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1.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 183-192, Junio 2024.
Article de Espagnol | LILACS, UNISALUD, BINACIS | ID: biblio-1556174

RÉSUMÉ

Se presenta a un paciente con liposarcoma mediastinal gigante con dolor torácico, disnea, cuyos estudios por imágenes revelaban la presencia de una gran tumoración de 42 cm en su diámetro mayor que abarcaba todo el mediastino, comprometía ambas cavidades torácicas, rechazaba los pulmones, corazón y grandes vasos. La biopsia con aguja cortante bajo guía ecográfica fue informada como liposarcoma. El paciente tuvo resección completa del tumor mediante la incisión Clamshell. En el post operatorio inmediato, presentó shock circulatorio más disfunción multiorgánica (DOMS): plaquetopenia, insuficiencia renal aguda con necesidad de soporte dialítico, injuria hepática. El soporte y monitoreo especializado en la Unidad de Cuidados Intensivos (UCI) permitió mejoría clínica y buena evolución. Salió de alta en buenas condiciones.


We present a patient with giant mediastinal liposarcoma with chest pain, dyspnea, whose imaging studies revealed the presence of a large tumor measuring 42 cm in its greatest diameter that covered the entire mediastinum, involved both thoracic cavities, rejected the lungs, heart and big glasses. The sharp needle biopsy under ultrasound guidance was reported as liposarcoma. The patient had complete resection of the tumor through the Clamshell incision. In the immediate postoperative period, he presented circulatory shock plus multiple organ dysfunction (DOMS): plateletopenia, acute renal failure with the need for dialytic support, liver injury. Specialized support and monitoring in the Intensive Care Unit (ICU) allowed clinical improvement and good evolution. He was discharged in good condition.


Sujet(s)
Humains , Mâle , Adulte , Thoracotomie , Liposarcome/chirurgie , Tumeurs du médiastin/diagnostic , Choc , Douleur thoracique , Tomographie , Toux , Soins de réanimation , Traitement médicamenteux , Dyspnée , Biopsie guidée par l'image , Défaillance multiviscérale/chirurgie
2.
Pneumologie ; 78(6): 420-426, 2024 Jun.
Article de Allemand | MEDLINE | ID: mdl-38866027

RÉSUMÉ

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the gold standard in the diagnosis of mediastinal and hilar lesions. For certain purposes, such as the diagnosis and subtyping of lymphoproliferative disorders or molecular pathology, a larger amount of intact sample material is required. EBUS cryobiopsy is a new and efficient tool for this purpose. As it is a new approach, there is still no standardised workflow. In this review, we present the procedure step by step as it is performed at the Ruhrlandklinik in Essen.


Sujet(s)
Cytoponction sous échoendoscopie , Humains , Cytoponction sous échoendoscopie/méthodes , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Maladies du médiastin/anatomopathologie , Maladies du médiastin/diagnostic , Bronchoscopie/méthodes , Médiastin/anatomopathologie , Cryochirurgie/méthodes
3.
Khirurgiia (Mosk) ; (6): 81-87, 2024.
Article de Russe | MEDLINE | ID: mdl-38888023

RÉSUMÉ

We present successful surgical treatment of a patient with chronic kidney disease (CKD) and hyperparathyroidism undergoing renal replacement therapy. At baseline, parathyroidectomy via cervical access was performed for parathyroid adenomas. After 6 years, clinical and laboratory relapse of disease required thoracoscopic resection of atypically located anterior mediastinal adenoma. This case demonstrates that this disease is one of the most difficult in modern medicine requiring a special approach in diagnosis and treatment. Patients with CKD and hyperparathyroidism need for follow-up, control of total and ionized serum calcium, inorganic phosphorus and parathormone, osteodensitometry, ultrasound and scintigraphy of thyroid and parathyroid glands, and, if necessary, CT or MRI of the neck and chest organs.


