measures to mitigate the risk of complications resulting from vascular anomalies should be considered by both radiologists and surgeons, with effective lines of communication essential to safe working.

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 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 Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lower Lobe ◽  
Middle Lobe ◽  
The Body ◽  
Single View ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

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 Castleman's Disease: An Intrapulmonary Form with Intrafissural Development

2009 ◽  
Vol 9 ◽  
pp. 940-945 ◽  
Author(s):  
Hajer Racil ◽  
Sana Cheikh Rouhou ◽  
Olfa Ismail ◽  
Saoussen Hantous-Zannad ◽  
Nawel Chaouch ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Castleman’S Disease ◽  
Lower Lobe ◽  
Unknown Etiology ◽  
Castleman's Disease ◽  
Curative Surgery ◽  
Abnormal Shadow ◽  
History Of ◽  
Chest X Ray ◽  
The Right

Castleman's disease (CD) is an uncommon, mainly benign, lymphoproliferative disorder of unknown etiology, mostly involving the mediastinum. Parenchymal lung involvement of the disease is exceedingly rare. We describe a case of CD in a 23-year-old woman with a 4-year history of recurring dyspnea and nonproductive cough, whose chest X-ray showed an abnormal shadow of the right hilum. Chest computed tomography confirmed the presence of a tissue-density mass of the right lower lobe, demonstrating poor contrast enhancement, associated with multiple laterotracheal and mediastinal lymphadenopathies. The patient underwent curative surgery, revealing a right hilar compressive mass, with an intrafissural development between the superior and middle lobes. Pneumonectomy was performed due to profuse bleeding. This case of CD is particular because of its unusual intrapulmonary location and its intrafissural development. Poor contrast enhancement is atypical in CD.

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