ABSTRACT
Inflammatory myofibroblastic tumors (IMTs) are rare tumors of intermediate malignant potential that can occur anywhere in the body. We describe an interesting case of a hypervascular IMT in the mediastinum that could be resected completely following embolization of the feeding vessels. A 17-month-old girl with complaints of cough and fever for 3 months was referred to our hospital. Computed tomography (CT) scan showed a large mass in the right hemithorax that shifted the mediastinum to the left. Primary excision was considered but not performed because there was very active capsule wall bleeding due to the hypervascular tumor. After embolization of the feeding vessels, successful complete resection was carried out. Approximately 6 weeks after the operation, follow-up CT scan showed no evidence of recurrent disease. Preoperative embolization is a good option for performing complete resection of hypervascular IMTs that could reduce the recurrence rate.
Subject(s)
Female , Humans , Infant , Cough , Embolization, Therapeutic , Fever , Follow-Up Studies , Granuloma, Plasma Cell , Hemorrhage , Mediastinal Neoplasms , Mediastinum , Myofibroblasts , Recurrence , Tomography, X-Ray ComputedABSTRACT
Primary sternal osteomyelitis is a rare disease. Common infectious organisms causing primary sternal osteomyelitis include Staphylococcus aureus and Pseudomonas aeruginosa. Actinomyces species are common saprophytes of the oral cavity, but there have been few reports in the literature of primary sternal osteomyelitis caused by Actinomyces species. We describe a case of primary sternal osteomyelitis caused by Actinomyces israelii without pulmonary involvement.
Subject(s)
Actinomyces , Actinomycosis , Mouth , Osteomyelitis , Pseudomonas aeruginosa , Rare Diseases , Staphylococcus aureus , SternumABSTRACT
Inflammatory myofibroblastic tumors (IMTs) are rare tumors of intermediate malignant potential that can occur anywhere in the body. We describe an interesting case of a hypervascular IMT in the mediastinum that could be resected completely following embolization of the feeding vessels. A 17-month-old girl with complaints of cough and fever for 3 months was referred to our hospital. Computed tomography (CT) scan showed a large mass in the right hemithorax that shifted the mediastinum to the left. Primary excision was considered but not performed because there was very active capsule wall bleeding due to the hypervascular tumor. After embolization of the feeding vessels, successful complete resection was carried out. Approximately 6 weeks after the operation, follow-up CT scan showed no evidence of recurrent disease. Preoperative embolization is a good option for performing complete resection of hypervascular IMTs that could reduce the recurrence rate.
Subject(s)
Female , Humans , Infant , Cough , Embolization, Therapeutic , Fever , Follow-Up Studies , Granuloma, Plasma Cell , Hemorrhage , Mediastinal Neoplasms , Mediastinum , Myofibroblasts , Recurrence , Tomography, X-Ray ComputedABSTRACT
We present a case of left ventricular pseudoaneurysm, which is a very rare and fatal complication of cardiac procedures such as mitral valve replacement. A 55-year-old woman presented to the Department of Thoracic and Cardiovascular Surgery at Hanyang University Seoul Hospital with chest pain. Ten years prior, the patient had undergone double valve replacement due to aortic regurgitation and mitral steno-insufficiency. Surgical repair was successfully performed using a prosthetic pericardial patch via a left lateral thoracotomy.
Subject(s)
Female , Humans , Middle Aged , Aneurysm, False , Aortic Valve Insufficiency , Chest Pain , Mitral Valve , Seoul , ThoracotomyABSTRACT
Enterobacter cloacae has emerged as an important nosocomial pathogen, but is rarely a cause of sacroiliitis. Herein, we present the first reported case of Enterobacter cloacae sacroiliitis associated with sepsis and acute respiratory distress syndrome (ARDS). A previously healthy 14-year-old boy presented with low-grade fever and pain in the left side of the hip that was aggravated by walking. Pelvic computed tomography (CT) showed normal findings, and the patient received supportive care for transient synovitis with no antibiotics. However, there was no clinical improvement. On the third day of hospitalization, magnetic resonance imaging of the hip revealed findings compatible with sacroiliitis, for which vancomycin and ceftriaxone were administered. The patient suddenly developed high fever with dyspnea. Chest radiography and CT findings and a PaO2/FiO2 ratio <200 mmHg were suggestive of ARDS; the patient subsequently received ventilatory support and low-dose methylprednisolone infusions. Within one week, defervescence occurred, and the patient was able to breathe on his own. Following the timely recognition of, and therapeutic challenge to, ARDS, and after 6 weeks of parenteral antimicrobial therapy, the patient was discharged in good health with no complications.
