Introduction:. A woman with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x-rays and ct thorax revealed a mass in mediastinum. Case Description: Patient is a 24 years old female with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x rays and CT thorax revealed a mass in mediastinum. Open biopsy on right neck mass and transthoracic FNAB resulting of chronic inflammation, so the patient was diagnosed with glandular tuberculosis and Mediastinal Tumor. Patient was getting worse after one month consuming OAT. Patient was consulted to Cardiovascular and thorax Surgery Department. Patient was performed thoracotomy and debulking. Anatomical pathology was examined from debulking mass, the result of immunohistochemistry was found nodular mediastinal gray zone lymphoma. Discussion: this case it is very difficult to enforce the diagnosis. Patients have done neck FNAB, transthoracic FNAB, open biopsy right neck mass and FOB have not been able to establish diagnosis. Until finally done thoracotomy and debulking in this patient, from immunohistochemistry results obtained nodular sclerosis Hodgkin lymphoma. Collaboration from pulmonologist, radiologist, cardiovascular and thorax surgeon, and patology anatomy specialist is needed to confirm the diagnosis in these patients.
Background: Chylothorax is a rare condition caused by accumulation of chyle in the pleural cavity (2-3%). More rare causes are Gorham's disease and tuberculosis Case: A 31-year-old male complained of swelling left arm and shortness of breath with recurrent pleural effusion. Pleural fluid analysis showed chylous. Bone survey showed osteolytic lesions of multiple bones as Gorham's disease. Thoracic CT showed left lung mass, atelectasis, massive fluidothorax, ipsilateral supraclavicular lymphadenopathy, destructive left scapula. Needleaspiration of left humerus revealed lymphangioma. Expert Mtb-Rif examination revealed Mtb detected. We assessed Gorham'sdisease, lymphangioma and lung tuberculosis with complication recurrent chylothorax and was treated anti-tuberculosis, anti-osteolytic and thorax catheter insertion. Conclusion: Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis. Keywords: Chylothorax, Gorham's Disease, Tuberculosis
Mediastinal lymphohemangioma is a very rare, benign, congenital malformation. Mediastinal lymphohemangioma originates from local proliferation of lymphatic vessels. This disorder is accountable for 4.5% among all mediastinal tumors. Most lymphohemangiomas are found in the neck and axillary region among children, whereas only 1% are found in the mediastinum and tend to occur in individuals aged over 20 years old. A proper understanding is needed to be able to make a diagnosis and perform effective management of mediastinal lymphohemangiomaIn this case report, a woman with a diagnosis of mediastinal lymphohemangioma, established through a multidisciplinary approach covering the fields of pulmonology, thoracic and cardiovascular surgery, radiology, and anatomical pathology.
Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, most patients will die after 3 years of diagnosis despite aggressive multimodality therapy. Case Description: A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlarging lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patient had Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma. Discussion: Sarcomatoid carcinoma is a type of thymic carcinoma that has both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This case was interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in this patient.
Background: Thymoma is a rare neoplasm. This incident is comparable to 390 new cases reported per year. Genetic factors are believed to be one of the factors of B3 thymoma and thymus carcinoma. Multimodality of thymoma therapy (surgery, radiation and chemotherapy) gives better results. Case Report: Mr A, 29 years old, with initial diagnosis of stage IV thymoma (according to Masaoka) with SVKS then undergo debulking, followed by chemotherapy with a regimen of Cisplatin + Vincristin, Cyclophospamid, Doxorubicin, Prednison every 21 days as much as 6 times. Subjective responses indicated by reduced complaints of chest pain and loss of swelling of the right arm. Semisubjective response indicated by increase of body weight. Objective response is progressive, so can be continued with second line chemotherapy or radiotherapy. Conclusion: The prognosis of patient with well differentiated thymic carcinoma stadium iv (thymoma b3) complicated with vena cava superior syndrome was poor because of the objective response of the chemotherapy was progressive, and the relapse case was higher.
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