Histiocytic necrotising lymphadenitis in mediastinum mimicking thymoma or lymphoma - case presentation and literature review of Kikuchi Fujimoto disease.

Kikuchi Fujimoto disease (KFD) as a rare self-limiting lymphadenopathy of short and benign course concerns most frequently the lymph nodes of the neck. The most common symptoms are painfulness of the diseased area, fever and night sweating. The etiology is not well understood, but in the role of pathogenesis viral, autoimmune and genetic factors are taken into account. In the presented case of 37-year-old female it was necessary to exclude diseases such as lymphoma or thymoma because of atypical mediastinal location of Kikuchi Fujimoto disease. After multidisciplinary consultation the lymph node was resected from the mediastinum with videothoracoscopic approach. The diagnosis was difficult for the pathologist because of the large percentage of necrosis of the lymph node but the image was typical for histiocytic necrotizing lymphadenitis. Two cases of patients with KFD limited to the mediastinum have been previously reported in the literature. This article presents the world's first reported case of this disease in the topographic location of the thymus. Furthermore, a review of current literature was made.

Surgical treatment of lung cancer in patients under 45 years of age.

AIM: The aim of the study was to evaluate the characteristics and prognosis of radical surgical treatment in young patients under the age of 45 with lung cancer. METHODS: We retrospectively analysed the data of 85 young patients and 211 older patients who underwent anatomical lung resections in Wroclaw Thoracic Surgery Centre. RESULTS: Less lobectomies were performed (p = 0.048), the incidence of carcinoid was significantly higher (p < 0.0001), stage I of lung cancer was observed less frequently (p = 0.023), the frequency of metastasis to subcarinal lymph nodes was higher (p = 0.007), a bronchial stump was microscopically infiltrated more frequently, the complete resection was noted rarer (p = 0.016) and 3-year survival rate of squamous cell carcinoma patients was worse in younger group (p = 0.017). The statistical significance was not observed between the frequency of recurrences and overall survival. CONCLUSIONS: Lung cancer in younger patients seems to be more advanced at the time of surgery. It is probable that the group of younger patients with squamous cell carcinoma will require additional treatment after surgery.

[Myxoma of the left atrium suggesting a connective tissue disease]. / Sluzak lewego przedsionka sugerujacy chorobe tkanki lacznej.

A case is presented of myxoma of the left atrium suggesting a connective tissue disease. In the foreground were musculo-articular symptoms, sub-febrile states, considerable loss a body weight. At the same time an increased sedimentation rate, hypergammaglobulinaemia, increased level of IgG and IgM, high CRP level, and the presence of antinuclear antibodies and LE cells were noted. The diagnosis of myxoma was made on the basis of echocardiographic examination. After surgical resection of the tumor all symptoms regressed, and a normalization was observed of the formerly observed abnormalities in the laboratory investigations.

One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period.

BACKGROUND: The conventional method of double chest tube drainage after lobectomy is well established. The aim of the study was to compare the efficacy of the two-drain versus the single-drain approach after this procedure. METHODS: The data of 183 consecutive patients who underwent lobectomy between January 2000 and May 2005 were analyzed: 93 had two drains and 90 had a single, midposition drain. All patients were operated on by one surgeon with the same surgical technique. RESULTS: Patients with one drain had a shorter hospital stay (7.6 days vs. 9.0 days; P = 0.001). There were no significant differences in the amount of drainage, the necessity of redrainage or broncho-aspiration, and postoperative mortality or complications. The period in which opioids (4.8 days vs. 5.6 days; P = 0.0001) and nonsteroidal anti-inflammatory drugs (6.8 days vs. 7.7 days; P = 0.002) were required was shorter in patients with one drain. The fourth postoperative day was more painful for patients with a double drain. The cost savings in the one-drain group were approximately 125 Euros per patient. CONCLUSION: A single-drain method is effective, reduces hospitalization times and the cost of treatment in patients who undergo lobectomy.