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1.
Kyobu Geka ; 59(13): 1159-62, 2006 Dec.
Article in Japanese | MEDLINE | ID: mdl-17163207

ABSTRACT

Carney complex is a rare syndrome which includes cardiac myxoma, hyperactive endocrine neoplasm, spotty pigmented skin, and extracardiac myxomatous tumors. We report a case of a 26-year-old woman with Carney complex in whom recurrent multiple cardiac myxomas were resected 4 years after the first operation for left atrial (LA) myxoma. She had a history of left adrenalectomy in 1997 for Cushing syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). In February 2001, she was diagnosed with Carney complex because of evidence of LA myxoma, her spotty pigmented skin lesions, her past history and family history of cardiac myxoma in her mother. Then, LA myxoma was successfully resected through the superior trans-septal approach and has been followed-up by ultrasound cardiography (UCG) every 6-month after discharge. In January 2005, UCG revealed 2 masses in the LA and the right ventricle outflow tract. The 2nd surgery was performed in February 2005. We found the 3rd myxoma during surgery, resembling a flat polyp in the LA just at the inflow of the right upper pulmonary vein. All 3 myxomas were successfully resected. Sixteen months after the 2nd operation, she has been doing well without any sign of recurrence of myxoma.


Subject(s)
Heart Neoplasms/surgery , Myxoma/surgery , Neoplasm Recurrence, Local/surgery , Adult , Cardiac Surgical Procedures , Echocardiography, Transesophageal , Endocrine Gland Neoplasms , Female , Heart Atria , Heart Neoplasms/diagnosis , Heart Neoplasms/genetics , Humans , Myxoma/diagnosis , Myxoma/genetics , Neoplasm Recurrence, Local/diagnosis , Pigmentation Disorders , Reoperation , Skin Pigmentation , Syndrome , Time Factors , Treatment Outcome
2.
Kyobu Geka ; 59(5): 365-8, 2006 May.
Article in Japanese | MEDLINE | ID: mdl-16715885

ABSTRACT

A 59-year-old man was admitted to our hospital due to sudden onset of unconsciousness caused by myocardial infarction with ventricular fibrillation. Emergent coronary angiography under intraaortic balloon pumping revealed 90% stenosis of the left main trunk and left anterior descending artery (LAD), and complete obstruction of the left circumflex artery (Cx) and right coronary artery (RCA). Emergent coronary artery bypass grafting (CABG) to LAD, Cx, and RCA was performed. During the postoperative course, the patient developed ventricular tachycardia/fibrillation. After implantation of an implantable cardioverter defibrillator (ICD), he was discharged on the postoperative day 36. The patient has now resumed normal daily life.


Subject(s)
Coronary Artery Bypass , Heart Arrest/surgery , Myocardial Infarction/surgery , Ventricular Fibrillation/surgery , Emergencies , Heart Arrest/etiology , Humans , Male , Middle Aged , Myocardial Infarction/complications , Ventricular Fibrillation/complications
3.
Kyobu Geka ; 58(13): 1159-61, 2005 Dec.
Article in Japanese | MEDLINE | ID: mdl-16359017

ABSTRACT

A 62-year-old man who underwent coronary artery bypass grafting (CABG) [left internal thoracic artery (LITA)-left anterior descending (LAD), saphenous vein graft (SVG) right coronary artery (RCA)] 13 years previously developed angina pectoris and congestive heart failure because of occlusion of SVG and native vessels. Coronary angiography (CAG) revealed that inflow to the coronary artery remained only from LITA. Repeat off-pump CABG (OPCAB) with SVG to the circumflex artery via left thoracotomy was performed. The proximal end of SVG was anastomosed to the left axillary artery because of the porcelain aorta and the patent LITA graft. The patient developed no complications and was discharged from hospital on postoperative day 21. OPCAB for circumflex artery by left thoracotomy is an effective and safe approach in redo CABG, particularly in instances of patent LITA.


