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Blood Sep 2022Primary mediastinal large B-cell lymphoma (PMBCL) is a separate entity in the World Health Organization's classification, based on clinicopathologic features and a...
Primary mediastinal large B-cell lymphoma (PMBCL) is a separate entity in the World Health Organization's classification, based on clinicopathologic features and a distinct molecular signature that overlaps with nodular sclerosis classic Hodgkin lymphoma (cHL). Molecular classifiers can distinguish PMBCL from diffuse large B-cell lymphoma (DLBCL) using ribonucleic acid derived from paraffin-embedded tissue and are integral to future studies. However, given that ∼5% of DLBCL can have a molecular PMBCL phenotype in the absence of mediastinal involvement, clinical information remains critical for diagnosis. Studies during the past 10 to 20 years have elucidated the biologic hallmarks of PMBCL that are reminiscent of cHL, including the importance of the JAK-STAT and NF-κB signaling pathways, as well as an immune evasion phenotype through multiple converging genetic aberrations. The outcome of PMBCL has improved in the modern rituximab era; however, whether there is a single standard treatment for all patients and when to integrate radiotherapy remains controversial. Regardless of the frontline therapy, refractory disease can occur in up to 10% of patients and correlates with poor outcome. With emerging data supporting the high efficacy of PD1 inhibitors in PMBCL, studies are underway that integrate them into the up-front setting.
Topics: Hodgkin Disease; Humans; Lymphoma, Large B-Cell, Diffuse; Mediastinal Neoplasms; Mediastinum; Rituximab
PubMed: 34496020
DOI: 10.1182/blood.2020008376 -
International Heart Journal Sep 2018Hemoptysis is a rare complication of acute aortic dissection. A 77-year-old woman was admitted to our department with epigastralgia and hemoptysis. Computed tomography...
Hemoptysis is a rare complication of acute aortic dissection. A 77-year-old woman was admitted to our department with epigastralgia and hemoptysis. Computed tomography showed Stanford A acute aortic dissection and massive posterior mediastinal hematoma which extended along the right pulmonary artery. Hemoptysis is a lethal sign of aortic dissection, therefore, emergency ascending aortic replacement was performed with a good clinical outcome.
Topics: Acute Disease; Aged; Aortic Dissection; Aorta; Female; Hematoma; Hemoptysis; Humans; Mediastinal Diseases; Pulmonary Artery; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 30158389
DOI: 10.1536/ihj.18-263 -
Journal of Veterinary Diagnostic... Mar 2022Three calves were submitted to the Iowa State University Veterinary Diagnostic Laboratory for diagnostic evaluation following an abrupt increase in morbidity and...
Three calves were submitted to the Iowa State University Veterinary Diagnostic Laboratory for diagnostic evaluation following an abrupt increase in morbidity and mortality in a calf herd associated with epistaxis and widespread hemorrhage. Each of the submitted calves had moderate-to-severe hemorrhage within various tissues and body cavities, including the thymus, subcutaneous region of the neck, mediastinum, lungs, pericardial sac, heart, spleen, perirenal fat, urinary bladder, and skeletal muscle, including the diaphragm. An anticoagulant rodenticide screen was performed on the livers of each calf. Significant concentrations of chlorophacinone were detected at 4.2, 3.6, and 2.9 ppm in liver. Multiple piles and an open pail of white powdery material were present within the facility in which the calves were housed and were identified as the sources of chlorophacinone. Acute hemorrhage and death occurred in fourteen 1.5-mo-old, crossbred calves following ingestion of the vitamin K antagonist chlorophacinone.
Topics: Animals; Anticoagulants; Cattle; Cattle Diseases; Hemorrhage; Indans; Rodenticides
PubMed: 35000500
DOI: 10.1177/10406387211069369 -
Canadian Medical Association Journal Apr 1963Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those...
