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Medicina Clinica Mar 1994The clinical symptoms of two cases of spontaneous mediastinal hemorrhage, a rare entity of unknown etiology, are presented. In both cases the evolution was acute with... (Review)
Review
The clinical symptoms of two cases of spontaneous mediastinal hemorrhage, a rare entity of unknown etiology, are presented. In both cases the evolution was acute with initial symptomatology similar to that observed in the upper caval vein syndrome. The appearance of a large hematoma in the cervical-thoracic region constituted the outstanding clinical symptom. Imaging techniques provided the second key to diagnosis, which was made following the exclusion of the other causes of bleeding in the mediastinum. Given the apparent stability of the lesion and the absence of hemodynamic changes, treatment should only be symptomatic.
Topics: Acute Disease; Female; Hematoma; Hemorrhage; Humans; Male; Mediastinal Diseases; Middle Aged
PubMed: 8164462
DOI: No ID Found -
Radiology Jan 1987The chest radiograph of a 79-year-old man with acute thoracic aortic rupture demonstrated enlarged, ill-defined bronchovascular markings. Examination of the lungs at...
The chest radiograph of a 79-year-old man with acute thoracic aortic rupture demonstrated enlarged, ill-defined bronchovascular markings. Examination of the lungs at autopsy revealed extensive dissection of blood from the mediastinum along the bronchovascular sheaths. Recognition that enlarged bronchovascular markings may represent hemorrhage rather than edema in the setting of acute aortic rupture has important therapeutic implications.
Topics: Aged; Aorta, Thoracic; Aortic Rupture; Diagnosis, Differential; Hematoma; Hemorrhage; Humans; Lung Diseases; Male; Mediastinal Diseases; Pulmonary Edema; Radiography
PubMed: 3786757
DOI: 10.1148/radiology.162.1.3786757 -
Emergency Radiology Feb 2004The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to... (Review)
Review
The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to emphasize that a failure to consider this diagnosis may result in delayed operative intervention with potentially fatal complications.
Topics: Adenoma; Adult; Diagnosis, Differential; Hematoma; Humans; Male; Mediastinal Diseases; Neck; Parathyroid Neoplasms; Radiography; Rupture
PubMed: 15290495
DOI: 10.1007/s10140-003-0317-0 -
Diagnostic Cytopathology Sep 2015Granulomatous inflammation on transbronchial needle aspirates from mediastinal lymph nodes is an infrequent yet important finding. We determined associations between...
BACKGROUND
Granulomatous inflammation on transbronchial needle aspirates from mediastinal lymph nodes is an infrequent yet important finding. We determined associations between cytomorphological features and underlying aetiology in an area of high prevalence of HIV-infection and tuberculosis.
METHODS
We identified cases with granulomatous inflammation on mediastinal aspirates from January 2003 to July 2010. Cytomorphological features were evaluated and graded according to a simple and reproducible system including the presence, quality (discrete or vague), and number (≤5 or more) of granulomas as well as the presence of necrosis, lymphocytes, multinucleated giant cells, and neutrophils.
RESULTS
In 81 patients (36 male, 9 HIV-positive) the final diagnosis was tuberculosis in 37 (46%), sarcoidosis in 40 (49%), fibrosing mediastinitis in 1 (1%), and unknown in 3 (4%). The presence of necrosis (P < 0.001) and neutrophils (P = 0.05) was associated with tuberculosis and numerous discrete granulomas were associated with sarcoidosis (P = 0.03). All HIV-positive patients were diagnosed with tuberculosis.
CONCLUSION
Granulomatous disease identified on TBNA from mediastinal lymph nodes is mostly associated with sarcoidosis and tuberculosis. Ancillary investigations for sarcoidosis are appropriate if numerous discrete granulomas are found. Tuberculosis must be excluded if necrosis and neutrophils are present and in HIV-positive individuals, particularly in high-burden areas of tuberculosis.
Topics: Adolescent; Adult; Biopsy, Fine-Needle; Bronchoscopy; Female; Granuloma; HIV Infections; Humans; Lymph Nodes; Lymphadenitis; Male; Mediastinitis; Mediastinum; Necrosis; Neutrophil Infiltration; Neutrophils; Retrospective Studies; Sarcoidosis; Sclerosis; Tuberculosis, Pulmonary
PubMed: 25939898
DOI: 10.1002/dc.23280 -
[Zasshi] [Journal]. Nihon Kyobu Geka... Jun 1991A 70-year-old man came to our hospital complaining mainly of acute dyspnea. A chest X-ray, echocardiogram, and chest CT showed a mediastinal mass, and pericardial and...
