RESUMO
A 74-year-old man presented with left chest pain. He had been given a diagnosis of sarcoidosis at age 65. Chest CT films on admission revealed a mass shadow in the left lower lung field and a small nodule in the left upper lung field. Because the specimens of transbronchial biopsy were not diagnostic, video-assisted thoracoscopic surgery was performed. The pathologic diagnosis of the resected lung was overlapping cancers (large cell neuroendocrine carcinoma and mucosa-associated lymphoid tissue lymphoma) complicated with sarcoidosis. Adjuvant chemotherapy was not performed. One year after surgery he continues to do well and has no evidence of recurrence.
Assuntos
Carcinoma de Células Grandes/diagnóstico , Carcinoma de Células Grandes/patologia , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/patologia , Neoplasias Primárias Múltiplas , Sarcoidose Pulmonar/complicações , Idoso , Carcinoma de Células Grandes/cirurgia , Carcinoma Neuroendócrino/cirurgia , Humanos , Neoplasias Pulmonares/cirurgia , Linfoma de Zona Marginal Tipo Células B/cirurgia , Masculino , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A 73-year-old woman presented at a private clinic because of non productive cough. She was treated with several drugs, but no relief was obtained. She was therefore referred to our hospital for further investigations. Chest CT films revealed a solitary nodule in the right lower lung field and mediastinal and bilateral hilar lymphadenopathy. The FDG-PET CT showed a high FDG uptake in the pulmonary nodule and bilateral hilar and mediastinal lymph nodes. Her serum angiotensin-converting enzyme level was normal and a PPD skin test was negative. Because the transbronchial biopsy specimens were not diagnostic, video-assisted thoracoscopic surgery was performed. The pathologic diagnosis of the resected lung and lymph node was sarcoidosis. There was no sign of other organ involvement. The symptoms remitted without steroid therapy and one year after surgery she continues to do well and has no evidence of recurrence.
Assuntos
Sarcoidose Pulmonar , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoidose Pulmonar/diagnósticoRESUMO
A 31-year-old man was referred to our hospital for further investigation of a pulmonary shadow in July, 2004. Chest X-ray and CT films revealed an ill-defined nodule in the right middle lung field. Because the specimens of transbronchial lung biopsy were not diagnostic, video-assisted thoracoscopic surgery was performed. The pathologic diagnosis of the resected lung was lymphomatoid granulomatosis/angiocentric immunoproliferative lesion (LYG/AIL), grade I. Adjuvant therapy was not performed. There has been no evidence of recurrence during the 2-year postoperative follow-up period.
Assuntos
Granulomatose Linfomatoide/diagnóstico , Adulto , Humanos , Granulomatose Linfomatoide/diagnóstico por imagem , Masculino , Radiografia TorácicaRESUMO
A 77-year-old man was given emergency admission because of fever and dyspnea in October, 2005. He had been treated with Sai-rei-to, a herbal drug, for tinnitus. Laboratory data showed high values of C-reactive protein and liver dysfunction. Chest X-ray and CT films revealed ground-glass attenuation in both lung fields. Bronchoalveolar lavage showed an increase in number of lymphocytes and the lymphocyte-stimulation test was positive for Sai-rei-to. Based on the above findings, we diagnosed this case as Sai-rei-to-induced pneumonitis. The patient recovered after discontinuation of Sai-rei-to and corticosteroid therapy.