1
|
Machboua A, Hamraoui S, Zarouki S, Kamaoui I, Alloubi I. [Posterior mediastinal glomangiomatosis: Exceptional location of a rare tumour]. Rev Mal Respir 2021; 38:848-852. [PMID: 34116882 DOI: 10.1016/j.rmr.2021.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Glomangiomatosis is a benign tumour proliferation which develops from the glomus cells in the wall of a vessel, and which contains abnormal venous capillaries. Its usual location is dermal at the extremities, mediastinal presentation is exceptional. OBSERVATION A 63-year-old patient, followed for scoliosis, was admitted for a spontaneous haemothorax. The CT scan found hypervascularized left paravertebral masses. Thoracoscopy with biopsy provided the diagnosis of a glomus tumour. Given that its diffuse nature makes surgical excision difficult and the risk of intraoperative bleeding very high, treatment with interleukin alpha 2 was proposed to the patient. After a 3-year course, we did not observe any evolutionary change in the lesions. CONCLUSION Glomangiomatosis is an insidiously evolving vascular tumour which must be considered in the presence of vascular lesions. The reference treatment is surgical excision when possible. On the other hand, hasty surgery in diffuse forms remains dangerous given the haemorrhagic nature of this tumour.
Collapse
Affiliation(s)
- A Machboua
- Service de chirurgie thoracique et cardiaque, C.H.U Mohamed VI, Oujda, Maroc.
| | - S Hamraoui
- Service de chirurgie thoracique et cardiaque, C.H.U Mohamed VI, Oujda, Maroc
| | - S Zarouki
- Service de chirurgie thoracique et cardiaque, C.H.U Mohamed VI, Oujda, Maroc
| | - I Kamaoui
- Service de radiologie, C.H.U Mohamed VI, Oujda, Maroc
| | - I Alloubi
- Service de chirurgie thoracique et cardiaque, C.H.U Mohamed VI, Oujda, Maroc
| |
Collapse
|
2
|
Issoufou I, Harmouchi H, Efared B, Belliraj L, Ammor FZ, Lakranbi M, Ouadnouni Y, Smahi M. [What contribution for mediastinoscopy in non-tumor specific mediastinal lesions?]. Rev Pneumol Clin 2018; 74:242-247. [PMID: 30017753 DOI: 10.1016/j.pneumo.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/14/2018] [Accepted: 05/19/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The aim of our study was to assess the interest of cervical mediastinoscopy in the management of benign mediastinal lymphadenopathy. METHOD We performed a single-center retrospective descriptive study over a period of 5 years (2013-2017) in the department of thoracic surgery of university hospital Hassan II of Fez. RESULTS During this period, a total of 137 cervical mediastinoscopies were performed among which 68 for a benign disease. This represents a frequency of 49.63 %. There were 22 men and 46 women with a mean age of 43.76 years±17.08. Chest CT showed isolated mediastinal lymphadenopathy in 52 %, associated with pulmonary images in 35 %. Cervical mediastinoscopy led to pathological diagnosis in 94 %. The pathological results showed a sarcoidosis in 51.5 %, tuberculosis in 41.2 % and a lymph node echinococcosis in 1 case. CONCLUSION Cervical mediastinoscopy remains a low risk modality in expert hands, which allows pathological diagnosis with excellent sensitivity, acceptable morbidity and no mortality in our experience.
Collapse
Affiliation(s)
- I Issoufou
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc.
