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World Journal of Gastroenterology Feb 2011Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment, with a major clinical impact in digestive and mediastinal diseases.... (Review)
Review
Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment, with a major clinical impact in digestive and mediastinal diseases. State-of-the-art EUS equipment now includes real-time sono-elastography, which might be useful for a better characterization of lesions and increased accuracy of differential diagnosis (for e.g. lymph nodes or focal pancreatic lesions). Contrast-enhanced EUS imaging is also available, and is already being used for the differential diagnosis of focal pancreatic masses. The recent development of low mechanical index contrast harmonic EUS imaging offers hope for improved diagnosis, staging and monitoring of anti-angiogenic treatment. Tridimensional EUS (3D-EUS) techniques can be applied to enhance the spatial understanding of EUS anatomy, especially for improved staging of tumors, obtained through a better assessment of the relationship with major surrounding vessels. Despite the progress gained through all these imaging techniques, they cannot replace cytological or histological diagnosis. However, real-time optical histological diagnosis can be achieved through the use of single-fiber confocal laser endomicroscopy techniques placed under real-time EUS-guidance through a 22G needle. Last, but not least, EUS-assisted natural orifice transluminal endoscopic surgery (NOTES) procedures offer a whole new area of imaging applications, used either for combination of NOTES peritoneoscopy and intraperitoneal EUS, but also for access of retroperitoneal organs through posterior EUS guidance.
Topics: Contrast Media; Elasticity Imaging Techniques; Endosonography; Gastrointestinal Diseases; Humans; Mediastinal Diseases; Natural Orifice Endoscopic Surgery
PubMed: 21390138
DOI: 10.3748/wjg.v17.i6.691 -
Korean Journal of Radiology 2012Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination.... (Review)
Review
Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.
Topics: Biopsy, Needle; Contrast Media; Equipment Design; Fluoroscopy; Humans; Lung Diseases; Mediastinal Diseases; Patient Positioning; Radiography, Interventional; Radiography, Thoracic; Tomography, X-Ray Computed
PubMed: 22438689
DOI: 10.3348/kjr.2012.13.2.210 -
European Review For Medical and... May 2021Severe Acute Respiratory Syndrome Corona Virus-2 is the causative factor of Coronavirus Disease 2019. Early in the pandemic, mediastinal lymphadenopathy was not... (Review)
Review
Severe Acute Respiratory Syndrome Corona Virus-2 is the causative factor of Coronavirus Disease 2019. Early in the pandemic, mediastinal lymphadenopathy was not considered to be a significant radiologic finding of the SARS-COV-2 disease. Nevertheless, most recent studies associate mediastinal lymphadenopathy with more severe COVID-19 disease and poorer patient outcomes.
Topics: COVID-19; Humans; Lymphadenopathy; Mediastinal Diseases; Mediastinum; Prevalence; SARS-CoV-2
PubMed: 34002835
DOI: 10.26355/eurrev_202105_25843 -
Annals of the Royal College of Surgeons... Apr 2014
Topics: Duodenoscopy; Esophageal Perforation; Esophagoscopy; Female; Humans; Male; Mediastinal Diseases
PubMed: 24895766
DOI: No ID Found -
Cancer Imaging : the Official... Oct 2007Multiple different types of anterior mediastinal masses may be encountered on computed tomography (CT) imaging, and many of these lesions are neoplastic in etiology.... (Review)
Review
Multiple different types of anterior mediastinal masses may be encountered on computed tomography (CT) imaging, and many of these lesions are neoplastic in etiology. These include masses arising from the thymus, thyroid and parathyroid glands, as well as lymph nodes, pericardium, and vessels and nerves. Often, the CT attenuation of the mass can be helpful in narrowing down the differential diagnosis, and attenuation values suggesting fat, water or calcium may suggest certain diagnoses; significant enhancement of the mass with intravenous contrast may also be a helpful feature. Lesions with fatty attenuation include teratomas, thymolipomas and Morgagni hernias. Lesions that may manifest the attenuation of water include pericardial and thymic cysts, abscesses, and lymphangiomas, as well as neurogenic and germ cell tumors. Multiple types of lesions may contain calcium, including thyroid goiters and cancers, thymomas, thymic carcinomas and carcinoids, treated lymphoma, germ cell tumors, parathyroid adenomas, and lymph nodes involved with silicosis, sarcoid, tuberculosis, fungal diseases and pneumocystis. Contrast enhancement may be seen in lesions of vascular origin and in vascular neoplasms, such as parathyroid adenomas and Castleman's disease. In addition to CT attenuation values, the exact location and morphology of the mass in question, in conjunction with clinical features such as patient age, gender, signs, symptoms, and laboratory values, can usually lead to a short list of possible etiologies, thereby directing appropriate additional diagnostic procedures or therapeutic approaches.
