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Journal of Cardiac Surgery Mar 2020IgG4-related disease (IgG4-RD)is a multifactorial and systemic immune-mediated disease. Pulmonary vein stenosis related to IgG4 is a rare entity. We report a case of a...
IgG4-related disease (IgG4-RD)is a multifactorial and systemic immune-mediated disease. Pulmonary vein stenosis related to IgG4 is a rare entity. We report a case of a 57-year-old male who presented with vague symptoms of weakness, easy fatigue, shortness of breathing, chest tightness, and occasional palpitations. The patient was admitted, and investigations were arranged in the form of anterior mediastinotomy and pleural biopsies were taken to look for a possible diagnosis. The histopathology was reported as IgG4-related immunopathy. A transoesophageal echocardiogram was performed and this showed severe stenosis of left superior pulmonary vein. In patients with rare pathologies such as IgG4-RD, a transesophageal can be a useful diagnostic aid especially in patients with severely impaired renal functions which does not allow utilization of contrast computed tomography.
Topics: Humans; Male; Echocardiography, Transesophageal; Immunoglobulin G4-Related Disease; Severity of Illness Index; Stenosis, Pulmonary Vein; Middle Aged
PubMed: 31945218
DOI: 10.1111/jocs.14428 -
Journal of Medical Case Reports Jun 2017Neuroendocrine tumors are a large group of tumors with a wide spectrum of behavior, affecting mainly the digestive system and the lung. The thymus is very rarely...
BACKGROUND
Neuroendocrine tumors are a large group of tumors with a wide spectrum of behavior, affecting mainly the digestive system and the lung. The thymus is very rarely affected.
CASE PRESENTATION
A 28-year-old Arab woman presented with chronic chest pain and dyspnea. A computed tomography scan showed a huge anterior mediastinal mass invading neighboring structures. A mediastinotomy was performed with biopsies of the mass. Pathological findings were consistent with a thymic large cell neuroendocrine carcinoma.
CONCLUSIONS
The occurrence of a large cell neuroendocrine carcinoma in the thymus, especially in young people, is extremely rare. In this current report, we discuss the clinicopathological issues of this rare tumor according to recent literature data.
Topics: Adult; Antineoplastic Agents; Carcinoma, Neuroendocrine; Chest Pain; Disease Progression; Dyspnea; Female; Humans; Thoracic Surgical Procedures; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 28602157
DOI: 10.1186/s13256-017-1331-2 -
Pneumonologia I Alergologia Polska 2015A 29-year old man was admitted to the intensive care unit after losing consciousness. On physical examination, a loud systolic murmur over the heart was found....
A 29-year old man was admitted to the intensive care unit after losing consciousness. On physical examination, a loud systolic murmur over the heart was found. Echocardiography revealed narrowing of pulmonary artery with high pressure gradient. Computed tomography of the chest revealed the presence of large tumour localised in the upper anterior mediastinum. Due to the risk of total closure of the pulmonary artery, interventional mediastinotomy was performed and diagnosis of carcinoma embryonale was established. Subsequent chemotherapy (BEP regimen) has brought regression of tumour and significant improvement in haemodynamic parameters (relief of pressure gradient in pulmonary artery). During the second surgery, the resection of all accessible tumour mass together with marginal resection of the right upper lobe was performed. No signs of cardiac or great vessels infiltration was found. Histopathologic examination revealed the necrotic masses and neoplastic foci diagnosed as teratoma immaturum. In a four-month follow-up the patient's condition remained good. The patient is still under the care of both oncological and cardiological specialists. Thus far he has not required further chemotherapy. Holter ECG monitoring revealed no arrhythmia, but the patient is still treated with mexiletine. The patient is planning to return to work.
Topics: Adult; Anti-Arrhythmia Agents; Carcinoma, Embryonal; Echocardiography; Heart Murmurs; Humans; Male; Mediastinal Neoplasms; Mediastinum; Mexiletine; Stenosis, Pulmonary Artery; Tomography, X-Ray Computed
PubMed: 25754058
DOI: 10.5603/PiAP.2015.0024 -
Journal of Cardiothoracic and Vascular... Aug 2014
Topics: Adult; Anesthetics; Biopsy; Eosinophilic Granuloma; Female; Humans; Mediastinal Diseases; Nerve Block; Thoracic Vertebrae
PubMed: 24035063
DOI: 10.1053/j.jvca.2013.04.001