A malignant peripheral nerve sheath tumor (MPNST) is an extremely rare soft tissue tumor in the general population. On the other hand, there is a higher incidence of MPNST in patients with neurofibromatosis type I (von Recklinghausen's disease). The common sites are the extremities, trunk, head and neck. However, an intraabdominal or intrathoracic manifestation is uncommon. This paper reports two patients, a 31 year-old woman with multiple neurofibromatosis presenting as an intraabdominal malignant peripheral nerve sheath tumor, and a 33 year-old woman with an intrathoracic malignant peripheral nerve sheath tumor. The patients were treated with chemotherapy followed by radiotherapy. However, one patient died as a result of disease progression 21 months after the diagnosis and the other patient is currently being treated with radiotherapy.
Abdominal Neoplasms/*diagnosis ; Adult ; Female ; Humans ; Nerve Sheath Tumors/*diagnosis ; Neurofibromatosis 1/*complications ; Thoracic Neoplasms/*diagnosis

Aberrant breast tissue is usually found in proximity to the normal breast, that is, in the axillary, sternal or clavicular regions. Carcinoma occurs more frequently in the aberrant tissue of the axilla than the extra-axillary site though the overall incidence of tumors of aberrant breast tissue is low. To our knowledge, studies regarding the carcinoma of aberrant breast tissue of the extra-axillary site have been reported rarely. Here we report a recent case of carcinoma originating from the extra-axillary aberrant breast tissue, presenting as a subcutaneous nodule on the right upper anterior chest wall. It is suggested that subcutaneous nodules of uncertain origin around the periphery of the breast should be suspected for breast carcinoma as a differential diagnosis and treated properly.
Breast Neoplasms/*diagnosis ; Choristoma/*diagnosis ; Diagnosis, Differential ; Female ; Human ; Middle Age ; Thoracic Neoplasms/*diagnosis ; Tomography, X-Ray Computed

Aorta, Thoracic ; abnormalities ; Esophageal Neoplasms ; diagnosis ; Humans ; Leiomyoma ; diagnosis ; Male ; Middle Aged

OBJECTIVE: To discuss the diagnosis and treatment of child cervical and thoracic angio lymphoma. METHOD: Three cases of huge cervicothoracic angio lymphoma were performed by cervicothoracic approach and median split of sternum under general anesthesia. RESULT: The pathological diagnosis of three cases were angio lymphoma, and there was no recurrence and complication during the follow-up. CONCLUSION The tumor could be fully exposed by cervicothoracic approach operation, which was the basic guarantee for completely revealed tumor, and no recurrence was found. Other treatment should not be recommend for huge cervicothoracic angio lymphoma.
Child ; Child, Preschool ; Female ; Humans ; Lymphangioma ; diagnosis ; surgery ; Male ; Neck ; Thoracic Neoplasms ; diagnosis ; surgery

Mammary-type myofibroblastoma of the soft tissue is a benign mesenchymal tumor, and it is a recently established clinical entity. We report a case of myofibroblastoma of the chest wall with a prominent epithelioid feature, that occurred in a 12-year old female. Although the lesion occurred in the breast area, there was no breast parenchyma in or around the mass, which favored soft tissue of the chest wall origin. The tumor was immunohistochemically identical to the mammary-type myofibroblastoma with diffuse and strong positivity against CD34 and desmin. The myoepithelial differentiation of the tumor was further supported by the electron microscopic analysis. This case indicates that mammary-type myofibroblastoma can occur in a young girl. The mammary-type myofibroblastoma should be considered a differential diagnosis, among epithelioid soft tissue neoplasms in the chest wall when the proper immunohistochemical work-up is done.
Breast ; Child ; Desmin ; Diagnosis, Differential ; Female ; Humans ; Neoplasms, Muscle Tissue* ; Soft Tissue Neoplasms ; Thoracic Wall* ; Thorax*

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

A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy.
Diagnosis, Differential ; Humans ; Male ; Meningeal Neoplasms/*diagnosis ; Meningioma/*diagnosis ; Spinal Cord Diseases/*diagnosis/surgery ; Thoracic Vertebrae ; Tuberculoma/*diagnosis/surgery ; Tuberculosis, Meningeal/*diagnosis/surgery ; Young Adult