Subject(s)
Coronary Artery Bypass, Off-Pump , Coronary Disease/surgery , Graft Occlusion, Vascular/surgery , Thoracotomy , Aorta/surgery , Axillary Artery/surgery , Cardiac Surgical Procedures , Coronary Vessels/surgery , Humans , Male , Mammary Arteries/transplantation , Middle Aged , Reoperation , Saphenous Vein/transplantation
4.
Int J Artif Organs ; 28(8): 834-40, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16211534

ABSTRACT

Poly(2-methoxyethylacrylate) (PMEA) is a new coating material that appears to reduce protein and platelet adsorption. However, the exact performance of PMEA coated circuit remains to be revealed in well-controlled experiments. Therefore, we compared its hemocompatibility with covalent-bound heparin-, and non-coated circuits during 6 hours of in vitro circulation, using donor blood from six volunteers. In our model, simple tubing circuits containing one-way ball valve were placed on the rotary table, which moved alternatively to generate pulsatile recirculation of heparinized human blood inside the tubing. Using this model, we expected fine assessment of the material surface, because we could reduce blood damage by avoiding air and a blood pump. Moreover, the small capacity of circuit allowed us to compare three kinds of circuits using a single unit of donor blood, eliminating effects by possible variations between blood donors. The anti-thrombin capacity of the PMEA-coated circuits was maintained even after six hours blood circulation, whereas surface thrombin generation increased markedly after use in non-coated circuits (P<0.05). Deposition of fibrin onto PMEA circuits was reduced more than 30% compared with heparin and non-coated circuits (P<0.05). However, the increase of plasma Factor XIIa was similar in all circuits. Increase of CD11b expression on circulating leukocytes and of plasma C3a was ameliorated in the heparin- and PMEA-coated circuits (P<0.05). PMEA-coated circuits appear to maintain their anti-thrombogenicity during use, otherwise PMEA-coated and heparin-coated circuits showed a similar character in hemocompatibility. This long-standing anti-thrombogenicity might be attributable to less adsorption of activated blood components onto the surface.


Subject(s)
Acrylates , Antithrombins , Coated Materials, Biocompatible , Extracorporeal Circulation/instrumentation , Polymers , Anticoagulants/pharmacology , Heparin/pharmacology , Humans , In Vitro Techniques , Materials Testing , Models, Cardiovascular , Polyvinyl Chloride
5.
Kyobu Geka ; 58(5): 410-4, 2005 May.
Article in Japanese | MEDLINE | ID: mdl-15881243

ABSTRACT

A 71-year-old male was admitted to the hospital complaining of cough. The chest X-ray and computed tomography (CT) revealed a large tumor in the right lower lung, which was diagnosed as poorly differentiated adenocarcinoma. As the tumor grew rapidly and caused obstructive pneumonia, right middle and lower lobectomy was performed even if right gingival tumor was suspected as metastasis from lung tumor. The patient complicated with aspiration pneumonia after operation and died on the 20th postoperative day. The prognosis of lung cancer with gingival metastasis is very poor. Early detection and appropriate therapy is necessary.


Subject(s)
Carcinoma/secondary , Gingival Neoplasms/secondary , Lung Neoplasms/pathology , Aged , Carcinoma/diagnostic imaging , Carcinoma/surgery , Gingival Neoplasms/diagnostic imaging , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Tomography, X-Ray Computed
6.
Kyobu Geka ; 56(12): 1065-7, 2003 Nov.
Article in Japanese | MEDLINE | ID: mdl-14608934

ABSTRACT

A 21-year-old man developed an abnormal shadow of left hilum of the lung, discovered in an annual X-ray examination. The tumor grew 3 times in size as large as it had been 1 year before. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a homogenous mass lesion at the left interloblar portion of the left lung. CT revealed that the left pulmonary artery was markedly compressed by the tumor of left hilum. Surgical operation was performed under usual thoracotomy. The ligation of the branches of the left bronchial artery before tumor resection was very helpful to control bleeding from the tumor. We showed that a tumor of Castleman's disease may be resected without lobectomy of the lung or further procedures.


Subject(s)
Castleman Disease/surgery , Lung Diseases/surgery , Adult , Bronchial Arteries/surgery , Castleman Disease/diagnosis , Castleman Disease/pathology , Humans , Ligation , Lung Diseases/diagnosis , Lung Diseases/pathology , Lymph Node Excision , Male , Thoracotomy
7.
Clin Dev Immunol ; 10(1): 53-9, 2003 Mar.
Article in English | MEDLINE | ID: mdl-14575158

