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1.
BMJ Case Rep ; 17(3)2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38514159

RESUMO

A mid-60s female with known primary progressive multiple sclerosis was admitted to our hospital with aspiration pneumonia. Due to reduced consciousness, a nasogastric (NG) tube was inserted for feeding. A chest x-ray (CXR) report from a thoracic radiologist confirmed an atypical tip position due to a hiatus hernia but concluded it was almost certainly within the stomach. However, after deteriorating on feed commencement, a CT scan of the chest confirmed the tube had perforated the nasopharynx and run parallel to the oesophagus through the mediastinum into the right pleural space. The patient subsequently developed an empyema and pneumothorax, requiring multiple therapeutic interventions and a prolonged hospital stay. This case demonstrates how the routine insertion of an NG tube can lead to serious complications. Additionally, position check CXRs can be difficult to interpret, so the decision to use the tube must be made cautiously by the clinical team.


Assuntos
Mediastino , Pneumotórax , Humanos , Feminino , Radiografia , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumotórax/terapia , Intubação Gastrointestinal/efeitos adversos , Nasofaringe
3.
BMJ Case Rep ; 17(3)2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38442975

RESUMO

Bronchogenic cysts are rare congenital lesions found primarily in the mediastinum. Most patients are asymptomatic and can be treated with minimally invasive resection. We present a case of a middle-aged patient who presented to a district general hospital with palpitations and shortness of breath. She underwent a computerised tomographic pulmonary angiogram that showed a likely bronchogenic cyst and was subsequently transferred to our hospital. She developed atrial fibrillation during admission requiring therapy with beta-blockers and digoxin. Cardiac MRI revealed a large cyst posterior to the left atrium, a moderate circumferential pericardial effusion and bilateral pleural effusions. There was significant left atrial compression. The patient underwent surgical removal of the cyst and was discharged. She returned to the hospital within a week with palpitations and was treated with intravenous antibiotics for sepsis. She was discharged a week later and remained clinically stable.


Assuntos
Fibrilação Atrial , Cisto Broncogênico , Pessoa de Meia-Idade , Feminino , Humanos , Fibrilação Atrial/etiologia , Cisto Broncogênico/complicações , Cisto Broncogênico/diagnóstico por imagem , Cisto Broncogênico/cirurgia , Átrios do Coração , Digoxina , Mediastino
4.
Int J Clin Pract ; 2024: 3711123, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38454935

RESUMO

Background: Endobronchial ultrasound (EBUS) sonographic features help identify benign/malignant lymph nodes while conducting transbronchial needle aspiration (TBNA). This study aims to identify risk factors for malignancy based on EBUS sonographic features and to estimate the risk of malignancy in lymph nodes by constructing a nomogram. Methods: 1082 lymph nodes from 625 patients were randomly enrolled in training (n = 760) and validation (n = 322) sets. The subgroup of EBUS-TBNA postoperative negative lymph nodes (n = 317) was randomly enrolled in a training (n = 224) set and a validation (n = 93) set. Logistic regression analysis was used to identify the EBUS features of malignant lymph nodes. A nomogram was formulated using the EBUS features in the training set and later validated in the validation set. Results: Multivariate analysis revealed that long-axis, short-axis, echogenicity, fusion, and central hilar structure (CHS) were the independent predictors of malignant lymph nodes. Based on these risk factors, a nomogram was constructed. Both the training and validation sets of 5 EBUS features nomogram showed good discrimination, with area under the curve values of 0.880 (sensitivity = 0.829 and specificity = 0.807) and 0.905 (sensitivity = 0.819 and specificity = 0.857). Subgroup multivariate analysis revealed that long-axis, echogenicity, and CHS were the independent predictors of malignancy outcomes of EBUS-TBNA postoperative negative lymph nodes. Based on these risk factors, a nomogram was constructed. Both the training and validation sets of 3 EBUS features nomogram showed good discrimination, with the area under the curve values of 0.890 (sensitivity = 0.882 and specificity = 0.786) and 0.834 (sensitivity = 0.930 and specificity = 0.636). Conclusions: Our novel scoring system based on two nomograms can be utilized to predict malignant lymph nodes.