Sujet(s)
Adénomes , Tumeurs de la parathyroïde , Parathyroïdectomie , Humains , Tumeurs de la parathyroïde/chirurgie , Tumeurs de la parathyroïde/complications , Tumeurs de la parathyroïde/diagnostic , Parathyroïdectomie/méthodes , Adénomes/chirurgie , Adénomes/complications , Adénomes/diagnostic , Résultat thérapeutique , Récidive tumorale locale/chirurgie , Glandes parathyroïdes/chirurgie , Adulte d'âge moyen , Thoracoscopie/méthodes , Mâle , Femelle , Tumeurs du médiastin/chirurgie , Tumeurs du médiastin/complications , Tumeurs du médiastin/diagnostic , Hyperparathyroïdie secondaire/chirurgie , Hyperparathyroïdie secondaire/étiologie , Hyperparathyroïdie secondaire/diagnostic , Insuffisance rénale chronique/complications , Insuffisance rénale chronique/diagnostic , Médiastin/chirurgie
4.
BMJ Case Rep ; 17(6)2024 Jun 06.
Article de Anglais | MEDLINE | ID: mdl-38844357

RÉSUMÉ

Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a case of a man in his 30s who initially presented with symptoms of spinal cord compression. Further imaging revealed a mediastinal tumour, with a biopsy confirming plasmacytoma. Immunofixation revealed IgA lambda paraprotein. Bone marrow biopsy demonstrated atypical T-cell cytotoxic proliferation and trilineage hypoplasia. The patient was diagnosed with extramedullary plasmacytoma with active IgA multiple myeloma. The patient received mediastinal radiation to the tumour, followed by anti-myeloma therapy. This diagnosis is critical as managing a solitary plasmacytoma drastically differs from an extramedullary plasmacytoma with active multiple myeloma.


Sujet(s)
Immunoglobuline A , Tumeurs du médiastin , Myélome multiple , Plasmocytome , Syndrome de compression médullaire , Humains , Mâle , Myélome multiple/complications , Myélome multiple/diagnostic , Syndrome de compression médullaire/étiologie , Syndrome de compression médullaire/imagerie diagnostique , Plasmocytome/diagnostic , Plasmocytome/complications , Plasmocytome/imagerie diagnostique , Tumeurs du médiastin/complications , Tumeurs du médiastin/imagerie diagnostique , Tumeurs du médiastin/diagnostic , Adulte , Imagerie par résonance magnétique , Diagnostic différentiel
5.
P R Health Sci J ; 43(2): 79-83, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-38860961

RÉSUMÉ

Currently, there is limited data available comparing Primary Mediastinal Large B-cell Lymphoma (PMBL) and mediastinal Hodgkin disease, nodular sclerosis type (HDNS). This is a retrospective cohort study that compares the clinical features, histology through immunohistochemistry (IHC) and treatment outcomes of 19 cases of PMBL and 39 cases of HDNS diagnosed over 13 years at a single institution in San Juan, PR. Superior Vena Cava syndrome (SVCS) and elevated Lactate Dehydrogenase (LDH) levels were more frequently seen in the PMBL cohort. At the median follow-up visit, of 74 months, no significant difference was seen in overall survival or progression free survival between PMBL and HDNS. Almost all of the relapses in the PMBL group occurred within 12 months of diagnosis. Our data suggests that PMBL and HDNS differ in their clinical presentation and have a favorable prognosis.


Sujet(s)
Maladie de Hodgkin , Lymphome B diffus à grandes cellules , Tumeurs du médiastin , Humains , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Tumeurs du médiastin/thérapie , Études rétrospectives , Maladie de Hodgkin/anatomopathologie , Maladie de Hodgkin/diagnostic , Maladie de Hodgkin/thérapie , Mâle , Femelle , Adulte , Adulte d'âge moyen , Lymphome B diffus à grandes cellules/anatomopathologie , Lymphome B diffus à grandes cellules/diagnostic , Lymphome B diffus à grandes cellules/thérapie , Jeune adulte , Sujet âgé , Études de cohortes , Résultat thérapeutique , Études de suivi , Pronostic , Adolescent , Syndrome de la veine cave supérieure/étiologie , Survie sans progression , Taux de survie
6.
Pediatr Int ; 66(1): e15754, 2024.
Article de Anglais | MEDLINE | ID: mdl-38924208