| | - H Harmouchi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - B Efared
- Service d'anatomopathologie, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - L Belliraj
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - F Z Ammor
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - M Lakranbi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - Y Ouadnouni
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - M Smahi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
| |
Collapse
|
3
|
Basille D, Hybiak C, Dayen C, Toublanc B, Douadi Y, Francois G, Rault I, Andrejak C, Berna P, Jounieaux V. [Endobronchial ultrasound with transbronchial needle aspiration: Evaluation of clinical practice]. Rev Mal Respir 2018; 35:305-312. [PMID: 29395562 DOI: 10.1016/j.rmr.2017.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/02/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) has undergone a large increase in France since 2007. The aim is to study the evolution of the indications for EBUS-TBNA in our region during the period 2008-2013. MATERIAL AND METHODS We conducted a retrospective observational study including all the patients who underwent an EBUS-TBNA procedure in Picardie from 2008 to 2013. The respective proportion for each indication was noted. RESULTS During the study period, 1036 EBUS-TBNA procedures were performed with a continuous increase in number (86 in 2008 versus 275 in 2013). We observed an increase in the proportion of procedures performed for a suspected diagnosis of sarcoidosis (OR=1.31; IC 95% [1.09-1.58]; P=0.005) and for the simultaneous diagnosis and staging of lung cancer (OR=1.12; IC 95% [1.02-1.24]; P=0.022). For the diagnosis of sarcoidosis, we observed an improvement in the diagnostic yield between the periods [2008-2010] and [2011-2013] (42.9% versus 72.5%). CONCLUSION A continuous increase in the number of EBUS-TBNA procedures was observed during the period 2008-2013. It was associated with a modification in practice with an increased proportion of procedures performed for the diagnosis of sarcoidosis.
Collapse
Affiliation(s)
- D Basille
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - C Hybiak
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - C Dayen
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - B Toublanc
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - Y Douadi
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - G Francois
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - I Rault
- Service de pneumologie, maladies infectieuses et tropicales, centre hospitalier Saint-Quentin, 02321 Saint-Quentin, France
| | - C Andrejak
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - P Berna
- Service de chirurgie thoracique, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, 80054 Amiens cedex 1, France
| |
Collapse
|
4
|
Issoufou I, Lakranbi M, Sani R, Belliraj L, Ammor FZ, Ghalimi J, Ouadnouni Y, Smahi M. [Neurogenic mediastinal tumors in adults]. Rev Pneumol Clin 2016; 72:310-315. [PMID: 27567980 DOI: 10.1016/j.pneumo.2016.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 05/11/2016] [Accepted: 05/17/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Neurogenic mediastinal tumors are tumors develop at the expense of peripheral nerve elements of the mediastinum, the sympathetic nervous tissue and paraganglia. The series that we propose has the distinction of a high frequency of malignant forms and a wealth of clinical symptomatology. METHODS This is a retrospective study of 9 patients collected over a period of 6 years. The epidemiological aspect, clinical, radiological, surgical treatment and his results, histological diagnosis and prognosis were reviewed. RESULTS Five women and 4 men were identified. All patients were symptomatic at diagnosis. Tumor resection was complete in 8 cases. In 3 patients, there was a malignant tumor. Two of them had received chemo-radiotherapy. The others showed good clinical progress with a mean of 35 months. CONCLUSION Neurogenic tumors in adults are usually discovered incidentally. When the malignant forms predominate or in the presence of large tumor, the symptoms can be quite marked. In all cases the treatment based on a complete surgical resection remains the only guarantee of a good prognosis.
Collapse
Affiliation(s)
- I Issoufou
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc.
| | - M Lakranbi
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - R Sani
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - L Belliraj
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - F Z Ammor
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - J Ghalimi
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - Y Ouadnouni
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| | - M Smahi
- Service de chirurgie thoracique, CHU Hassan II, BP 1893, km 2200, route de Sidi Hrazem, 3000 Fes Maroc
| |
Collapse
|
5
|
Stern JB, Wyplosz B, Girard P, Validire P, Escaut L, Caliandro R. [Endobronchial ultrasonography (EBUS) for the internist]. Rev Med Interne 2016; 37:759-765. [PMID: 27363931 DOI: 10.1016/j.revmed.2016.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/28/2016] [Indexed: 12/25/2022]
Abstract
Endobronchial ultrasonography (EBUS) is a recent mini-invasive technique allowing transbronchial needle aspiration (TBNA) of mediastinal lymph nodes as well as peribronchial lesions. EBUS was initially developed for lung cancer mediastinal staging. Over the years, indications for EBUS have been progressively extended to the scope of inflammatory disorders, mediastinal lymphomas, and infectious diseases. Particularly in immunosuppressed patients, including HIV-infected patients, EBUS allows the diagnosis of several diseases that involve the mediastinum, avoiding invasive surgical explorations such as mediastinoscopy or thoracoscopy. This review aims at discussing the technical aspects, and specifies indications, results, and limits of EBUS for the internist.