Assuntos
Neoplasias Pulmonares , Nomogramas , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Mediastino/diagnóstico por imagem , Mediastino/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Ultrassonografia
5.
Kyobu Geka ; 77(1): 68-71, 2024 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-38459848

RESUMO

Double aortic arch is an embryological abnormality of the aortic arch forming a vascular ring. It has been noted that the right recurrent nerve travels differently in patients with a duplicated aortic arch and may be in close proximity to the area of superior mediastinal lymph node dissection in lung cancer. We report a surgical case of a patient with right middle lung cancer associated with a duplicated aortic arch. A 64-year-old man was referred to our hospital because of a nodular shadow in the right lung field noted on chest X-ray during a medical checkup. A transbronchial needle biopsy revealed a diagnosis of adenocarcinoma, and right middle lobe resection and lymph node dissection were performed. When dissecting the superior mediastinal lymph nodes in a patient with an overlapping aortic arch, it was necessary to carefully perform the operation, paying attention to the running of the right recurrent nerve.


Assuntos
Neoplasias Pulmonares , Anel Vascular , Masculino , Humanos , Pessoa de Meia-Idade , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Anel Vascular/patologia , Anel Vascular/cirurgia , Pulmão/patologia , Mediastino , Excisão de Linfonodo
6.
Kyobu Geka ; 77(2): 115-120, 2024 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-38459861

RESUMO

A ganglioneuroma is a rare, benign, neurogenic tumor originating from the sympathetic ganglion. Mediastinal ganglioneuroma are mostly detected in children, typically around 10 years of age, and are rarely identified in adults. Herein, we report two surgically resected cases of mediastinal ganglioneuroma in adults. In Case 1, a 53-year-old man, without any symptom, underwent a computed tomography, revealing a 3.2 cm well-defined paravertebral superior mediastinal tumor with long craniocaudal axis. In case 2, a 29-year-old woman presented with newly-developed ptosis and a history of left-sided facial hypohidrosis since the age of 10. Chest computed tomography (CT) revealed a 7.8 cm well-defined paravertebral superior mediastinal tumor with long craniocaudal axis. Both patients were initially suspected to have neurogenic tumors, particularly schwannomas. They underwent mediastinal tumor resections, requiring sympathetic nerve trunk dissection. Pathological examination confirmed the diagnosis of ganglioneuromas in both cases. Mediastinal ganglioneuroma must be differentiated from schwannoma, the most common neurogenic tumor in adults. Unlike schwannoma, ganglioneuroma cannot be enucleated, therefore attention should be focused on complications associated with sympathetic nerve trunk dissection, such as Horner's syndrome, hyperhidrosis, and arrhythmia. Identifying this rare entity and its characteristic imaging aids in preoperative differentiation, strategizing surgical approaches, and predicting complications.


Assuntos
Ganglioneuroma , Neoplasias do Mediastino , Neurilemoma , Adulto , Masculino , Feminino , Criança , Humanos , Pessoa de Meia-Idade , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/cirurgia , Tomografia Computadorizada por Raios X , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Mediastino
7.
Chest ; 165(3): e65-e69, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38461020

RESUMO

CASE PRESENTATION: A 49-year-old man, a farmer, had been experiencing coughing, phlegm, and difficulty breathing for 2 months. He underwent a CT scan at a local hospital that showed a mediastinal mass. Bronchoscopy showed no obstruction in the tracheal lumen, and an endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) biopsy was performed on the mediastinal mass. The cytologic smear of the mediastinal mass showed a few atypical epithelial cells; the possibility of a tumor could not be ruled out. The patient visited our thoracic surgery outpatient department; based on the advice of the thoracic surgeon, the patient underwent another endobronchial ultrasound-guided transbronchial fine needle aspiration biopsy of the mediastinal mass 4 days before this admission. The patient went home and waited for the results. Two days later, the patient experienced a fever and palpitations accompanied by chills, yellow phlegm, and orthopnea. The patient visited our ED, underwent tracheal intubation, and was admitted to our ICU. The patient had had occasional coughing and phlegm for the past 10 years, which were not taken seriously or investigated. The patient does not smoke or drink alcohol, and there is no history of cancer in the family.


