Dyspnoea, thoracic pain and fever in a young caucasian female: A case report
| Autor: | Elisabetta Zinellu, Alessandra Cancellieri, Alessandro G. Fois, Pietro Pirina, Silvia Negri, Rocco Trisolini, Alessandra Garau, Giorgio Carlo Ginesu |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Mediastinal mass Lymphadenopathy Physical examination Malignancy Article 03 medical and health sciences 0302 clinical medicine Chest CT CT Computer tomography ED Emergency department Biopsy Case report medicine HL Hodgkin’s lymphoma PET Positron emission thomography Pathological medicine.diagnostic_test business.industry Emergency department medicine.disease Lymphoma medicine.anatomical_structure 030228 respiratory system 030220 oncology & carcinogenesis Surgery Radiology Presentation (obstetrics) business Thoracic wall |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • The diagnostic approach to patients with mediastinal pathology is not always simple. • Mediastinal masses should always be considered to be potentially malignant. • Surgical biopsy could be the only way to correctly diagnose mediastinal mass. Introduction The diagnostic approach to patients with mediastinal pathology is not always simple and an improper diagnostic work-up can lead to significant diagnosis delay. Presentation of case : We report on the case of a young woman who was admitted to the Emergency Department complaining of thoracic pain, dyspnoea, fever and productive cough. The physical examination showed a painful swelling over the sternum’s upper left margin, which had become evident 4 months earlier. A Computer Tomography showed the presence of a retrosternal oval lesion (5.5 x 4 cm) infiltrating the thoracic wall and showed the presence of discretely enlarged mediastinal lymph nodes in several mediastinal stations. Discussion The Multidisciplinary Team decided to perform an ultrasound-guided biopsy of the retrosternal mass that showed an inflammatory pattern, whereas microbiology tests proved negative. The lack of improvement with medical therapy (non steroideal anti-inflammatories and antibiotics) and the clinical suspicion of malignancy led us to perform a surgical biopsy of the mass that finally proved to be diagnostic for Hodgkin’s lymphoma. Conclusions Mediastinal masses with an aggressive behavior, should always be considered to be potentially malignant. Surgical biopsy, sometimes, can be the only way to correctly diagnose the pathological process, especially in the case of Hodgkin’s lymphoma in which few diagnostic cells (Reed-Sternberg cells) are generally embedded in an abundant inflammatory background tissue. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|