Pulmonary inflammatory pseudotumor is the most common primary lung mass seen in children, but extraparenchymal involvement is relatively rare. We report here on a case of inflammatory pseudotumor involving the mediastinum and the pulmonary artery. A 48-year-old man presented with enlargement of the right hilum on a simple chest radiograph. He had a history of exertional dyspnea for 1 year. A non-homogeneous enhancing mass was noted in the right pulmonary artery on computed tomography. Mediastinotomy and pulmonary artery angiography with a forcep biopsy revealed inflammatory pseudotumor of the mediastinum and pulmonary artery.
Angiography ; Biopsy ; Child ; Dyspnea ; Granuloma, Plasma Cell* ; Humans ; Lung ; Mediastinum ; Middle Aged ; Plasma Cell Granuloma, Pulmonary ; Pulmonary Artery* ; Radiography, Thoracic ; Surgical Instruments

Intracranial epidermoid cysts usually show homogeneous hypodensity on CT scans, hypointensity on T1-weighted MR images and hyperintensity on T2-weighted MR images. Most of them arise in the cerebellopontine angle and parasellar areas. We report a case of middle cranial fossa epidermoid tumor with unusual image findings. The entire tumor mass showed inhomogeneous low density, without any enhancing solid portion on the CT scans. The lateral portion of the tumor showed homogeneous T1 low signal intensity and T2 high signal intensity. The medial portion of the tumor showed heterogeneous T1 and T2 intermediate to high signal intensity. On the gadolinium enhanced MR images, enhancement of the thickened dura was observed behind the tumor. Surgery and pathologic examination revealed the presence of an extradural epidermoid cyst.
Cerebellopontine Angle ; Cranial Fossa, Middle* ; Epidermal Cyst* ; Gadolinium ; Tomography, X-Ray Computed

BACKGROUND: Cardiopulmonary bypass(CPB) induces the productions of several inflammatory mediators that may be implicated in postoperative organ dysfunction, a problem to which the pediatric population is particularly prone. The purpose of this study was to determine if gene expressions of proinflammatory cytokines and chemokines were activated in plasma subjected to pediatric patients who underwent CPB for congenital heart diseases. MATERIAL AND METHOD: Blood was taken from the radial artery of eighteen pediatric patients after induction of anesthesia(baseline), immediately after CPB(0 hour), 2 hours, 24 hours, and 48 hours after CPB. The mRNA expressions of interleukin-1alpha (IL-1alpha ), Interleukin-1beta(IL-1beta), Interleukin-6 (IL-6), Interleukin-8(IL-8), Tumor necrosis factor-alpha (TNF-alpha ), Interleukin-15(IL-15), and Interferon-gamma(INF-gamma) were evaluated with semiquantitative reverse transcription-polymerase chain reaction(RT-PCR). IL-6 protein levels were measured in six patients by using enzyme-linked immunosorbent assay(ELISA.) RESULT: Systemic IL-6 mRNA and protein increased from baseline to a peak at 0 hour(239.5 pg/ml; p=0.01 versus baseline) and sustained at 2 hours before declining at 24 hours(82.7 pg/ml; p<0.05 versus 0hour). In IL-8 mRNA, there was a similar pattern but the increase was smaller than that of IL-6. IL-1 and IL-1 mRNA expressions peaked later(2 hours) from baseline, and declined by 48 hours. TNF- levels peaked at 24 hours, and declined by 48hours. There were no significant differences between before and after bypass were seen in IL-15 mRNA production. IFN- levels gradually decreased during the course of time. CONCLUSION: Gene expressions of IL-6, IL-8, IL-1alpha , IL-beta and TNF-alpha were changed significantly in plasma of pediatric patients who underwent CPB for congenital heart disease. IL-15 showed a different proinflammatory. response, and reverse responses were shown in IFN-gamma mRNA expression. These may result in high concentrations of proinflammatory cytokines and chemokines in the blood after CPB, contributing to the tissue injury.
Cardiopulmonary Bypass ; Chemokines* ; Cytokines* ; Gene Expression* ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Interleukin-1 ; Interleukin-15 ; Interleukin-1alpha ; Interleukin-6 ; Interleukin-8 ; Plasma ; Radial Artery ; RNA, Messenger ; Tumor Necrosis Factor-alpha