Subject(s)
Adolescent , Humans , Male , Anti-Bacterial Agents , Ceftriaxone , Dyspnea , Enterobacter cloacae , Fever , Hip , Hospitalization , Magnetic Resonance Imaging , Methylprednisolone , Radiography , Respiratory Distress Syndrome , Sacroiliitis , Sepsis , Synovitis , Thorax , Vancomycin , WalkingABSTRACT
No abstract available.
Subject(s)
Adult , Female , Humans , Arthritis, Rheumatoid/diagnosis , Incidental Findings , Predictive Value of Tests , Thoracic Vertebrae/abnormalities , Tomography, X-Ray ComputedABSTRACT
Bronchogenic cysts are usually located in the pulmonary parenchyma or in the mediastinum. When bronchogenic cysts are located in the mediastinum, they are usually near the bronchus or esophagus, and rarely located in the retroperitoneal space. It is difficult to differentiate between bronchogenic cysts and benign cysts prior to surgert. We report here on a patient for who had a mass in the retroperitoneum, with the preoperative diagnosis being a benign neurogenic tumor. Via left open thoracotomy, pathologic reports revealed that the mass was a bronchogenic cyst. We report here on the case of a bronchogenic cyst that was located in the retroperitoneal space of the diaphragm.
Subject(s)
Humans , Bronchi , Bronchogenic Cyst , Diaphragm , Esophagus , Mediastinum , Retroperitoneal Neoplasms , Retroperitoneal Space , ThoracotomyABSTRACT
BACKGROUND: For staging primary lung cancer, integrated positron emission tomography/computed tomography (PET/CT) imaging is popular. The purpose of this study was to evaluate the accuracy of PET/CT scanning in lymph nodal staging of lung cancer. MATERIAL AND METHOD: We studied 48 patients who had received CT, PET/CT and pulmonary resections due to primary non-small cell lung cancer in our hospital between January 2006 and August 2009. Mediastinal lymph nodes were classified as superior mediastinal nodes, aortic nodes, inferior mediastinal nodes, or N1 nodes. We compared the power of CT and PET/CT for diagnosing pulmonary lymph nodes for each of the four types of nodes. RESULT: PET/CT was more sensitive than CT for all groups except inferior mediastinal nodes. However, the differences were not significant (McNemar's test: superior mediastinal nodes, p=0.109; aortic nodes, p=1.000; inferior mediastinal nodes, p=0.625, N1 nodes, p=0.424). CONCLUSION: The accuracy of PET/CT is similar to that of CT alone for staging lymph nodes. The two imaging modalities might be used as complementary, cooperative tools. We expect that integrated PET/CT will be found to be significantly mmore sensitive after more trials are done and more data is accumulated.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Electrons , Lung , Lung Neoplasms , Lymph Nodes , Lymphatic Metastasis , Positron-Emission TomographyABSTRACT
Acquired bronchoesophageal fistula rare. Conservative treatment such as endoscopy is widely used. The recurrence rate after endoscopic treatment, however, is not well known. We report here on a case of a 54-year-old female who presented with recurrent bronchoesophageal fistula after endoscopic treatment that filled the fistula tract with Histoacryl(R).
