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Policardo F, Tralongo P, Vegni F, Feraco A, De Stefano I, Carlino A, Ferraro G, Navarra E, Mulè A, Rossi ED. Some uncommon cystic lesions in the anterior head and neck region: Pitfalls to be avoided on cytology. Cytopathology 2024; 35:23-29. [PMID: 37522315 DOI: 10.1111/cyt.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/10/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023]
Abstract
Cystic lesions of the anterior head and neck region are a challenging and frequent finding on cytological smears. The scant amount of cellular material in cystic slides poses the greatest difficulty to interpretation, so that frequently they are diagnosed as inadequate or with minimal cellular component. Despite the majority of cystic lesions being benign, a minor portion consist of malignant cystic entities. In these latter cases, the evidence of very scant malignant cells can be misdiagnosed and/or underestimated, leading to a false negative diagnosis. Many papers have already described and detailed the range of possible benign and malignant cystic lesions in head and neck. In the current review we have focused on the less common entities that often lead to serious misinterpretation.
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Affiliation(s)
- Federica Policardo
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Pietro Tralongo
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Federica Vegni
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Angela Feraco
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Ilenia De Stefano
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Angela Carlino
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Giulia Ferraro
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Elena Navarra
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Antonino Mulè
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy
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Mora A, Ghavamrezaii A, Abidali H, Caballero H, Hamidullah A, Mitzov N. Mediastinal Bronchogenic Cyst With Superior Vena Cava Syndrome: A Case Report. Cureus 2023; 15:e42040. [PMID: 37593276 PMCID: PMC10431947 DOI: 10.7759/cureus.42040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Bronchogenic cysts are rare in adults and often remain undetected until discovered incidentally on imaging or during a symptomatic investigation. The possibility of superior vena cava (SVC) compression due to a bronchogenic cyst arises in complex patient presentations. SVC syndrome poses several unique challenges due to the wide range of clinical symptoms and difficulty identifying the cause when symptoms first manifest. This case report examines a 39-year-old male who presented with symptoms resulting from SVC compression caused by a bronchogenic cyst, leading to SVC syndrome. We discuss the various imaging modalities used to assess the severity of the obstruction and the surgical interventions employed to alleviate the symptoms. A surgical intervention provides symptomatic relief and promises an excellent prognosis when performed without complications.
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Affiliation(s)
- Annalee Mora
- Internal Medicine, Oak Hill Hospital, Brooksville, USA
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Hsu DS, Banks KC, Velotta JB. Surgical approaches to mediastinal cysts: clinical practice review. MEDIASTINUM (HONG KONG, CHINA) 2022; 6:32. [PMID: 36582973 PMCID: PMC9792838 DOI: 10.21037/med-22-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
The traditional approach to mediastinal cyst and mass resection has been open via median sternotomy or thoracotomy. With the advent of minimally invasive techniques, there have been successful cases completed via video-assisted thoracoscopic (VATS) and robot-assisted thoracoscopic surgery (RATS). Although mediastinal cysts are uncommon, they are a significant and relevant topic in the practice of thoracic surgery. Thus, this clinical practice review aims to summarize and highlight some of the key case series and retrospective studies in order to provide insight on each of the approaches. In addition, there is a brief review of other approaches, such as subxiphoid, and the utility of endobronchial ultrasound in the management of mediastinal cysts. In this review, the identified benefits of VATS and RATS lie largely in quality improvement of the patient experience-decreased length of stay (LOS) and pain-without compromising patient outcomes. However, the open approach remains a viable option, particularly for the management of large cysts or as a bail-out option. When surgeons approach with VATS or RATS and encounter bleeding or difficult dissection planes, it is consistent in the literature that conversion to thoracotomy is the safe next step. Our clinical practice is to attempt VATS or RATS approach for mediastinal cysts when possible. The data used for this review relies heavily on case reports and case series, and thus is the main limitation of this clinical practice review.
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Affiliation(s)
- Diana S. Hsu
- UCSF East Bay Surgery, Highland Hospital, Oakland, CA, USA;,Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Kian C. Banks
- UCSF East Bay Surgery, Highland Hospital, Oakland, CA, USA;,Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Jeffrey B. Velotta
- Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
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Bansal RC, Lafian H, Kirk S. Aortocoronary Saphenous Vein Graft Aneurysm: Diagnosis Using Color Doppler and Contrast Transesophageal Echocardiography. CASE 2021; 5:368-372. [PMID: 34993365 PMCID: PMC8712998 DOI: 10.1016/j.case.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ramesh C. Bansal
- Department of Cardiology, Loma Linda University, Loma Linda, California
- Reprint requests: Ramesh C. Bansal, MD, FASE, Professor of Medicine, Director, Adult Echocardiography Laboratory Loma Linda University School of Medicine 11234 Anderson Street, Troesh Medical Campus (TMC), Room MC-1B-255, Loma Linda, CA 92354.
| | - Haig Lafian
- Department of Cardiology, Loma Linda University, Loma Linda, California
| | - Shannon Kirk
- Department of Radiology, Loma Linda University, Loma Linda, California
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