RÉSUMÉ

BACKGROUND: Recently, reports of endoscopic approaches for neuroblastoma, ganglioneuroblastoma, and ganglioneuroma (peripheral neuroblastic tumor; PNTs) have been increasing. This study aimed to clarify the indications for endoscopic surgery for PNTs. METHODS: Pediatric patients who underwent endoscopic surgery for PNTs at our institution were included in this study. Image-defined risk factors (IDRFs) were analyzed using preoperative computed tomography (CT). RESULTS: Twenty-four patients underwent endoscopic surgery for PNTs. The diagnoses included neuroblastoma (n = 11), ganglioneuroma (n = 10), and ganglioneuroblastoma (n = 3). Regarding the tumor site, there were 18 cases of adrenal tumors, five cases of mediastinal tumors, and one case of retroperitoneal tumors. Image-defined risk factors were positive in eight cases (contacted with a renal vessel, n = 6; compression of principal bronchi, n = 2). Complete resection was accomplished in 21 cases (14 of 16 IDRF-negative cases and seven of eight IDRF-positive cases). All patients survived without recurrence during the follow-up period. CONCLUSIONS: The CT findings of contact with renal vessels and compression of principal bronchi do not seem to be indicators of incomplete resection. An endoscopic approach to PNTs in pediatric patients is feasible with a good prognosis if patients are selected strictly.


Sujet(s)
Ganglioneuroblastome , Ganglioneurome , Neuroblastome , Tomodensitométrie , Humains , Mâle , Femelle , Enfant d'âge préscolaire , Neuroblastome/chirurgie , Neuroblastome/diagnostic , Enfant , Nourrisson , Ganglioneurome/chirurgie , Ganglioneurome/diagnostic , Ganglioneuroblastome/chirurgie , Ganglioneuroblastome/diagnostic , Études rétrospectives , Endoscopie/méthodes , Résultat thérapeutique , Adolescent , Études de suivi , Tumeurs de la surrénale/chirurgie , Tumeurs de la surrénale/diagnostic , Tumeurs du médiastin/chirurgie , Tumeurs du médiastin/diagnostic
9.
J Cardiothorac Surg ; 19(1): 291, 2024 May 16.
Article de Anglais | MEDLINE | ID: mdl-38755707

RÉSUMÉ

BACKGROUND: Immunoglobulin (Ig)G4-related disease affects nearly every organ, and its clinical course varies depending on the involved organ; however, its occurrence in the mediastinum is rarely reported. CASE PRESENTATION: A 58-year-old woman presented with a posterior mediastinal tumor along the thoracic spine on imaging. Based on her elevated serum IgG4 level of 349.7 mg/dL, IgG4-related disease was suspected. Since the tumor was growing and malignancy could not be excluded, surgical resection was performed for definitive diagnosis. Robot-assisted thoracoscopic surgery was performed via the left semipronation and right thoracic approaches. The irregularly-shaped tumor was located on the level of the seventh to ninth thoracic vertebra, along the sympathetic nerve. A malignancy was not excluded based on the appearance of the tumor. The tumor had poor mobility. The sympathetic nerves, intercostal arteries, and veins were also excised. In this case, the articulated forceps, used during the robotic surgery, were useful in achieving complete tumor resection along the vertebral body. The pathological examination revealed IgG4-positive plasma infiltration, which fulfilled the criteria for IgG4-related diseases. The postoperative course was uneventful, and the patient underwent follow-up on an outpatient basis without additional medications. CONCLUSION: The clinical presentation of IgG4-related disease varies, based on the involved organs. This case was rare because the mediastinum was involved, and it emphasized the effectiveness of surgical resection.


