An 8-month old intact male Turkish Angora cat was referred to the Veterinary Medical Teaching Hospital (VMTH), Seoul National University, for an evaluation of anorexia and severe dyspnea. The thoracic radiographs revealed significant pleural effusion. A cytology evaluation of the pleural fluid strongly suggested a lymphoma containing variable sized lymphocytes with frequent mitotic figures and prominent nucleoli. The feline leukemia virus and feline immunodeficiency virus tests were negative. The cat was euthanized at his owner's request and a necropsy was performed. A mass was detected on the mediastinum and lung lobes. A histopathology evaluation confirmed the mass to be a lymphoma. Immunohistochemistry revealed the mass to be CD3 positive. In conclusion, the cat was diagnosed as a T-cell mediastinal lymphoma.
Animals ; Cat Diseases/*diagnosis/pathology ; Cats ; Lymphoma/diagnosis/pathology/*veterinary ; Male ; Mediastinal Neoplasms/diagnosis/pathology/*veterinary

Mediastinal ectopic thyroid is a very rare condition, with few reported cases in the literature and no reported cases in Korea. This report describes an asymptomatic 65-year-old man with a right paratracheal mass compressing the superior vena. Additionally, the epidemiology, clinical manifestation, diagnosis, and management of mediastinal ectopic thyroids are discussed. A mediastinal ectopic thyroid should be considered in the differential diagnosis of all mediastinal masses. Surgical excision is recommended for both the diagnosis and treatment of this condition, because of its potential for malignancy and compression of mediastinal structures. This case demonstrates the clinical importance of mediastinal etopic thyroid.
Aged ; Choristoma/*diagnosis ; Humans ; Incidental Findings ; Male ; Mediastinal Diseases/*diagnosis ; *Thyroid Gland

Abscess/diagnosis* ; Cardiac Tamponade/etiology* ; Humans ; Klebsiella Infections/diagnosis* ; Klebsiella pneumoniae ; Mediastinal Diseases/diagnostic imaging*

OBJECTIVETo determine the value of video-mediastinoscopy in clinical application.

METHODSThe clinical data of 54 patients receiving video-mediastinoscopy were reviewed retrospectively. This operation consisted of cervical mediastinoscopy in 44 patients, parasternal mediastinoscopy in 6, and combined procedures in 4. Of these patients, 18 underwent video-mediastinoscopy for the evaluation of undifferentiated mediastinal disease. Thirty-six patients with suspected lung cancer showed enlarged mediastinal lymph nodes radiographically in the chest and underwent video-mediastinoscopy.

RESULTSSeventeen of 18 patients with undetermined mediastinal diseases had a definitive pathologic diagnosis, with an accuracy of 94.4% (17/18). In the 36 patients with suspected lung cancer, 22 were positive, and 14 negative. In the negative patients who underwent thoracotomy with resection, mediastinal lymph nodes revealed no evidence of metastasis. There were no postoperative complication and deaths.

CONCLUSIONVideo-mediastinoscopy as a highly effective and safe procedure could be used in the diagnosis and staging of thoracic diseases.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; diagnosis ; Male ; Mediastinal Diseases ; diagnosis ; Mediastinoscopy ; Middle Aged ; Neoplasm Staging ; Thoracic Diseases ; diagnosis

Radiological analysis of chest lesions detected on chest radiographs or CT scans begins with their classification into parenchymal, pleural, or extrapleural lesions according to their presumed origin. The mediastinum is divided anatomically into the anterior, middle, and posterior mediastinal compartments, and localizing a mediastinal mass to one of these divisions can locationfacilitate their differential diagnosis. A differential diagnosis of a mediastinal mass is usually based on a number of findings, including its ; the structure from which it is arising; whether it is single, multifocal (involving several different areas or lymph node groups), or diffuse; its size and shape; its attenuation (fatty, fluid, soft-tissue, or a combination of these); the presence of calcification along with its characteristics and amount; and its opacification following the administration of contrast agents.
Classification ; Contrast Media ; Diagnosis, Differential ; Lymph Nodes ; Mediastinal Diseases* ; Mediastinal Neoplasms ; Mediastinum ; Pleural Diseases ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

