ABSTRACT
Introduction: Computed tomography guided fine needleaspiration cytology is a safe and well established technique forthe diagnosis of lung and mediastinal lesions. This study wascarried out in the department of pathology in the tertiary healthcare and teaching institute where radiology department is wellestablished. The aim was to study the cytomorphology of thespectrum of the lung and mediastinal lesions and to correlatethe cytological diagnosis with the radiological diagnosis.Material and methods: Computed tomography guided fineneedle aspiration cytology was done in 90 pateints after takingwritten consent of the patient. Patients were explained thebenefits and risks of the procedure. The results were analysed.Results: A total of 90 patients were included in the study.There were 81 patients of lung lesions and nine patients ofmediastinal lesions. There were 63(70%) males and 27(30%)females. Adequate aspirate was obtained in 77 patientsgiving the adequacy rate of 85.55%. Adenocarcinomawas the most common type of lung malignancy and NonHodgkins Lymphoma was the most common malignancyin the mediastinum. Inflammatory lesions were seen in 13cases. Granulomatous lesions were found in six patients. Oneinteresting case of hydatid with aspergillosis was diagnosedon cytology smears, which on radiology was diagnosed asneoplastic. Pneumothorax was seen in three patients. Nopatient required chest tube insertion.Conclusion: Computed tomography guided fine needleaspiration cytology is a safe and reliable method for thediagnosis of lung and mediastinal lesions. It can help inearly diagnosis and initiation of the treatment avoiding majorsurgical procedures.
ABSTRACT
En neonatología, las masas torácicas generalmente responden a anomalías congénitas del aparato respiratorio. Comprenden un extenso número de patologías que pueden comprometer el desarrollo de laringe, tráquea, bronquios, parénquima pulmonar, diafragma o pared torácica. El diagnóstico, en la mayoría de los casos, se efectúa en el período prenatal mediante ecografía. El resto se diagnostica por la clínica, difcultad respiratoria en el recién nacido, o es un hallazgo radiológico en el transcurso de la vida. Presentamos el caso de un recién nacido de término con diagnóstico prenatal de "masa pulmonar" con imágenes quísticas en su interior. Al examen físico solo presentó disminución de la entrada de aire en base derecha. Se realizaron diferentes estudios por imágenes para caracterizar mejor la lesión y estudiar su extensión. Al quinto mes de vida, el paciente fue sometido a tratamiento quirúrgico y quimioterápico. El estudio anatomopatológico de la pieza quirúrgica arrojó como diagnóstico "blastoma pleuropulmonar" (BPP), tumor intratorácico maligno, muy poco frecuente, que aparece casi exclusivamente en niños menores de 7 años.
Thoracic masses in neonates usually respond to congenital anomalies of the respiratory system. They comprise a large number of diseases that can compromise the development of larynx, trachea, bronchi, pulmonary parenchyma and diaphragm or chest wall. Diagnosis is carried out during prenatal period by ultrasound in most cases. In others, respiratory distress is diagnosed during post-birth examination or later as a radiological fnding. We present the case of a full term newborn with prenatal diagnosis of cystic "lung mass". Physical examination was unremarkable except for decreased breath sounds on the right lung. Different image studies were carried out to characterize the lesion. The patient underwent surgery and chemotherapy at ffth month of life. Pleuropulmonary blastoma diagnosis was confrmed by pathological study of the surgical specimen. This is a rare intrathoracic malignant tumor, appearing almost exclusively in children less than 7-years-old.
Subject(s)
Humans , Infant, Newborn , Male , Pulmonary Blastoma/diagnosis , Pulmonary Blastoma/etiologyABSTRACT
The esophageal hiatal hernia is a herniation of an abdominal organ, usually the stomach, through the esophageal hiatus into thoracic cavity. It is a rare disease, usually congenital and frequently associated with gastroesophageal reflux and other congenital malformations in children. It is classified according to their anatomic characteristics as type I (sliding hiatal hernia), type II (paraesophageal hiatal hernia), type III (combined hiatal hernia) and type IV (multiorgan hiatal hernia). We experienced a case of type III congenital esophageal hiatal hernia simulating chest mass on simple chest x-ray because of right intrathoracic stomach secondary to congenital esophageal hiatal hernia and organoaxial rotation in 10 months male. After the operation, he showed an improved general condition and was discharged at the 14th hospital day. We report the case with the brief review of the related literatures.