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Annals of Surgery Jul 1994The authors introduce thoracic intrathymic thyroid as a clinical entity.
OBJECTIVE
The authors introduce thoracic intrathymic thyroid as a clinical entity.
SUMMARY BACKGROUND DATA
Although accessory aberrant thyroid has not been found in other tissues in the mediastinum, a thoracic intrathymic location has not been described previously. It is believed that mediastinal thyroid tissue represents accessory ectopic tissue from the median thyroid anlage. Moreover, the close association of the thymus and thyroid supports the theory that mediastinal ectopic thyroid tissue develops from abnormal descent of these structures during embryogenesis.
METHODS
Benign thoracic intrathymic thyroid lesions are described in patients with mediastinal masses.
CONCLUSION
Thoracic intrathymic thyroid is a distinct entity. Its occurrence is supported both clinically and embryologically.
Topics: Adult; Choristoma; Humans; Lymphatic Diseases; Male; Mediastinal Diseases; Middle Aged; Thymus Gland; Thyroid Gland
PubMed: 8024364
DOI: 10.1097/00000658-199407000-00013 -
Pulmonology 2018Endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) has proven to be an effective and minimally invasive tool to diagnose and stage lung cancer.... (Review)
Review
Endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) has proven to be an effective and minimally invasive tool to diagnose and stage lung cancer. However, its use for the diagnosis of rare mediastinal and lung pathologies has been rarely described. Hereby we describe a retrospective chart review of our EBUS-TBNA database for unusual diagnosis made between July 2012 and October 2016. Those conditions considered unusual for EBUS-TBNA diagnosis were identified and their medical records reviewed.
Topics: Adult; Aged; Bronchoscopy; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Female; Humans; Lung Diseases; Male; Mediastinal Diseases; Middle Aged
PubMed: 29627400
DOI: 10.1016/j.pulmoe.2017.12.004 -
BioMed Research International 2018This study aims to discuss the appropriate treatment strategy for spontaneous esophageal rupture.
PURPOSE
This study aims to discuss the appropriate treatment strategy for spontaneous esophageal rupture.
METHODS
Clinical data from twenty-one cases were retrospectively analyzed. The parameters included etiology, time interval between onset and treatment, therapy methods, prognosis, and length of stay.
RESULTS
The ratio of males/females was 17/4, age range was 32-82 years (mean = 43.1), and the time interval between onset and treatment was as follows: <24 h: nine cases (42.8%); 24-48 h: six cases (28.6%); and >72 h: six cases (28.6%). All patients underwent operative treatment, and the following primary healing rates were achieved: <24 h: 88.9%, 24-48 h: 66.7%, and >72 h: 0. No patients died in this study. All patients were discharged with recovery, and the average hospitalization times were 18.1 days (<24 h), 27.8 days (24-48 h), and 51.2 days (>72 h).
CONCLUSIONS
Surgical treatment remains an effective method for treating spontaneous esophageal rupture, and the shorter the time interval between onset and treatment, possibly the better the prognosis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Esophageal Perforation; Female; Humans; Male; Mediastinal Diseases; Middle Aged; Retrospective Studies; Rupture, Spontaneous; Young Adult
PubMed: 30050944
DOI: 10.1155/2018/8483401 -
Annals of Agricultural and... Jun 2023In December 2019, an atypical form of severe pneumonia emerged in Wuhan in China's Hubei province, which in February 2020 was named COVID-19. The disease may have...
In December 2019, an atypical form of severe pneumonia emerged in Wuhan in China's Hubei province, which in February 2020 was named COVID-19. The disease may have features of interstitial pneumonia and severe respiratory failure requiring intensive oxygen therapy. Spontaneous pneumomediastinum is a rare pathological condition with air in the mediastinum outside the trachea, oesophagus and bronchi. It is potentially life-threatening complication of both invasive and non-invasive mechanical ventilation. There have been reports that it may complicate the course of interstitial lung disease in the course of COVID-19. The report describes two cases of young patients who spontaneously developed this complication. Immediate diagnose is important in order to applicate adequate procedures.
Topics: Humans; COVID-19; Mediastinal Emphysema; Rare Diseases
PubMed: 37387393
DOI: 10.26444/aaem/166324 -
Transnasal endoscopic mediastinal exploration and intubation for mediastinal abscess: A case report.Asian Journal of Surgery Feb 2021
Topics: Abscess; Endoscopy; Esophageal Perforation; Humans; Intubation, Intratracheal; Mediastinal Diseases
PubMed: 33339680
DOI: 10.1016/j.asjsur.2020.11.021 -
Annals of the Royal College of Surgeons... Nov 2013Boerhaave's syndrome is associated with high mortality and morbidity. This study aimed to assess outcome following treatment in a specialist upper gastrointestinal...
