scholarly journals Transitional type of Castleman's disease manifested as the POEMS syndrome

2004 ◽  
Vol 61 (4) ◽  
pp. 439-444 ◽  
Author(s):  
Ilija Tomic ◽  
Goran Plavec ◽  
Olga Tasic ◽  
Aleksandar Ristanovic ◽  
Vlado Cvijanovic
Keyword(s):  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Poems Syndrome ◽  
Mediastinal Lymphadenopathy ◽  
Cell Type ◽  
Mixed Cell ◽  
Vascular Type ◽  
Disease Case ◽  
Transitional Type ◽  
Angiofollicular Hyperplasia

Background. Castleman?s disease is an atypical lymphoproliferative disorder characterized by angiofollicular hyperplasia of lymph nodes. Histologically it can be classified into a hyaline-vascular type, plasma-cell type, and transitional (mixed-cell) type, while clinically localized type has been classified as unicentric, or generalized (multicentric) form of the disease. Case report. This paper presents a 21 years old male patient with multicentric Castleman?s disease, a transitional (mixed-cell) type. The disease was manifested by fever, generalized enlargement of peripherial lymph nodes, breast glands enlargement, hyperemia of the face, and weakness of the lower extremities. We found mediastinal lymphadenopathy, pleural and pericardial effusions, sensorimotor peripherial neuropathy and polyclonal hypergammaglobulinemia. The simultaneous presence of these manifestations of the disease (sensomotor peripheral neuropathy, lymphadenopathy, effusions endocrinopathy, polyclonal gammaglobulinemia and skin changes) is indentified as POEMS syndrome. The diagnosis of Castleman?s disease was based on the results of histopathologic analysis of mediastinal lymph node biopsies after thoracotomy. The patient was treated with corticosteroids (prednisone 80 mg daily for 2 weeks followed by 60 mg daily). A partial response was achieved after 4 months of treatment. Conclusion. A transitional type of multicentric Castleman?s disease may be present itself as POEMS syndrome. The effect of corticosteroid therapy in this form of the disease is unpredictable.

PS01.108: SPONTANEOUS ESOPHAGOCUTANEOUS FISTULA IN KIKUCHI DISEASE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 80-80
Author(s):  
Kelvin Voon ◽  
Mustafa Mohammed Taher ◽  
Reynu Rajan ◽  
Nik Ritza Kosai
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Fistula Tract ◽  
Mediastinal Lymphadenopathy ◽  
Esophageal Fistula ◽  
Mediastinal Lymph Nodes ◽  
Transhiatal Approach ◽  
Laparoscopic Excision ◽  
Paraspinal Abscess

Abstract Background Kikuchi disease is a rare, self-limiting condition that is characterized by histiocytic necrotizing lymphadenitis with unknown pathogenesis. Common presentation is cervical lymphadenopathy and fever in a previously well young female. Mediastinal lymph node involvement is uncommon. Methods We report a case of spontaneous esophagocutaneous fistula secondary to necrotizing mediastinal lymphadenopathy in a patient with Kikuchi disease. Results A 38-year-old lady presented with fever and right back pain of two weeks duration. She had background history of Kikuchi disease which was diagnosed 1 year ago. Examination revealed multiple enlarged left cervical lymph nodes and right back tenderness. CT scan showed an esophagocutaneous fistula with right paraspinal abscess and multiple enlarged cervical and mediastinal lymph nodes. OGDS revealed a 5mm fistula opening at right posterior wall of distal esophageal, 3cm proximal to esophagogastric junction. Rest of esophagus and stomach were normal. Tuberculosis and SLE workup were negative. Cervical lymph node biopsy was consistent with Kikuchi disease. She was treated as spontaneous esophagocutaneous fistula secondary to necrotizing mediastinal lymph node with underlying Kikuchi disease. Percutaneous drainage of paraspinal abscess was done and antibiotics were commenced. Laparoscopic feeding jejunostomy was done for feeding. Esophageal stenting and endoscopic clipping of fistula were attempted but the fistula tract persisted. She then underwent laparoscopic excision of esophageal fistula tract (LEEFT). Intraoperative findings were dense inflamed paraesophageal tissue with thickened fistula tract at right posterolateral wall of distal esophagus with multiple enlarged mediastinal lymph nodes. Fistula tract and the lymph nodes were excised via laparoscopic transhiatal approach. She had an uneventful recovery and was discharged on post-operative day 7. Conclusion Spontaneous esophageal fistula is rare and necrotizing mediastinal lymphadenopathy needs to be considered. Laparoscopic excision of esophageal fistula tract (LEEFT) is a novel transhiatal approach and it is feasible in distally located fistula. Disclosure All authors have declared no conflicts of interest.

scholarly journals Purulent Appearing Material in an Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal Lymph Node: A Diagnostic Challenge

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Damaris Pena ◽  
Gilda Diaz-Fuentes ◽  
Sindhaghatta Venkatram
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Tumors ◽  
Mediastinal Lymph Node ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes. Growing tumor cells require a blood supply; if the vascular stroma is insufficient due to rapidly growing malignant tumors this could lead to large central areas of ischemic necrosis. Necrotic aspiration of lymph nodes is not always of infectious etiology. Aspiration of fluid in EBUS-TBNA is a rare occurrence, and malignancy should be considered when purulent fluid material is obtained. We present an elderly woman who underwent bronchoscopy with EBUS-TBNA for evaluation of upper lung nodule and mediastinal lymphadenopathy. Pus-like material was obtained on needle aspiration and endobronchial biopsy and mediastinal core biopsy revealed squamous cell carcinoma.

