1/3. Y-nitinol airway stent for management of central airway compression due to metastatic colon cancer.Tumor masses in the area between the esophagus and the tracheobronchial tree can lead to complications involving both systems, mainly strictures and compressions. Malignant esophageal strictures are nowadays often treated by insertion of a metal stent which, however, can cause airway compression especially in the proximal area. We present here a new method of creating a Y-stent out of two self-expandable tracheal nitinol stents, utilizing fiber bronchoscopy, in a 55-year-old woman with advanced colon cancer metastastic to the mediastinum. The endo-Y-stent technique can be performed with the patient under sedation and having topical anesthesia. The opening through which the second tracheal stent must be placed for the Y construction is created by laser. In this case, the patient suffered from airway compression which was efficiently relieved by this method. Within a short time the endo-Y-stent provides effective restoration and maintenance of airway patency in patients with tumor compression in the region of the esophagus and airway, and in those with airway compression following esophageal stenting. Expertise in both stent implantation and laser application is, however, mandatory.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/3. Pneumomediastinum as a complication to treatment of mediastinal (thymic) large B-cell lymphoma.Mediastinal (thymic) large B-cell lymphoma (Med-DLBCL) is a subtype of diffuse large B-cell lymphomas (DLBCL) with a typical radiological appearance of bulky anterior mediastinal mass, often with areas of necrosis. We report a case of Med-DLBCL with unusual radiological findings and clinical development. Computed tomography (CT) obtained at presentation revealed a huge anterior mediastinal tumor with an axial diameter of 180 mm. Nineteen days after the first cycle of chemotherapy, chest radiography and CT revealed large areas of tumor necrosis and pneumomediastinum with air-fluid levels. To our knowledge, air-fluid levels inside Med-DLBCL have not been previously described. This finding, in combination with necrotic sputum, may indicate communication between the tracheobronchial tree and the tumor.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/3. Invasive papillomatosis and squamous carcinoma complicating juvenile laryngeal papillomatosis.Juvenile laryngeal papillomatosis (JLP), usually a benign, self-limited disease, occasionally has a highly aggressive course characterized by extension of neoplastic cells into the tracheobronchial tree, lung, and soft tissues. Less frequently, squamous carcinoma has arisen in JLP, most commonly following radiation therapy. Rarely, carcinoma has occurred without previous irradiation, but distant metastases do not generally occur. We describe a 14-year-old boy, with a particularly aggressive form of JLP, who developed invasion of the lungs, intrapulmonary lymph nodes, and arteries by cytologically benign neoplastic tissue. He also developed a metastasizing squamous carcinoma of the lung and humoral hypercalcemia of malignancy. A discussion of the implications of the case and a review of the current literature are provided.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |