Value of sonography in monitoring the therapeutic response of mediastinal lymphoma: comparison with chest radiography and CT (original) (raw)
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Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2005
The study points out the value of CT scan in the investigative algorithm of mediastinal lymphomas. Thirty-eight cases of mediastinal malignant lymphoma were evaluated in a statistical retrospective study. CT scan was used for staging the disease in 25 cases and for post-therapeutic evaluation in the other 13 cases. The CT scan for staging purpose has shown the presence of significant isolated and confluent enlarged lymph nodes in the mediastinum in all 25 cases. Post-therapeutic evaluation of the 13 cases examined by CT showed six remissions, five reductions of lymph node masses and two extra nodal extensions. CT scan is the imaging method of choice in the clinico-morphological and anatomical assessment of mediastinal lymphomas.
Respirology Case Reports, 2015
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is highly accurate in diagnosing mediastinal lymphadenopathies of lung cancer and benign disorders, with the advantage that it is a minimally invasive technique, unlike open surgery and mediastinoscopy. However, the diagnostic accuracy of EBUS-TBNA for the diagnosis of lymphoma in patients with mediastinal lymphadenopathy is not well defined. The lack of tissue architecture obtained by cytological needles decreases the diagnostic accuracy for diagnosis and subtyping of de novo and relapsed mediastinal lymphomas. We present the first described case in the literature of an anaplastic large cell lymphoma relapsed, diagnosed on tissue fragments obtained by EBUS-TBNA with the particularity of using a histological needle.
Mediastinal Mass as a Prognostic Factor of Hodgkin Lymphomacase Review
Acta medica …, 2008
Many studies have researched the prognostic factors of Hodgkin disease. Up date, seven most important prognostic factors have been defined. Among them, as an important negative prognostic factor, the dissemination of the disease at the moment of diagnosis stands out. The aim of this study was to determine the influence of the presence of mediastinal mass greater than a third of the chest diameter in Hodgkin lymphoma on the disease outcome. In this study, an 18-year-old patient P.A. was presented. At the time of diagnosis, the patient had Bulky disease. Mediastinal mass was observed by radiography, computed tomography, ultrasound of the heart. The patient was treated with ABVD, GDP, BEACOPP, miniBEAM protocol and mediastinal radiation. In this patient, the mediastinal mass persisted in spite of the therapy. The course of disease deteriorated due to the presence of resistant pericardial effusion, and the patient died three years after.
Mediastinal lymphomas – A clinicopathologic study
Background: Mediastinal lymphomas are relatively uncommon lesions that sometimes pose an interesting diagnostic and therapeutic problem for the clinician. A multifaceted approach to both disease definition and diagnosis, as proposed by the Revised European and American Lymphoma (REAL) classification and updated in the WHO classification is now considered the state of the art. Objective: To classify and evaluate the histomorphology of mediastinal lymphomas and correlate the clinical findings with radiological, immunohistologic and other laboratory parameters. Method: A 5 year study was done in Dept. of Pathology, of a private Medical College on mediastinal lesions. Total number of cases studied was 66, with lymphomas making up 8 cases. Histopathology sections taken were stained with routine Hematoxylin and Eosin stains. Immunohistochemistry was done as required. Results: The age range of patients with mediastinal lymphomas were 12 to 80 years with a mean of 41 years. All non-Hodgkin’s lymphomas (NHL) were NHL-B cell type and were in the older age group. Three out of the four cases of Hodgkin lymphoma (HL) were mixed cellularity type and the fourth was nodular sclerosing type. The HLs were seen in a younger age group. Immunohistochemistry was done in all cases to confirm the diagnosis. Conclusion: Mediastinal lymphomas are rare & interesting neoplasms, usually located in all compartments of mediastinum. A histomorphological analysis aided by immunohistochemistry and radiology permits an exact diagnosis in many cases. Keywords: Hodgkin lymphoma, Mediastinum, Non-Hodgkin lymphoma
Background :Mediastinal cavity (anterior middle and posterior mediastinum) harbours many vital organs,nerves and vessels of the body and hence can give rise to various mass lesions arising from those organs, both benign and malignant. According to percentage of incidence lymphomas and germ cell tumor top the list.Even though imaging helps to localise the lesion histopathological examinations in the form of image guided trucut biopsy still happens to be the gold standard. However, early diagnosis of these lesions along with further categorisation and grading needs to be done promptly to start treatment and benefit the patients.This study presents an array of such cases with special emphasis to mediastinal lymphoma and their clinico pathologic correlation over a small period of time. Material And Methods : A cross sectional observational study was done in RGKar medical college over a period of 2 years. CT scan was done along with other imaging techniques to localise the mediastinal mass lesions and then guided tru cut biopsy was done for confirmation,categorisation and grading of the lesions. Immunohistochemistry was done as and when required. Result: All the avialable.information were meticulously documented in a grand chart along with other variables like age, sex, addictive habbits, presenting complaints, anatomical location etc. Spss software was used to calculate statistical significance if any,of these variables with the final etiology or histological dignosis. Conclusion : Lymphomas constitute a considerable peecentage of mediastinal masslesions.This study help in early diagnosis, classification, topographical, demographical and symptomatic correlation help us in initiating early treatment and will be beneficial to the patients in more than one ways.
European Journal of Cardio-Thoracic Surgery, 1992
We selected 95 patients with mediastinal adenopathy and no signs of goiter, myasthenia gravis or mediastinal involvement by other disease. All patients underwent, for screening purposes, transthoracic fine needle aspiration biopsy based on chest x-ray and CT findings. Patients were then subdivided into 4 groups. One group of 22 patients with prevalent anterior mass localization underwent anterior mediastinotomy. One group of 19 patients with prevalent middle mediastinal mass localization underwent cervical mediastinoscopy. Two other groups of 27 patients each with both anterior and middle mediastinum localization randomly underwent anterior mediastinotomy or mediastinoscopy. Fifty-one Hodgkin's and 44 non-Hodgkin's lymphomas were diagnosed in total. In 11 cases (11.57 %), median sternotomy (2) or thoracotomy (9) were necessary for establishing the final diagnosis. The overall diagnostic accuracy was 80.43% for cervical mediastinoscopy and 95.91% for anterior mediastinotomy. The statistical analysis performed on all patients showed a significant difference (X2 = 5.56, P < 0.025, df = 1) between the two procedures.
European Journal of Radiology, 2006
Objective: To describe the computed tomography (CT) features at diagnosis and after treatment of adenocarcinoma of unknown primary (ACUP) mimicking lymphoma of the mediastinum. Methods: Fifteen patients with pathologically proven ACUP and with primarily mediastinal involvement were initially referred to the Hematologic Department of our institution with a suspected diagnosis of lymphoma, and accounted for our study population. Presenting symptoms and baseline biological values were analyzed. All thoraco-abdominal CT studies were reviewed for the location and size of the mediastinal involvement and associated findings. Follow-up chest CT was performed in 14 patients after radiotherapy, chemotherapy or surgical treatment. Results: The most frequent CT feature was a large anterior and middle mediastinal mass (67%), with no calcification. Associated findings included the presence of lung nodules (40%), compression of large mediastinal vessels (33%) and pleural effusion (27%). Follow-up CT, performed in 14 cases, suggested partial or complete responses in 7 patients (50%) 4 weeks after the treatment onset. Conclusions: Mediastinal ACUP is a differential diagnosis of large mediastinal masses and is frequently associated with lung nodules and mediastinal vascular compression.