ABSTRACT
Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune paraneoplastic syndrome with proximal muscle weakness, that often complicates small cell lung cancer. It is known that neurological symptoms do not improve with malignancy treatment alone in many LEMS patients, therefore treatment is often difficult. Since Lambert-Eaton myasthenic syndrome is a rare disease with a frequency of about 1/100 that of myasthenia gravis, there are only a few case reports on malignancy complications other than small cell lung cancer. We report a LEMS patient in his 40s who was found to have an anterior mediastinal mass. We performed surgical resection and confirmed the diagnosis of primary thymic marginal zone B-cell lymphoma by pathological diagnosis using immunostaining. Thymectomy and malignant lymphoma treatment with rituximab had no effect on neurological symptoms. The neurological symptoms improved only after we provided comprehensive care with the haematology, neurology, and rehabilitation department.
ABSTRACT
Tuberculosis is a disease that causes latent infection and is sometimes activated by a variety of factors. Descending necrotizing mediastinitis (DNM) is a serious disease caused by spreading oropharyngeal infection. We present a case of mediastinal tuberculosis following mediastinal dissection and antibiotic therapy for DNM. A 62-year-old man was admitted to the hospital with an increasing mass in the right mediastinum during outpatient follow-up after surgical drainage and antibiotic treatment for idiopathic cervical abscess and left DNM caused by oral bacteria. The patient underwent right mediastinal abscess dissection 4 months after the last surgery. As a result of culture tests, no general bacteria but Mycobacterium tuberculosis was detected. Anti-tuberculosis treatment was continued for 9 months, and the patient has progressed without any recurrence of infection. The possibility of relapse of tuberculosis should always be considered in patients with unexplained masses.
