ABSTRACT
An 82 year-old-woman was referred to our hospital because of infiltrative shadow of the lingula in 201X. She was asymptomatic, so we followed up with imaging observation. After 1 year, the infiltrative shadow had progressed, so we performed bronchoscopy. Glandular epithelium with the mild aberrant type was detected, but did not lead to a definitive diagnosis. There was increased eosinophilic compartmentalization of immune response in the bronchoalveolar lavage, so we started treatment with corticosteroids for chronic eosinophilic pneumonia. However, there was no improvement of the shadow. Subsequent computed tomography-guided lung biopsy revealed evidence of papillary adenocarcinoma.
ABSTRACT
We report on an apparently healthy woman in her 50s who noticed pain in the left side of her neck anteriorly and was prescribed an antimicrobial agent at a nearby clinic. However, she developed hypotension and hypoxemia and was brought to our hospital. Laboratory investigations revealed evidence of inflammation, and imaging findings showed low-density areas corresponding to the left lobe of the thyroid gland. The low-density areas extended to the superior mediastinum, raising suspicion of a thyroid gland mediastinal abscess. We performed inferior mediastinal drainage with video-assisted thoracoscopic surgery and resection of the left lobe of the thyroid gland. Culture of mediastinal aspirate yielded Streptococcus viridans. Based on these findings, the final diagnosis was descent-related mediastinitis secondary to acute suppurative thyroiditis.