PURPOSE: To compare the precise roles of high-resolution computed tomography (HRCT) and fiberoptic bronchoscopy (FOB) in the evaluation of patients presenting with hemoptysis and to determine the optimal timing for HRCT. MATERIALS AND METHODS: The results of HRCT and FOB were compared in 23 patients (15 men, 8 women) presenting with hemoptysis. Etiologies included bronchietasis (n=4), parenchymal pulmonary tuberculosis (n=4), lung cancer (n=4), endobronchial tuberculosis (n=2), and broncholithiasis (n=2). Hemoptysis was proved to be due to miscellaneous causes in an additional three cases and to be cryptogenic in four. The diagnostic results of FOB performed before and after HRCT were compared as were those of HRCT performed within and after the first 48 hours of active bleeding. RESULTS: FOB and HRCT offered a correct diagnosis in 39% and 65% of cases, respectively (p=0.005). HRCT demonstrated three cases of bronchiectasis and three of parenchymal pulmonary tuberculosis which were beyond the range of a bronchoscope. In two of five cases in which HRCT findings were nonspecific, chondromatous hamartoma and lung cancer were confirmed by FOB. In cases where HRCT was performed prior to FOB, the latter demonstrated the location and diagnosis in 82% and 47% of cases, respectively (p=0.303) ; when HRCT was performed after FOB, HRCT was correct in 67% and 17% of cases, respectively (p=0.178). In none of three cases (0%) in which HRCT was performed during the first 48 hours of active bleeding did the procedure allow a specific diagnosis. In 15 of 20 (75%) cases in which HRCT was performed after the first 48 hours, however, the diagnosis provided by CT was correct. CONCLUSION: The results of this study suggest that in patients presenting with hemoptysis, both HRCT and FOB should be used for evaluation, since they are diagnostically complementary. FOB is more useful for the diagnosis of endobronchial lesion, and HRCT for bronchiectasis and parenchymal pulmonary tuberculosis. If, in cases of hemoptysis, initial diagnosis is attempted within the first 48 hours of active bleeding, FOB should be the initial step, and HRCT images should not be obtained until active bleeding has been shown on plain chest radiograph to have abated. If this initial approach takes place after the first 48 hours of active bleeding, FOB and HRCT are equally suitable.
Bronchiectasis ; Bronchoscopes ; Bronchoscopy* ; Diagnosis ; Hamartoma ; Hemoptysis* ; Hemorrhage ; Humans ; Lung Neoplasms ; Male ; Radiography, Thoracic ; Tuberculosis ; Tuberculosis, Pulmonary

Cardiomegaly is a commonly encountered clinical presentation on simple chest radiographs, and it usually indicates the enlargement of one or more cardiac chambers. However, cardiomegaly less commonly comes from abnormalities in the structures adjacent to the heart, including pericardial effusion, enlarged great vessels, or mediastinal tumors. Pericardial lipoma is a rare primary cardiac tumor that can grow to a large size by the time of diagnosis and result in huge cardiomegaly because of a lack of symptoms. Here, we report a rare case of giant pericardial lipoma that presented as huge cardiomegaly on simple chest radiographs. Multi-modality cardiovascular imaging, including echocardiography and cardiac magnetic resonance imaging, played a key role in the diagnosis and development of a therapeutic treatment plan for the present case.
Cardiomegaly* ; Diagnosis ; Echocardiography ; Heart ; Heart Neoplasms ; Lipoma* ; Magnetic Resonance Imaging ; Pericardial Effusion ; Pericardium ; Radiography, Thoracic

A mass excision surrounding the bronchial stump was performed to exclude malignancy in a 42-year-old man who had undergone a right lower lobectomy for lung cancer. The mass was identified as a cicatricial fibroma. Cicatricial fibromatosis, which is desmoid fibromatosis that arises in a surgical scar, is a well-known clinical condition. It consists of histologically benign neoplasms. Their occurrence after thoracic surgery is extremely rare. Biopsy or excision of suspicious lesions is very important for diagnosis. R0 resection remains the principal outcome for intra-thoracic desmoid fibromatosis. We report that a cicatricial fibromatosis in the subcarinal space was removed after suspicion of local recurrence at the bronchial stump follwing lobectomy for lung cancer.
Adult ; Biopsy ; Cicatrix ; Diagnosis* ; Fibroma* ; Fibromatosis, Aggressive ; Humans ; Lung Neoplasms* ; Lung* ; Recurrence* ; Thoracic Surgery