Assuntos
Neoplasias Pulmonares , Doenças do Mediastino , Masculino , Humanos , Pessoa de Meia-Idade , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/efeitos adversos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Broncoscopia/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Tosse/etiologia , Tosse/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Mediastino/diagnóstico por imagem
8.
Folia Med (Plovdiv) ; 66(1): 142-146, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38426478

RESUMO

Resection and reconstruction of the superior vena cava (SVC) are required in a selected group of patients with anterior mediastinal tumors and lung neoplasms. We present the case of a 63-year-old woman who underwent invasive type B2 thymoma resection and a rare type of reconstruction of the superior vena cava using a patch of the left brachiocephalic vein (LBV). The various types of reconstruction of the superior vena cava are discussed.


Assuntos
Timoma , Neoplasias do Timo , Feminino , Humanos , Pessoa de Meia-Idade , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/cirurgia , Veia Cava Superior/patologia , Veias Braquiocefálicas/diagnóstico por imagem , Veias Braquiocefálicas/cirurgia , Veias Braquiocefálicas/patologia , Mediastino/patologia , Timoma/diagnóstico por imagem , Timoma/cirurgia , Timoma/patologia , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/cirurgia , Neoplasias do Timo/patologia
9.
J Cardiothorac Surg ; 19(1): 131, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491470

RESUMO

Benign mediastinal tumor is usually asymptomatic and exhibits uncomplicated clinical course. Posterior mediastinal schwannoma is common, but a huge benign tumor causing acute respiratory failure due to mass effect is unusual. We present a patient who suffered from acute respiratory failure due to huge mediastinal mass effect and improved after en bloc surgical resection. A 56-year-old woman had no history of systemic disease, but experienced general discomfort and malaise for several months. She was referred to our emergency department after developing sudden respiratory failure. Intubation was performed with ventilator support and she was admitted to the intensive care unit. Chest radiograph and computed tomography showed a huge mass over the left pleural cavity causing left lung, heart, and mediastinal compression. After en bloc resection, she was weaned off the ventilator successfully and was discharged at 24 days after the operation. Postoperative outpatient follow-up showed no symptoms. Mediastinal ancient schwannoma is a rare posterior mediastinal benign tumor. However, mass effect might lead to lethal complications. En bloc resection is necessary for curative treatment.


Assuntos
Neoplasias do Mediastino , Neurilemoma , Insuficiência Respiratória , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/cirurgia , Neurilemoma/complicações , Neurilemoma/cirurgia , Neurilemoma/patologia , Mediastino/patologia , Insuficiência Respiratória/etiologia
10.
Comput Biol Med ; 171: 108038, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38442552

RESUMO

Radial endobronchial ultrasonography (R-EBUS) has been a surge in the development of new ultrasonography for the diagnosis of pulmonary diseases beyond the central airway. However, it faces challenges in accurately pinpointing the location of abnormal lesions. Therefore, this study proposes an improved machine learning model aimed at distinguishing between malignant lung disease (MLD) from benign lung disease (BLD) through R-EBUS features. An enhanced manta ray foraging optimization based on elite perturbation search and cyclic mutation strategy (ECMRFO) is introduced at first. Experimental validation on 29 test functions from CEC 2017 demonstrates that ECMRFO exhibits superior optimization capabilities and robustness compared to other competing algorithms. Subsequently, it was combined with fuzzy k-nearest neighbor for the classification prediction of BLD and MLD. Experimental results indicate that the proposed modal achieves a remarkable prediction accuracy of up to 99.38%. Additionally, parameters such as R-EBUS1 Circle-dense sign, R-EBUS2 Hemi-dense sign, R-EBUS5 Onionskin sign and CCT5 mediastinum lymph node are identified as having significant clinical diagnostic value.


