RESUMO
BACKGROUND Lymphangioma is an atypical non-malignant, lymphatic lesion that is congenital in origin. Lymphangioma is most frequently observed in the head and neck, but can occur at any location in the body. About 65% of lymphangiomas are apparent at birth, while 80-90% are diagnosed by two years of age. Occurrence in adults is rare, as evidenced by less than 100 cases of adult lymphangiomas reported in the literature. CASE REPORT A 36-year-old Indian woman with a medical history of recurrent pleural effusions presented with chief complaints of dyspnea on exertion for one year and a low-grade fever for one month. A thorax CT revealed left-sided pleural effusion with thin internal septations. Thoracoscopy revealed a large cystic lesion arising from the mediastinum from the hilum surrounding the mediastinal great vessels. The diagnosis of lymphangioma was confirmed via histopathologic examination of the cyst. It was managed with partial cystectomy along with the use of a sclerosing agent (talc). CONCLUSIONS The size and location of lymphangiomas can vary, with some patients presenting with serious problems like respiratory distress, while others may be asymptomatic. Complete cyst resection is the gold standard treatment for mediastinal cystic lymphangioma. Partial cyst resection along with the use of sclerosing agents can be an effective option when complete cystectomy is not possible. Although lymphangioma is a rare patient condition, it should be included in the differentials for patients presenting with pleural effusions. Also, a biopsy should be done at the earliest opportunity to differentiate lymphangioma from other mediastinal malignant tumors.
Assuntos
Linfangioma/complicações , Neoplasias do Mediastino/complicações , Derrame Pleural Maligno/diagnóstico , Doenças Raras , Adulto , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Linfangioma/diagnóstico , Neoplasias do Mediastino/diagnóstico , Derrame Pleural Maligno/etiologia , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
Kearns-Sayre syndrome (KSS) was first described in 1958 as 'a rare neuromuscular disorder defined by a characteristic triad of progressive external ophthalmoplegia, pigmentary retinopathy, atrioventricular block and cerebellar ataxia'. The prevalence rate of KSS is â¼1-3 per 100 000 individuals. Here, we report a rare case of a 17-year-old Venezuelan male with KSS.
RESUMO
BACKGROUND: Hepatopulmonary syndrome (HPS) is a pulmonary complication characterized by a triad of chronic liver disease, arterial hypoxemia, and pulmonary vascular dilations. Agitated saline contrast echocardiography is a simple inexpensive criterion standard procedure for confirming the diagnosis of HPS. CASE REPORT: Here, we discuss a case of a 45-year-old male Indian patient with no medical history who presented to our hospital with exertional dyspnea, hypoxia, and classical signs of HPS. A diagnosis of cirrhosis was made on the basis of history, liver enzymes, and ultrasound, while HPS was diagnosed using transthoracic echocardiography with agitated saline. CONCLUSIONS: HPS, although a complication of cirrhosis, can be the initial presentation in undiagnosed cirrhotic patients. Thus, it is important to include HPS in differentials when dealing with cases of progressive dyspnea. Also, the possibility of a liver disease etiology should be explored in patients with unexplained hypoxemia.