Subject(s)
Female , Humans , Middle Aged , Endoscopy , Esophageal Diseases , Fistula , RecurrenceABSTRACT
Maternal diabetes is known to have teratogenic effects which increase the risk for congenital anomalies, such as caudal dysplasia, cardiac defects, hydronephrosis, and small left colon syndrome. Infants of diabetic mothers have a 10-fold higher frequency of anomalies in the central nervous system and a 5-fold higher frequency of congenital heart defects. However, jejunal atresia combined with multiple anomalies of the face, ears, and hands has rarely been reported. Herein we report a neonate born to a diabetic mother, who had hemifacial microsomia, displacement of the lacrimal ducts, polydactyly of the right hand, microtia of the right ear and proximal jejunal atresia presenting as bile regurgitation on the 1st day of life.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Bile , Central Nervous System , Colon , Congenital Abnormalities , Diabetes, Gestational , Displacement, Psychological , Ear , Facial Asymmetry , Hand , Heart Defects, Congenital , Hydronephrosis , Intestinal Atresia , Mothers , PolydactylyABSTRACT
Multilocular thymic cyst (MTC) has been reported to develop in concert with various mediastinal neoplasms that have intrinsic inflammatory components, such as thymoma, thymic carcinoma, Hodgkin's disease, and seminoma. However, development of mediastinal teratoma without intrinsic inflammation in association with MTC has rarely been reported. Here, we report the findings of a case of MTC associated with mediastinal mature cystic teratoma on computed tomography (CT) with CT-histopathologic correlation.
Subject(s)
Hodgkin Disease , Inflammation , Mediastinal Cyst , Mediastinal Neoplasms , Mediastinum , Seminoma , Teratoma , ThymomaABSTRACT
Multilocular thymic cyst (MTC) has been reported to develop in concert with various mediastinal neoplasms that have intrinsic inflammatory components, such as thymoma, thymic carcinoma, Hodgkin's disease, and seminoma. However, development of mediastinal teratoma without intrinsic inflammation in association with MTC has rarely been reported. Here, we report the findings of a case of MTC associated with mediastinal mature cystic teratoma on computed tomography (CT) with CT-histopathologic correlation.
Subject(s)
Hodgkin Disease , Inflammation , Mediastinal Cyst , Mediastinal Neoplasms , Mediastinum , Seminoma , Teratoma , ThymomaABSTRACT
PURPOSE: We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age gropus and its lateral chest radiographic appearances. MATERIALS AND METHODS: The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. RESULTS: The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n= 49, 50.4%) and middle one third (n=36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n=8). Lateral chest radiography showed a normal diaphragmatic contour (n=51, 49.5%), blunting of the posterior costophrenic sulcus (n=41, 39.8%), focal humping of the posterior diaphragm (n=7, 6.8%), or upward convexity (n=4, 3.9%) of the posterior costophrenic sulcus on the affected side. CONCLUSION: The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect.
Subject(s)
Humans , Diaphragm , Hernia, Diaphragmatic , Incidence , Intra-Abdominal Fat , Kidney , Radiography , Radiography, Thoracic , Thorax , Tomography, X-Ray ComputedABSTRACT
Amiodarone is a potent antiarrhythmic agent that is used to treat ventricular arrhythmias and atrial fibrillation. But it has a wide range of adverse effects, including pulmonary toxicity, thyroid dysfunction, liver toxicity, gastrointestinal events, corneal deposits, peripheral neuropathy and so on. Patients treated with amiodarone should be followed regularly to assess ongoing need for amiodarone, efficacy of the drug, appropriateness of dosage, adverse effects, and potential drug interactions. We experienced a case of severe weight loss due to amiodarone-induced multiple toxicity after a long course of a low dose therapy. So we report this unusual case with literature review.
Subject(s)
Humans , Amiodarone , Anorexia , Arrhythmias, Cardiac , Atrial Fibrillation , Drug Interactions , Liver Diseases , Peripheral Nervous System Diseases , Thyroid Gland , Thyrotoxicosis , Weight LossABSTRACT
Nocardiosis is uncommon in healthy people, but occurs as an opportunistic infection in patients with connective tissue disease, solid organ transplantation, lung disease, malignancies, and the acquired immune deficiency syndrome (AIDS). Nocardia is a gram positive, variably acid-fast aerobic bacterium of the family Nocardiaceae characterized by branching and filamentous growth, with distinctive aerial hyphae. In systemic lupus erythematosus (SLE) patients, immunosuppressiion with cytotoxic drugs or corticosteroids, proteinuria, renal insufficiency, and active SLE itself are known as risk factors for serious bacterial infections and opportunistic infections. We report a case of pulmonary Nocardiosis in patient with lupus nephritis treated with cyclophosphamide and high dose corticosteroid.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , Adrenal Cortex Hormones , Bacterial Infections , Connective Tissue Diseases , Cyclophosphamide , Hyphae , Lung Diseases , Lupus Erythematosus, Systemic , Lupus Nephritis , Nocardia , Nocardia Infections , Nocardiaceae , Opportunistic Infections , Organ Transplantation , Proteinuria , Renal Insufficiency , Risk Factors , TransplantsABSTRACT
Bilateral coronary artery to pulmonary artery fistulas are very rare anomaly. Echocardiography, cardiac catheterization and coronary angiography of two patients having chest pain and dyspnea showed bilateral coronary to pulmonary artery fistulas. One patient had left anterior descending coronary artery stenosis and the other patient had cystic tumor. We report the good results of the surgical treatment of two patients with bilateral coronary to pulmonary artery fistulas.