Assuntos
Pneumopatias , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Mediastino/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Ultrassonografia/métodos , Pneumopatias/patologia
11.
BMJ Case Rep ; 17(3)2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38453221

RESUMO

We present a case of descending necrotising mediastinitis (DNM) originating from a retropharyngeal abscess in a healthy early childhood patient. The patient had a history of fever, odynophagia and refusal to eat, followed by rapid deterioration of the clinical state. Cervicothoracic CT was performed, which revealed a right parapharyngeal abscess, extending to the mediastinum and occupying the retropharyngeal/visceral space, with gaseous content throughout this collection, associated with bilateral pleural effusion, aspects compatible with DNM. She started broad-spectrum antibiotic therapy and transoral drainage of the parapharyngeal and retropharyngeal collections was performed under general anaesthesia. She was admitted to the intensive care unit. The patient showed clinical, analytical and imaging improvement, having been transferred to the ear, nose and throat department, with favourable evolution. Early diagnosis of DNM by cervicothoracic CT and multidisciplinary approaches, including intensive care, broad-spectrum antibiotics and surgical intervention, are crucial to minimise the morbidity and mortality.


Assuntos
Mediastinite , Abscesso Retrofaríngeo , Pré-Escolar , Feminino , Humanos , Drenagem/métodos , Mediastinite/diagnóstico por imagem , Mediastinite/terapia , Mediastino/diagnóstico por imagem , Pescoço , Necrose/complicações , Abscesso Retrofaríngeo/diagnóstico por imagem , Abscesso Retrofaríngeo/terapia
12.
Tokai J Exp Clin Med ; 49(1): 12-16, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509007

RESUMO

A 75-year-old male visited our hospital with bilateral hilar lymph node swelling detected on chest radiography during an annual medical checkup. Chest computed tomography revealed swelling of multiple hilar mediastinal lymph nodes. Histopathological and immunohistochemical examinations of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimens from the hilar lymph nodes revealed amyloid deposition. Bilateral hilar and mediastinal lymphadenopathies can be the first manifestations of amyloidosis diagnosed using EBUS-TBNA.


Assuntos
Amiloidose , Neoplasias Pulmonares , Linfadenopatia , Masculino , Humanos , Idoso , Neoplasias Pulmonares/diagnóstico , Linfadenopatia/etiologia , Linfadenopatia/patologia , Mediastino/patologia , Linfonodos/patologia , Amiloidose/complicações , Amiloidose/diagnóstico , Broncoscopia/métodos
14.
Sci Rep ; 14(1): 5316, 2024 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438473

RESUMO

This study aims to compare the perioperative outcomes and long-term survival of U-VATS lobectomy for NSCLC with multiportal VATS (M-VATS, involving two ports or more) lobectomy. A total of 339 patients who underwent intentional VATS lobectomy for lung cancer between 2012 and 2017 were included in the analysis. Perioperative outcomes and long-term survival were evaluated. Propensity score matching was utilized to minimize baseline characteristic differences between the two groups. Out of the total cases, 17 (5.01%) were converted to open thoracotomy. The conversion rates were 4.96% (7/141) in the U-VATS group and 5.05% (10/198) in the M-VATS group. A total of 322 consecutive patients underwent VATS lobectomy and mediastinal lymphadenectomy. After propensity matching, 106 pairs were obtained, consisting of 83 males and 129 females. Intraoperative bleeding volume, number of retrieved lymph nodes, explored nodal stations, drainage time and volume, and postoperative hospital stay were similar between the two groups. Both groups exhibited comparable morbidity and mortality rates. From the multivariable analysis, there was no significant difference observed in terms of overall survival (OS) and disease-free survival (DFS) between the two patient cohorts. U-VATS demonstrated comparable perioperative outcomes and long-term efficacy to M-VATS. However, further confirmation of these findings is required.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Feminino , Masculino , Humanos , Neoplasias Pulmonares/cirurgia , Cirurgia Torácica Vídeoassistida , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Mediastino , Transporte de Íons
15.
J Cardiothorac Surg ; 19(1): 136, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38504342

