scholarly journals Pulmonary Nodule in a Patient with Oral and Lung Cancer: Cryptococcus Infection

2019 ◽  
Vol 7 (4) ◽  
pp. 102
Author(s):  
Yamagata ◽  
Hirano ◽  
Kanno ◽  
Uchida ◽  
Fukuzawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mediastinal Lymph Node ◽  
Left Lung ◽  
Pulmonary Nodules ◽  
Pulmonary Cryptococcosis ◽  
Thoracoscopic Resection ◽  
Inferior Lobe ◽  
Primary Lung Tumors ◽  
Oral Cancer Patients ◽  
The Right

Pulmonary nodules are frequently considered to be a metastatic disease or primary lung tumors in oral cancer patients. We present a case of pulmonary cryptococcosis in a 68-year-old man with oral and lung cancer. This lung cancer was treated with thoracoscopic resection of the right inferior lobe and mediastinal lymph node dissection. Lower gingival cancer was treated with a mandibulectomy, neck dissection, and reconstruction after chemoradiotherapy. A 20 mm cavitary nodule appeared at the left lung S6 one-month after surgery, during post-operative computed tomography. Thoracoscopic partial resection of the left inferior lobe was performed under the suspicion of lung metastasis. Pathology results revealed a pseudo-epithelial granuloma with necrosis and many yeast-shaped fungi with capsules. A pathological diagnosis of Cryptococcus infection was made. The patient was prescribed the antifungal agent fosfluconazole, which was administered intravenously for 1 week and intraoral fluconazole for 12 months. No recurrence of the Cryptococcus infection has been noted after 1.5 years.

Chronic lung lymph fistula that only drains the left lung

1995 ◽  
Vol 269 (4) ◽  
pp. R943-R947
Author(s):  
Y. Kikuchi ◽  
H. Nakazawa ◽  
D. L. Traber
Keyword(s):  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Mediastinal Lymph Node ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Left Lung ◽  
Lymph Flow ◽  
Pulmonary Arterial ◽  
The Right ◽  
Arteries And Veins

We developed a chronic lung fistula that drains only the left lung, allowing for evaluation of injury in a single lung. To remove lymph drainage from the right lung into the caudal mediastinal lymph node, the right lower pulmonary ligament was severed. Pneumatic occluders were placed on the left pulmonary arteries and veins. To ensure that lymph drained from only the left lung, we increased the right pulmonary arterial pressure (RPAP) from 21.2 +/- 0.5 to 36.5 +/- 0.6 mmHg. The left pulmonary arterial pressure (LPAP) was kept at wedge pressure level for 1 h by inflating pneumatic occluders. Lymph flow from the left lung fistula was stable during this occlusion. Six hours after recovery was increased the LPAP from a baseline level of 19.1 +/- 1.0 to 36.4 +/- 0.9 mmHg and the RPAP from 21.2 +/- 0.5 to 38.0 +/- 0.8 mmHg for 2 h by inflating the pneumatic occluders on the left and right pulmonary veins. Lymph flow increased from 5.3 +/- 1.0 to 28.0 +/- 2.9 ml/h. Reflection coefficient was calculated at 0.80 +/- 0.02.

CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma

2021 ◽  
Vol 17 ◽  
Author(s):  
Yan Chen ◽  
Xiang He ◽  
Jianfeng Shang ◽  
Nan Zhang ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Pulmonary Metastasis ◽  
Pulmonary Metastases ◽  
Mediastinal Lymph Node ◽  
Pulmonary Nodules ◽  
Maximum Diameter ◽  
Imaging Features ◽  
Cardiac Angiosarcoma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
The Right

Background: Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study. Methods: This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. The patients’ age ranged from 17 to 74 (mean: 48) years. CT was performed in all patients with unenhanced, contrast-enhanced, and both scans were done in 1, 3 and 4 patients, respectively. Results: Nodular lesions were observed in 7 patients with multiple solid nodules observed in 6 out of 7 patients. A solitary solid nodule was found in the remaining patient in the upper lobe and apical segment of the right lung with a diameter of 11.7 mm. All solid nodules were distributed along with bronchovascular bundles in the lungs, and their maximum diameter ranged from 2.3 to 19.9 mm. Nodules larger than 10 mm in diameter were heterogeneously enhanced on contrast-enhanced CT images (5/8 patients), whereas those smaller than 10 mm were homogeneously enhanced (3/8 patients). Other imaging features, namely the tree-in-bud pattern, emphysema, pleural effusion, and mediastinal lymph node enlargement, were observed in 4, 3, 3, and 2 patients, respectively. Conclusion: CT enhancement features of pulmonary metastasis in patients with primary cardiac angiosarcoma depend on the size of pulmonary nodules, with larger ones being heterogeneous and smaller ones homogeneous. Other signs are less noticed.

scholarly journals Oncological issues in staging mediastinal lymph node metastases in left lung cancer