ABSTRACT

Normal human thymuses at various ages were immunohistologically examined in order to determine whether adult or aged thymus maintained the microenvironment for the T cell development and thymopoiesis was really ongoing. To analyze the thymic microenvironment, two monoclonal antibodies (MoAb) were employed. One is MoAb to IL-1 receptor (IL-1R) recognizing medullary and subcapsular cortical epithelial cells of normal infant human thymus. The other is UH-1 MoAb recognizing thymic epithelial cells within the cortex, which are negative with IL-1R-MoAb. Thymus of subjects over 20 years of age was split into many fragments and dispersed in the fatty tissue. However, the microenvironment of each fragment was composed of both IL-1R positive and UH-1 positive epithelial cells, and the UH-1 positive portion was populated with lymphocytes showing a follicle-like appearance. Lymphocytes in these follicle-like portions were mostly CD4+CD8+ double positive cells and contained many proliferating cells as well as apoptotic cells. Thus these follicle-like portions in adult and aged thymus were considered to be functioning as cortex as in infant thymus. Proliferative activity of thymocytes in the thymic cortex and the follicle-like portions definitely declined with advance of age, while incidence of apoptotic thymocytes increased with aging.


Subject(s)
Aging/immunology , Lymphopoiesis , T-Lymphocytes/physiology , Thymus Gland/cytology , Thymus Gland/immunology , Adolescent , Adult , Aged , Antibodies, Monoclonal , Apoptosis , CD4 Antigens/analysis , CD8 Antigens/analysis , Cell Count , Cell Division , Child , Child, Preschool , Epithelial Cells/cytology , Epithelial Cells/immunology , Humans , Immunoblotting , Immunohistochemistry , Infant, Newborn , Middle Aged , Receptors, Interleukin-1/analysis , T-Lymphocytes/immunology
8.
Kyobu Geka ; 56(3): 243-6, 2003 Mar.
Article in Japanese | MEDLINE | ID: mdl-12649919

ABSTRACT

A 52-year-old female was admitted to the hospital because of increasing hemoptysis for twenty years. Chest computed tomography (CT) on admission showed bronchoectasia with dilated bronchial arteries in the left lower lung field. Bronchial arteriogram showed racemose hemangioma of bronchial arteries draining to left lower pulmonary arteries. Transresection of bronchial artery and partial lung resection was performed. The cut surface of the resected specimen showed bronchoectasia with dilated bronchial arteries (8 mm in diameter). She is well 15 months following the treatment with no evidence of hemoptysis.


Subject(s)
Bronchial Arteries/surgery , Hemangioma/surgery , Vascular Neoplasms/surgery , Female , Hemangioma/complications , Hemoptysis/etiology , Humans , Middle Aged , Pneumonectomy , Thoracic Surgical Procedures/methods , Vascular Neoplasms/complications
9.
J Cardiovasc Surg (Torino) ; 43(6): 817-25, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12483172

ABSTRACT

BACKGROUND: Several recent studies have suggested an ATP-sensitive potassium channel opener (2-nicotinamidoethyl nitrate: 2-NN) may exert a protective effect against the myocardial ischemic/reperfusion injury. This study examines the effects of 2-NN on intracellular signaling by measuring intracellular cyclic AMP, cyclic GMP accumulation and protein kinase C (PKC) activity after 2-NN perfusion. METHODS: Ischemia/reperfused hearts were made by LAD occlusion for 30 min followed by 30 min of reperfusion in isolated rat hearts. Hearts were pre-perfused with 0.1 mM 2-NN, 100 nM Calphostin C, or 2-NN plus Calphostin C for 10 min prior to ischemia. The left ventricular function, cyclic AMP, cyclic GMP and LDH were examined to determine the effects of 2-NN on ischemic/reperfusion injury. Four separate groups of hearts were stained with a bisindolylmaleimide PKC inhibitor conjugated to fluorescein (fim, Teflabs) and PKC activity was measured. RESULTS: 2-NN reduced ischemia/reperfusion injury as evidenced by the enhanced myocardial functional recovery, decreased LDH release after reperfusion, and decreased reperfusion arrhythmias. The PKC inhibitor attenuated myocardial functional recovery but not reperfusion arrhythmias. Cyclic AMP levels decreased after 10 min of 2-NN perfusion, compared to controls. We observed an increase in PKC activity after 2-NN treatment. CONCLUSIONS: These results suggest that PKC plays a significant role in the cardioprotective effect of 2-NN on ischemic and reperfused myocardium. The anti-arrhythmic effect of 2-NN in the reperfusion phase may be linked its action on the ATP-sensitive potassium channel itself rather than its effect on PKC activity.