Foregut cysts frequently cause symptoms in the first three decades of life. The symptoms consist of dyspnea, wheezing, cough and sputum, dysphagia, stridor, and those associated with right heart strain. Symptoms and the radiological appearance of the uncomplicated cyst mimic mediastinal tumour and mediastinal obstruction. The symptoms and radiological appearance of the ruptured infected cyst simulate those of lung abscess, diaphragmatic hernia, ruptured hydatid cyst, cavitated peripheral carcinoma and pulmonary tuberculosis. In this series the differentiation from other cysts was made thus: with intralobar sequestration, a systemic arterial blood supply was demonstrated; with hydatid cyst, there was a positive intradermal skin test and (radiologically) following rupture, the appearance of a pericystic pneumatocele followed by the water-lily sign was diagnostic; with emphysematous cysts, the signs of associated bronchitis were present; in the presence of pseudocysts, there was a previous history of lung abscess, staphylococcal infection or tuberculosis. Cysts should be removed when first diagnosed.
Topics: Animals; Bronchitis; Cough; Cysts; Dyspnea; Echinococcosis; Echinococcus; Hernia, Hiatal; Humans; Lung Abscess; Mediastinum; Radiology; Respiratory Sounds; Rupture; Sputum; Tuberculosis, Pulmonary
PubMed: 13974421
DOI: No ID Found -
Blood Jan 2015Primary mediastinal B-cell lymphoma (PMBL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that is putatively derived from a thymic B cell. Accounting for up to... (Review)
Review
Primary mediastinal B-cell lymphoma (PMBL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that is putatively derived from a thymic B cell. Accounting for up to 10% of cases of DLBCL, this subtype predominantly affects women in the third and fourth decades of life. Its clinical and molecular characteristics are distinct from other subtypes of DLBCL and, in fact, closely resemble those of nodular sclerosing Hodgkin lymphoma (NSHL). Recently, mediastinal lymphomas with features intermediate between PMBL and NSHL, called mediastinal gray-zone lymphomas, have been described. The optimal management of PMBL is controversial, and most standard approaches include a combination of immunochemotherapy and mediastinal radiation. Recently, the recognition that mediastinal radiation is associated with significant long-term toxicities has led to the development of novel approaches for PMBL that have shown excellent efficacy and challenge the need for routine mediastinal radiation.
Topics: Antibodies, Monoclonal, Murine-Derived; B-Lymphocytes; Decision Making; Drug Therapy; Female; Fluorodeoxyglucose F18; Gene Expression Profiling; Hodgkin Disease; Humans; Immunophenotyping; Immunotherapy; Lymphoma; Lymphoma, B-Cell; Male; Mediastinal Neoplasms; Mediastinum; Positron-Emission Tomography; Recurrence; Rituximab; Treatment Outcome
PubMed: 25499450
DOI: 10.1182/blood-2014-05-575092 -
Clinical Advances in Hematology &... Sep 2011
Topics: Humans; Male; Mediastinum; Necrobiotic Xanthogranuloma; Paraproteinemias; Plasma Cells
PubMed: 22402516
DOI: No ID Found -
BMC Surgery Apr 2015We have initially published our experience with the robotic transthoracic esophagectomy in 32 patients from a single institute. The present paper is the extension of our...
BACKGROUND
We have initially published our experience with the robotic transthoracic esophagectomy in 32 patients from a single institute. The present paper is the extension of our experience with robotic system and to best of our knowledge this represents the largest series of robotic transthoracic esophagectomy worldwide. The objective of this study was to investigate the feasibility of the robotic transthoracic esophagectomy for esophageal cancer in a series of patients from a single institute.
METHODS
A retrospective review of medical records was conducted for 83 esophageal cancer patients who underwent robotic esophagectomy at our institute from December 2009 to December 2012. All patients underwent a thorough clinical examination and pre-operative investigations. All patients underwent robotic esophageal mobilization. En-bloc dissection with lymphadenectomy was performed in all cases with preservation of Azygous vein. Relevant data were gathered from medical records.
RESULTS
The study population comprised of 50 men and 33 women with mean age of 59.18 years. The mean operative time was 204.94 mins (range 180 to 300). The mean blood loss was 86.75 ml (range 50 to 200). The mean number of lymph node yield was 18. 36 (range 13 to 24). None of the patient required conversion. The mean ICU stay and hospital stay was 1 day (range 1 to 3) and 10.37 days (range 10 to 13), respectively. A total of 16 (19.28%) complication were reported in these patents. Commonly reported complication included dysphagia, pleural effusion and anastomotic leak. No treatment related mortality was observed. After a median follow-up period of 10 months, 66 patients (79.52%) survived with disease free stage.