Sujet(s)
Maladie associée aux immunoglobulines G4 , Tumeurs du médiastin , Interventions chirurgicales robotisées , Humains , Femelle , Adulte d'âge moyen , Interventions chirurgicales robotisées/méthodes , Tumeurs du médiastin/chirurgie , Tumeurs du médiastin/diagnostic , Maladie associée aux immunoglobulines G4/chirurgie , Maladie associée aux immunoglobulines G4/diagnostic , Thoracoscopie/méthodes , Tomodensitométrie
10.
Surg Pathol Clin ; 17(2): 243-255, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-38692808

RÉSUMÉ

Primary sarcoma of the lung and mediastinum is rare. The diagnosis requires careful exclusion of sarcomatoid carcinoma, sarcomatoid mesothelioma, and metastases from extra-thoracic sites. This review summarizes the key morphologic, immunohistochemical, and molecular characteristics of sarcomas that are encountered in the lung and mediastinum. The tumor types discussed are synovial sarcoma, well-differentiated/dedifferentiated liposarcoma, myxoid pleomorphic liposarcoma, intimal sarcoma of the pulmonary artery, inflammatory myofibroblastic tumor, epithelioid hemangioendothelioma, primary pulmonary myxoid sarcoma, malignant peripheral nerve sheath tumor, Ewing sarcoma, and CIC-rearranged sarcoma. Relevant differential diagnoses are also addressed.


Sujet(s)
Tumeurs du poumon , Tumeurs du médiastin , Sarcomes , Humains , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Tumeurs du poumon/anatomopathologie , Tumeurs du poumon/diagnostic , Sarcomes/anatomopathologie , Sarcomes/diagnostic , Diagnostic différentiel , Marqueurs biologiques tumoraux
11.
BMJ Case Rep ; 17(5)2024 May 24.
Article de Anglais | MEDLINE | ID: mdl-38789269

RÉSUMÉ

Tumours of adipose tissue origin are relatively rare in the head and neck. Here, we report a case of an unfamiliar lipomatous lesion that involved the neck and mediastinum. A nil-comorbid man in his 40s presented with a slowly progressive anterior neck swelling of 3 years, which was diagnosed as lipoma by histopathological sampling. Computed tomography demonstrated the lesion to be involving parapharyngeal and retropharyngeal spaces with mediastinal extension. The lesion was removed by the transcervical approach. The final histology of the excised specimen, with immunohistochemistry for mouse double minute 2 (MDM2) and p16, suggested an atypical lipomatous tumour (ALT). This report accentuates the occurrence of this rare neoplasm in the neck, which often mimics lipoma clinically. Although radiology can demonstrate suggestive features, histology with MDM2 and/or p16 positivity can confirm the diagnosis of ALT as against the lipoma. A successful transcervical excision, despite the deeper extension of the lesion between the critical structures of the neck and mediastinum, demonstrates the non-infiltrating nature of the tumour.


Sujet(s)
Tumeurs de la tête et du cou , Lipome , Tomodensitométrie , Humains , Mâle , Tumeurs de la tête et du cou/chirurgie , Tumeurs de la tête et du cou/anatomopathologie , Tumeurs de la tête et du cou/diagnostic , Tumeurs de la tête et du cou/imagerie diagnostique , Lipome/chirurgie , Lipome/imagerie diagnostique , Lipome/anatomopathologie , Lipome/diagnostic , Adulte , Tumeurs du médiastin/chirurgie , Tumeurs du médiastin/imagerie diagnostique , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Cou/anatomopathologie , Cou/imagerie diagnostique , Diagnostic différentiel , Médiastin/anatomopathologie , Médiastin/imagerie diagnostique
12.
Zhonghua Xue Ye Xue Za Zhi ; 45(3): 209-214, 2024 Mar 14.
Article de Chinois | MEDLINE | ID: mdl-38716591

RÉSUMÉ

Primary mediastinal large B-cell lymphoma (PMBL) is an aggressive B-cell lymphoma that is thought to arise from thymic (medullary) B cells and has unique clinicopathologic and molecular features. In recent years, the understanding of the pathogenesis and treatment of PMBL has been updated to varying degrees, particularly in the area of new drug therapy. In order to improve the diagnosis and treatment of PMBL in China, the Lymphocyte Disease Group of the Chinese Medical Association (CMA) and the Anti-Lymphoma Alliance of the Chinese Society of Clinical Oncology (CSCO) commissioned a group of experts to formulate this consensus.