Reactive Mediastinal Lympadenopathy in Bronchiectasis Assessed by CT

1993 ◽  
Vol 34 (5) ◽  
pp. 489-491 ◽  
Author(s):  
R. D. Thomas ◽  
R. M. Blaquiere
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Maximum Size ◽  
Mediastinal Lymphadenopathy ◽  
Mediastinal Lymph Nodes ◽  
Disease States ◽  
Size Number ◽  
Lymph Node Enlargement ◽  
Specific Finding

Mediastinal lymphadenopathy is commonly detected on CT. It is a non-specific finding, but because of its significance in the treatment in lung carcinoma it is important to know with which other disease states it is associated. We present a series of 42 patients in whom CT of the chest was used to confirm a clinical diagnosis of bronchiectasis. The size, number and distribution of mediastinal lymph nodes is documented. Lymph nodes were visible in 81% of patients. Nodes larger than 10 mm, the recognised maximum size for normal nodes in the U. K., were detected in 29%. In the absence of other recognised causes of lymphadenopathy in these patients, these findings confirm “reactive” mediastinal lymph node enlargement in bronchiectasis.

scholarly journals Surgical treatment of unicentric plasma cell histological type Castleman's disease

2011 ◽  
Vol 68 (9) ◽  
pp. 795-799 ◽  
Author(s):  
Nebojsa Maric ◽  
Vojkan Stanic ◽  
Vlado Cvijanovic ◽  
Aleksandar Ristanovic ◽  
Snezana Kovacevic ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Lymph Nodes ◽  
Plasma Cell ◽  
Histological Type ◽  
Cell Type ◽  
Mixed Cell ◽  
Vena Cava Superior ◽  
Plasma Cell Type ◽  
Therapy Effect

Introduction. Castleman?s disease or angiofollicular lymph hyperplasia is a rare disease with two identified clinical forms. Unicentric or localized form is characterized by isolated growth of lymph nodes, most often in mediastinum, and multicentric form is expressed as systemic disease with spread lymphadenopathy, organomegaly and presence of general symptoms of the disease. Histological types are hyalovascular, plasma-cell and transitive (mixed) cell. Case report. This case report shows a woman, 59 years old, with unicentric form of plasma-cell type of Castleman?s disease. Unicentric form is usually shown as hyalovascular histological type, extremely rare as plasma-cell type, and transitive (mixed) cell type was never described in literature as localized clinical form. The disease was manifested with chest pain, loss of body weight, exhaustion and weakness of legs. Further diagnostic procedures found the presence of enlarged lymph nodes paratracheally right, in a close contact with vena cava superior. The disease was confirmed by histopathological analysis of bioptated mediastinal lymph node after mediastinoscopy. Surgical treatment included extirpation of enlarged lymph nodes. After the regular postoperative condition, a full therapy effect was confirmed. Conclusion. Unicentric form of Castleman?s disease is expressed with enlarged lymph nodes on predilected places, usually in mediastinum. Surgical treatment is best method for the management of the disease and brings a full recovery of patient.

scholarly journals The Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) Technique in Assessment of Mediastinal Lymph Nodes

2021 ◽  
Author(s):  
Shahab Rafieian ◽  
Reza Ershadi ◽  
Hossein Ebrahimpoor ◽  
Matin Vahedi
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Mediastinal Lymph Nodes ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) technique provides a complementary assessment of the areas of mediastinal lymph node involvement, and allows sampling of suspected lymph nodes. But, the usefulness of EBUS-TBNA in assessing all areas of mediastinal lymph nodes is little known and it seems that such assess is dependent to various factors related to the patient's condition and especially the characteristics of local lymph nodes. We aimed to evaluate the utility of EBUS-TBNA in assessing mediastinal lymph nodes and the factors associated with this utility.Methods: This cross-sectional study was performed on 40 patients suspected to mediastinal lymphadenopathy scheduled for assessment by EBUS-TBNA and mediastinoscopy. The diagnostic yield of EBUS-TBNA to mediastinal lymph nodes was evaluated and non diagnostic cases evaluated by mediastinoscopy .Results: In evaluation with EBUS-TBNA, the diagnostic yield of EBUS in assess to mediastinal lymph nodes including 34 out of 40 cases was equal to 85%. The size of lymph node (lower than 10mm), the area of sample (left and right upper paratracheal), and the nature of the lymph node sample (benign type) were associated with lower diagnostic yield for EBUS-TBNA.Conclusion: The diagnostic yield of EBUS in assessing mediastinal lymph nodes for sampling and diagnosis is 85%. This benefit is expected in the case of lesions larger than 10 mm, lesions of a malignant nature, as well as lesions in the inferior paratracheal and subcarinal stations.

