Primary idiopathic chylopericardium presenting with cardiac tamponade.

Primary idiopathic chylopericardium is an extremely rare condition especially in children and young adults. Although the exact pathophysiology of primary chylopericardium has not been established, the reflux of chylous fluid into the pericardial space was suggested as the etiology. Damage to the thoracic duct valves and the communication of the thoracic duct to the pericardial lymphatics or abnormally elevated pressure in the thoracic duct could cause chylous fluid reflux. In this report, we described the case of a 4-year-old boy with primary idiopathic chylopericardium presenting as cardiac tamponade who was treated with video-assisted thoracoscopic window and then surgical duct ligation.

Pulmonary pseudocyst secondary to blunt or penetrating chest trauma: clinical course and diagnostic issues.

PURPOSE: Traumatic pulmonary pseudocysts (TPPs) are rare complications of chest trauma. The aim of this retrospective study was to report the clinical presentations, diagnosis, complications and treatment for a series of TPPs at a hospital in Turkey. METHODS: The charts of 996 patients who were admitted for thoracic trauma between 1999 and 2012 were retrospectively reviewed. Fifty-two patients had TPPs, and the data collected for these individuals were sex, age, and type of trauma (blunt and/or penetrating). Univariate analysis of categorical data was performed using Pearson's Chi square test. Results for continuous variables were statistically compared using the Mann-Whitney U test. RESULTS: The patients were 42 males and 10 females aged 12-72 years (mean age 33.1 years). Forty-one had blunt trauma and 11 had penetrating trauma. There was no significant difference between the proportion of blunt trauma patients who developed TPP (41/761, 5.3%) and the proportion of penetrating trauma patients who developed TPP (11/235, 4.6%) (p > 0.05). All 42 patients had pulmonary contusion. Only 10 patients (19.2%) had TPP identified on their chest X-ray, and thoracic computed tomography revealed TPP clearly in all these cases. Forty-two patients (80.7%) were diagnosed with TPP on day 1 post-trauma. The hospital stays ranged from 2 to 35 days for the patients with blunt-trauma, and from 4 to 15 days for those with penetrating trauma (means 8.8 and 8.0 days, respectively; p > 0.05). Only one patient required thoracotomy for a pseudocyst that did not resolve and became progressively enlarged. This TPP was resected at 6 months post-trauma. One patient died on day 9 post-trauma due to multiple organ failure. The other 40 pseudocysts resolved spontaneously within 1-5 months. CONCLUSIONS: Traumatic pulmonary pseudocysts are pulmonary lesions that occur after either blunt or penetrating trauma and tend to be overlooked. Most of these lesions are self-limiting, benign lesion.

Cytogenetic findings in thirty lung carcinoma patients.

Primary tissue cultures of human lung tumors were prepared from 30 cases of which 16 were diagnosed as squamous cell carcinoma, six adenocarcinoma, four adenosquamous cell carcinoma, three large cell carcinoma, and one small cell lung carcinoma. Chromosomal abnormalities were observed in 26 cases by cytogenetic studies with a GTG banding technique. Specific chromosome bands frequently involved in structural abnormalities were seen on 1p11, 1q11, 2p10, 6p10, 7q11, 7q22, 7q32, 8q22, 9q22, 11q11, 21q10, and Xq24. We assumed that especially i(2)(p10), i(9)(p10), i(21)(q10), t(11;12), t(14;15), del(X)(q24), and loss of the Y chromosome may play a role in the development of lung cancer as secondary changes. In this way, our cytogenetic findings provide evidence that multiple genetic lesions are associated with the pathogenesis of lung cancer.

An unusual cause of hemoptysis: ventriculopulmonary fistula.

A 55-year-old man presented with massive hemoptysis following coronary artery bypass grafting and repair of a left ventricular aneurysm. Radiological and bronchoscopic examinations revealed no bronchial cause. The findings of computed tomography (CT) of the chest and echocardiography showed a pseudoaneurysm of the left ventricle. Surgical exploration confirmed that the pseudoaneurysm communicated with the lung parenchyma.

Surgical treatment of tracheal hamartoma.

Tracheal hamartoma is a rare tumor and difficult to diagnose. A case is presented in which tracheal hamartoma was misdiagnosed and treated for four years as asthma. The tumor was curatively excised via posterolateral thoracotomy.