Sujet(s)
Consensus , Lymphome B diffus à grandes cellules , Tumeurs du médiastin , Humains , Tumeurs du médiastin/diagnostic , Tumeurs du médiastin/thérapie , Chine , Lymphome B diffus à grandes cellules/diagnostic , Lymphome B diffus à grandes cellules/thérapie
13.
Respiration ; 103(7): 359-367, 2024.
Article de Anglais | MEDLINE | ID: mdl-38588649

RÉSUMÉ

INTRODUCTION: Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TMC), a novel technique, has been reported to improve the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lesions in recent studies. Current literature suggests that this procedure has greater diagnostic efficacy compared to conventional EBUS-TBNA. This systematic review and meta-analysis aimed to evaluate the diagnostic yield and complications associated with EBUS-TMC in comparison to EBUS-TBNA, thereby exploring the potential of this novel technique in enhancing the diagnostic utility for mediastinal lesions. METHODS: A comprehensive literature review was conducted by searching the PubMed, Embase, and Google Scholar databases for articles published from inception to December 31, 2023. The objective of this review was to evaluate the utilization of EBUS-TMC in diagnosing mediastinal disease, while also assessing the quality of each study using the QUADAS-2 tool. The diagnostic yield estimates were subjected to a meta-analysis utilizing inverse variance weighting. Furthermore, a comprehensive analysis of the complications associated with this procedure was performed. RESULTS: The meta-analysis included 10 studies involving a total of 538 patients. The findings of the meta-analysis demonstrated that EBUS-TMC yielded an overall diagnostic rate of 89.59% (482/538), while EBUS-TBNA yielded a rate of 77.13% (415/538). The calculated inverse variance-weighted odds ratio was 2.63 (95% confidence interval, 1.86-3.72; p < 0.0001), and I2 value was 11%, indicating a statistically significant difference between the two techniques. The associated complications consisted of pneumothorax, pneumomediastinum, mediastinitis, and bleeding, with an incidence of 0.74% (4/538), 0.37% (2/538), 0.0% (0/538), and 1.12% (6/538), respectively. Moreover, the funnel plot displayed no discernible publication bias. Further subgroup analysis revealed a notable improvement in the diagnosis value for lymphoma (86.36% vs. 27.27%, p = 0.0006) and benign disorder (87.62% vs. 60.00%, p < 0.0001). CONCLUSION: This review of the current available studies indicated that EBUS-TMC enhanced overall diagnostic yields compared to EBUS-TBNA, particularly for diagnosing benign disease and lymphoma. This procedure was not associated with any serious complications.


Sujet(s)
Cytoponction sous échoendoscopie , Maladies du médiastin , Humains , Cytoponction sous échoendoscopie/méthodes , Cytoponction sous échoendoscopie/effets indésirables , Maladies du médiastin/anatomopathologie , Maladies du médiastin/diagnostic , Médiastin/anatomopathologie , Cryochirurgie/méthodes , Bronchoscopie/méthodes , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic
14.
J Cardiothorac Surg ; 19(1): 198, 2024 Apr 10.
Article de Anglais | MEDLINE | ID: mdl-38600577