2021 ◽  
Author(s):  
Yukinori Sakao ◽  
Kenji Suzuki ◽  
Sadanori Takeo ◽  
Akihioro Hayashi ◽  
Masanori Tsuchida ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Mediastinal Lymph Node ◽  
Left Lung ◽  
Node Metastases ◽  
Mediastinal Lymph Node Metastases

scholarly journals An aberrant mediastinal mediobasal segmental pulmonary artery in a patient with lung cancer undergoing right lower lobectomy: a case report

2021 ◽  
Author(s):  
Kazuyuki Komori ◽  
Hiroshi Hashimoto ◽  
Kotaro Yoshikawa ◽  
Koji Kameda ◽  
Shinichi Taguchi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Artery ◽  
Ct Angiography ◽  
Multidetector Ct ◽  
Mediastinal Lymph Node ◽  
Pulmonary Veins ◽  
Main Pulmonary Artery ◽  
Lower Lobectomy ◽  
The Right ◽  
Right Lower Lobectomy

Abstract Background A mediastinal mediobasal segmental pulmonary artery (A7) from the right main pulmonary artery is extremely rare. Case presentation: We have reported a case of a 71-year-old woman with aberrant A7 who underwent right lower lobectomy for lung cancer (cT1bN0M0, stage IA2). Preoperative three-dimensional computed tomography (CT) angiography revealed an aberrant mediastinal A7 from the right main pulmonary artery. Right lower lobectomy and mediastinal lymph node dissection were performed. Intraoperatively, A7 was observed between the superior and inferior pulmonary veins, and at the front of the lower bronchus near the anterior hilum. The artery was carefully dissected from the caudal side after dissection of the inferior pulmonary vein. Then, the lung parenchyma, which was within the fissure due to poor lobulation between the middle and lower lobes, was safely divided. Conclusions Thoracic surgeons need to evaluate CT angiography or enhanced multidetector CT carefully at preoperative conferences and always keep this anomaly in mind.

scholarly journals Renal pelvis metastasis from lung cancer with extension of renal venous thrombus: a case report and literature review

2020 ◽  
Author(s):  
Shengjiang Bai ◽  
Li Lai ◽  
Ming Shi ◽  
Hang Xu ◽  
Haoran Lei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Renal Pelvis ◽  
Nsclc Patient ◽  
Left Lung ◽  
Treatment Strategies ◽  
Venous Invasion ◽  
Metastatic Carcinoma ◽  
Venous Thrombus ◽  
First Case ◽  
The Right

Abstract Background Non-Small Cell Lung Cancer (NSCLC) rarely metastases to the renal pelvis, especially with renal venous tumor thrombus, we presented the first case of a NSCLC patient with renal pelvis metastasis and renal venous invasion.Case presentation A 50-year-old man was referred to the thoracic facility after experiencing a healthy examination revealing solitary pulmonary mass in the left lung, he received surgery of left upper lobe resection and hilar and mediastinal lymph nodes dissection at our hospital in June 2016. Postoperative histopathologic diagnosis was NSCLC (pT3N0M0), and regular follow-up was performed after operation. After eighteen months, he was referred to the urology facility complaining of visible hematuria and pain in the right waist. Abdominal enhanced computed tomography (CT) indicated a neoplasm in the right renal pelvis, and filling coloboma could be seen in the right renal vein during the CT enhancement period. Simultaneously two nodules were found in his right lung. He received radical nephrectomy (RN) for the right kidney and removal of renal venous thrombus in December 2017. The neoplasm occupying the right pelvis and the solid ingredient occupying the right renal venous lumen were histologically considered as a metastatic carcinoma from the NSCLC. Icotinib Hydrochloride Tablets were adminstrated to treat nodules in the right lung since the RN. According to the last re-examination in March 2020, the efficacy was evaluated as partial remission.Conclusions Renal venous invasion of renal tumor not only occurs in renal cell carcinoma (RCC) and upper urinary tract urothelial carcinoma (UTUC), but also can be seen in the state of metastasis. Acquiring correct preoperative diagnosis is of great importance in determining proper treatment strategies. Besides, the aggressive RN for patients suffering advanced metastatic carcinoma of renal pelvis is safe under perfect perioperative management and favorable to treat metastatic carcinoma in other sites.

scholarly journals Computer tomography guided thoracoscopic resection of small pulmonary nodules in the hybrid theatre

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258896
Author(s):  
Ioannis Karampinis ◽  
Nils Rathmann ◽  
Michael Kostrzewa ◽  
Steffen J. Diehl ◽  
Stefan O. Schoenberg ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Computer Tomography ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Histological Diagnosis ◽  
Maximum Diameter ◽  
Clinical Indication ◽  
Thoracoscopic Resection ◽  
Small Pulmonary Nodules