Subject(s)
Humans , Cardiac Catheterization , Cardiac Catheters , Chest Pain , Coronary Angiography , Coronary Stenosis , Coronary Vessels , Dyspnea , Echocardiography , Fistula , Pulmonary ArteryABSTRACT
Bilateral coronary artery to pulmonary artery fistulas are very rare anomaly. Echocardiography, cardiac catheterization and coronary angiography of two patients having chest pain and dyspnea showed bilateral coronary to pulmonary artery fistulas. One patient had left anterior descending coronary artery stenosis and the other patient had cystic tumor. We report the good results of the surgical treatment of two patients with bilateral coronary to pulmonary artery fistulas.
Subject(s)
Humans , Cardiac Catheterization , Cardiac Catheters , Chest Pain , Coronary Angiography , Coronary Stenosis , Coronary Vessels , Dyspnea , Echocardiography , Fistula , Pulmonary ArteryABSTRACT
Pulmonary involvement is more common in systemic lupus erythematosus (SLE) than in any other connective tissue disease, and more than half of patients with SLE suffer from respiratory dysfunction during the course of their illness. Although sepsis and renal disease are the most common causes of death in SLE, lung disease is the predominant manifestation and is an indicator of overall prognosis. Respiratory disease may be due to direct involvement of the lung or as a secondary consequence of the effect of the disease on other organ systems.
Subject(s)
Humans , Cause of Death , Connective Tissue Diseases , Lung , Lung Diseases , Lupus Erythematosus, Systemic , Prognosis , SepsisABSTRACT
PURPOSE: To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. MATERIALS AND METHODS: Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. RESULTS: The complications manifesting mainly as pulmonary nodules were lung cancer(4/4), tuberculosis (1/2), and Kaposi's sarcoma(1/1). Pulmonary consolidation was a main feature in bacterial infection(4/4), fungal infection(3/4), tuberculosis(1/2), chlamydial infection(1/1), and varicellar pneumonia(1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia(4/6), and increased interstitial marking was a predominant radiographic feature in CMV pneumonia(2/6). CONCLUSION: The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.
Subject(s)
Humans , Bacteria , Chickenpox , Chlamydia , Diagnosis, Differential , Fungi , Kidney Transplantation , Lung , Lung Neoplasms , Pulmonary Edema , Sarcoma, Kaposi , Thorax , TuberculosisABSTRACT
OBJECTIVE: We assessed the contribution of genetic polymorphisms of glutathione S-transferase M1 (GSTM1), T1 (GSTT1), and P1 (GSTP1, Ile105Val) to carotid atherosclerosis in 40 postmenopausal rheumatoid arthritis (RA) women without histories of smoking. METHODS: We measured mean intima-media thickness (IMT) and plaque of the common carotid arteries by ultrasonography, and evaluated relations among the known risk factors for atherosclerosis, genetic polymorphisms, RA outcomes and markers of inflammation. RESULTS: Subjects with the GSTT1-null genotype had greater IMT (p<0.05). On univariate analysis, carotid IMT was positively associated with age, systolic BP, antihypertensive drug use and the GSTT1-null genotype (p<0.05). When compared to subjects with a double- positive GSTM1/T1 genotype, IMT in subjects with concurrent lack of the GSTM1 and GSTT1 gene was significantly increased (p=0.008). CONCLUSION: This study suggests that the GSTT1-null genotype might have an interaction with carotid atherosclerosis related to RA in Korean postmenopausal RA women free of smoking history.