RÉSUMÉ

This case report details a rare thymic basaloid carcinoma initially misinterpreted as a mediastinal teratoma, underscoring the diagnostic challenges posed by such tumors. A 71-year-old female presented with an asymptomatic anterior mediastinal tumor discovered incidentally during a routine health examination. Surgical intervention, followed by pathological and immunohistochemical analysis including CK-pan, p63, p40, and CD117 molecules, led to a definitive diagnosis of basaloid carcinoma of the thymus. This case highlights the critical importance of differential diagnosis in mediastinal lesions, especially those presenting with multilocular thymic cysts on chest CT. The subxiphoid video-assisted thoracoscopic surgery enabled complete tumor resection with minimal trauma and favorable postoperative outcomes. The patient opted against further radiotherapy or chemotherapy and she has survived for over eight months without recurrence. This case report contributes to the growing understanding of thymic basaloid carcinoma, a rare and potentially aggressive thymic carcinoma subtype. It emphasizes the necessity for precise surgical techniques and enhanced diagnostic acumen among cardiothoracic surgeons and oncologists.


Sujet(s)
Carcinome épidermoïde , Kyste médiastinal , Tumeurs du médiastin , Tératome , Thymome , Tumeurs du thymus , Femelle , Humains , Sujet âgé , Tumeurs du médiastin/diagnostic , Tumeurs du thymus/diagnostic , Tumeurs du thymus/chirurgie , Tumeurs du thymus/anatomopathologie , Kyste médiastinal/diagnostic , Kyste médiastinal/chirurgie , Kyste médiastinal/anatomopathologie , Thymome/anatomopathologie , Tératome/diagnostic
15.
Ann Diagn Pathol ; 71: 152300, 2024 Aug.
Article de Anglais | MEDLINE | ID: mdl-38574567

RÉSUMÉ

INTRODUCTION: Fine Needle Aspiration cytology (FNAC) and core needle biopsy (CNB) are rapid, minimally invasive and useful techniques to evaluate mediastinal lesions. OBJECTIVES: To compare cytopathology with histopathology of mediastinal lesions and analyse reasons for discordance. MATERIAL & METHODS: Retrospective analysis was done in a tertiary care centre in North West India over a period of seven and half years from 1stJuly 2016 to 31st December 2023. Only those patients who had undergone FNAC and trucut biopsy of mediastinal masses were included. The cytopathology and histopathology slides were studied to analyse causes of discordance. Sensitivity, specificity, positive and negative predictive values of FNAC were calculated keeping histopathology as gold standard. RESULTS: Out of 57 cases analysed, eight cases were non diagnostic on cytology. Cytology could effectively classify a lesion as non neoplastic (7) or neoplastic (42). For further subtyping, histopathology and Immunohistochemistry (IHC) were required. Out of 27 cases of cytological - histopathological discordance, 8 cases had sampling error, 15 cases had limited concordance where FNAC could predict possibility of tumor and 4 cases were discordant where subtyping of malignancy varied on CNB. Sensitivity of FNAC to predict definite diagnosis was 90.2 %, specificity was 50 %, positive predictive value of FNAC to give a definite diagnosis was 93.9 %, negative predictive value was 37.5 %. CONCLUSION: Evaluation of mediastinal masses requires combination of cytology, histopathology and ancillary techniques like IHC. FNAC and CNB are complementary modalities and both are essential for rapid, accurate and comprehensive diagnosis.


Sujet(s)
Tumeurs du médiastin , Médiastin , Sensibilité et spécificité , Humains , Biopsie au trocart/méthodes , Études rétrospectives , Cytoponction/méthodes , Mâle , Femelle , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Adulte , Adulte d'âge moyen , Médiastin/anatomopathologie , Inde , Sujet âgé , Jeune adulte , Adolescent , Cytodiagnostic/méthodes , Valeur prédictive des tests , Enfant , Cytologie
16.
Medicine (Baltimore) ; 103(14): e37704, 2024 Apr 05.
Article de Anglais | MEDLINE | ID: mdl-38579068

