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Southeast Asian J Trop Med Public Health ; 2004 Jun; 35(2): 453-7
Artigo em Inglês | IMSEAR | ID: sea-32993

RESUMO

Between 1997 and 2002, 107 patients with symptoms of superior vena cava (SVC) obstruction presented at a university hospital in Northeast Thailand. Age averaged 50.7 years (range, 1 to 84). The male to female ratio was 5.7:1. Duration of symptoms before diagnosis was 29.4 days (range, 2 to 240), including facial swelling, cough, and chest discomfort. About 20% of cases developed respiratory failure and 11.2% died shortly after admission. The mean hospital stay was 23.7 days. Anteroposterior and lateral chest radiographs and computed chest tomography helped locate the lesion. Transbronchial biopsy through bronchoscopy, transthoracic needle biopsy under computed tomography, lymph node biopsy, pleural fluid cytology and/or biopsy were used for histopathologic sampling. High levels of alpha-fetoprotein and beta-HCG indicated an anterior mediastinal mass. The most common etiology of SVC obstruction was bronchogenic carcinoma (51.8%), followed by an anterior mediastinal mass (14.5%), lymphoma (13.6%--with an LDH of 262 to 1459 U/l), metastatic cancer (9.1%), and acute lymphoblastic leukemia (1.8%). Benign SVC thrombosis was found in four patients with Behcet's disease or some other idiopathy. Mediastinal fibrosis from melioidosis occurred in three patients, which is rare, has not been previouly reported. Most patients (63.6%) received a combination of radiotherapy and corticosteroid and this helped 55.2% improve.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Broncogênico/complicações , Terapia Combinada , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Neoplasias Pulmonares/complicações , Masculino , Neoplasias do Mediastino/complicações , Pessoa de Meia-Idade , Síndrome da Veia Cava Superior/diagnóstico , Tailândia , Resultado do Tratamento , Veia Cava Superior/fisiopatologia
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