INTRODUCTION
Boerhaave's syndrome is associated with high mortality and morbidity. This study aimed to assess outcome following treatment in a specialist upper gastrointestinal surgical unit.
METHODS
Patients were identified from a prospectively collected database (Lothian Surgical Audit) and their records reviewed. Primary outcomes were mortality and serious morbidity. Secondary outcomes included time to theatre, operation undertaken and length of hospital stay.
RESULTS
Twenty patients with Boerhaave's syndrome were identified between 1997 and 2011. Four patients (20%) died in hospital. The mean time to theatre from symptom onset was 2.4 days. This was 7.3 days in the patients who died compared with 1.5 days in survivors. Five patients underwent primary repair of rupture, eleven underwent direct closure over a T-tube and one rupture was irreparable. Three patients were managed non-operatively and all survived. Outcomes were similar for the different surgical groups. There was one death following primary closure (20%) and two after T-tube drainage (18%). The mean length of hospital stay was 35.7 days after T-tube drainage and 20.5 days after primary repair. The 3 patients with small, self-contained leaks had a mean length of stay of 5.7 days.
CONCLUSIONS
Aggressive surgical management with direct repair is associated with good survival in patients with Boerhaave's syndrome. Delayed time to theatre is associated with increased mortality. Patients with small, contained leaks without signs of sepsis can be managed non-operatively with a good outcome.
Topics: Adult; Aged; Aged, 80 and over; Early Diagnosis; Esophageal Perforation; Female; Humans; Length of Stay; Male; Mediastinal Diseases; Middle Aged; Postoperative Care; Preoperative Care; Prospective Studies; Treatment Outcome; Young Adult
PubMed: 24165336
DOI: 10.1308/rcsann.2013.95.8.557 -
Advances in Respiratory Medicine 2019Diffusion weighted imaging (DWI) has shown its potential as a reliable noninvasive technique for tissue characterization. DWI reflects the tissue specific diffusion...
INTRODUCTION
Diffusion weighted imaging (DWI) has shown its potential as a reliable noninvasive technique for tissue characterization. DWI reflects the tissue specific diffusion capacity which can be used for tissue characterization. Hypercellular tissue (e.g; malignant tumors) had restricted diffusion capacity with increased signals on DWI and low ADC values. Non-tumoral tissues show low cellularity, and diffusion capacity is not restricted resulting in signal loss on DWI and high apparent diffusion coefficient (ADC). Differential diagnosis of mediastinal lymphadenopathy is an issue of debate, especially in malignant benign differentiation. Diffusion weighted imaging with magnetic resonance could improve the diagnostic accuracy in differentiation between benign and malignant mediastinal nodes.
OBJECTIVES
to determine the efficacy of diffusion weighted MRI in evaluation of mediastinal lymphadenopathy with histopathological correlation to differentiate benign from malignant lymph nodes.
MATERIAL AND METHODS
30 patients with mediastinal lymphadenopathy underwent diffusion weighted MRI. ADCs of lymph nodes were derived and constructed from b = 0 and b = 1000 sec/mm2 values by drawing regions of interests (ROI). Consequently, mediastinal nodes were studied, biopsies and histopathological analysis were done after MRI examination.
RESULTS
The best cutoff point of ADC to differentiate benign from malignant lesions was 1.15 mm/sec (sensitivity 77%, specificity 92% and AUC 81.4%). Significant negative correlation of ADC by DW MRI and the size of the LNs. The mean ADC values in the lymphoma group was lower than in the sarcoidosis group, and the difference was statistically significant.
CONCLUSION
The study supports that MRI with diffusion weighted images can differentiate benign from malignant mediastinal lymphadenopathy and differentiate lymphoma from sarcoidosis non-invasively.
Topics: Diffusion Magnetic Resonance Imaging; Humans; Lymph Nodes; Lymphadenopathy; Lymphatic Diseases; Mediastinal Diseases; Sensitivity and Specificity
PubMed: 31282559
DOI: 10.5603/ARM.2019.0033 -
Turkish Journal of Medical Sciences 2015Mediastinoscopy is an invasive procedure that is used in the diagnosis of mediastinal diseases and in staging lung cancer. Tumor cell seeding during mediastinoscopy...
BACKGROUND/AIM
Mediastinoscopy is an invasive procedure that is used in the diagnosis of mediastinal diseases and in staging lung cancer. Tumor cell seeding during mediastinoscopy along the mediastinum and the incision line is a very rare complication. This study aimed to test the safety of mediastinoscopy in terms of tumor seeding by cytological evaluation of mediastinal lavage samples taken before and after biopsy.