Topics: Contrast Media; Diagnosis, Differential; Humans; Mediastinal Neoplasms; Tomography, X-Ray Computed
PubMed: 17921091
DOI: 10.1102/1470-7330.2007.9014 -
Saudi Medical Journal Feb 2021To evaluate resected congenital lung and mediastinal lesions among children and their characteristics in a single tertiary hospital.
OBJECTIVES
To evaluate resected congenital lung and mediastinal lesions among children and their characteristics in a single tertiary hospital.
METHODS
A retrospective chart review analysis of all patients under 14 years of age who underwent congenital lung and mediastinal lesion resection in a single tertiary center from June 1997 to June 2018 was performed.
RESULTS
In total, 108 cases of resected lung and mediastinal lesions were performed from June 1997 to June 2018. Congenital lung and mediastinal lesions were found in 52 (48%) cases. Overall, 23 cases were males (44%) and 29 (56%) were females. The most common histopathology was congenital lobar emphysema.
CONCLUSION
This study provides a 21-year review of the clinical and histopathological features of resected congenital lung and mediastinal lesions in a single center. Congenital lung and mediastinal lesions represented 48% of all resected lesions.
Topics: Bronchopulmonary Sequestration; Child; Female; Humans; Lung; Lung Diseases; Male; Mediastinal Diseases; Pulmonary Emphysema; Retrospective Studies
PubMed: 33563741
DOI: 10.15537/smj.2021.2.25705 -
Thorax Oct 1978657-659. This communication deals with an unusual presentation of cryptococcoma as a mediastinal mass infiltrating the airways and great vessels.
657-659. This communication deals with an unusual presentation of cryptococcoma as a mediastinal mass infiltrating the airways and great vessels.
Topics: Adult; Cryptococcosis; Humans; Male; Mediastinal Diseases
PubMed: 725836
DOI: 10.1136/thx.33.5.657 -
Annals of Thoracic and Cardiovascular... 2014Hydatid disease is endemic in many parts of the world. Mediastinal hydatidosis is seen less than 0.1% of all hydatid diseases. We want to report our primary mediastinal...
PURPOSE
Hydatid disease is endemic in many parts of the world. Mediastinal hydatidosis is seen less than 0.1% of all hydatid diseases. We want to report our primary mediastinal hydatid cysts.
MATERIALS AND METHODS
In this retrospective study, from January 2010 to December 2012, 158 patients with intrathoracic hydatid cysts were operated in our thoracic surgery clinic. Nine of 158 (5.69%) patients had mediastinal hydatid cyst. Chest X-ray and computed tomography (CT) were used as diagnostic tools.
RESULTS
Hydatid cyst was confirmed surgically and pathologically in all the patients. Anterior mediastinal hydatid cysts and one cardiac involvement were determined in our study. While total cyst excision was performed in seven patients, partial pericystectomy could be done in two patients. In one patient, left ventricle invasion was seen and it was totally excised. Postoperative albendazole was applied to patients and there was no recurrence of disease till now.
CONCLUSIONS
Mediastinal hydatid cysts are uncommon and should be kept in mind in differential diagnosis of mediastinal cystic lesions especially in endemic regions. Surgical resection must be done and then medical therapy is needed to prevent recurrence.