RESUMO

BACKGROUND: A right-sided aortic arch is a rare congenital vascular structure variation. Right lobectomy is not commonly performed on patients with such a condition. Further, there are no reports on lobectomy under uniportal video-assisted thoracoscopic surgery (VATS) in this patient group. CASE PRESENTATION: A 67-year-old man with a right-sided aortic arch and Kommerell diverticulum underwent right upper lobectomy with mediastinal lymph node dissection under uniportal VATS for primary lung cancer. Due to the right descending aorta, which narrows the space of the dorsal hilum, handling of the stapler for stapling the right upper lobe bronchus from the uniport in the 6th intercostal space at the medial axillary line can be challenging. This issue was resolved by manipulating the staple over the azygos vein toward the inferior margin of the aortic arch. Via mediastinal lymphadenectomy, we found that the right recurrent laryngeal nerve branched from the right vagus nerve and hooked around the right-sided aortic arch. CONCLUSIONS: Right lobectomy with mediastinal lymph node dissection under uniportal VATS can be performed for lung cancer in patients with a right-sided aortic arch.


Assuntos
Neoplasias Pulmonares , Masculino , Humanos , Idoso , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/patologia , Cirurgia Torácica Vídeoassistida , Aorta Torácica/anormalidades , Pneumonectomia , Mediastino/cirurgia , Mediastino/patologia
16.
Cancer Med ; 13(4): e6919, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38466235

RESUMO

OBJECTIVE: To explore whether the upper and/or middle mediastinal nodes (UMMN) should be dissected in Siewert type II adenocarcinoma (AC) according to the incidence of lymph node metastasis. Additionally, to investigate the association between the length of esophageal involvement (LEI) and the UMMN metastases. METHODS: A cohort with Siewert type II AC who were operated on by a surgical team that routinely treated esophagogastric junction (EGJ) tumors with esophagectomy and extended lymphadenectomy were assessed retrospectively. The primary endpoint of the research was the metastasis rate of UMMN. RESULTS: A total of 94 patients with EGJ tumor from July 2018 to September 2022 were enrolled. Station 106recR (6.4%, 6/94) was the only station among upper mediastinal nodes (UMN) that presented positive nodes. Middle mediastinal nodes (MMN) metastases of station 107, 109 and station 108 were 2.1% (2/94) and 5.0% (4/80), respectively. Among the 11 patients with MMN or UMN metastases, 63.6% (7/11) had lesser than seven metastatic nodes, and 54.5% (6/11) had a pathological N stage ≤2. LEI >3 cm (p = 0.042) showed a higher risk for MMN metastases in univariable logistic analysis. However, no independent risk factor for mediastinal node metastases was detected. CONCLUSION: This study demonstrated that the incidence of positive MMN and UMN is relatively low in resectable Siewert type II AC, which indicated that it is not necessary to perform a routine dissection upon these stations. LEI >3 cm might be associated with higher risk for mediastinal node metastasis. Certain patients could benefit from extended lymphadenectomy since most of the patients with positive MMN or UMN have a limited number of metastatic nodes.


Assuntos
Adenocarcinoma , Neoplasias do Mediastino , Humanos , Mediastino , Metástase Linfática , Estudos Retrospectivos , Adenocarcinoma/cirurgia
18.
Eur J Surg Oncol ; 50(3): 108019, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38359725