Subject(s)
Coronary Circulation/physiology , Myocardial Ischemia/drug therapy , Myocardial Reperfusion Injury/drug therapy , Naphthalenes/pharmacology , Nicorandil/pharmacology , Animals , Cyclic AMP/analysis , Cyclic GMP/analysis , Disease Models, Animal , Heart Function Tests , Hemodynamics/physiology , Male , Microscopy, Fluorescence , Myocardial Contraction/physiology , Myocardial Ischemia/diagnosis , Myocardial Reperfusion Injury/prevention & control , Probability , Random Allocation , Rats , Rats, Sprague-Dawley , Reference Values , Sensitivity and Specificity
10.
Thorac Cardiovasc Surg ; 50(6): 325-8, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12457306

ABSTRACT

BACKGROUND: Despite a negative Allen test, some patients develop hand ischemia after radial artery harvesting. The presence of large interosseous collaterals may reduce the sensitivity of Allen test. To evaluate the combination of ulnar flow measurements and the Allen test as an effective screening technique, we performed Doppler ultrasonography during Allen's maneuver. METHODS: The Allen test was used to select candidates for harvesting radial artery from 80 patients undergoing coronary bypass surgery. RESULTS: Of 71 patients with a negative Allen test, one patient developed hand ischemia. This patient was one of six (7.5 %) possessing low ulnar flow levels (less than 40 ml/min/m(2) during compression of the radial artery). This low-flow group had a higher risk for ischemia of the 71 patients with a negative Allen test. The post-operative flow differed greatly from the pre-operative flow in eight patients (11.3 %), which was likely due to large sacrificed interosseous collaterals. CONCLUSION: Combined use of ulnar flow measurement with the Allen test appears to increase the sensitivity of the Allen test. Neither test, however, is sufficient for a group of patients with large interosseous collaterals.


Subject(s)
Hand/blood supply , Hand/diagnostic imaging , Ischemia/diagnosis , Radial Artery/transplantation , Coronary Artery Bypass , Female , Humans , Linear Models , Male , Middle Aged , Patient Selection , Predictive Value of Tests , Preoperative Care , Regional Blood Flow , Ultrasonography
11.
Kyobu Geka ; 55(12): 1069-72, 2002 Nov.
Article in Japanese | MEDLINE | ID: mdl-12428345

ABSTRACT

A 53-year-old male was admitted to the hospital because of progressive paralysis of inferior limb. Chest X-ray film and chest computed tomography (CT) on admission showed a small nodule with bullae in the right lower lung field. After CT-guided marking, partial lung resection including the nodule was performed. The cut surface of the resected specimen showed a tumor (10 mm in diameter) in a bullae measuring 14 mm in diameter. The tumor was diagnosed as amyloidosis. Fourty-six cases of primary localized pulmonary amyloidosis were reported in Japan. However, primary localized pulmonary amyloidosis with bullae is extremely rare, only 3 cases have been reported.


Subject(s)
Amyloidosis/complications , Cysts/complications , Pulmonary Emphysema/complications , Solitary Pulmonary Nodule/complications , Amyloidosis/pathology , Diagnosis, Differential , Humans , Male , Middle Aged , Solitary Pulmonary Nodule/pathology
12.
Kyobu Geka ; 55(9): 815-8, 2002 Aug.
Article in Japanese | MEDLINE | ID: mdl-12174631

ABSTRACT

A 14-year-old male was admitted for complaints of dyspnea and cough. Chest radiography revealed a huge mass in the right lung field. The serum alpha fetoprotein (AFP) level was elevated to 1,251 ng/ml. Histological findings of the specimens obtained by needle biopsy revealed a mature teratoma with non-seminoma. After 2 courses of chemotherapy [cisplatin (CDDP) and etoposide (VP-16)], serum AFP level decreased to 25 ng/ml, and the tumor was resected with pericardium (the tumor size was 14 x 10 x 20 cm). Two courses of chemotherapy were administered again postoperatively with normalization of serum AFP level. The patient has no sign of recurrence of the tumor.


Subject(s)
Germinoma/surgery , Mediastinal Neoplasms/surgery , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor/analysis , Cisplatin/administration & dosage , Combined Modality Therapy , Etoposide/administration & dosage , Germinoma/diagnosis , Germinoma/drug therapy , Humans , Male , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/drug therapy , Treatment Outcome , alpha-Fetoproteins/analysis
13.
Kyobu Geka ; 55(5): 437-9, 2002 May.
Article in Japanese | MEDLINE | ID: mdl-11995330

ABSTRACT

A 71-year-old woman was admitted to our hospital with general fatigue and dyspnea. Emergency pacemaker implantation was performed after diagnosis of complete AV block. After 1 month, a small lung nodule, which had been 10 mm in diameter 1 year ago, was revealed to have grown to 15 mm in diameter by CT scan. Thoracoscopical resection of the lung nodule resulted in sarcoidosis. Abnormality in the posteroinferior heart was detected by 99mTC-PYP myocardial perfusion scintigraphy and it was diagnosed as cardiac sarcoidosis.


