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Mediastinum (Hong Kong, China) 2020The mediastinum is the visceral compartment of thoracic cavity divided into the superior and inferior mediastinum, further inferior compartmentalize into anterior,... (Review)
Review
The mediastinum is the visceral compartment of thoracic cavity divided into the superior and inferior mediastinum, further inferior compartmentalize into anterior, middle, and posterior mediastinum. Lymphoma in the mediastinum may be primary or secondary to systemic disease. Lymphoma may arise from lymphoid organs-like thymus, mediastinal lymph nodes or other mediastinal organs like heart, lung, pleura, and pericardium. It comprises about 12% of all the mediastinal tumors in adults however, it constitutes 50% of the pediatric mediastinal mass. Anatomically lymphoma most commonly involves anterior mediastinum. Among the pediatric mediastinal lymphomas, lymphoblastic lymphoma (LBL) predominate followed by Hodgkin lymphoma (HL), primary mediastinal large B cell lymphoma (PMBCL) and very rarely Grey zone lymphoma. Other types of non-HLs (NHLs) are rare among pediatric population. Radiologically and clinically present as an anterior mediastinal mass with symptoms of dyspnea, cough, and superior vena cava syndrome. Also, clinically and radiologically all the pediatric mediastinal mass shares the overlapping features, hence, for treatment and prognostic points of view its essential to differentiate the three entities, i.e., LBL, HL and PMBCL. The pathological diagnosis of pediatric mediastinal lymphomas is quite challenging for general histopathologists. In this review, we describe the pathology, genetics, differential diagnosis, treatment, prognosis, and a simplified histopathological and immunophenotypical approach to differentiate the pediatric mediastinal lymphomas.
PubMed: 35118290
DOI: 10.21037/med-20-37 -
Kyobu Geka. the Japanese Journal of... Sep 2021A completion pneumonectomy(CP) is a procedure used to remove remaining lung tissue following an operation previously performed for anatomical resection. During the...
A completion pneumonectomy(CP) is a procedure used to remove remaining lung tissue following an operation previously performed for anatomical resection. During the initial operation, manipulation of the pulmonary artery and vein during incision of the mediastinal pleura can influence dissection of the hilum vessels and bronchus in the mediastinum, causing severe adhesion and tissue fragility, thus making a CP difficult to perform. As compared to a standard pneumonectomy, it is considered to be a more challenging technical procedure, and associated with increased operative mortality and morbidity. Intrapericardial manipulation of pulmonary vessels by early opening of the pericardium is safe and effective in cases when difficulty with tearing of the hilar pulmonary vessels is encountered. CP may be a reasonable option for lung cancer cases, including postoperative lung cancer recurrence, second primary tumors, or metastasis from tumors in other organs occurring after a previous lobectomy done for treatment of malignant or benign disease. However, it should only be performed in carefully selected cases, in which the potential oncological benefits outweigh the surgical risk. In this paper, indications for CP and the procedures employed, as well as perioperative management are discussed.
Topics: Humans; Lung; Lung Neoplasms; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Pneumonectomy
PubMed: 34548454
DOI: No ID Found -
The Medical Journal of Malaysia Mar 2021Sarcoidosis is a chronic, multisystem disorder. A 38 years old lady presented at Hospital Raja Perempuan Zainab II, Kota Bharu ,Malaysia with cough and breathless for 2...
Sarcoidosis is a chronic, multisystem disorder. A 38 years old lady presented at Hospital Raja Perempuan Zainab II, Kota Bharu ,Malaysia with cough and breathless for 2 months and constitutional symptoms of weight loss and loss of appetite. She was initially treated as smear negative pulmonary tuberculosis for 5 months. However, her clinical condition deteriorated with worsening New York Heart Association (NYHA) class 1 to class 3. Subsequently, workout of computed tomography( CT) thorax showed multiple perilymphatic distribution of nodules and multiple mediastinal lymphadenopathy coupled with pleura biopsy showed non caseating granuloma and cardiac magnetic resonance imaging (MRI) with positive late gadolinium enhancement revised the diagnosis of pulmonary sarcoidosis with cardiac involvement. Patient's functional status and cough improved with immunosuppresant was given in tapering dose fashion.
Topics: Adult; Contrast Media; Female; Gadolinium; Humans; Sarcoidosis; Sarcoidosis, Pulmonary; Tomography, X-Ray Computed
PubMed: 33742636
DOI: No ID Found