RESUMO

BACKGROUND: Mediastinal Yolk sac tumors (YST) are rare and highly malignant extragonadal germ cell tumors with rapid growth and early metastases. We sought to conduct a meta-analysis of published case reports/case series to compare differences in survival, demographics, and treatment modalities between adult and pediatric patients with YST. METHODS: Ovid Embase, Cochrane, and Ovid Medline databases were searched for primary mediastinal pure YST cases. The primary outcome was overall survival (OS). Log-rank and Cox regression were used. This study is registered on PROSPERO (CRD42022367586). RESULTS: Among 846 studies, 87 met our inclusion criteria including 130 patients (Adults: 90 and Pediatrics: 40). About 41.5% of the patients were from the United States. The median age was 23.0 (Q1-Q3: 17.0-30.0), 88.5% were males, and (32.3%) were Asian. Stage II represented almost 40%. AFP was elevated in 96.9%. Respiratory distress was the presenting symptom in 65.4%. Chemotherapy, radiotherapy, and surgery were utilized in 84.6, 23.1, and 64.7% respectively. Median OS was 24 months (Adults: 23 months, Pediatrics: 25 months, P = 0.89). 3- and 5-year OS were 34.4% and 22.9% in adults and 41.5% and 41.5% in pediatrics, respectively. On multivariate analysis, anterior location of tumors, receipt of chemotherapy, and undergoing surgery were associated with better OS. CONCLUSION: Primary mediastinal YSTs are rare, but lethal neoplasms. Our meta-analysis showed that mediastinal YSTs mimic other non-seminomatous mediastinal GCTs in terms of clinical characteristics and available treatment options. Early diagnosis, neoadjuvant chemotherapy, and surgical resection are the key points for effective management and improved outcomes.


Assuntos
Tumor do Seio Endodérmico , Neoplasias do Mediastino , Neoplasias Embrionárias de Células Germinativas , Masculino , Adulto , Humanos , Criança , Adulto Jovem , Feminino , Tumor do Seio Endodérmico/tratamento farmacológico , Tumor do Seio Endodérmico/patologia , Neoplasias do Mediastino/terapia , Neoplasias do Mediastino/patologia , Mediastino/patologia , Terapia Neoadjuvante
19.
J Cardiothorac Surg ; 19(1): 69, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326810

RESUMO

BACKGROUND: Differential diagnosis of mediastinal lymphadenopathy is an issue of debate. Lymph nodes may be enlarged due to a variety of inflammatory, infectious, or malignant reasons. Therefore, obtaining samples from the affected nodes is crucial for the diagnosis. Usually, these patients are subjected to TBNA (EBUS or conventional) or mediastinoscopy if TBNA is not conclusive. This study evaluated the safety and feasibility of this new technique of transbronchial forceps biopsy for the diagnosis of mediastinal lymphadenopathy. METHODS: The study included 18 patients with confirmed mediastinal lymphadenopathy who were admitted in Chest Department, Cairo University in the period from December 2019 to December 2020. All patients were subjected to flexible bronchoscopy with conventional transbronchial needle aspiration (C-TBNA) and transbronchial forceps biopsy (LN-TBFB) from the enlarged mediastinal lymph node in the same procedure. RESULTS: we found the technique of LN-TBFB safe with no serious complications. We were able to reach a diagnosis in 7/7 (100%) cases of sarcoidosis, 6/7 (85.7%) cases of malignant lymph nodes. We had three cases where the histopathology showed hyperactive follicular hyperplasia, and a single case of tuberculous lymphadenitis. C-TBNA was diagnostic in 71.4% of sarcoidosis cases, 42.9% of malignant cases, but failed to diagnose the one patient with tuberculous lymphadenitis. CONCLUSION: Lymph node transbronchial forceps biopsy (LN-TBFB) was found to be safe and effective in the diagnosis of mediastinal lymphadenopathy. We strongly advocate the use of this minimally invasive technique for diagnosing pathologically enlarged mediastinal lymph nodes, as a last step before mediastinoscopy.


Assuntos
Linfadenopatia , Doenças do Mediastino , Sarcoidose , Tuberculose dos Linfonodos , Humanos , Projetos Piloto , Mediastino/patologia , Doenças do Mediastino/diagnóstico , Linfadenopatia/diagnóstico , Linfadenopatia/patologia , Linfonodos/patologia , Biópsia por Agulha Fina , Broncoscopia/métodos , Instrumentos Cirúrgicos , Sarcoidose/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Estudos Retrospectivos
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