Thoracic duct cyst of posterior mediastinum: a "challenging" differential diagnosis.

Thoracic duct cysts of the mediastinum are extremely rare entities and their pathogenesis still remains unknown. Imaging methods are not specific and show a cystic mass, however the real nature of the lesion is confirmed only with the help of histopathological examination after surgical excision. Here, we present a case of thoracic cyst in a 28-year-old female, lining in posterior lower mediastinum. The cyst was removed by video-assisted thoracic surgery (VATS) and the histopathological findings were that of thoracic duct cyst. Through this case, we propose an ideal surgical approach and diagnostic procedure.

Fibrous tumor of the lung: diagnostic and therapeutic considerations apropos of two cases.

Solitary fibrous tumor (SFT) of the pleura and the lung is an uncommon spindle cell neoplasm arising from the visceral pleura in the majority of the cases. Current diagnostic and therapeutic considerations are discussed apropos of 2 recent cases. 1st case: A 46-year-old male, heavy smoker, presented with nonspecific complaints and a mass in the left posterior mediastinum at the level of the 5th thoracic vertebra. Computed tomography (CT) and magnetic resonance imaging (MRI) of the chest confirmed the position of the mass in proximity to the thoracic wall at that level. Through a left posterolateral thoracotomy, a 4 x 5 x 2 cm mass, mushroom-shaped, stalky, completely covered by the lung parenchyma, was resected. Histopathological examination revealed a SFT of the lung. 2nd case: A 54-year-old woman presented with symptoms of respiratory distress and persistent hypoglycaemia. CT scan of the chest showed a huge mass within the right hemithorax, compressing the mediastinum and the contralateral lung. The mass was initially detected on chest radiography and CT scan 3 years before resection. Fine needle biopsy (FNB) results were inconclusive and resection of the mass through a right thoracotomy established the diagnosis of malignant SFT. Resection of the mass resulted in recovery of respiratory function and the paraneoplastic hypoglycaemia. Radiologic features and inconclusive fine needle aspiration (FNA)/FNB results make preoperative diagnosis of SFTs of the pleura and lung difficult. Diagnosis of SFT will be established with certainty after surgery. Resection with clear margins is the main important prognostic factor.

Mola invasiva--special form of GTD.

Invasive hydatidiform mole is a relative rare form of gestational trophoblastic disease (GTD). Most of hydatidiform moles remit after evacuation but some of them have the tendency to invade the myometrium. In some rare cases the trophoblastic tissue can be found in other tissues like lungs, vulva, vagina or broad ligament. The aim of the study was to demonstrate some of clinical, immunohistochemical and DNA analysis findings of a patient with a previous diagnosis of a complete hydatidiform mole.