MATERIALS AND METHODS
The patients who underwent mediastinoscopy in our hospital between 2011 and 2014 were studied prospectively. Seventy-three patients with a diagnosis of lung or mediastinal malignancy were included in the study. All patients underwent classical cervical mediastinoscopy and mediastinal lavages were taken before and after the biopsy. Both lavage samples were sent to the pathology department in syringes for malignant cell cytology screening.
RESULTS
The results of the histopathological examinations of lymph node biopsies were reactive in 25 patients and positive for malignancy in 48 patients. In 2 of 48 patients whose lymph nodes were reported to be positive for malignancy, the mediastinal lavage sample was reported to be positive for malignancy after biopsy, although it was negative preoperatively. In two patients, both the pre- and postbiopsy lavage samples were reported to be positive for malignancy.
CONCLUSION
While performing dissection and biopsy during mediastinoscopy, tumor seeding into the mediastinum may occur. Long follow-up periods and large patient series are needed to determine how cytopathological examination of both fluids would affect the prognosis.
Topics: Biopsy; Female; Humans; Lung Neoplasms; Lymphatic Diseases; Lymphatic Metastasis; Male; Mediastinal Diseases; Mediastinoscopy; Mediastinum; Middle Aged; Neoplasm Seeding; Neoplasm Staging; Prospective Studies; Secondary Prevention; Therapeutic Irrigation
PubMed: 26422860
DOI: 10.3906/sag-1406-11 -
Pediatrics and Neonatology Jun 2011Mediastinal abscess following retropharyngeal abscess is a rare entity. We report the first neonate presenting with a large mediastinal abscess as a complication of a...
Mediastinal abscess following retropharyngeal abscess is a rare entity. We report the first neonate presenting with a large mediastinal abscess as a complication of a retropharyngeal abscess. The initial manifestations of this newborn were fever and stridor. The chest sonography revealed a mediastinal mass, and the neck and chest computed tomography showed multiple abscesses in the retropharyngeal space, parapharyngeal space, and superior mediastinum. The mediastinal cystic mass was excised, and antibiotic treatment was completed for 7 weeks. She did well without any sequelae at follow-up clinic. Pediatricians should consider retropharyngeal and mediastinal abscesses among the differential diagnoses when confronting a newborn with fever and stridor.
Topics: Female; Humans; Infant, Newborn; Mediastinal Diseases; Mediastinum; Neck; Respiratory Sounds; Retropharyngeal Abscess; Tomography, X-Ray Computed
PubMed: 21703562
DOI: 10.1016/j.pedneo.2011.03.011 -
Journal of Medical Case Reports Nov 2021Boerhaave's syndrome is the spontaneous rupture of the esophagus, which requires early diagnosis and treatment. Symptoms may vary, and diagnosis can be challenging.
BACKGROUND
Boerhaave's syndrome is the spontaneous rupture of the esophagus, which requires early diagnosis and treatment. Symptoms may vary, and diagnosis can be challenging.
CASE PRESENTATION
Case 1: A 54-year-old Chinese man presented to us with sudden-onset epigastric pain radiating to the back following hematemesis. Upper gastrointestinal endoscopy revealed a full-thickness rupture of the esophageal wall. Subsequent computed tomography showed frank pneumomediastinum and heterogeneous pleural effusion. Immediately, esophageal perforation repair operation and jejunostomy were performed. The postoperative period was uneventful, and he was discharged. Case 2: A 62-year-old Chinese man was admitted to the emergency department with thoracic dull pain and chest distress. Chest computed tomography scan showed pneumomediastinum and large left-sided pleural effusion. Esophagus fistula was confirmed by contrast esophagography. Then, we performed thoracotomy to repair the esophageal tear as well as to debride and irrigate the left pleural space. His postoperative period was uneventful, with no leakage or stricture. Case 3: The patient was a 69-year-old Chinese male presenting with severe retrosternal and upper abdominal pain following an episode of forceful vomiting. Thoracic computed tomography scan revealed a rupture in the left distal part of the esophagus, a pneumomediastinum, and left-sided pleural effusions. Conservative treatment failed to improve disease conditions. Open thoracic surgery was performed with debridement and drainage of the mediastinum and the pleural cavity, after which he made a slow but full recovery.
CONCLUSIONS
We highlight that early diagnosis and appropriate surgical treatment are essential for optimum outcome in patients with esophageal rupture. We emphasize the importance of critical care support, particularly in the early stages of management.
Topics: Aged; Esophageal Perforation; Humans; Male; Mediastinal Diseases; Middle Aged; Pleural Effusion; Rupture, Spontaneous
PubMed: 34749789
DOI: 10.1186/s13256-021-03080-1