Synovial sarcoma of the esophagus: a case report and review of literature

Synovial sarcoma is an uncommon soft tissue tumor occurring mainly in the periarticular region of the extremities in young adults. It happens less frequently in the head and neck, mediastinum, lungs, heart, and digestive tract

A 28-year-old man two months after total esophagectomy with final diagnosis of esophageal synovial sarcoma was referred to our Positron Emission Tomography [PET-CT] department for the evaluation of treatment response and further treatment planning. To our knowledge this case is the 11[th] case of esophageal synovial sarcoma, being reported in the literature

We presented the 11[th] case of esophageal synovial sarcoma. Synovial sarcomas are very rare tumor entities, particularly in the gastrointestinal tract and are likely to be mistaken with other more common tumors such as gastrointestinal stromal tumors

Determining the lymphadenopathy characteristics of the mediastinum in lung CT scan of children with tuberculosis

Objective/Background: Most tuberculosis cases in children are primary infection, with difficult and imprecise diagnosis mainly based on the existence of mediastinal lymphadenopathy. Here, we investigated the characteristics of mediastinal lymphadenopathy in lung computed tomography [CT] scans of children with tuberculosis

Methods: This cross-sectional study was performed on 75 children with tuberculosis referred to Masih Danesh-vari Hospital in Tehran, Iran, from 2009 to 2013. Their medical records were investigated, and CT-scan characteristics were extracted by a radiologist

Results: Mean +/- standard deviation age of cases was 11.2 +/- 4.6 years. CT-scan results indicated 94.7% of cases had lymphadenopathy, with lower paratracheal, upper paratracheal, hilar, and subcarinal forms observed in 81.7%, 69.1%, 53.5%, and 47.9% of cases as the most involved stations in lymph nodes, respectively. In 74.6% of patients with mediastinal lymphadenopathy, perilymph node fat inflammation [matting] was observed, with 52.11% exhibiting conglomeration. Bronchial pressure was observed in 4.23% of children with tuberculosis, and bilateral-, right-, and left-parenchymal involvement was observed in 42.7%, 25.3%, and 8% of these cases, respectively. Left- and right-pleural effusion and calcification was reported in 6.7%, 12%, and 5.6% of patients, respectively

Additionally, nearly 80% of patients exhibited mediastinal lymphadenopathy and lung-parenchyma involvement simultaneously. Lung-parenchyma involvement was significantly correlated with subcarinal [p < .001], hilar [p < .001], subaortic [p = .030], lower paratracheal [p = .037], and axillary [p = .006] stations

Conclusion: Situation of mediastinal lymphadenopathy and its synchronicity with lung-parenchyma involvement can help in differential diagnosis of pulmonary tuberculosis from other lung diseases

Case of tracheal diverticulum and bronchiectasis

Tracheal diverticulum is a rarely encountered entity usually diagnosed incidentally on CT scan. It may be asymptomatic or may present with recurrent respiratory infections or other symptomatology. Here we report a 59-year-old baker presented with shortness of breath, cough, and sputum production that had tracheal diverticulum in association with bronchiectasis on HRCT which has rarely been reported in the literature

Primary lung cancer subtypes: how does chest CT scan help to differentiate them?

Lung cancer has wide variety of clinical presentations and different imaging features relating its subtypes. This study is focused on the role of CT scan in differentiating primary lung cancer subtypes including adenocarcinoma, squamous cell carcinoma and small cell carcinoma. This retrospective study is conducted on 55 pathologically diagnosed primary lung cancer patients. Several CT features including lung mass and pleural effusion and parenchymal nodule characteristics, mediastinal and hilar involvement, pericardial effusion and thickening, chest wall invasion, reticulation, superior vena cava [SVC] syndrome and encasement of main bronchus were checked. We enrolled 55 primary lung cancer patients including 29 adenocarcinomas, 19 squamous cell carcinomas and 7 small cell carcinomas, 36 males and 19 females with mean age of 60.3 years. Most common CT features of primary lung cancer were lung mass [94.5%] particularly located in hilum [51.9%] and irregular bordered [55.8%]. Other prevalent findings included parenchymal nodules [60%], pleural effusion [41.8%], mediastinal adenopathy [47.3%], hilar adenopathy [42.9%], mediastinal invasion [43.6%] and reticulation [56.4%]. Hilar adenopathy [47.4%], reticulation [48.3%] and parenchymal nodule [62.1%] in adenocarcinoma; hilar mass [57.9%] and parenchymal nodule [68.4%] in squamouos cell carcinoma; hilar and mediastinal involvement in small cell carcinoma were the most frequent findings. Comparing three subtypes, we found squamous cell and adenocarcinoma more similar regarding CT images parenchymal nodules, mass calcification and cavitation were more frequently seen in them compared to small cell lung cancer whereas hilar involvement, mediastinal involvement, irregular bordered mass and encasement of main bronchus were more prevalent in small cell carcinoma