Collapse
Affiliation(s)
- J-B Stern
- Unité de pneumologie, département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France; Service de maladies infectieuses et tropicales, Assistance publique-Hôpitaux de Paris, CHU Bicêtre, Le Kremlin-Bicêtre, France.
| | - B Wyplosz
- Service de maladies infectieuses et tropicales, Assistance publique-Hôpitaux de Paris, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - P Girard
- Unité de pneumologie, département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - P Validire
- Département d'anatomie pathologique, institut mutualiste Montsouris, Paris, France
| | - L Escaut
- Service de maladies infectieuses et tropicales, Assistance publique-Hôpitaux de Paris, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - R Caliandro
- Unité de pneumologie, département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| |
Collapse
|
6
|
Laffay L, Gérinière L, Couraud S, Souquet PJ. [Endobronchial ultrasound transbronchial needle aspiration initiation into the Lyon Sud hospital center: Experience of the first three years]. Rev Pneumol Clin 2016; 72:17-24. [PMID: 26305022 DOI: 10.1016/j.pneumo.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 02/23/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Endobronchial ultrasound is a recent technique for the diagnosis and the lymph node staging in lung cancer. It also showed interest in non tumoral mediastinal lymph nodes diagnosis. This work relates the CHLS first three years' experience in terms of EEB practical use as a new diagnostic tool in this field. METHODS Retrospective study of consecutive cases patients having undergone endobronchial ultrasound from November 2008 till June 2011 in the CHLS. RESULTS On 65 endobronchial ultrasound, general anesthesia was practiced in 89 % of the cases, with a good tolerance in 81 % of the cases. In 77 % cases, EEB allowed diagnosis and avoided mediastinoscopy in 60.5 % of the cases. The respective sensibility, specificity, positive and negative predictive values were 74 %, 100 %, 100 % and 48 %. CONCLUSION These data, reflect of a novice team experience, illustrate the results obtained in the current practice in terms of etiologic diagnosis. Endobronchial ultrasound seems destined to a bright future but requires the development of dedicated centers allowing pulmonologists training and specialized pathologists in this field.
Collapse
Affiliation(s)
- L Laffay
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France.
| | - L Gérinière
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France
| | - P-J Souquet
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France
| |
Collapse
|
7
|
Bacha S, Chaouch N, Ayadi A, Zidi A, Cheikhrouhou S, Racil H, Chabbou A. [Malignant peripheral sheath nerve tumor: An exceptional mass of the anterior and middle mediastinum]. Rev Pneumol Clin 2015; 71:364-368. [PMID: 26190334 DOI: 10.1016/j.pneumo.2015.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 03/12/2015] [Accepted: 03/28/2015] [Indexed: 06/04/2023]
Abstract
Malignant peripheral nerve sheath tumors (MPNST) are rare nervous tumors usually located in the posterior mediastinum in the paravertebral gutters. We report the case of a non-smoking 62-year-old man who was admitted with a 4 months history of cough, hoarseness and shortness of breath. Physical examination noted a superior vena cava syndrome. CT scan of the chest revealed a right anterior and middle mediastinal mass compressing the superior vena cava, the ascending aorta, the right pulmonary artery, invading the superior root of the pulmonary vein and the right auricle. Flexible bronchoscopy showed extrinsic compression of the right main bronchus, the right upper lobe bronchus and intermedius bronchus. The patient underwent surgical biopsy of the mass by mediastinoscopy. Histological examination revealed a malignant peripheral nerve sheath tumor. The patient received a single cycle of chemotherapy (ifosfamid-adriamycin). Clinical course was marked by the fast worsening of the dyspnea and the general state. Patient died three weeks after the cure of the chemotherapy. This case is original by the exceptional clinical presentation of MPSNT with a superior vena cava syndrome and the very rare location of this tumor in the anterior and middle mediastinum.
