ABSTRACT
Buffalo chest refers to the pleuro-pleural communication that results in a single pleural cavity. Iatrogenic buffalo chest can occur following heart or heart-lung transplantation and other major thoracic surgeries. We present the case of malignant pleural mesothelioma in which iatrogenic buffalo chest after extended thymectomy caused bilateral pneumothoraces and contralateral dissemination of the disease. The free communication between bilateral pleural cavities had facilitated the rapid progression of tumor and the consequent bilateral malignant pleural effusions had made the management of disease much more difficult, leading to the early fatal outcome. To our knowledge, this is the first case of buffalo chest that was associated with bilateral malignant pleural effusions.
Subject(s)
Iatrogenic Disease , Mesothelioma/secondary , Pleural Diseases/etiology , Pleural Neoplasms/pathology , Thymectomy/adverse effects , Aged , Disease Progression , Fatal Outcome , Humans , Male , Mesothelioma/complications , Mesothelioma/diagnostic imaging , Mesothelioma/therapy , Pleural Diseases/diagnostic imaging , Pleural Effusion, Malignant/etiology , Pleural Neoplasms/complications , Pleural Neoplasms/diagnostic imaging , Pleural Neoplasms/therapy , Pneumothorax/etiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Air embolism in the arterial system is a very rare but potentially fatal complication of percutaneous transthoracic needle biopsy or marking. We report a case of a patient with interstitial pneumonia associated with Sjögren syndrome, who presented with systemic arterial air embolism as a complication of computed tomography-guided marking of the lung. The air inflow route was depicted clearly on computed tomography from the peripheral pulmonary vein that crossed the needle pathway to the left atrium.
Subject(s)
Biopsy, Needle/adverse effects , Embolism, Air , Heart Atria , Intracranial Embolism/complications , Pulmonary Veins , Tomography, X-Ray Computed/adverse effects , Aged , Embolism, Air/complications , Female , Heart Atria/diagnostic imaging , Humans , Lung Diseases, Interstitial/complications , Pulmonary Veins/diagnostic imagingABSTRACT
Although the association between seminoma and sarcoidosis or a sarcoid-like reaction has been well recognized, a paradoxical case during chemotherapy for seminoma has not been reported. We report the first case of a sarcoid-like reaction that developed paradoxically during successful chemotherapy for recurrent seminoma. A 36-year-old Japanese man had recurrent seminoma in abdominal lymph nodes four years after left orchiectomy. Chemotherapy consisting of bleomycin, etoposide and cisplatin had reduced the abdominal mass, but mediastinal and bilateral hilar lymphadenopathy newly appeared. Surgical biopsy of the mediastinal lymph nodes and left nephrectomy and retroperitoneal lymphadenectomy revealed noncaseating granulomas only in mediastinal lymph nodes and confirmed complete remission of seminoma. Nine months later the thoracic lymphadenopathy had resolved spontaneously.
Subject(s)
Antineoplastic Agents/adverse effects , Sarcoidosis/chemically induced , Sarcoidosis/diagnosis , Seminoma/drug therapy , Testicular Neoplasms/drug therapy , Adult , Antineoplastic Agents/therapeutic use , Humans , Male , Seminoma/pathology , Testicular Neoplasms/pathology , Treatment OutcomeABSTRACT
BACKGROUND: Not only is a radiation ulcer nonviable itself, but the surrounding irradiated tissue also shows poor healing. Therefore, healing in an irradiated field cannot be expected if a flap used for reconstruction fails even partially. For repair of radiation ulcers, a flap with a stable blood supply is required. A superiorly based vertical rectus abdominis myocutaneous (VRAM) flap is commonly used for chest wall reconstruction. Because the VRAM flap is nourished only by the superior epigastric vessels, the blood supply to the distal part of the flap often is precarious. CASE REPORT: A case is reported in which a delayed VRAM flap was used successfully to treat a radiation ulcer on the anterior chest wall. RESULTS: Consecutive angiograms showed that the delay procedure augmented the blood supply to the VRAM flap. The flap showed complete take without any postoperative complications. CONCLUSIONS: A delay procedure may make the VRAM flap more reliable for anterior chest wall reconstruction. This flap may be a valuable option for reconstruction of intractable ulcers such as radiation ulcers, and may be applicable for breast reconstruction after radiation therapy.
Subject(s)
Plastic Surgery Procedures/methods , Radiation Injuries/surgery , Rectus Abdominis/surgery , Surgical Flaps , Thoracic Wall/surgery , Female , Humans , Middle Aged , Radiation Injuries/chemically induced , Radiotherapy/adverse effects , Time FactorsABSTRACT
We describe a case of giant pulmonary aspergilloma in a 79-year old man. He had undergone an operation for pulmonary tuberculosis of the right lung at the age of 49 years. His chest ragiograph showed a large fungus ball in the right upper lung field. Taking his age and pulmonary condition into consideration, we performed a cavernostomy and fungus ball resection to prevent life-threatening hemoptysis. The postoperative course was satisfactory and without complication. Cavernostomy may be an alternative choice in high-risk aspergilloma patients.