Purpose Thoracic surgeons are currently asked to resect smaller and deeper lesions which are difficult to detect thoracoscopically. The growing number of those lesions arises both from lung cancer screening programs and from follow-up of extrathoracic malignancies. This study analyzed the routine use of a CT-aided thoracoscopic approach to small pulmonary nodules in the hybrid theatre and the resulting changes in the treatment pathway. Methods 50 patients were retrospectively included. The clinical indication for histological diagnosis was suspected metastasis in 46 patients. Technically, the radiological distance between the periphery of the lesion and the visceral pleura had to exceed the maximum diameter of the lesion for the patient to be included. A spiral wire was placed using intraoperative CT-based laser navigation to guide the thoracoscopic resection. Results The mean diameter of the lesions was 8.4 mm (SD 4.27 mm). 29.4 minutes (SD 28.5) were required on average for the wire placement and 42.3 minutes (SD 20.1) for the resection of the lesion. Histopathology confirmed the expected diagnosis in 30 of 52 lesions. In the remaining 22 lesions, 9 cases of primary lung cancer were detected while 12 patients showed a benign disease. Conclusion Computer tomography assisted thoracoscopic surgery (CATS) enabled successful resection in all cases with minimal morbidity. The histological diagnosis led to a treatment change in 42% of the patients. The hybrid-CATS technique provides good access to deeply located small pulmonary nodules and could be particularly valuable in the emerging setting of lung cancer screening.

Salvage surgery for lung cancer with tracheo-oesophageal fistula during concurrent chemoradiotherapy

2019 ◽  
Vol 29 (4) ◽  
pp. 641-643
Author(s):  
Isamu Watanabe ◽  
Kazuya Takamochi ◽  
Shiaki Oh ◽  
Kenji Suzuki
Keyword(s):  
Lung Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Salvage Surgery ◽  
Mediastinal Lymph Node ◽  
Advanced Lung Cancer ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Initial Surgery ◽  
The Right ◽  
Staged Reconstruction

Abstract A 48-year-old man presenting with cough, dysphagia and chest pain was diagnosed with advanced inoperable squamous cell carcinoma located in the right S2 with mediastinal lymph node metastases invading the oesophagus (c-T4N2M0 stage IIIB). Concurrent chemoradiotherapy (66 Gy) was planned, but he developed a tracheo-oesophageal fistula during the chemoradiotherapy course (26 Gy). A right sleeve pneumonectomy with oesophagectomy, cervical oesophagostomy and enterostomy were performed. Although bilateral recurrent nerve palsy occurred, he recovered via enhanced rehabilitation and was discharged 28 days after the salvage surgery. Three months after the initial surgery, staged reconstruction surgery of the stomach was performed. Intensive rehabilitation resulted in restored swallowing ability. He is alive with recurrent disease 12 months after surgery. This is the first report of salvage surgery for advanced lung cancer with tracheo-oesophageal fistula during concurrent chemoradiotherapy.

scholarly journals Experience of tracheo-bronchoplastic surgery for lung cancer

2021 ◽  
Vol 20 (4) ◽  
pp. 46-52
Author(s):  
D. N. Pilkevich ◽  
S. A. Dovbnya ◽  
P. M. Kholnyy ◽  
A. S. Tsvirenko
Keyword(s):  
Lung Cancer ◽  
Main Bronchus ◽  
Superior Vena ◽  
Left Lung ◽  
Vena Cava ◽  
Morphological Structure ◽  
Pathological Process ◽  
Vagus Nerves ◽  
The Right ◽  
Functional Operability

Introduction. Currently, surgical treatment of lung cancer is impossible without the use of tracheobronchoplastic operations, which in advanced specialized clinics take up to 5-10% of all radical operations. Material and methods. We conducted a retrospective study including 21 patients with centrally located lung cancer who underwent 22 tracheobronchoplastic radical operations between 2000 and 2021. The operated patients included 18 men and 3 women aged 42 to 67 years (mean age 54.5 ± 12.5 years). The morphological structure of the tumors was represented by carcinoid (2) and squamous cell carcinoma (19). The pathological process was located in the right lung in 16 patients and in the left lung — in five patients. Comorbid status was present in 20 patients. Standard lateral thoracotomy was used in 18 cases, and video-assisted minithoracotomy — in three cases. Extended lymphodissection up to D2 was performed in all surgeries. Combined surgeries included resection of adjacent organs: pericardium (2), unpaired vein (2), superior vena cava (1), diaphragmatic and vagus nerves (1), pleura (1). Results. The average duration of operations was 242.3 minutes (125-345 minutes), the average blood loss was 283.2 ml (50–1000 ml). Complications developed in 5 (22.7%) patients. Mortality was observed in 2 (9.1%) cases. Conclusion. The use of tracheobronchoplastic operations significantly expands the possibilities of thoracic surgery in treatment of lung cancer both due to technical resectability of the tumor at the transition to the main bronchus and trachea and due to functional operability at low respiratory functions and impossibility to perform pneumonectomy.

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