A new method in thoracoscopic inferior mediastinal lymph node biopsy: a case report

<p>Abstract</p> <p>Introduction</p> <p>We performed video-thoracoscopy with a video-mediastinoscope to conduct a mediastinal lymph node biopsy. Here, we discuss the various advantages of the method.</p> <p>Case presentation</p> <p>A 56-year-old Turkish Caucasian man had been complaining of dyspnea on exertion, hacking cough, fever and continuous sweating for one and a half months. Thoracic computed tomography revealed enlarged paratracheal and aorticopulmonary lymph nodes, the largest of which was 1 cm in diameter and reticulo-micronodular interstitial infiltration extending symmetrically to the pleural surfaces in both pulmonary perihilar areas. Computed tomography supported positron emission tomography showed increased fluorodeoxyglucose retention in lymph nodes in both hilar areas (10R and 10L) (maximum standardized uptake values 5.6 and 5.7), and in the right lower paratracheal (4R) (maximum standardized uptake value 4.1) and right para-esophageal (8) (maximum standardized uptake value 8.9) lymph nodes. Pathological examination of the right lymph node number 8 biopsy using the video-mediastinoscope revealed the presence of granulomatous inflammation. No problems were observed during the postoperative period.</p> <p>Conclusion</p> <p>The use of the video-mediastinoscope for inferior lymph node biopsy in thoracoscopy is an easy, safe and practical method, especially in patients with pleural adhesions.</p

Surgical Treatment of a Giant Primary Cardiac Angiosarcoma

Primary cardiac angiosarcoma is a rare tumor, and surgical resection is often required to relieve its symptoms. A 54-year-old male with a large primary cardiac angiosarcoma is described in this case report. The tumor was located in the right atrium and right ventricle. The bulk was resected with the right coronary artery (RCA), and partial right atrium and partial right ventricle resections were performed during cardiopulmonary bypass. The resected tumor measured 15 x 10 x 8 cm, and the histopathological diagnosis was well differentiated primary cardiac angiosarcoma. In the postoperative period, the patient was followed up for 22 months, and radiotherapy and chemotherapy were performed for metastases. The optimal therapy for cardiac angiosarcoma is still controversial, but combined treatment including surgical resection should be considered