Fibrous lung tumor: a peculiar case.

Solitary fibrous tumor (SFT) of the pleura and the lung is an uncommon spindle cell neoplasm arising from the visceral pleura in the majority of the cases. However there are some extrapleural sites including the lung. Current considerations were raised by a peculiar recent case: an 81-year-old female, no smoker, presented with undefined left thoracic pain. Radiographic findings of a large solid lung mass (10 cm × 9 cm). Computed tomography (CT) confirmed the thoracic mass showing characteristics of a well defined mass with capsule, the position of the mass in proximity of the postero-basal and lateral-basal wall. No secondary lesions were found. Through a left inferior lobectomy and ilo-mediastinal lymph node sampling, the entire mass was resected. Histopathological examination revealed a SFT. In conclusion STF is a rare lesion and this case showed a peculiar extremely large lesion never described before in literature.

Curved cutter stapler for the application of bronchial sutures in anatomic pulmonary resections: the clinical experience of 139 cases.

OBJECTIVES: One of the fundamental steps in an anatomical pulmonary resection is the main and lobar bronchus suture. Nowadays, two different types of staplers are on the market: the linear TA stapler for open surgery (Tyco Healthcare Group LP, Norwalk, CT, USA), which is based on a 'guillotine' mechanism, sewing, but not cutting the bronchus, and the endoscopic linear stapler which both cuts and sews. This study aimed to fill the void in the use of an instrument used to staple and cut at the same time in 'open' thoracic surgery, eliminating the need for a scalpel: the curved cutter stapler (Contour Curved Cutter Stapler; Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA). METHODS: Between May 2009 and March 2011, the Contour Curved Stapler (Ethicon) was used for the bronchus in 139 cases of non-small cell lung carcinoma (NSCLC)-29 females and 110 males ranging between 48 and 85 years (average 71.1)-and comprising 115 lobectomies (8 bilobectomies) and 24 pneumonectomies (8 on the right lung, 16 on the left lung). RESULTS: All patients underwent a bronchoscopic check-up 30 days after they were discharged: in all cases, the bronchial stump was clearly within normal limits. No cases of bronchopleural fistulas were observed in the 139 patients. CONCLUSIONS: On the basis of this study, the curved cutter stapler showed to be a satisfactory device for securing the bronchus during an anatomic resection (whether lobar or main), in 'open' thoracic surgery. However, even though there were no cases of fistula, we consider that our data is still too limited to be statistically significant.

[Current treatment of chylothorax: a report of ten cases]. / Il trattamento attuale del chilotorace: a proposito di diecl casi di personale osservazione.

Chylothorax is an uncommon disease resulting from many factors, all of which cause damage to the thoracic duct or its main collectors. The incidence of this disease has increased over the years due to increasing heart and thoracic surgery, in these cases ranging from 0.2% to 0.5%. Its aetiology also includes thoracic traumatic injury, lymphatic neoplasms and inflammatory disease. Over the period considered we observed more than 9000 thoracic patients, ten of whom presented chylothorax, due to a variety of causes. Diagnostic instrumental procedures and clinical investigations enabled us to develop a personalised therapeutic strategy for each case, related to the particular causes responsible for the condition. Most of the patients observed were treated successfully with a non-invasive approach. In two cases surgery (duct ligature and lymphangioma debulking) was performed with positive results. The postoperative course was uneventful with an average hospital stay of 13 days (range: 7-24 days).