Appropriate Extent of Lymphadenectomy in Segmentectomy: A Multicenter Study

2020 ◽  
Author(s):  
Yoshinori Handa ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Hiroyuki Ito ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Clinical Stage ◽  
Oncological Outcome ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients ◽  
Clinical Stage Ia ◽  
Group 5

Abstract Background The significance of lymphadenectomy is yet to be fully examined in segmentectomy. We compared the oncological outcomes of mediastinal lymph node dissection (LND) and hilar LND for lung cancer treated with segmentectomy via a multicenter database using propensity score-matched analysis. Methods We reviewed 357 clinical stage IA radiologically solid-dominant lung cancer patients who underwent segmentectomy with lymphadenectomy. The extent of LND was classified into systematic/lobe-specific mediastinal LND and hilar LND only groups. Postoperative results after segmentectomy with mediastinal LND (n = 179) and hilar LND (n = 178) were analyzed for all patients and their propensity score-matched pairs. Results Cancer-specific survival (CSS) and recurrence-free interval (RFI) rates for the mediastinal LND group were determined to be not significantly different compared with the hilar LND group in all non-adjusted cohorts. In the propensity score-matched cohort (129 pairs), mediastinal LND harvested more lymph nodes compared with hilar LND, and both groups had significantly different pathological stages (P = 0.015). Adjuvant chemotherapy was performed in 10 (7.8%) patients in the mediastinal LND group and 4 (3.1%) in the hilar LND group. The mediastinal LND group tended to have better prognosis than the hilar LND group (5-year CSS rates, 97.4% vs 93.2%; 5-year RFI rates, 93.5% vs 88.5%). Conclusions Mediastinal LND was found to provide more appropriate pathological staging compared with hilar LND in patients with segmentectomy by harvesting more lymph nodes. In addition, mediastinal LND might lead to better oncological outcome than hilar LND in segmentectomy.

CXC chemokine receptor 4 is expressed in uveal malignant melanoma and correlates with the epithelioid-mixed cell type

2007 ◽  
Vol 56 (10) ◽  
pp. 1589-1595 ◽  
Author(s):  
Stefania Scala ◽  
Caterina Ieranò ◽  
Alessandro Ottaiano ◽  
Renato Franco ◽  
Anna La Mura ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Chemokine Receptor ◽  
Cell Type ◽  
Mixed Cell ◽  
Cxc Chemokine Receptor 4 ◽  
Cxc Chemokine ◽  
Uveal Malignant Melanoma ◽  
Chemokine Receptor 4

scholarly journals Anal Cancer with Mediastinal Lymph Node Metastasis

2021 ◽  
pp. 1-4
Author(s):  
Mangalore Amith Shenoy ◽  
Lydia Winnicka ◽  
Leili Mirsadraei ◽  
Douglas Marks
Keyword(s):  
Breast Cancer ◽  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Anal Cancer ◽  
Squamous Cell ◽  
Mediastinal Lymph Node ◽  
Hpv Infection ◽  
Mediastinal Lymphadenopathy ◽  
Prior History

Squamous cell carcinoma of the anal canal remains rare, with metastatic disease even less commonly reported. We present a case of a patient with both a prior history of squamous cell carcinoma of the anal canal as well as breast cancer, who was without evidence of disease for 1 year. She was subsequently found to have FDG-avid mediastinal lymphadenopathy, initially assumed to be related to her more recent breast cancer. However, a biopsy confirmed recurrent anal cancer, with HPV infection. This represents a novel site of spread for anal cancer, one not yet reported in the literature.

Right Superior Mediastinal Lymph Node Dissection in Thoracoscopic Surgery Using a Bipolar Sealing Device

2013 ◽  
Vol 8 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Hitoshi Igai ◽  
Takashi Ibe ◽  
Natsuko Kawatani ◽  
Yoichi Ohtaki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection ◽  
Chest Drainage ◽  
Sealing Device

Objective This study investigated the use of a new bipolar sealing device (BSD) in right superior mediastinal lymph node dissection during thoracoscopic surgery. Methods The study population consisted of 42 consecutive patients undergoing lobectomy with right superior mediastinal lymph node dissection for primary lung cancer. Operative results were compared with those of conventional surgery in 42 background-matched controls. The primary endpoint for the present analysis was the success of right superior mediastinal lymph node dissection during thoracoscopic surgery using a BSD. The secondary endpoints included the duration of the operation, number of dissected lymph nodes, chest drainage volume and duration, postoperative hospital stay, morbidity, and mortality. Results The BSD was used successfully in 42 patients. No significant difference in duration of lymph node dissection, chest drainage volume, drainage duration, or number of dissected lymph nodes was observed between the study group and the controls. Because of a learning curve, the procedure initially took more than 20 minutes to complete, but surgical time was reduced to approximately 15 minutes after the procedure was performed in 15 patients. Conclusions Our method is safe and in no way inferior to the conventional procedure. The tendency of the learning curve suggests that a significantly shorter duration of lymph node dissection is possible using this method.

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