RÉSUMÉ

BACKGROUND: Posterior mediastinal leiomyosarcoma is an extremely rare malignant mesenchymal tumor with no special clinical symptoms, which is easily confused with some common tumors in the posterior mediastinum, affecting the accuracy of the first diagnosis by clinicians and delaying the treatment of patients. CASE SUMMARY: We report a 59-year-old woman with a space-occupying lesion in the posterior mediastinum. The patient was mistakenly diagnosed with lumbar muscle or vertebral body lesions due to chest and back pain and underwent conservative treatment, but her symptoms did not improve significantly and she gradually developed pain in both lower limbs. Chest computed tomography (CT) scan indicated the left lower lung paraspinal space and underwent standard single-aperture video-assisted thoracoscopic surgery (VATS), which was pathologically confirmed as posterior mediastinal leiomyosarcoma. CONCLUSION: Complete surgical resection of posterior mediastinal leiomyosarcoma can achieve good clinical results.


Sujet(s)
Léiomyosarcome , Tumeurs du médiastin , Humains , Femelle , Adulte d'âge moyen , Médiastin/anatomopathologie , Léiomyosarcome/diagnostic , Léiomyosarcome/chirurgie , Léiomyosarcome/anatomopathologie , Tumeurs du médiastin/diagnostic , Tumeurs du médiastin/chirurgie , Tumeurs du médiastin/anatomopathologie , Thorax/anatomopathologie , Tomodensitométrie/méthodes
17.
Lung Cancer ; 191: 107558, 2024 May.
Article de Anglais | MEDLINE | ID: mdl-38569278

RÉSUMÉ

OBJECTIVES: Mediastinal neoplasms are typical but uncommon thoracic diseases with increasing incidence and unfavorable prognoses. A comprehensive understanding of their spatiotemporal distribution is essential for accurate diagnosis and timely treatment. However, previous studies are limited in scale and data coverage. Therefore, this study aims to elucidate the distribution of mediastinal lesions, offering valuable insights into this disease. MATERIALS AND METHODS: This multi-center, hospital-based observational study included 20 nationwide institutions. A retrospective search of electronic medical records from January 1st, 2009, to December 31st, 2020, was conducted, collecting sociodemographic data, computed tomography images, and pathologic diagnoses. Analysis focused on age, sex, time, location, and geographical region. Comparative assessments were made with global data from a multi-center database. RESULTS: Among 7,765 cases, thymomas (30.7%), benign mediastinal cysts (23.4%), and neurogenic tumors (10.0%) were predominant. Distribution varied across mediastinal compartments, with thymomas (39.6%), benign cysts (28.1%), and neurogenic tumors (51.9%) most prevalent in the prevascular, visceral, and paravertebral mediastinum, respectively. Age-specific variations were notable, with germ cell tumors prominent in patients under 18 and aged 18-29, while thymomas were more common in patients over 30. The composition of mediastinal lesions across different regions of China remained relatively consistent, but it differs from that of the global population. CONCLUSION: This study revealed significant heterogeneity in the spatiotemporal distribution of mediastinal neoplasms. These findings provide useful demographic data when considering the differential diagnosis of mediastinal lesions, and would be beneficial for tailoring disease prevention and control strategies.


Sujet(s)
Tumeurs du médiastin , Humains , Mâle , Femelle , Tumeurs du médiastin/épidémiologie , Tumeurs du médiastin/anatomopathologie , Tumeurs du médiastin/diagnostic , Tumeurs du médiastin/imagerie diagnostique , Adulte , Adulte d'âge moyen , Études rétrospectives , Adolescent , Jeune adulte , Sujet âgé , Enfant , Analyse spatio-temporelle , Enfant d'âge préscolaire , Tomodensitométrie , Incidence
18.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 85-92, Marzo 2024.
Article de Espagnol | LILACS, UNISALUD, BINACIS | ID: biblio-1551285

RÉSUMÉ

El sarcoma folicular de células dendríticas (SFCD) es una neoplasia maligna rara derivada de las células dendríticas foliculares. Ha sido clasificado, dadas sus características inmunohistoquímicas, como parte del grupo de los sarcomas, donde representa un porcentaje menor al 1%. Actualmente, existen menos de 1.000 reportes en la literatura a nivel mundial, lo cual plantea una dificultad no sólo diagnóstica, siendo confundido frecuentemente con neoplasias de tipo linfoide; sino también terapéutica al no existir un claro consenso sobre su manejo definitivo. Esta revisión de caso clínico describe el primer caso reportado de SFCD en Costa Rica.


