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3.
Medicine (Baltimore) ; 99(35): e21935, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871936

RESUMO

RATIONALE: Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor that originates from germinal center follicular dendritic cells, and can occur at both nodal and extranodal sites. There are very few described cases of FDCS arising in the chest wall. PATIENT CONCERNS: A 44-year-old male patient presented with a history of right chest wall pain for 5 months. DIAGNOSES: Positron emission tomography/computed tomography showed a significant increase in F-fluorodeoxyglucose uptake and multiple small axillary lymph nodes without hypermetabolic lesions. Immunohistochemistry results of a core-needle biopsy indicated FDCS, which was consistent with the postoperative pathological examination. INTERVENTIONS: The patient underwent tumor resection with lymphadenectomy of level I axillary nodes. No metastasis in the lymph nodes was observed in the postoperative pathological examination. The patient did not accept chemotherapy or radiotherapy. OUTCOMES: After 18 months, the patient remains in good condition with no evidence of disease recurrence. LESSONS: This report highlights a rare case of a FDCS arising in the chest wall. Accurate clinical diagnosis and staging of this rare malignant sarcoma is essential for the developmnt of effective treatment strategies. Preoperative F-fluorodeoxyglucose positron emission tomography/computed tomography scanning combined with core-needle biopsy could provide differentiation between benign and malignant tumors, as well as lymph node involvement and metastatic status.


Assuntos
Sarcoma de Células Dendríticas Foliculares/diagnóstico , Neoplasias Torácicas/diagnóstico , Parede Torácica , Adulto , Biópsia com Agulha de Grande Calibre , Dor no Peito/etiologia , Sarcoma de Células Dendríticas Foliculares/patologia , Sarcoma de Células Dendríticas Foliculares/cirurgia , Fluordesoxiglucose F18 , Humanos , Imuno-Histoquímica , Excisão de Linfonodo , Linfonodos/patologia , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Torácicas/patologia , Neoplasias Torácicas/cirurgia , Parede Torácica/diagnóstico por imagem , Parede Torácica/patologia , Parede Torácica/cirurgia
4.
Medicine (Baltimore) ; 99(37): e22093, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925751

RESUMO

RATIONALE: Infection with the severe acute respiratory coronavirus disease 2019 (COVID-19) has been shown to cause multi-organ involvement including cardiopulmonary serosal layers infection and inflammation. As a result, pericarditis and pericardial effusion may occur with or without COVID-19 related respiratory signs. Due to limitations in sensitivity and specificity of current COVID-19 diagnostic studies, cases that trigger high clinical intuition, even with negative serologic and polymerase chain reaction testing results, may necessitate further diagnostic workup to discover the underlying etiology. PATIENT CONCERNS: Here we present a rare case of pericardial effusion in the setting of asymptomatic COVID-19 infection manifesting with the chief complaint of chest pain. DIAGNOSIS: While undergoing diagnostic workup, the patients first 2 sets of COVID 19 reverse transcription-polymerase chain reaction (RT-PCR) were negative while a latter RT-PCR test, as well as serology, were positive, leading to the diagnosis of COVID-19 reinfection or subacute presentation of viral infection with pericardial effusion. Echocardiogram depicted large circumferential pericardial effusion with mildly thickened pericardium. INTERVENTIONS: The patient underwent pericardial window placement followed by ibuprofen administration and discharged from the hospital. OUTCOMES: During the follow-up visit patient had no symptoms and echocardiogram demonstrated complete resolution of the effusion. LESSONS: Due to the possible establishment of pericardial effusions and consecutively tamponade even without any COVID-19 related clinical presentation, it is crucial for clinicians to trust their intuition, conduct the appropriate diagnostic tests, find the underlying diagnosis and prevent the devastating consequences.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Ecocardiografia/métodos , Pandemias , Derrame Pericárdico , Pericardiocentese/métodos , Pneumonia Viral , Infecções Assintomáticas , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Eletrocardiografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiologia , Derrame Pericárdico/fisiopatologia , Derrame Pericárdico/cirurgia , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Resultado do Tratamento
13.
Clin Ter ; 171(4): e291-e294, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614360

RESUMO

The aim of this case report is to share with the forensic science community the experience of a rare complication of sickle cell anemia: acute chest syndrome. In October 2016, at the port of the city of Trapani (Sicily, Italy), the landing of an ONG "Médecins Sans Frontières" ship took place with 548 non-EU citizens and a corpse on board. The man, in the hours before his death, complained of severe chest pain and respiratory difficulties, and, despite of the therapeutic aids and resuscitation maneuvers, lastly died. The Public Prosecutor ordered that autopsy be executed on the corpse of the young Ghanaian, and it was to be supplemented by histological, toxicological, genetic investigations, and the dating of the biological age. The autoptic examination findings were indicative of bilateral bronchopneumonia, and were also confirmed by the histological findings, which identified a condition of massive adipose pulmonary embolism, due to the presence of extramedullary hematopoietic tissue, site of endovascular thrombosis secondary to hemolysis of sickle cells. The spleen appeared of small volume, with fibrotic phenomena. The predisposition to infections, thrombosis, extramedullary hematopoiesis are all complications of sickle cell anemia. The severe pulmonary condition characterized by vaso-occlusive findings and pulmonary inflammation with infiltrate, symptoms like fever, chest pain and severe systemic hypoxia allowed to ascribe the plausible cause of death as acute chest syndrome, a rare complication of sickle cell anemia. The peculiarity of this clinical case is also related to the methods of medical intervention (boat with non-governmental medical support for assistance to migrants).


