11/67. Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis.A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
12/67. Multicystic mesothelial cyst of the mediastinum: report of a case.We report the rare case of a multicystic mesothelial cyst of the mediastinum. A 43-year-old man was referred to our department after a routine chest X-ray showed an anterior mediastinum mass. The lesion was resected by thoracoscopy, which revealed multicystic, thin-walled tense masses arising in the anterior mediastinum. The cysts were not adherent to the pericardium or to the thymus of the right lobe. immunohistochemistry revealed that the cyst was lined with a layer of mesothelial cells and there were no malignant foci. The lining cells were positive for keratin and negative for the lymphocyte marker. These findings were consistent with a diagnosis of multicystic mesothelial cyst.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
13/67. Rhabdomyomatous multilocular thymic cyst.The thymus is the seat of a diverse array of pathologic conditions given its embryologic roots. Multilocular thymic cysts, although well described, are uncommon, and one associated with rhabdomyomatous elements has not been described previously. A 15-year-old boy complained of sudden-onset chest pain of a month's duration, but was otherwise well. Chest radiographs localized the mass to the anterior mediastinum, arising from the thymus. A computed tomography scan demonstrated the lesion to be a multilocular fluid-containing cyst. A large, 15-cm cyst contiguous with the thymus was removed. Histologic evaluation confirmed a multilocular cyst lined mainly by mucinous epithelium with focal areas of ciliated and squamous lining. A prominent finding was skeletal muscle elements in the form of spider cells, strap-like cells, and foci reminiscent of fetal-type muscle with cross-striations. At the periphery of the cyst, thymic tissue with branching ducts and Hassall corpuscles were noted. No evidence of skin and/or its appendage structures, cartilage, or other differentiated tissue was seen despite generous sampling of the specimen. The muscle elements, most likely, were derived from thymic myoid cells, while the multilocular cyst arose from remnants of the thymomedullary system.- - - - - - - - - - ranking = 0.81573913262352keywords = chest pain, chest (Clic here for more details about this article) |
14/67. Thoracoscopic excision of mediastinal bronchogenic cyst: a case report and review of literature.Thoracoscopic resection of mediastinal cysts results in less postoperative pain, shorter hospital stay and better cosmetic outcome when compared to the standard thoracotomy. We report successful thoracoscopic resection of a mediastinal cyst in a 17-year-old male who presented with right-sided chest pain.- - - - - - - - - - ranking = 0.81573913262352keywords = chest pain, chest (Clic here for more details about this article) |
15/67. Pericardial cysts in children: surgical or conservative approach?The authors present a case of an 11-year-old boy with a history of mild asthma and cough who underwent radiographic examination of the chest. The radiograph showed a round, discrete mass in the right cardiophrenic angle. The patient underwent thoracoscopic excision, and histologic examination found a unilocular, pericardial cyst. The possible causes of mediastinal masses and an argument for their surgical removal is presented.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
16/67. Detection of retained surgical sponge by transthoracic and transesophageal echocardiography.We describe an unusual case of extracardiac mass in a patient who was assymptomatic and submitted to an open-chest coronary artery bypass operation 5 years previously. Transthoracic and transesophageal echocardiography revealed a rounded mass compressing the right atrium with a thick contour surrounding a heterogeneous center, suggestive of foreign body. magnetic resonance imaging identified the mass as a pericardial cyst. Operation revealed a fibrinous cyst encapsulating a sponge. This case illustrates the central role of echocardiography for the diagnosis and treatment of patients with suspected retained surgical sponges.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
17/67. Pericardial cyst: case reports and a literature review.Pericardial cysts are rare mediastinal abnormalities, which are usually congenital but may also be acquired after cardiothoracic surgery. cysts frequently occur in the right cardiophrenic angle and their diagnosis is usually suspected after an abnormal chest X ray is obtained. The presence of a pericardial cyst in this typical location or, less frequently, in an unusual location, poses a diagnostic challenge in distinguishing it from other intracardiac or mediastinal abnormalities. Two-dimensional echocardiography and transesophageal echocardiography are extremely valuable in diagnosing the presence of a pericardial cyst. Although most pericardial cysts are asymptomatic, patients may present with chest pain and dyspnea. In addition, life-threatening complications such as pericardial tamponade have been reported in association with pericardial cysts. The following cases illustrate the usefulness of two-dimensional echocardiography in making an accurate diagnosis of a pericardial cyst, as well as in follow-up of these patients for the development of possible complications.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
18/67. Familial thymic cyst.Thymic cysts are rare lesions of the anterior mediastinum or neck. The majority are asymptomatic, and the remainder are associated mainly with symptoms of dysphagia or dyspnea. diagnosis is difficult before surgery. Cervical thymic cysts are relatively rare; age at presentation ranges from the neonatal period to adulthood, and the most frequent presenting sign is a lateral neck mass. Mediastinal thymic cysts are more common and account for 1% of all mediastinal masses. They tend to occur in the older age group and are usually detected incidentally on chest x-ray film or computed tomography scans. Dysphagia and dyspnea are the main symptoms. We describe two brothers, aged 5 and 8 years, with mediastinal thymic cysts that presented as low cervical masses and review the embryology, diagnosis and management of thymic cysts.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
19/67. mediastinal cyst with rim calcification.A 58-year-old man who had been undergoing treatment for chronic pericarditis for 15 months was found to have a calcified mediastinal mass shadow on a chest X-ray and was referred to us for further study and treatment. Chest computed tomography and magnetic resonance imaging showed an anterior mediastinal multilocular tumor with rim calcification. Tumor markers were within normal limits. The patient was preoperatively diagnosed as having a calcified mediastinal cyst, and median sternotomy was performed to remove the cystic tumor and the surrounding thymic tissues. Histological examination revealed that the cyst wall consisted of dense fibrous tissue and calcification without epithelial cell lining on the inner surface. Thymic tissue was present around the cyst wall. Although we suspected a thymic cyst from the intraoperative findings, the final diagnosis was made as mediastinal cyst with rim calcification. We herein present a rare case of mediastinal cyst with rim calcification.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
20/67. Mediastinal pancreatic pseudocyst with recurrent pleural effusion. Demonstration by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan.Mediastinal pseudocysts of internal pancreatic fistulas are rare as a cause of bilateral pleural effusions even in relapsing pancreatitis. We describe a 38-year-old man with recurrent bilateral pleural effusion as a complication of a pancreatic pseudocyst. Extension of a pancreatic pseudocyst into the posterior mediastinum was clearly identified by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan of the abdomen and chest, and the complication was successfully treated by surgical management. We stress the importance of definite assessment of the communication of pancreatic pseudocyst with mediastinum in patients with pancreatitis who develop recurrent pleural effusions.- - - - - - - - - - ranking = 0.18426086737648keywords = chest (Clic here for more details about this article) |
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