Follicular dendritic cell sarcoma (SFCD) is a rare malignant neoplasm derived from follicular dendritic cells, which has been classified, given its immunohistochemical characteristics, as part of the group of sarcomas, where it represents less than 1%. Currently, there are less than 1000 reports in the literature worldwide, which generates a difficulty not only in diagnosis, being frequently confused with lymphoid type neoplasms; but also, as therapeutic as there is no clear consensus on its definitive management. This clinical case review describes the first reported case of SFCD in Costa Rica.


Sujet(s)
Humains , Femelle , Adulte , Asthme/diagnostic , Toux/diagnostic , Sarcome folliculaire à cellules dendritiques/diagnostic , Tumeurs du médiastin/diagnostic , Obésité/diagnostic , Biopsie , Présentations de cas , Imagerie diagnostique , Immunohistochimie , Thoracotomie , Costa Rica
19.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 23-30, Marzo 2024.
Article de Espagnol | LILACS, UNISALUD, BINACIS | ID: biblio-1551185

RÉSUMÉ

Introducción: La EBUS ha sido el foco de numerosos estudios destinados a evaluar su utilidad y rendimiento diagnóstico en diversas patologías. Objetivo principal: Identificación de las características ganglionares evaluadas en el procedimiento de Ultrasonido Endobronquial (EBUS) y su relación con el diagnóstico de malignidad en pacientes del Instituto Nacional del Cáncer de Colombia del 1 de enero de 2017 al 31 de marzo de 2021.Métodos: Estudio analítico observacional transversal. La recopilación de datos implicó un muestreo de casos consecutivos no probabilísticos entre individuos que cumplían los criterios de inclusión.Resultados: Un total de 75 pacientes fueron sometidos a EBUS. Se identificaron 6 características ecográficas de los ganglios de la biopsia asociadas a malignidad destacándose los ganglios mayores de 1 cm, márgenes mal definidos, ecogenicidad heterogénea, ausencia de una estructura hiliar central, presencia de signos de necrosis o coagulación y presencia de conglomerado ganglionar. Conclusión: Este estudio caracterizó la frecuencia de los hallazgos en la ultrasonografía endobronquial destacando algunas características ecográficas de los ganglios mediastínicos que podrían predecir patología maligna.


Introduction: The EBUS has been the focus of numerous studies aiming to evaluate its utility and diagnostic performance across various pathologies. Objective: Identification of the node characteristics evaluated in the Endobronchial Ultrasound (EBUS) procedure and their relationship with malignancy diagnosis in patients at the National Cancer Institute of Colombia from January 1st, 2017, to March 31st, 2021. Methods: Observational cross-sectional analytical study. Data collection involved non-probabilistic consecutive case sampling among individuals meeting the inclusion criteria.Results: A total of 75 patients underwent the EBUS procedure. Our findings revealed six predictors of malignancy based on sonographic features of biopsy nodes, including nodes larger than 1 cm, poorly defined margins, heterogeneous echogenicity, absence of a central hilar structure, presence of signs indicating necrosis or coagulation, and the presence of a ganglion conglomerate. Conclusions: This study showed that endobronchial ultrasonography has several sonographic characteristics at the time of evaluating mediastinal nodes that could predict malignant and benign pathology.


Sujet(s)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Lymphadénopathie/anatomopathologie , Tumeurs du poumon/diagnostic , Noeuds lymphatiques/imagerie diagnostique , Tumeurs du médiastin/diagnostic , Biopsie/méthodes , Échographie/méthodes , Colombie , Stadification tumorale/méthodes
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