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Georgakopoulou VE, Damaskos C, Mantzouranis K, Melemeni D, Gkoufa A, Chlapoutakis S, Garmpis N, Sklapani P, Aravantinou A, Garmpi A, Trakas N, Tsiafaki X. Invasive methods for the diagnosis and management of intrathoracic extramedullary hematopoiesis: A literature review. Respir Med Res 2021; 79:100815. [PMID: 33610912 DOI: 10.1016/j.resmer.2021.100815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Extramedullary hematopoiesis is defined as hematopoiesis occurring outside of the bone marrow. It usually compensates insufficient bone marrow function or ineffective erythropoiesis and is observed mostly in hematological disorders. Most common locations of extramedullary hematopoiesis are the spleen, the liver and the lymph nodes. Intrathoracic extramedullary hematopoiesis is rare presenting as bilateral lobulated masses of lower paravertebral regions. This review summarizes the role of invasive techniques in the diagnosis and management of intrathoracic EMH and its complications. METHODS An electronic search in PubMed and Google Scholar was conducted with the keywords "intrathoracic extramedullary hematopoiesis" AND "surgery" OR "video-assisted thoracic surgery (VATS)" OR "medical thoracoscopy" OR "biopsy" OR "thoracotomy" OR "image-guided biopsy" OR "median sternotomy", within 1970 to 2020 with the limitation of English language to include those articles reporting data on invasive techniques in intrathoracic extramedullary hematopoiesis. RESULTS Overall, 93 articles were originally identified using our search criteria and from the reference list of the previously identified documents. Following elimination of duplicates, 29 were excluded after title, abstract or full text screening, since they did not report the use of invasive techniques in the diagnosis and management of intrathoracic extramedullary hematopoiesis. CONCLUSIONS Although in some cases radiological features are typical for the diagnosis of intrathoracic extramedullary hematopoeisis, invasive methods such as bronchoscopy with transbronchial biopsy, ιmage-guided fine needle aspiration, endobronchial ultrasound-guided fine needle aspiration of the mass and mediastinoscopy, medical thoracoscopy, median sternotomy, video-assisted thoracoscopic surgery and thoracotomy, are essential for definite diagnosis and management.
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Affiliation(s)
- V E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, 17 Agiou Thoma Street, 11527, Athens, Greece.
| | - C Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - K Mantzouranis
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - D Melemeni
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - A Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - S Chlapoutakis
- Department of Thoracic Surgery, Agios Savvas Hospital, Athens, Greece
| | - N Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - P Sklapani
- Department of Cytology, Mitera Hospital, Athens, Greece
| | - A Aravantinou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - X Tsiafaki
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
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Ogier M, Kerjouan M, Libessart T, Merzoug A, Leroyer C, Desrues B, Jouneau S. [Posterior mediastinal mass]. Rev Mal Respir 2015; 32:959-62. [PMID: 26232209 DOI: 10.1016/j.rmr.2015.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Affiliation(s)
- M Ogier
- EA 3149, EA 3878 (GETBO), IFR 148, département de médecine interne et de pneumologie, université européenne de Bretagne, CHU de La Cavale-Blanche, 29609 Brest, France; Service de pneumologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France.
| | - M Kerjouan
- Service de pneumologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - T Libessart
- Service de radiologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - A Merzoug
- Service de pneumologie, centre hospitalier de Fougères, 133, rue de la Forêt, 35300 Fougères, France
| | - C Leroyer
- EA 3149, EA 3878 (GETBO), IFR 148, département de médecine interne et de pneumologie, université européenne de Bretagne, CHU de La Cavale-Blanche, 29609 Brest, France
| | - B Desrues
- Service de pneumologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - S Jouneau
- Service de pneumologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France; IRSET UMR 1085, université de Rennes 1, 35043 Rennes, France
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Ng CSH, Yim APC. Technical advances in mediastinal surgery: videothoracoscopic approach to posterior mediastinal tumors. Thorac Surg Clin 2010; 20:297-309. [PMID: 20451139 DOI: 10.1016/j.thorsurg.2010.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Videothoracoscopic approach to posterior mediastinal tumors is a safe operation in experienced hands. This approach produces results comparable to the other conventional surgical techniques for excision. This article describes the operative procedure and summarizes the advantages of this approach.
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Affiliation(s)
- Calvin S H Ng
- Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T. Hong Kong SAR, China
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Ng CSH, Wong RHL, Hsin MKY, Yeung ECL, Wan S, Wan IYP, Yim APC, Underwood MJ. Recent advances in video-assisted thoracoscopic approach to posterior mediastinal tumours. Surgeon 2010; 8:280-6. [PMID: 20709286 DOI: 10.1016/j.surge.2010.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 05/29/2010] [Accepted: 06/01/2010] [Indexed: 11/17/2022]
Abstract
Minimal invasive video-assisted thoracic surgery can be a safe alternative technique in the assessment, diagnosis and surgical resection of posterior mediastinal tumours. Video-assisted thoracic surgery may be particularly suited for the management of posterior mediastinal tumours as most are benign. Surgical technique continues to evolve from the classic 3-port access in order to tackle more complex tumours positioned at the apical and inferior recesses of the posterior mediastinum. The preoperative identification of dumbbell tumours is important to facilitate arrangements for a single-stage combined resection for both the intra-thoracic and intraspinal tumour. Results from Video-assisted thoracic surgery posterior mediastinal tumour resection are comparable with conventional surgical techniques in terms of symptomatic improvement, recurrence and survival. Video-assisted thoracic surgery approach has been shown to result in less post-operative pain, improved cosmesis, shorter hospital stay, and more rapid recovery and return to normal activities. In over a decade, video-assisted thoracic surgery has gradually matured and is now a promising therapeutic alternative to open approach. In certain selected patients, video-assisted thoracic surgery may be considered the standard of care for conditions of the posterior mediastinum. Recent developments in robotic surgery for the management of mediastinal tumours are promising, however, long-term results are pending.
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Affiliation(s)
- Calvin S H Ng
- Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, China.
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