Collapse
Affiliation(s)
- S Bacha
- Service de pneumologie, pavillon 2, hôpital Abderrahman-Mami, Ariana, Tunisie.
| | - N Chaouch
- Service de pneumologie, pavillon 2, hôpital Abderrahman-Mami, Ariana, Tunisie
| | - A Ayadi
- Service d'anatomie pathologique, hôpital Abderrahman-Mami, Ariana, Tunisie
| | - A Zidi
- Service de radiologie, hôpital Abderrahman-Mami, Ariana, Tunisie
| | - S Cheikhrouhou
- Service de pneumologie, pavillon 2, hôpital Abderrahman-Mami, Ariana, Tunisie
| | - H Racil
- Service de pneumologie, pavillon 2, hôpital Abderrahman-Mami, Ariana, Tunisie
| | - A Chabbou
- Service de pneumologie, pavillon 2, hôpital Abderrahman-Mami, Ariana, Tunisie
| |
Collapse
|
8
|
Bacha S, Chaouch N, Mlika M, Racil H, Cheikhrouhou S, Chabbou A. [Unusual location of an intrathoracic mesothelial cyst in the posterior and upper mediastinum]. Rev Mal Respir 2015; 33:626-9. [PMID: 26596228 DOI: 10.1016/j.rmr.2015.10.740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/06/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Intrathoracic mesothelial cysts are congenital lesions due to an abnormal development of the pericardial coelom. They are usually asymptomatic and found incidentally on chest radiography or computed tomography. As their classic anatomical location is in the cardiophrenic angle, they are also referred to pleuropericardial cysts. CASE REPORT A 50-year-old male presented with a history of chest pain. Physical examination and chest X-ray were normal. Computed tomography (CT) scan revealed a cystic lesion in the posterior and upper mediastinum. The cyst was surgically removed through a posterolateral thoracotomy. Histopathological examination confirmed that it was a mesothelial cyst. The surgical resection of the cyst lead to relief of the thoracic pain over a three-year follow-up period. CT-scan showed an aberrant right subclavian artery or arteria lusoria, which is an anomaly of the aortic arch secondary to abnormal embryogenesis. We know no other report of concurrent ectopic coelomic cyst and aberrant right subclavian artery. CONCLUSION Although the majority of coelomic cysts needs only radiological and clinical follow-up, surgical resection should be performed when the patient is symptomatic or when the diagnosis is uncertain.
Collapse
Affiliation(s)
- S Bacha
- Service de pneumologie, pavillon 2, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie.
| | - N Chaouch
- Service de pneumologie, pavillon 2, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie
| | - M Mlika
- Service d'anatomopathologie, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie
| | - H Racil
- Service de pneumologie, pavillon 2, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie
| | - S Cheikhrouhou
- Service de pneumologie, pavillon 2, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie
| | - A Chabbou
- Service de pneumologie, pavillon 2, hôpital de pneumo-phtisiologie Abderrahmane Mami, 2080 Ariana, Tunisie
| |
Collapse
|
9
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| |
Collapse
|
10
|
El Hammoumi MM, Sinaa M, El Oueriachi F, Arsalane A, Kabiri EH. [Pleuropericardial cyst rupturing into the pericardium causing tamponade]. Rev Mal Respir 2014; 31:442-6. [PMID: 24878162 DOI: 10.1016/j.rmr.2013.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 08/28/2013] [Indexed: 11/29/2022]
Abstract
Pleuropericardial cysts of the mediastinum are rare lesions, usually congenital but exceptionally acquired. They are often asymptomatic, but complications can occur. We report below the case of a 35-year-old man who presented with an acquired right-sided para-tracheal mesothelial cyst that ruptured into the pericardium and was responsible for clinical tamponade. Although the majority of mesothelial cysts are asymptomatic, only a strict clinical and radiological follow-up can provide an indication for surgical resection. This should be reserved for symptomatic patients or for those facing an uncertain diagnosis.
