ABSTRACT
Ewing's sarcoma (ES) is a rare and highly aggressive tumor belonging to a family of neoplasms of neuroectodermal origin, which primarily affects the bones or soft tissues. ES originating from lung parenchyma without chest wall involvement is extremely rare with less than 40 cases reported in the English literature. A 41-year-old man admitted to the thoracic surgery department presenting with intermittent non-productive cough, dyspnea, left-sided chest pain for two months for further evaluation and treatment with a preliminary diagnosis of pulmonary mass. Contrast-enhanced thorax CT and MRI revealed a large heterogeneous soft-tissue mass in the left lower lobe with no distant metastases or occult primary tumor. Following the percutaneous transthoracic biopsy, histopathological and immunohistochemical results were consistent with primary pulmonary ES. Though rare, primary pulmonary ES should be considered in the differential diagnosis of young patients presenting with a large heterogeneous soft tissue mass in the lung. This case report highlights the diagnosis, radiologic and pathologic findings, and management of primary pulmonary ES.
ABSTRACT
OBJECTIVE: To evaluate the clinical characteristics and detailed imaging features in coronavirus disease 2019 (COVID-19) patients without comorbidities. MATERIAL AND METHODS: This retrospective study included laboratory-confirmed and symptomatic COVID-19 patients without comorbid diseases who were admitted to our second level hospital between March 2020 and September 2020. We assessed the clinical, biochemical and imaging diagnostic parameters on admission. The patients were classified as non-severe and progress to severe group and then the initial parameters were compared. RESULTS: We enrolled 135 adult COVID-19 patients, 12 progressed to severe disease during hospitalization. Compared to the non-severe group, patients who progressed to severe were older (pâ¯< 0.001) and were more likely to manifest coughing (pâ¯= 0.011) and have higher lactate dehydrogenase (LDH) levels (pâ¯= 0.011). On chest computed tomography (CT) images, multilobar (pâ¯= 0.016), peripherally (pâ¯= 0.001) distributed mixed ground glass opacities and consolidation (pâ¯< 0.001), crazy paving (pâ¯= 0.007) and higher total CT severity score (pâ¯< 0.001) were significantly associated with severe disease. CONCLUSION: Knowledge of the clinical and radiological parameters associated with disease severity might be useful to guide clinical decision-making for COVID-19 patients without comorbidities.