Subject(s)
Cardiomyopathies/diagnosis , Lymph Node Excision/methods , Sarcoidosis/diagnosis , Thoracoscopy , Aged , Female , Heart Block/complications , Humans
14.
Int J Gynecol Cancer ; 12(2): 208-13, 2002.
Article in English | MEDLINE | ID: mdl-11975682

ABSTRACT

The objective of this article is to investigate the clinical features of pulmonary metastasis (PM) from endometrial adenocarcinoma, in particular, the predictors of prolonged survival after PM detection. Fifteen patients who developed PM and underwent chest computed tomography (CT) scans for evaluation of PM were studied: 12 patients with pulmonary recurrence and 3 patients with PM on presentation. All patients with bilateral nodules or lymphangitic spread had metastases in other sites prior to or concomitant with PM, most of which were detected in para-aortic lymph nodes and/or the vaginal wall, while only one of five patients with a limited number (n < or = 5) of unilateral nodules had these metastases. The median survival time for the 10 patients with bilateral PMs was significantly shorter than that of the 5 patients with a limited number of unilateral nodules who were treated with surgery (7 versus 50 months, P = 0.005). Patients who developed pulmonary recurrence 2 years after the initial therapy had a significantly longer survival than those who developed it within 2 years (31 versus 10 months, P = 0.01). In conclusion, the distribution of PM determined by CT scans and the time interval between the initial therapy and the detection of pulmonary recurrence are the predictors of survival after PM detection.


Subject(s)
Adenocarcinoma/secondary , Endometrial Neoplasms/pathology , Lung Neoplasms/secondary , Adenocarcinoma/diagnostic imaging , Adult , Aged , Female , Humans , Lung Neoplasms/diagnostic imaging , Middle Aged , Neoplasm Staging , Prognosis , Retrospective Studies , Risk Factors , Survival Analysis , Tomography, X-Ray Computed
17.
Kyobu Geka ; 54(10): 895-7, 2001 Sep.
Article in Japanese | MEDLINE | ID: mdl-11554086

ABSTRACT

We report a case of a woman who at age 58 had an operation on the right femur for malignant fibrous histiocytoma (MFH). At age 63, a chest X-ray examination disclosed a tumor shadow, for which we suspected metastasis from the MFH. Chest computed tomography showed that the tumor had infiltrated to the left atrium via the pulmonary vein. We operated on the patient, first dividing the arterial supply to the lower lobe, and then opening the pericardium. We blocked the lower pulmonary vein and left atrium with a Cooley-Dera clamp and resected the tumor. The tumor was polypoid and had invaded the left atrium. Fifteen months after this lung surgery, the patient was diagnosed with a brain tumor, which was resected. Invasive primary lung cancer to the left atrium via the pulmonary vein is common, but metastasis from a sarcoma such as MFH to the left atrium via the pulmonary vein is extremely rare.


Subject(s)
Heart Neoplasms/pathology , Histiocytoma, Benign Fibrous/secondary , Lung Neoplasms/secondary , Soft Tissue Neoplasms/pathology , Female , Heart Atria/pathology , Histiocytoma, Benign Fibrous/surgery , Humans , Middle Aged , Neoplasm Invasiveness , Pulmonary Veins/pathology , Soft Tissue Neoplasms/surgery
18.
Pathol Res Pract ; 197(9): 611-9, 2001.
Article in English | MEDLINE | ID: mdl-11569925