Spontaneous pneumomediastnum has been reported only recently as a rare complication of dermatomyositis. We are reporting two cases of spontaneous pneumomediastinum in dermatomyositis. The diagnosis of dermatomyositis was based on the diagnostic criteria requiring symmetric weakness of limb-girdle muscles and anterior neck flexors, elevation of serum skeletal muscle enzymes, electromyograpic findings of inflammatory myopathy, positive findings on muscle biopsy and dermatologic features including heliotrope rash and Gottron s papule. Vasculitis may be the common denominator leading to the association of dermatomyositis and pneumomediasinum. In reported cases, the prognosis of pneumomediastinum seems unfavorable. Interestingly the 2 cases we are reporting resolved spontaneously without any recurrence.
Biopsy ; Dermatomyositis* ; Diagnosis ; Exanthema ; Lung Diseases, Interstitial ; Mediastinal Emphysema* ; Muscle, Skeletal ; Muscles ; Myositis ; Neck ; Prognosis ; Recurrence ; Vasculitis

Boerhaave's syndrome is difficult to diagnosis because of the esophageal rupture, which is caused by nausea and vomiting, and Boerhaave's syndrome is known to have a high mortality rate. The mortality increases with a delayed diagnosis; therefore, an early diagnosis and surgical treatment are critical for a good prognosis. Yet some recent cases have shown that non-surgical treatments are successful in some classified patient groups. These groups should be considered according to their symptoms and their laboratory and radiological findings. Sepsis and multi-organ failure should be continuously checked for to see if they occurred and/or progressed. We report here on a 51 year old woman who had Boerhaave's syndrome, and this was caused by heavy drinking, nausea and vomiting, and she improved with just non-surgical treatment such as fasting, antibiotics and endoscopic clipping.
Anti-Bacterial Agents ; Drinking ; Early Diagnosis ; Esophageal Perforation ; Fasting ; Female ; Humans ; Mediastinal Diseases ; Nausea ; Prognosis ; Rupture ; Sepsis ; Vomiting

We report here on a rare case of an ectopic pancreatic tissue in the anterior mediastinum. A 32-year-old woman without any symptoms was transferred to our hospital because of an abnormal large mediastinal shadow on her chest radiograph during a checkup. The computed tomography (CT) scan revealed a giant cystic-solid mass that measured 16 x 13 x 8 cm and it was located in the center of the anterior mediastinum and it symmetrically grew to two sides. On enhanced CT scans, the solid component of the mass showed marked enhancement. We performed total surgical resection of the mass and complete pancreatic tissues were verified on the pathological examination.
Adult ; Choristoma/*radiography/surgery ; Diagnosis, Differential ; Female ; Humans ; Mediastinal Diseases/*radiography/surgery ; *Pancreas ; Tomography, X-Ray Computed

Boerhaave's syndrome is spontaneous transmural perforation of the esophagus, which occurs most often after forceful vomiting or retching. This commonly occurs in the lower third of the esophagus but spontaneous perforation of the pharynx or cervical esophagus is extremely rare. This case presented a 20-yr-old healthy man with spontaneous pharyngeal perforation after forceful vomiting who had no history of instrumentation, cervical trauma, or having eaten anything sharp. Cervical pain and crepitus were the early symptom and sign of pharyngeal perforation and the rupture was detected on gastrografin swallow and CT examinations. The rupture site was higher than the upper esophageal sphincter, differing from Boerhaave's syndrome. The patient was conservatively managed without significant morbidity and mortality. Although this may resolve without surgical intervention, the pharyngeal rupture should receive early detection and clinical attention for preventing potential morbidity by late diagnosis.
Delayed Diagnosis ; Diatrizoate Meglumine ; Esophageal Perforation ; Esophageal Sphincter, Upper ; Esophagus ; Humans ; Mediastinal Diseases ; Neck Pain ; Pharynx ; Rupture ; Vomiting

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.
Adult ; Diagnosis, Differential ; Fluorodeoxyglucose F18/*diagnostic use ; Granuloma, Plasma Cell/*diagnosis ; Humans ; Male ; Mediastinal Diseases/*diagnosis ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed/*methods