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Clinical cases

Multiple bilateral traumatic pulmonary pseudocysts in a 53 year-old male diagnosed retrospectively

Mohammad Hossein Rahimi-Rad, Afshin Mohammadi
Multiple bilateral traumatic pulmonary pseudocysts in a 53 year-old male diagnosed retrospectively

Traumatic pulmonary pseudocyst (TPPC) is a rare complication, which  encountered after   thoracic trauma.  It is most  often  (75-100%) seen in  children  and  young  adults.  A 53 year-old male presented with multiple bilateral cysts after a motor vehicle accident. We evaluated the patient for abscess, tuberculosis, and Wegener's granulomatosis with negative results. Follow up chest X-rays showed spontaneous resolutions of pseudocysts with replacement with pneumatocele. In patients with recent chest trauma, TPPC should be kept in mind to prevent unnecessary invasive tests.

Key words: pulmonary pseudocysts, thoracic trauma

Mycobacterial mediastinal adenopathy

Alexandru Crisan, Voicu Tudorache, Ruxandra Laza, Alexandru Nicodin
Mycobacterial mediastinal adenopathy

Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an uncommon feature of intrathoracic tuberculosis in adults.

The authors present the case of a 64 year old man who developed prolonged fever and was admitted to Clinical Hospital of Infectious Diseases and Pneumophtisiology Dr.V.Babes Timisoara during 06.04-15.04.2009.

Diagnosis of mediastinal lymph node tuberculosis was established only after axillary thoracotomy and biopsy of tumoral mass, although the first results obtained after mediastinoscopy were negative. Dynamics of biological features, diagnostic pitfalls, differential diagnosis difficulties and peculiar aspects of evolution are presented.

Mediastinal tuberculous adenopathy, without associated pulmonary affection is a rare form of presentation among adults, generally evolving with sustained fever. Diagnosis of mediastinal tuberculosis is difficult due to non-specific clinical aspects and lack of characteristic radiographic features and so invasive diagnostic procedures gain importance (mediastinoscopy and biopsy).

Key words: prolonged fever, mycobacterial mediastinal adenopathy, thoracotomy

 

Remediastinoscopy current indications. A case report

Ciprian Bolca, Ana-Maria Sasu, Adrian Istrate, Genoveva Cadar, Olga Danaila, Cristian Paleru, Ioan Cordos
Remediastinoscopy current indications. A case report

Current indications for remediastinoscopy include an inadequate first procedure, recurrent and second primary lung cancer, lung cancer occurring after an unrelated disease such as lymphoma, and restaging after induction therapy. Nowadays, restaging is the most frequent indication for remediastinoscopy. We present the case of a 42 years old male with a mediastinoscopy performed in another surgical unit 4 months before being admitted in our department. The CT scan showed bulky mediastinal lymph node enlargement, in evolution compared with the prior one, and no other lesions in the lung parenchyma. As the histopathological examination from the first specimen was negative, a diagnosis was requested in order to allow a correct treatment. A remediastinoscopy was successfully performed and avoided a more invasive procedure.

Key words: remediastinoscopy, restaging of lung cancer