جستجوی مقالات مرتبط با کلیدواژه « مدیاستن » در نشریات گروه « پزشکی »

One of the most important steps in the treatment of patients with mediastinal lymphadenopathy is the definitive diagnosis using tissue sampling of the intra-mediastinal lesion. Mediastinoscopy is one of the methods used for this purpose. In this regard, this study aims to investigate the role of mediastinoscopy in determining the cause of mediastinal lymphadenopathy in patients referred to Shahid Beheshti Hospital in Babol, Iran.

This cross-sectional study was conducted on 36 patients with mediastinal lymphadenopathy who were admitted to Shahid Beheshti Hospital in Babol (April 2009-March 2020) and underwent mediastinoscopy. Recorded medical information of all patients without known lung cancer under mediastinoscopy was reviewed. Mediastinoscopy was performed by a specialist doctor for all patients and the biopsy sample was sent to Shahid Beheshti Hospital Pathology for final diagnosis. Descriptive data were analyzed using SPSS25 software at a significance level of 0.05.

The mean age of the patients was 47.97±11.04 years (range: 28-76 years). The majority of patients were women (n=27; 75.00%). According to the pathology results, the final diagnosis for 33 people (91.67%) was benign, and 3 people (8.33%) were diagnosed with malignant. The most common pathology result was sarcoidosis with 23 cases (63.90%), active infection in 4 cases (11.11%), and squamous cell carcinoma in 3 cases (8.33%). Other benign results were reported with the frequency of one case (78.2%). Pathology findings had no significant relationship with the age and gender of patients (P<0.05).

Based on the findings of the study, it can be concluded that mediastinoscopy can help determine the causes of mediastinal lymphadenopathy and it is still a reliable method for examining mediastinal lesions.

The bronchopulmonary carcinoid tumor accounts for 1-2% of all adult malignancies of the lung and 20-30% of all carcinoid tumors. Cushing’s syndrome is the result of chronic exposure to increased concentration of exogenous or endo-genus cortisol hormone, and it is generally associated with central obesity, metabolic syndrome, and hypertension. Treatment is based on decreasing cortisol levels in the blood, through medical or surgical approaches. Surgery is considered the main treatment for ectopic ACTH-secreting tumors. Paraneoplastic Cushing’s syndrome due to bronchopulmonary carcinoid tumor is a rare clinical occurrence, which has been reported in only a few case reports and case series. An average of 71% of typical carcinoid tumors were found to be central. 79% of patients with a peripheral carcinoid tumor and evidence of mediastinal node enlargement are likely to have an atypical carcinoid.

A 45 Years old male with a history of ectopic Cushing’s syndrome over the last two years was admitted to our department (Department of thoracic surgery, Teahran, Iran). He had a positive Octreotide scan of the hilar lymph nodes of the left lung at last evaluations. During the surgery, in the left lower lobe was resected (because a small nodule with tumoral appearance was seen in left lower lobe) with hilar and mediastinal lymph node dissection. Pathology indicated a typical carcinoid tumor with mediastinal lymph node metastasis. Plasma cortisol and ACTH were normalized following the surgery.

The present study reported a rare case of Cushing paraneoplastic syndrome with typical bronchopulmonary carcinoid tumor and N2 lymph node metastasis. The high prevalence of lymph node involvement confirms the aggressive nature of these tumors and warrants complete anatomic resection with radical lymphadenectomy.

Ganglioneuroma as a neuroblastoma-family tumor is a rare case with a ganglion cell origin. In most cases, ganglioneuroma is found in the mediastinal and retroperitoneal incidentally and may be presented with nonspecific symptoms. Here, we reported a 5-year-old boy with a retroperitoneal ganglioneuroma referred with abdominal pain.
Case Report: The case was a 5 years old boy with abdominal pain started one month ego, the pain is not generalized in a specific abdominal area. Patient in the physical examination had tenderness and mass in the right side of the abdomen. Laboratory tests, except for urine analysis, were normal. Imaging assessment reported one huge mass in the right side of retroperitoneal cavity. According to the patient's condition was decided to perform laparotomy. The pathological examination of the samples confirmed the ganglioneuroma.
For a case manifested with pain and the abdominal and retroperitoneal mass are established in his/her imaging. The ganglioneuroma should be considered as a differential diagnosis. The treatment and the final diagnosis of the anglioneuroma are accomplished through complete surgical resection of the lesion and histology.

Incidence of thymic lesions in the form of mediastinal cyst is very rare and is accompanied by risk of malignancy, which may induce signs of compression in mediastinum or accidentally be found during imaging. A case of mediastinal thymic cyst with compression-induced shortness of breath is presented.
CASE REPORT: A 40 year old woman underwent diagnostic assessment because of shortness of breath. Considering imaging results regarding upper mediastinal cystic lesion with possible origin of thymus, she underwent excision of mass and middle sternum. Histopathologic examination reported a simple thymic cyst.