ABSTRACT

The purpose of this study was to verify the WHO classification of thymic tumors using immunohistological methods, and to discover whether these methods can be applied to differentiate thymoma from squamous cell carcinoma (SCC) of the esophagus and the lung. Twenty-nine thymoma cases were classified according to WHO and were then immunohistologically examined for the positivity of these molecules. All thymoma cases investigated in this study were positive for IL-1R, and most of them were also positive for bek. In contrast, UH-1 was highly positive in B1 and B2 type thymomas, but negative or weakly positive in A, AB and B3 type thymomas. Twelve esophageal cancers and 21 lung cancers were also examined for the positivity of the same molecules. All esophageal cancers were negative for UH-1. Three of 12 cases were weakly positive for IL-1R, and four of these 12 cases were also weakly positive for bek. Twelve of 21 lung cancer cases were adenocarcinomas, all of them negative for IL-1R, bek and UH-1. Nine of 21 lung cancer cases were SCCs, all of them negative for UH-1. Eight of nine SCC cases were strongly positive for IL-1R, while seven of these were weakly positive for bek. We conclude that the WHO classification of thymic tumors is still valid as demonstrated by immunohistological analysis and that the positivity of UH-1, IL- 1R and bek might be helpful in differentiating thymoma from SCC of the esophagus and the lung.


Subject(s)
Biomarkers, Tumor/metabolism , Esophageal Neoplasms/metabolism , Lung Neoplasms/metabolism , Thymoma/metabolism , Thymus Gland/metabolism , Thymus Neoplasms/metabolism , Adenocarcinoma/chemistry , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal/immunology , Antigens, Neoplasm/analysis , Biomarkers, Tumor/analysis , Carcinoma, Squamous Cell/chemistry , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Child, Preschool , Diagnosis, Differential , Esophageal Neoplasms/chemistry , Esophageal Neoplasms/pathology , Humans , Infant , Lung Neoplasms/chemistry , Lung Neoplasms/pathology , Male , Middle Aged , Receptor Protein-Tyrosine Kinases/analysis , Receptor, Fibroblast Growth Factor, Type 2 , Receptors, Fibroblast Growth Factor/analysis , Receptors, Interleukin-1/analysis , Thymoma/chemistry , Thymoma/classification , Thymoma/pathology , Thymus Gland/embryology , Thymus Gland/pathology , Thymus Neoplasms/chemistry , Thymus Neoplasms/classification , Thymus Neoplasms/pathology
19.
Jpn J Thorac Cardiovasc Surg ; 49(6): 384-7, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11481844

ABSTRACT

A 28-year-old woman suffered severe back pain and headache during exercising on three occasions during the prior two-month period. On admission, the physical examination revealed symptoms of meningeal irritation, nuchal rigidity, severe headache, continuous nausea, and vomiting. Cerebral computed tomography of the intracranial subarachnoidal space revealed no subarachnoid hemorrhage. Her cerebrospinal fluid was bloody. Spinal magnetic resonance imaging identified a posterior mediastinal tumor adherent to the left side of the 5th thoracic vertebra and an abnormally expanded blood vessel near the mediastinal tumor. In addition, a high signal intensity lesion appeared to be present on the surface of the spinal cord. A mediastinal neoplasm was removed through standard thoracotomy. During surgery, marked enlargement was noted in some veins (hemiazygos and 5th intercostal veins) which apparently had been constricted by the mediastinal tumor. Surgical and radiological findings suggested a relationship between the constricted venous return due to the tumor and the patient's spinal subarachnoid hemorrhage.


Subject(s)
Mediastinal Neoplasms/complications , Neurilemmoma/complications , Subarachnoid Hemorrhage/etiology , Adult , Female , Humans , Magnetic Resonance Imaging , Spinal Cord/pathology , Subarachnoid Hemorrhage/diagnosis
20.
Kyobu Geka ; 54(9): 742-6, 2001 Aug.
Article in Japanese | MEDLINE | ID: mdl-11517542

ABSTRACT

A 58-year-old female was admitted to the hospital complaining of dyspnea. The chest roentgenogram and CT scan revealed a large mediastinum tumor and massive pleural effusion in the right hemithorax. The diagnosis of lung cancer with carcinomatous pleulitis was performed through thoracocentesis an treatment of chemotherapy was chosen. After 6 years, she was admitted again to the hospital complaining of dull pain in the right leg. Chest CT scan and MRI showed a giant dumbbell shaped mass connected to the spinal canal. The tumor was larger than that of six years ago and diagnosed as schwannoma by CT-guided pericutaneous needle biopsy. At operation, hemilaminectomy of Th 1-3 was done first, and total tumor resection was performed through posterolateral thoracotomy. Intrathoracic adhesion was severe and it was difficult to control air leakage from the lung, thoracoplasty was performed.


Subject(s)
Mediastinal Neoplasms/complications , Neurilemmoma/complications , Pleural Effusion, Malignant/etiology , Female , Humans , Mediastinal Neoplasms/surgery , Middle Aged , Neurilemmoma/surgery
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