ABSTRACT
Herein, we report a rare case of type B aortic dissection that occurred after endovascular aortic aneurysm repair (EVAR). A 66-year-old man underwent successful EVAR for an abdominal aortic aneurysm (AAA). Computed tomography (CT) 2 years after EVAR showed a type B aortic dissection with stent-graft migration and AAA expansion. Juxtarenal aortic expansion precluded simple stent-graft placement. He underwent hepato-spleno-renal bypass followed by stent-graft placement just below the superior mesenteric artery. Postoperative CT showed no endoleaks. This case reconfirms the importance of regular follow-up after EVAR and illustrates the usefulness of a hybrid approach.
ABSTRACT
An 76-year-old man was referred to our hospital due to right hydrothorax. The diffuse thickening of parietal pleura with increased fluoro-2-deoxy-D-glucose (FDG) uptake was noted by computed tomography (CT) and positron emission tomography (PET). Surgical biopsy was performed and the tumor was diagnosed as mucosal associated lymphoid tissue (MALT) lymphomas of parietal pleura origin by pathology. Complete remission was achieved by postoperative chemotherapy (R-CHOP), and the patient is now alive without recurrence.
Subject(s)
Lymphoma, B-Cell, Marginal Zone/pathology , Pleural Neoplasms/pathology , Aged , Humans , Lymphoma, B-Cell, Marginal Zone/diagnosis , Male , Pleural Neoplasms/diagnosisABSTRACT
OBJECTIVE: To evaluate outcomes after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) with neck thrombus. METHODS: We retrospectively reviewed patients who underwent EVAR for AAA at our institution from 2007 to 2011. Patients with ruptured AAA, chronic renal failure, or hostile neck characteristics other than thrombus were excluded. Patients were divided into 2 groups: group T (with neck thrombus) and group N (without neck thrombus). We compared complications and mid-term outcomes. RESULTS: There were no differences in success rates between the groups, but there were higher rates of thromboembolic complications such as distal embolization (20% vs 0%, P = .02) and renal dysfunction (36.8% vs 11.1%, P = .03) in group T than in group N. Suprarenal thrombus and suprarenal fixation in the presence of suprarenal thrombus were associated with postoperative renal dysfunction (P = .01). CONCLUSION: The EVAR for AAA with neck thrombus is associated with thromboembolic complications.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Endovascular Procedures/adverse effects , Thromboembolism/etiology , Thrombosis/surgery , Aged , Aged, 80 and over , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Chi-Square Distribution , Endoleak/etiology , Endovascular Procedures/instrumentation , Female , Foreign-Body Migration/etiology , Humans , Kaplan-Meier Estimate , Logistic Models , Male , Odds Ratio , Predictive Value of Tests , Proportional Hazards Models , Retrospective Studies , Risk Factors , Stents , Thrombosis/complications , Thrombosis/diagnostic imaging , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 77-year-old woman was admitted to our hospital with abnormal chest shadow detected on a medical checkup. Chest computed tomography(CT)showed a well-defined tumor in the upper lobe of the right lung. On positron emission tomography by fluorodeoxyglucose(FDG),the tumor revealed to be positive. We performed right upper lobectomy with hilar and mediastinal lymph node dissection. The histopathological diagnosis was lymphoepithelioma-like carcinoma (LELC). In the past 25-years, 41 cases have been reported in Japan. The average age is 64 years old, including 25 male cases and 16 female cases. Among these cases, more than half were in the early resectable stage.
Subject(s)
Carcinoma, Large Cell/diagnosis , Lung Neoplasms/diagnosis , Aged , Carcinoma, Large Cell/pathology , Female , Humans , Lung Neoplasms/pathologyABSTRACT
60-year-old woman was admitted with an abnormal shadow on the chest roentgenogram. Computed tomography showed atelectasis of the right middle lobe and hilar and mediastinal lymphadenopathy. Bronchoscopic examination revealed an obstruction at the orifice of the right middle lobe bronchus and biopsy was performed. The biopsy suggested malignant lymphoma. A diagnosis of methotrexate-associated lymphoproliferative disorders was suspected because the patient was administered methotrexate to treat the rheumatoid arthritis. The video-assisted thoracoscopic surgery was performed. Histological examination showed no malignancy and sarcoidosis in the peribronchial lymph nodes. The compressed middle lobe bronchus by enlarged lymph nodes was consider to be the cause of the middle lobe atelectasis.
