Intrathoracic hibernoma: an uncommon tumour / Hibernoma intratorácico: un tumor poco frecuente

Hibernomas are uncommon benign tumours that arise from the remnants of fetal brown adipose tissue. They are usually asymptomatic and have a slow growth pattern. Intrathoracic and pleural locations are exceptional for localization of hibernoma. A review of the English language medical literature revealed more than 110 cases, 20 of which were intrathoracic. In the article below, we discuss a 40-year old male patient who had pleural involvement and was treated by surgical resection. Following resection, the patient has remained problem-free for nine years.

Los hibernomas son tumores benignos poco frecuentes que surgen de restos del tejido adiposo marrón fetal. Son generalmente asintomáticos y tienen un patrón de crecimiento lento. Las localizaciones intratorácicas y pleurales son excepcionales para la localización del hibernoma. Una revisión de la literatura médica en lengua inglesa reveló más de 110 casos, 20 de los cuales se trataban de hibernomas intratorácicos. En el siguiente artículo, discutimos el caso de un paciente de 40 años de edad, que tenía una afección pleural y fue tratado con una resección quirúrgica. Después de la resección, el paciente ha permanecido sin problemas durante nueve años.

Intrathoracic hibernoma: an uncommon tumour.

Hibernomas are uncommon benign tumours that arise from the remnants of fetal brown adipose tissue. They are usually asymptomatic and have a slow growth pattern. Intrathoracic and pleural locations are exceptional for localization of hibernoma. A review of the English language medical literature revealed more than 110 cases, 20 of which were intrathoracic. In the article below, we discuss a 40-year old male patient who had pleural involvement and was treated by surgical resection. Following resection, the patient has remained problem-free for nine years.

Cavernous hemangioma of the rib: a rare tumour.

Hemangioma is exceedingly rare in the ribs. A case of rib hemangioma in a 54-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass in the left lateral costaphrenic sinus with bone destruction. She underwent resection of the 7th and 8th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

Achieving efficient anti-adhesion in re-mediastinoscopy: an experimental study in rats.

OBJECTIVE: Re-mediastinoscopy can be a difficult procedure due to fibrosis in the mediastinum. We have investigated the effect of an anti-adhesive barrier agent "hylan B gel" on the formation of adhesions after dissection in the superior mediastinum in a rat model. METHODS: The study was conducted in 70 male Sprague-Dawley rats weighing 300 g. The strap muscles were divided by a midline cervical incision. The anterior and lateral aspects of the trachea were dissected to the level of the carina. Hylan B gel (Sepragel Sinus, Genzyme Company, Redgefield, NJ, USA) was used to create an anti-adhesive barrier. The rats who were subjected to surgery were sacrificed on postoperative days 14 and 28. All rats were previously divided into 5 groups: Sham group (n = 10); Group 1 (n = 15) surgery alone, sacrificed on day 14; Group 2 (n = 15) surgery and Sepragel, sacrificed on day 14; Group 3 (n = 15) surgery alone, sacrificed on day 28; Group 4 (n = 15) surgery and Sepragel, sacrificed on day 28. Histopathological analysis was performed to study the effect of the anti-adhesive agent. Scores were calculated based on collagen fibrosis, fibroblasts, granulation tissue, muscle alterations/inflammation, histiocytes, mononuclear giant cells, inflammation and vascular proliferation. RESULTS: Collagen fibrosis and fibroblast scores, which represent adhesions, were significantly higher in Groups 1, 2, 3, 4 than in the Sham group ( P < 0.01). The degree of adhesions on day 14 was found to be higher in Group 1 compared to Group 2 ( P < 0.01). Adhesions on day 28 were higher in Group 3 compared to Group 4 ( P < 0.01). There were no differences between groups with regard to foreign body reactions ( P > 0.05). CONCLUSION: Adhesions causing technical difficulty during re-mediastinoscopy can be reduced by the application of anti-adhesive agents during the primary procedure.

A huge mass destroying the fifth rib: a rare case of cavernous haemangioma.

A 28-year-old female patient presented with back pain, dyspnea and coughing. Chest radiograph showed a mass in the middle zone of the right hemithorax. CT confirmed the mass was confined to the 5th rib. During the exploratory thoracotomy, a smooth, firm mass measuring 7 x 9 x 5 cm was found to have destroyed the middle and posterior parts of the 5th rib. Together with the adjacent intercostal muscles, the 5th rib was excised en-block. Postoperative pathology was cavernous haemangioma. Cavernous haemangioma of the rib is very rare, and very few cases have been reported in the literature.

Primary pulmonary lymphoma disguised as asthma.

Primary pulmonary lymphomas (PPL) only constitute 4% of extra-nodal, non-Hodgkin lymphomas (NHL), less than 1% of NHL in general, and between 0.5% and 1% of malignant pulmonary neoplasms. Fifty-eight to 87% of cases of this extremely uncommon disease are low-grade B-cell lymphomas and 11%-19% are high-grade or large B-cell lymphomas. The prognosis for.high-grade or large B-cell lymphomas is worse than for low-grade lymphomas; respiratory and general symptoms are usually present. However asthmatic symptoms are not often found in their clinic. We report the case of a 49-year old woman with resistant asthma clinic in the form of wheezing, dyspnea and non-productive painless cough; associated with an irregular lobulated mass with air bronchograms in the lower lobe of the right lung. Histological diagnosis showed a pattern of high-grade B-cell lymphoma and all asthmatic symptoms disappeared following gross total resection of this lesion.