Considering respiratory problems of patients with mediastinal cystic lesion, timely diagnosis and treatment is necessary to prevent probable malignancy in addition to relieving symptoms.

Castleman disease is a rare lymphoprolifrative disorder. Mediastinum is the most common site of disease. There is no consensus on definite treatment strategy but it seems that surgical resection is appropriate treatment and recurrence is rare even with incomplete resection. Here we report a case of mediastinal mass that underwent surgical resection and the final diagnosis was Castleman disease.

Mediastinal widening is a serious complication in patients with chest trauma. The gold standard method for diagnosis of this condition is chest Computed Tomography (CT) scan which is not applicable in many cases due to the high dose of radiation, high-cost, and emergency conditions. One of the most practicable and cost-effective diagnostic methods is supine Chest X-Ray (CXR). This study aimed to assess the diagnostic value of supine chest radiography for mediastinal widening by comparing the mediastinal width in supine CXR and chest CT scan (gold standard method) in patients with blunt chest trauma.
In this prospective non-interventional study, multi-detector chest CT scan was performed for patients with blunt chest trauma who had abnormal supine CXR or suspicious clinical findings. Mediastinal width was compared in CXR and CT scan in each patient for determination of accuracy of supine CXR in diagnosis of mediastinal widening.
The sensitivity, specificity, positive predictive value, and negative predictive value of supine chest radiography were 16.6%, 97.5%, 57.1%, and 85.5%, respectively.
Considering the high positive predictive value of supine CXR, it can be concluded that normal supine CXR could be highly suggestive of exclusion of mediastinal widening. CT scan remains the gold standard diagnostic method in patients with high clinical suspicion of mediastinal widening.

Mediastinal masses can occur at any age, but prevalence of them differs according to age. Studies show that the prevalence of malignant masses has increased recently. The aim of this study was evaluation of frequency of mediastinal masses according to the location, pathologic findings, and ages of them. This retrospective and descriptive study was done with pathological review of 87 patient's documents that had undergone surgery for a mediastinal masses in Emam Khomeini Hospital of Urmia. 53 patients were male and 34 of them were female. The frequency of tumor location were 52 cases (59.8%) in the anterior mediastinum, 13 (14.9%), more than one site, 11 cases (12.6%) posterior Mediastinum, 7 (8%) the upper mediastinum and 4 (4.6%) were in the middle mediastinum. The frequency of tumor pathology included 30 lymphomas (34.5%), Thymoma 8 (9.2%), germ cell tumor 6 (6.8%) and 2 (2.3%) neuroendocrine, the remained 29 (33.3%) patients hadother pathology. Differences between women and men in the type of tumors werestatistically significant. Neuroendocrine tumor in male and germ cell tumor in female was not reported. Anterior mediastinal tumors (47 cases) in order of frequency were included lymphoma (24 cases), Thymoma (7 cases), 5 cases of germ cell tumors and 11 patients with other pathology (benign lesions,metastasis,..). Middle mediastinal tumors (4 cases) were included lymphomas (1case), and 3 had otherpathgology. Posterior mediastinal tumors (9 cases) are included neuroendocrine tumors (2 cases) and 7 patients had other pathologies. Upper mediastinal tumors (5 cases) were included lymphoma (1case), and 4 had other pathology

Deep neck infections are relatively common and appear in the vicinity of the great vessels, organs and mediastinum. The aim of this study was to determine the epidemiology of deep neck infections among the hospitalized patients in Kashan Matini hospital. This cross-sectional study was carried out on patients hospitalized with the diagnosis of deep neck infections in Kashan Matini hospital from Sep 2006 to August 2007. Demographic data of the participants and the history and clinical findings of the disease were recorded using a questionnaire. Then to provide the smear, culture and antibiogram, the samples were taken from the infected area. Finally, the findings and treatment measures were recorded. Among the 66 participants (mean age: 34.48 ± 17.71), 27 (40.9%) were male and 39 female. The most common problems on admission were fever (70%), pain (67%), tenderness and dysphasia (52%), respectively. Regarding the etiology of the disease, the most common bacteria were mixed bacteria (39.39 %), anaerobic (33.33 %) and aerobic ones. Approximately two thirds of the patients underwent surgery had shorter lengths of hospital stay than the other patients (P=0.0002). Pritonsilar and submandible abscess, the most common infections among the patients in this hospital, are mostly associated with the early stages of tonsil and pharynx infections as well as the improperly performed dental procedures.