Topics: Adolescent; Adult; Albendazole; Anthelmintics; Echinococcosis; Female; Humans; Male; Mediastinal Cyst; Middle Aged; Retrospective Studies; Thoracic Surgical Procedures; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
PubMed: 23801183
DOI: 10.5761/atcs.oa.13.02273 -
Respiration; International Review of... 2013Transbronchial needle aspiration (TBNA) is a safe and useful sampling technique for the diagnosis of mediastinal adenopathies/masses, but its accuracy seems to be... (Review)
Review
BACKGROUND
Transbronchial needle aspiration (TBNA) is a safe and useful sampling technique for the diagnosis of mediastinal adenopathies/masses, but its accuracy seems to be influenced by selected clinical and procedural aspects.
OBJECTIVES
We performed a systematic review to identify the main predictors of a successful transbronchial aspirate according to different clinical settings.
METHODS
We searched Medline and Embase for all studies evaluating predictors of TBNA diagnostic yield, published up to February 2012. Two authors reviewed all titles/abstracts and retrieved the full text of articles that are potentially relevant to identify studies according to predefined selection criteria. The methodological quality of studies was assessed through the revised Quality Assessment of Diagnostic Accuracy Studies tool. Evidence synthesis was graded according to overall number of studies, patients involved and methodological features.
RESULTS
Fifty-three studies, involving more than 8,000 patients and evaluating 23 potential predictive factors, were included. Major predictors in an unselected population, as well as in patients with suspected/known lung cancer, included lymph node size (short axis length ≥ 2 cm), presence of abnormal endoscopic findings, subcarinal and right paratracheal location, and the use of histological needle by an experienced bronchoscopist. Stage I and sampling of more than one lymph node stations were the only predictors of a successful TBNA result in patients with suspected sarcoidosis.
CONCLUSIONS
The diagnostic yield of TBNA depends on selected clinical and procedural features. Knowledge of factors that predict a positive TBNA result may help optimize the diagnostic success of the procedure in different clinical settings.
Topics: Biopsy, Needle; Bronchoscopy; Humans; Mediastinal Diseases; Reproducibility of Results
PubMed: 23817073
DOI: 10.1159/000350466 -
Journal of Investigative Medicine High... 2020Kikuchi-Fujimoto disease is an uncommon lymphohistiocytic disorder that frequently presents with acute or subacute clinical disease course. Cervical lymphadenopathy is...
Kikuchi-Fujimoto disease is an uncommon lymphohistiocytic disorder that frequently presents with acute or subacute clinical disease course. Cervical lymphadenopathy is the most common involved lymph node. Very rare cases of pathologic diagnosis of Kikuchi-Fujimoto disease with bilateral pleural effusion and multiple mediastinal lymphadenopathies have been reported in the literature. In this article, we report the case of a 60-year-old male presented with bilateral pleural effusion and multiple mediastinal lymphadenopathies. He received video-assisted thoracoscopic surgery of the right pleura and thoracoscopic excision of the mediastinal lymph node. The pathologic findings from the lymph node and pleura were compatible with Kikuchi-Fujimoto disease. He was treated with oral hydroxychloroquine and oral prednisolone. A computed tomography scan of the chest 4 months later showed regressive mediastinal lymphadenopathy and bilateral pleural effusion. Our case is a first reported case of Kikuchi-Fujimoto disease diagnosis by the pathology of the lymph node and pleura in the literature. Results from our case suggest that Kikuchi-Fujimoto disease should be included in the differential diagnosis of bilateral pleural effusion and multiple mediastinal lymphadenopathies.
Topics: Diagnosis, Differential; Histiocytic Necrotizing Lymphadenitis; Humans; Hydroxychloroquine; Lymph Nodes; Male; Mediastinal Diseases; Middle Aged; Pleural Effusion; Prednisolone; Tomography, X-Ray Computed
PubMed: 32517589
DOI: 10.1177/2324709620933422