RESUMO
Background: Schwannomaare benign tumors arising from Schwann cells of nerve root sheaths. Schwannomasare mostly solid / heterogeneous solid tumours, rarely cystic. Presentation of cystic schwannomainthorax is extremely rare. Case Study: A 62-year-old female came to our hospital withthe complaint of right sided chest pain for 2 months, which is dull, non-radiating. She had history of fever 4 months back, diagnosed to have covid and took treatment at home. Chest x-ray showed a homogenous opacity in the right upper lobe extending up to 1stintercostal space. Ct reported well-defined thick-walled cyst, hypodensewith central low attenuation, forming acute angles with lung parenchyma in apical segments of right upper lobe towards mediastinum. Mild perilesional atelectasis is seen.On contrast, cyst is non enhancing. Patient is evaluated for the possibilities of Foregut duplication cyst, Hydatidcyst, Neoplasm. Endoscopic ultrasonography revealed a 5cms×5cms cyst, which is not communicating, infiltrating to esophagus. Patient was referred to ctvswhere excision of cyst is done by right thoracotomy .A 6cms×6cms×2cms unilocularcyst with wall thickness ranging from 0.1- 0.4cms. Its outer surface is congested, inner surface showed dark-brown hemorrhagic contents. Histopathological examination revealed cystic schwannoma. Discussion: Schwannomasare mostly benign in nature .Treatment includes excision of Bronchogenic cyst, Brachial cyst, neurogenic tumours, apical lung tumour, hydatid cyst, foregut duplication cyst are to be considered as differential diagnosis. It is important to consider cystic schwannomasin the differential diagnosis of thoracic cystsince the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.
RESUMO
Background: SARS-COV-2 has caused morbidity and mortality at an unprecedented scale globally. During recovery, several patients are found to have functional impairment and radiological abnormalities. Case Study: An observational study done on 54 post-covid patients attending our center during July to November. A detailed history, radiology and clinical data during acute and post-covid visit were analyzed. Aims: To document various post-covid complications, assessing risk factors for complications Discussion: Mean age group of presentation 49.2years, mean time of follow-up presentation is 66.4 days. Incidence is higher in males (64.8%) than females (35%),83.3% are having one or more existing comorbidities during acute covid mainly diabetes 61%, hypertension 38%, Both in 25%, copdin 7.4%, tuberculosis in 3.7%, HIV in 1.85 %. About 79.6% had more than 3 weeks of hospital stay,46.2% are on NIV support during acute covid. Majority of post-covid patients came with dyspnea -75.9%, cough -74%, fatigue -31.4%, productive cough -14%, fever -9%, chest pain -7%. Resting hypoxia is seen in 29.6% of patients. Of post-covid patients,88% presented with pulmonary fibrosis,12.9% with pnemothorax,12.9%with lung cavity,3.6%with necrotizing pneumonia and 1.8%with lung abscess. Both pneumothorax and fibrosis are seen in 9.25%, both cavity and fibrosis in 5.5%. post-covid pulmonary cavities (7) were due to tuberculosis, klebsiella, pseudomonas, E. coli, fungal itology.Comparativelyradiological improvement is seen in 86% of the patients Conclusion: Diabetes,nonvaccinating, severe covid at admission, mechanical ventilation, older age contributes to severe post-covid complications.Regularfollow up,rehabilitation therapy, screening for tuberculosis is to be considered.