CONCLUSIONS
We found robot-assisted thoracoscopic esophagectomy feasible in cases of esophageal cancer. The procedure allowed precise en-bloc dissection with lymphadenectomy in mediastinum with reduced operative time, blood loss and complications.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma; Esophageal Neoplasms; Esophagectomy; Female; Humans; Length of Stay; Lymph Node Excision; Male; Mediastinum; Middle Aged; Operative Time; Retrospective Studies; Robotic Surgical Procedures
PubMed: 25898903
DOI: 10.1186/s12893-015-0024-2 -
Journal of Nuclear Cardiology :... Dec 2023
Topics: Humans; Cardiovascular System; Molecular Imaging; Heart; Mediastinum
PubMed: 33655449
DOI: 10.1007/s12350-021-02534-9 -
Internal Medicine (Tokyo, Japan) Aug 2017A 66-year-old woman, who was diagnosed with iritis, visited our hospital due to general malaise. A blood analysis revealed hypercalcemia. Computed tomography revealed... (Review)
Review
A 66-year-old woman, who was diagnosed with iritis, visited our hospital due to general malaise. A blood analysis revealed hypercalcemia. Computed tomography revealed mediastinal and hilar lymph node hyperplasia. Moreover, Gallium scintigraphy demonstrated strong accumulation in the lesions, suggesting sarcoidosis. A core needle biopsy (CNB) of the hypoechoic areas of the thyroid was performed because the patient refused to undergo a bronchoscopic examination. The scattering of slightly acidophilic epithelioid cell granulomas was observed in the pathological examination of the biopsy specimen. Based on this finding, the patient was diagnosed with sarcoidosis. Although sarcoidosis rarely involves the thyroid gland, in the present case, thyroid CNB was an alternative diagnostic method that allowed a pathological diagnosis to be obtained.
Topics: Aged; Biopsy, Needle; Female; Granuloma; Humans; Lung; Lymphadenopathy; Mediastinum; Radiography; Radionuclide Imaging; Sarcoidosis; Thyroid Diseases; Thyroid Gland; Tomography, X-Ray Computed; Ultrasonography
PubMed: 28781308
DOI: 10.2169/internalmedicine.8324-16 -
BMC Endocrine Disorders Jun 2023Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal... (Review)
Review
BACKGROUND
Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal PC and conduct a related literature review.
CASE PRESENTATION
We described a case of a 50-year-old female patient with PHPT due to mediastinal PC. She was initially admitted to a local hospital in her hometown with hypercalcemia and high blood concentrations of PTH (parathyroid hormone). The patient underwent neck parathyroidectomy and pathological examination suggested parathyroid adenoma. Although the overproduction of serum calcium and PTH declined after the surgery, calcium and PTH increased again one month later, so the patient was transferred to our hospital. A 99Tc-sestamibi scan revealed an ectopic finding in the mediastinum, which was also indicated on the CT image. After removing the mediastinal mass, the metabolism of calcium and PTH quickly reverted to normal and the pathologic features of the mass were consistent with PC. By reviewing the related literature, we noticed that only scattered reports were published before 1982, and those were not included in the present review due to their differences with current radiological examination and treatment methods. After excluding outdated studies, we summarized and analyzed 20 reports of isolated mediastinal PC and concluded that. Parathyroidectomy remains the only curative treatment for the disease. Furthermore, the success of treatment directly depends on accurate preoperative localization.
CONCLUSION
With this study, we emphasize the importance of accurate preoperative diagnosis of mediastinal PC and improve clinicians' understanding of the disease.
Topics: Humans; Female; Middle Aged; Parathyroid Neoplasms; Mediastinum; Calcium; Parathyroid Hormone; Parathyroidectomy; Hyperparathyroidism, Primary
PubMed: 37280629
DOI: 10.1186/s12902-023-01363-w