Initial presentation of Hodgkin’s Lymphoma as Extradural Spinal Cord Compression: A case report

A 23 year old female presented with acute onset paraparesis. She denied any history of fever, weight loss or drenching night sweats. Neither did she have any obvious lymphadenopathy on general examination. Chest Xray was however suggestive of mediastinal widening and her MRI spine showed metastases with superior mediastinal SOL. Biopsy of this SOL ultimately revealed classical Hodgkin lymphoma. Thus this was a very unusual initial presentation of Hodgkin lymphoma presenting as Epidural Spinal Cord Compression. Hasenclever IPS score was 2. Patient was treated with radiotherapy followed by ABVD chemotherapy and achieved remission in 3months.

An Unusual Benign Cause of an Alarming Finding on Chest-X ray: A Case Report of Widened Mediastinum due to Rare Congenital Abnormality (Azygos Vein Continuation of Inferior Vena Cava)

Acute widened mediastinum is an alarming finding. It has many possible differential diagnoses; aortic dissection (AD) is considered one that carries catastrophic outcomes. AD is relatively uncommon; it requires early and accurate diagnosis and treatment for better patient survival. However, acute mediastinal widening also can be present in more benign conditions. We report a case of a 50-year-old African American female with postoperative shortness of breath; initial imaging studies revealed an acute widened mediastinum, but on further management with diuresis and follow-up imaging, she was diagnosed with azygous vein continuation of the Inferior vena cava (IVC). This is considered as a rare benign cause of wide mediastinum. Clinicians must be aware of the presence of such a benign cause when dealing with acute wide mediastinum.

Przewlekły kaszel jako główna manifestacja chłoniaka Hodgkina – opis przypadku

A cough lasting longer than 4-8 weeks, defined as chronic cough, always requires thorough diagnostic evaluation. In addition to detailed history-taking and physical examination, simple and available diagnostic methods, such as chest x-ray and spirometry, should be performed. They may be helpful tool to establish the underlying cause of cough. Many younger children may have difficulties in performing the forced expiratory maneuvers and fulfilling repeatability criteria for spirometry. The disturbances resulting from insufficient cooperation should be considered in interpratation of the obtained results. The shape of the flow-volume curve, which suggests upper or central airways obstruction, can not be ignored and always requires further investigation for diagnosis of respiratory pathology. The chest x-ray is the most frequently performed radiographic examination in children. Accurate interpretation is essential in reaching a correct diagnosis. Mediastinal widening on the chest x-ray in children can occur due to a large variety of causes. The normal thymus can take on a variety of sizes and shapes and still be considered normal in the first few years of life. In older children mediastinal widening should be differentiated from mediastinal masses. Lymph node enlargement represents a frequent cause, usually as a result of infection or malignancy. The article reports a case of a 12-year-old boy with chronic cough, mediastinal widening on the chest X-ray and abnormal spirometry results, who was finally diagnosed with stage III Hodgkin’s lymphoma.

Thoracic Vascular Injury

Although rare, vascular injury represents one of the most feared complications of penetrating and blunt trauma. These life-threatening injuries can often be cured safely if detected early, especially in the era of vascular stenting. Original detection of aortic injury often relies on chest radiography and findings of mediastinal widening with displacement of structures away from the aortic isthmus. Great vessel injury may manifest with a mediastinal hematoma seen superiorly and on the right. Chest radiography is notoriously nonspecific as many causes of mediastinal widening may be encountered. Chest CT has become the standard for diagnosing thoracic vascular injury and relies on the identification of direct findings of vascular injury.

A case report on incidental finding of thymoma as anterior mediastinal mass

Thymomas are rare tumors in the anterior mediastinum, representing 50% of anterior mediastinal masses and about 20-30% of all mediastinal tumors. They are of unknown etiology; about 50% of patients with thymomas are diagnosed incidentally with chest radiography. Thymoma is classified into different stages, which determine the prognosis and type of management, the standard primary treatment for these tumors is Thymectomy. We present a case of 55-year female presented with shortness of breath, cough with expectoration and fever for past ten days. Chest x-ray revealed mediastinal widening. CECT chest showed a well-circumscribed heterogeneous solid enhancing mass lesion. FNAC was planned that showed features in favour of thymoma. Biopsy was done that confirmed lymphocyte rich type B thymoma.

Large left innominate vein aneurysm presenting as an anterior mediastinal tumour in a young female

We report a rare case of large innominate vein aneurysm in a young women clinically presenting with persistent dry cough and retrosternal pressure. Chest X-ray showed a mediastinal widening leading to thoracic computed tomography, MRI, and phlebography. Initial conservative treatment with regular follow-up was performed. Upon aneurysm growth and recurrent pulmonary infection we decided to surgically resect the aneurysm via a minimally invasive approach.