ABSTRACT
A diffuse angiomatosis affecting thoracal organs is a rare, frequently fatal disorder occurring mainly in childhood. The definite diagnosis is usually made by autopsy. A specific treatment does not exist. In the case report presented here we describe the course of an 37-year old patient presenting initially with dyspnea and hemoptysis. Radiological investigations showed a mass lesion in the anterior superior mediastinum, bihilar masses and a periesophageal mass with soft tissue density and a pericardial effusion. Bilateral interstitial infiltrations were also present. CT-guided mediastinal biopsies and bronchial mucosal biopsies were nonspecific. Open-lung biopsy revealed the diagnosis of an extensive diffuse angiomatosis affecting mediastinum, pericardium and pleura. During the 18-month monotherapy with interferon-alpha 2a the patient showed significant improvements of clinical as well as laboratory and radiological parameters. The presented case confirms the experience of several authors, that the diagnosis of a diffuse thoracal authors can only be made by open lung biopsy or autopsy. The presented case also underlines the possibility of a palliative therapy of aggressive angiomatous diseases with interferon-alpha 2a.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Angiomatosis/drug therapy , Interferon-alpha/therapeutic use , Thoracic Diseases/drug therapy , Adult , Angiomatosis/diagnosis , Dyspnea , Hemoptysis , Humans , Interferon alpha-2 , Male , Recombinant Proteins , Thoracic Diseases/diagnosisABSTRACT
BACKGROUND: Actinomycosis is caused by a variety of gram-positive anaerobic or microaerophilic rods belonging to the genus Actinomyces or Propionibacterium. The production of suppurative abscesses or granulomas that eventually develop draining sinuses are hallmarks of the disease. We describe the case of a 55 year old smoker who presented himself 4 months ago with right thoracic pain and an unproductive cough. He developed a warm, red mass in the lower part of the right thorax. We performed an ultrasound guided needle aspiration and the pathologic examination revealed typical sulfur granules and masses of neutrophils in the aspirate. After surgical resection of the abscess and under high-dose therapy with penicillin G the further course of disease was uneventful. CONCLUSIONS: Although uncommon, thoracic actinomycosis should always taken into account in the differential diagnosis of chronic inflammatory processes that involve the pulmonary parenchyma or pleural space.
Subject(s)
Actinomycosis/diagnosis , Lung Diseases/diagnosis , Thoracic Diseases/diagnosis , Actinomycosis/pathology , Actinomycosis/surgery , Drainage , Humans , Lung/pathology , Lung/surgery , Lung Abscess/diagnosis , Lung Abscess/pathology , Lung Abscess/surgery , Lung Diseases/pathology , Lung Diseases/surgery , Male , Middle Aged , Smoking/adverse effects , Thoracic Diseases/pathology , Thoracic Diseases/surgery , Tomography, X-Ray ComputedSubject(s)
Aortic Aneurysm, Thoracic/complications , Arterio-Arterial Fistula/etiology , Pulmonary Artery , Acute Disease , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/pathology , Arterio-Arterial Fistula/diagnostic imaging , Arterio-Arterial Fistula/pathology , Autopsy , Humans , Male , Middle Aged , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/pathology , Thrombosis/pathology , Tomography, X-Ray ComputedABSTRACT
Ossifying renal tumor of infancy is a rare but distinctive tumor that presents as a mass in the pelvicaliceal system. It is usually suspected to be a calculus until surgical exploration reveals dense tumor attachment to the renal parenchyma. The histogenesis of this lesion has not been established. We present a case of this unusual neoplasm. A renal sparing procedure was performed on this biologically benign tumor. Followup after 20 months showed no evidence of recurrence.
Subject(s)
Kidney Neoplasms , Ossification, Heterotopic , Female , Humans , Infant , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Ossification, Heterotopic/diagnostic imaging , Ossification, Heterotopic/pathology , RadiographyABSTRACT
Psammombodies are dystrophic calcifications with high density in CT being helpful to detect even small metastases. Examination should be done without oral administration of iodine to prevent mimicking metastases in contrasted bowel loops. In 3 cases with seropapillary carcinoma radiologic findings including scintigraphy and problems of diagnosis and follow-up are discussed.