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Clinical Cases

Coexistence of mediastinal adenopathies of different etiologies - case report

Anca Macri1, Ancuţa Constantin1, Ion Cordoş2, Radu Stoica3
1. Secţia III de Pneumologie, Institutul de Pneumoftiziologie „Marius Nasta” Bucureşti. 2. Secţia de chirurgie toracică, Institutul de Pneumoftiziologie „Marius Nasta” Bucureşti. 3. Secţia A.T.I, Institutul de Pneumoftiziologie „Marius Nasta” Bucureşti

Coexistence of mediastinal adenopathies of different etiologies - case report. The paper presents the case of a 52-year-old Caucasian female with several comorbidities (diabetes mellitus II, transitory ischemic stroke, sarcoma of uterus - operated, chemotherapy), which was addressed to the pneumology department for the diagnosis of sarcoidosis, established through mediastinoscopy followed by histopathological examination of lymph node biopsies. Further investigations performed in our department sustained the diagnosis of stage I sarcoidosis and expectative without systemic corticotherapy was the clinicians' decision. The follow-up during several months showed spontaneous remission of the mediastinal adenopathies except one, in the medium lobe, which was supposed to have other ethiology than sarcoidosis. Surgical excision of this tumor and several lymph-node biopsies was performed through right thoracotomy; the histopathological exam sustained the diagnosis of "ganglionar metastasis from endometrial sarcoma", but immunohistochemical tests showed that it was a "sclerosing hemangioma of the lung" - tumor with benign evolution. The coexistence of adenopathies of different and rare etiologies make this case interesting, the different evolution of these adenopathies suggested the different morphological pattern of them.

Keywords: sarcoidosis, adenopathies, uterine sarcoma, sclerosing hemangioma of the lung