A 70-year-old man came to our hospital complaining mainly of acute dyspnea. A chest X-ray, echocardiogram, and chest CT showed a mediastinal mass, and pericardial and pleural effusions. A thoracotomy revealed a cystic tumor along the thymus. The tumor contained bloody fluid, coagula, and fibrin calculi. Rapid specimens showed no tumor cells and the hematoma was assumed to have been caused by the thymus. Therefore, a thymectomy was performed and as much of the hematoma as possible was removed. After the operation, a careful pathological examination revealed a thymoma with a diameter of about 7 mm. In addition, coagula and fibrin calculi contained some tissue from the thymoma, and the diagnosis was made that a mediastinal hematoma had formed due to hemorrhage from the thymoma. Several cases of mediastinal tumor of cyst hemorrhages in the thorax have been reported. However, only a few cases of thymomal hemorrhages in the thorax have been reported; one case each of mediastinal hematoma, hemothorax, and cardiac tamponade. Great care is necessary when dealing with atraumatic mediastinal hematomas if malignant tumors such as thymoma are present.
Topics: Aged; Hematoma; Hemorrhage; Humans; Male; Mediastinum; Thoracic Diseases; Thymoma; Thymus Neoplasms
PubMed: 1894970
DOI: No ID Found -
Journal of Vascular and Interventional... Mar 2022
Topics: Arteries; Embolization, Therapeutic; Hematoma; Humans; Mediastinal Diseases; Thyroid Gland
PubMed: 34742896
DOI: 10.1016/j.jvir.2021.10.026 -
Anesthesia and Analgesia 1974
Comparative Study Review
Topics: Bacterial Infections; Catheterization; Embolism, Air; Hematoma; Humans; Jugular Veins; Mediastinum; Neck; Needles; Pleura; Punctures; Skin Diseases; Subclavian Vein; Thoracic Duct; Thrombophlebitis; Vena Cava, Superior
PubMed: 4589503
DOI: No ID Found -
Journal of Cardiothoracic Surgery Sep 2011Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.®) therapy, has become one of the most popular (and efficacious) interim (prior to... (Meta-Analysis)
Meta-Analysis Review
Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.®) therapy, has become one of the most popular (and efficacious) interim (prior to flap reconstruction) or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate) decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.
Topics: Hemorrhage; Humans; Mediastinitis; Negative-Pressure Wound Therapy; Sternum; Surgical Wound Infection
PubMed: 21955731
DOI: 10.1186/1749-8090-6-121 -
Der Chirurg; Zeitschrift Fur Alle... Jun 2016Chronic mediastinitis is a rare disorder characterized by the proliferation of fibrous tissue within the mediastinum resulting in compression of mediastinal structures. (Review)
Review
BACKGROUND
Chronic mediastinitis is a rare disorder characterized by the proliferation of fibrous tissue within the mediastinum resulting in compression of mediastinal structures.
OBJECTIVE
This article gives an overview of the treatment options for chronic mediastinitis.
MATERIAL AND METHODS
A literature search was carried out regarding treatment options for chronic mediastinitis
RESULTS AND CONCLUSION
Little is known about the pathogenesis of chronic mediastinitis, which has hampered the development of novel therapeutic approaches. There is no convincing evidence for the success of medicinal (antifungal or conventional anti-inflammatory) therapy and it is not recommended. In cases of clinical symptoms procedures for decompression, such as endovascular or endobronchial stents or surgical procedures, such as decompression interventions or extra-anatomic bypasses should be considered. The prognosis for unilateral involvement is better than for bilateral involvement if performed in specialized centers.
Topics: Anti-Inflammatory Agents; Antifungal Agents; Blood Vessel Prosthesis Implantation; Chronic Disease; Decompression, Surgical; Humans; Mediastinitis; Prognosis; Sclerosis; Stents; Superior Vena Cava Syndrome; Treatment Outcome
PubMed: 27193006
DOI: 10.1007/s00104-016-0197-y -
The Annals of Thoracic Surgery Oct 1999Polymorphous hemangioendothelioma is a rare vascular tumor; only 5 patients have been previously described. Half of all cases described have occurred in the thoracic... (Review)
Review
Polymorphous hemangioendothelioma is a rare vascular tumor; only 5 patients have been previously described. Half of all cases described have occurred in the thoracic cavity, all being discovered on chest radiologic studies obtained for other reasons. This report presents the case of a female patient with polymorphous hemangioendothelioma and a brief review of the current literature.
Topics: Adult; Diagnosis, Differential; Female; Hemangioendothelioma; Hemothorax; Humans; Mediastinal Neoplasms; Mediastinum
PubMed: 10543515
DOI: 10.1016/s0003-4975(99)00708-0