Assuntos
Anemia Falciforme/mortalidade , Emigrantes e Imigrantes , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico , Dor no Peito/etiologia , Dispneia/etiologia , Febre/etiologia , Gana/etnologia , Humanos , Masculino , Mar Mediterrâneo , Sicília
17.
Methodist Debakey Cardiovasc J ; 16(2): 155-157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670476

RESUMO

A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous thromboembolic events in patients who are positive for COVID-19, especially in the setting of elevated inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further explored in this novel pandemic.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico por imagem , Síndrome Respiratória Aguda Grave/complicações , Doença Aguda , Adulto , Anticoagulantes/uso terapêutico , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Angiografia por Tomografia Computadorizada/métodos , Infecções por Coronavirus/diagnóstico , Tosse/diagnóstico , Tosse/etiologia , Serviço Hospitalar de Emergência , Seguimentos , Humanos , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Síndrome Respiratória Aguda Grave/diagnóstico , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
18.
Medicine (Baltimore) ; 99(29): e21104, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702859

RESUMO

RATIONALE: Pulmonary sequestration is a congenital abnormality of the lower airway. It is characterized by a nonfunctioning mass of lung tissue that lacks normal communication with the tracheobronchial tree or pulmonary arteries and always receives its arterial blood supply from the systemic circulation. Most cases of extralobar pulmonary sequestrations (ELSs) are asymptomatic and found incidentally or in prenatal ultrasound screening. PATIENT CONCERNS: A 10-year-old boy had severe chest pain and vomiting for 2 days. DIAGNOSES: ELS was diagnosed, and torsion of the ELS had developed as a complication. INTERVENTIONS: In video-assisted thoracoscopic surgery, the ELS was resected. OUTCOMES: The clinical symptoms were relieved the 2nd day after surgery and did not recur over a follow-up period of 3 months. LESSONS: In young patients with sudden abdominal pain or chest pain, in whom computed tomography shows a well-defined mass of homogeneous soft-tissue density in the thorax, ELS with torsion should be suspected. The presence of a feeding artery greatly supports the diagnosis of ELS, and the absence of this classic finding may indicate torsion of the pulmonary sequestration.


Assuntos
Sequestro Broncopulmonar/complicações , Anormalidade Torcional/complicações , Sequestro Broncopulmonar/cirurgia , Dor no Peito/etiologia , Criança , Humanos , Masculino , Cirurgia Torácica Vídeoassistida/métodos , Anormalidade Torcional/cirurgia , Vômito/etiologia
19.
J Card Surg ; 35(6): 1351-1353, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-596954

RESUMO

The novel coronavirus, now termed SARS-CoV-2, has caused a significant global impact in the space of 4 months. Almost all elective cardiac surgical operations have been postponed in order to reduce transmission and to allocate resources adequately. Urgent and emergency cardiac surgery is still taking place during the pandemic. The decision to operate in urgent patients with active/recent COVID-19 infection is difficult to make, particularly as it is still an unknown disease entity in the setting of emergent cardiac surgery. We present a case series of three patients who underwent urgent cardiac surgery and who have had recent or active COVID-19 infection.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Infecções por Coronavirus/complicações , Procedimentos Cirúrgicos Eletivos/métodos , Segurança do Paciente , Pneumonia Viral/complicações , Adulto , Idoso , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Serviço Hospitalar de Emergência , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Humanos , Masculino , Parada Cardíaca Extra-Hospitalar/diagnóstico por imagem , Parada Cardíaca Extra-Hospitalar/cirurgia , Pandemias/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Prognóstico , Medição de Risco , Gestão da Segurança , Amostragem , Tempo para o Tratamento , Resultado do Tratamento
20.
J Card Surg ; 35(6): 1351-1353, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32531128

RESUMO

The novel coronavirus, now termed SARS-CoV-2, has caused a significant global impact in the space of 4 months. Almost all elective cardiac surgical operations have been postponed in order to reduce transmission and to allocate resources adequately. Urgent and emergency cardiac surgery is still taking place during the pandemic. The decision to operate in urgent patients with active/recent COVID-19 infection is difficult to make, particularly as it is still an unknown disease entity in the setting of emergent cardiac surgery. We present a case series of three patients who underwent urgent cardiac surgery and who have had recent or active COVID-19 infection.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Infecções por Coronavirus/complicações , Procedimentos Cirúrgicos Eletivos/métodos , Segurança do Paciente , Pneumonia Viral/complicações , Adulto , Idoso , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Serviço Hospitalar de Emergência , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Humanos , Masculino , Parada Cardíaca Extra-Hospitalar/diagnóstico por imagem , Parada Cardíaca Extra-Hospitalar/cirurgia , Pandemias/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Prognóstico , Medição de Risco , Gestão da Segurança , Amostragem , Tempo para o Tratamento , Resultado do Tratamento
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