CHEST WALL HEMANGIOMA: A DIFFICULT PREOPERATIVE DIAGNOSIS

We report a case that presents a diagnostic challenge in a 22 year-old female. CT-Scan and MRI showed a soft-density mass (12 cm) causing middle arch erosion of the fifth rib. In this rapidly-growing chest wall tumor a surgical-biopsy was very hemorrhagic and frozen section was unabled to disclose a sarcoma. Angiography and embolization of the feeding arteries were done. The final histopathology pointed out hemangioma. Complete resection was performed without prosthesis interposition. We emphasize two points regarding vascular chest wall tumors: (1) its possibility to mimick a sarcoma, so the surgical planning demands preoperative diagnosis; (2) the positive role of embolization in large and fast-growing lesions

Chest wall hemangioma : a difficult preoperative diagnosis

We report a case that presents a diagnostic challenge in a 22 year-old female. CT-Scan and MRI showed a soft-density mass (12 cm) causing middle arch erosion of the fifth rib. In this rapidly-growing chest wall tumor a surgical-biopsy was very hemorrhagic and frozen section was unabled to disclose a sarcoma. Angiography and embolization of the feeding arteries were done. The final histopathology pointed out hemangioma. Complete resection was performed without prosthesis interposition. We emphasize two points regarding vascular chest wall tumors: (1) its possibility to mimick a sarcoma, so the surgical planning demands preoperative diagnosis; (2) the positive role of embolization in large and fast-growing lesions

Dipstick Test for Rapid Diagnosis of Shigella dysenteriae 1 in Bacterial Cultures and Its Potential Use on Stool Samples

International audienceBACKGROUND: We describe a test for rapid detection of S. dysenteriae 1 in bacterial cultures and in stools, at the bedside of patients. METHODOLOGY/PRINCIPAL FINDINGS: The test is based on the detection of S. dysenteriae 1 lipopolysaccharide (LPS) using serotype 1-specific monoclonal antibodies coupled to gold particles and displayed on a one-step immunochromatographic dipstick. A concentration as low as 15 ng/ml of LPS was detected in distilled water and in reconstituted stools in 10 minutes. In distilled water and in reconstituted stools, an unequivocal positive reaction was obtained with 1.6×10⁶ CFU/ml and 4.9×10⁶ CFU/ml of S. dysenteriae 1, respectively. Optimal conditions to read the test have been determined to limit the risk of ambiguous results due to appearance of a faint yellow test band in some negative samples. The specificity was 100% when tested with a battery of Shigella and unrelated strains in culture. When tested on 328 clinical samples in India, Vietnam, Senegal and France by laboratory technicians and in Democratic Republic of Congo by a field technician, the specificity (312/316) was 98.7% (95% CI:96.6-99.6%) and the sensitivity (11/12) was 91.7% (95% CI:59.8-99.6%). Stool cultures and the immunochromatographic test showed concordant results in 98.4 % of cases (323/328) in comparative studies. Positive and negative predictive values were 73.3% (95% CI:44.8-91.1%) and 99.7% (95% CI:98-100%). CONCLUSION: The initial findings presented here for a simple dipstick-based test to diagnose S. dysenteriae 1 demonstrates its promising potential to become a powerful tool for case management and epidemiological surveys

Chest wall hemangioma : a difficult preoperative diagnosis

We report a case that presents a diagnostic challenge in a 22 year-old female. CT-Scan and MRI showed a soft-density mass (12 cm) causing middle arch erosion of the fifth rib. In this rapidly-growing chest wall tumor a surgical-biopsy was very hemorrhagic and frozen section was unabled to disclose a sarcoma. Angiography and embolization of the feeding arteries were done. The final histopathology pointed out hemangioma. Complete resection was performed without prosthesis interposition. We emphasize two points regarding vascular chest wall tumors: (1) its possibility to mimick a sarcoma, so the surgical planning demands preoperative diagnosis; (2) the positive role of embolization in large and fast-growing lesions