Collapse
Affiliation(s)
- M M El Hammoumi
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, université Mohamed V, Riad 10100, Rabat, Maroc.
| | - M Sinaa
- Departement d'anatomopathologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Maroc
| | - F El Oueriachi
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, université Mohamed V, Riad 10100, Rabat, Maroc
| | - A Arsalane
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, université Mohamed V, Riad 10100, Rabat, Maroc
| | - E H Kabiri
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, université Mohamed V, Riad 10100, Rabat, Maroc
| |
Collapse
|
11
|
Bagan P, Mordant P, Pricopi C, Le Pimpec Barthes F, Riquet M. [Metastatic thoracic lymph node carcinoma from extra-thoracic malignancy or from unknown primary site]. Rev Pneumol Clin 2013; 69:363-367. [PMID: 24210159 DOI: 10.1016/j.pneumo.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
Malignant mediastinal lymph nodes without pulmonary disease may be lymphomatous or the metastases from thoracic or extrathoracic malignancy. More rarely, metastatic lymph nodes are without primary site. Surgery is generally diagnostic, restricted to confirming the metastatic process, because of too numerous and disseminated or unresectable lymph nodes. Radical surgery consisting in lymphadenectomy can be effective in case of mediastinal lymph node malignancy without other extra- and intrathoracic disease. We observed in our experience and in several case reports long-term good results in such cases. We suggest that including surgery in the multimodality treatment of mediastinal metastatic lymph nodes may be advisable in selected patients.
Collapse
Affiliation(s)
- P Bagan
- Service de chirurgie thoracique et transplantation pulmonaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, 20, rue Leblanc, 75015 Paris, France.
| | - P Mordant
- Service de chirurgie thoracique et transplantation pulmonaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, 20, rue Leblanc, 75015 Paris, France
| | - C Pricopi
- Service de chirurgie thoracique et transplantation pulmonaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, 20, rue Leblanc, 75015 Paris, France
| | - F Le Pimpec Barthes
- Service de chirurgie thoracique et transplantation pulmonaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, 20, rue Leblanc, 75015 Paris, France
| | - M Riquet
- Service de chirurgie thoracique et transplantation pulmonaire, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, 20, rue Leblanc, 75015 Paris, France
| |
Collapse
|
12
|
Assouad J, Fénane H, Masmoudi H, Giol M, Karsenti A, Gounant V, Grunenwald D. [Flexible endoscope in thoracic surgery: CITES or cVATS?]. Rev Pneumol Clin 2013; 69:294-297. [PMID: 24041974 DOI: 10.1016/j.pneumo.2013.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 04/11/2013] [Accepted: 05/06/2013] [Indexed: 06/02/2023]
Abstract
Early pain and persistent parietal disorders remains a major unresolved problem in thoracic surgery. Thoracotomy and the use of multiple ports in most Video Assisted Thoracic Surgery (VATS) procedures are the major cause of this persistent pain. For the last decade, a few publications describing the use of either single incision VATS and cervical thoracic approaches have been reported without significant results in comparison with current used techniques. Intercostals compression during surgery and early after by intercostals chest tube placement, are probably the major cause of postoperative pain. Flexible endoscope is currently used in several surgeries and will take more and more importance in our daily use in thoracic surgery. Instrument flexibility allows its use through minimally invasive approaches and offers a very interesting intra-thoracic navigation. We describe here the first use in France of a flexible endoscope in thoracic surgery through a single cervical incision to perform simultaneous exploration and biopsies of the mediastinum and right pleura using the original approach of Cervical Incision Thoracic Endoscopic Surgery (CITES).
Collapse
Affiliation(s)
- J Assouad
- Service de chirurgie thoracique, hôpital Tenon, 58, avenue Gambetta, 75020 Paris, France.
| | | | | | | | | | | | | |
Collapse
|