Medullary thyroid cancer (MTC) is a neuroendocrine tumor which originates from the parafollicular cells. The prognosis of MTC is poor and thyroidectomy can be effective. Castleman's disease or angiofollicular lymph node hyperplasia is an uncommon benign lymphoproliferative disorder. The most common form is hyaline vascular type which is usually asymptomatic and surgical resection often cures it. Case Report: The case was a 38-year-old male with a thyroid mass resected by surgery. The pathology of the mass was MTC. He returned with dyspnea and imaging revealed a mediastinal mass that was Castleman's disease as reported by pathology. MTC lesions can metastasize to regional lymph nodes but the pathology of the mediastinal mass was not metastatic. According to the literature, medullary thyroid cancer and Castleman's disease are not predisposing factors for each other up to now. This is the first case with simultaneous occurrence of these two diseases that might help to find a new etiology for them.

:Primary intrathoracic goiter, especially of posterior mediastinum were rare and were less than 1%. Primary intrathoracic goiters supplied by intrathoracic blood vessels. We introduce a patient who referred with a huge mass in the posterior mediastinum extended to the anterior superior mediastinum with a sign of dyspnea and chronic cough. This mass was easily removed through standard postrolateral thoracotomy and all the symptoms of the patient were resolved. The blood supply of mass arises from intrathoracic vessels.

The most common tumors of mediastinum are neurogenic tumors, while mediastinal tumors are common in adolescent and middle ages. Lymphoma is a common cause of mediastinal tumors in children. We observed an increase in prevalence of lymphoma in adults. This study was to evaluate mediastinal masses over 5 years duration.Subjects and The study was carried out over five years stated from 1382 (2003) in three sugery departments of Ahvaz University of Medical Sceinces, Iran. Patients with mediastinal mass were evaluated for age, gender, signs and symptoms, chest X-ray, chest CT scan and the methods of removal and the pathological reports of results of tissue samples. Sixty patients were evaluated and there was no difference in gender. Mediastinal masses were most common in 3rd and 4th decades of life. Anterior mediastinum was the most common involved site. Anterior mediastinotomy was the most common operation from which large tissue samples were taken from 78. 33 % and 51.67 % of the mediastinal masses were lymphoma. The best method to take large tissue of these tumors is anterior mediastinotomy. The most common pathology in mediastinal masses is lymphoma. Lymphoma must be suspected in young patients with fever, cough, dyspnea and a mediastinal mass.

The primary ectopic goiters of mediastinum, specially of posterior mediastinum is rare and estimated on 1% of the goiters of retro sternal and mediastinum and their blood supplies is from intra thoracic vessels.

We introduce a patient who referred with the complain of a huge mass in the anterior medistinum. His complain presented by dyspnea breathlessness and chronic cough at first. This mass was removed easily through collar incision and partial strernotomy. Throught surgery we found that blood supply of mass arised from thoracic vessels and inominate artery, with drainage to inominate vien. Following mass removal, all the symptoms of the patient were resolved.

we presented an uncommon true primary ectopic mediastinal goiter resected through a median strnotomy with complete excision and relief of all symptoms.

With regard to the mediastinum importance as a central region of thorax and its physiologic traffic of vital structures,the knowledge of mediastinal masses is necessary. This survey was conducted to determine the prevalence of different kinds of mediastinal tumors in patients who underwent surgical procedures at Taleghani hospital between 2002 and 2006. Methods & Materials: This is a descriptive sectional study that was done on the patients files and we used an information form containing variable factors such as kind of mass, place of mass, age, sex, metastasis, clinical signs. After gathering of information, data was analyzed by statistical soft ware. Among 318 nontraumatic thoracotomies performed in this period, 89 cases were mediastinal masses and most frequent masses were thymic (25.8%) and lymphoma (15.7%). Anterior mediastinum was the most common site affected 66.9% of patients. The average age was 28.2 years and 42% of patients were female. The most significant clinical signs were: Weight loss (60.5%), cough (42%), dyspnea (42 %), and chest pain (39.5 %). Metastasis occurred in 33.3% of patients and the most frequent sites were lung and pleural. The frequency of myasthenia gravis in thymoma was 73.7%. Patients with myasthenia gravies with normal thymus and thymectomy were excluded from the study. There was little difference between our statistical results and other studies (mass types frequencies and mediastinal compartments most involved by each type of this masses). The only exception was the high prevalence of tuberculosis lymphadenopathy in our study. Knowing of common location of mediastinal masses prevents unnecessary aggressive surgical procedures because masses like tuberculosis lymphadenopathy and lymphoma only needs tissue diagnosis and the definite treatments for such diseases are antibiotic and chemoradiation respectively.