Neck as mediastinal extension: diagnosis of sarcoidosis by core biopsy of cervical lymph nodes

ConclusionsGiven the clear advantages of cervical diagnosis in terms of invasiveness and economy compared to mediastinal alternatives, it is suggested that where the expertise for core biopsy of normal sized cervical lymph nodes is readily available, the technique may be considered as a first line investigation for the diagnosis of sarcoidosis.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research

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We describe a cohort of patients who have evidence of granulomatous inflammation during EBUS-TBNA (endobronchial ultrasound-guided transbronchial needle aspiration) done for the investigation of sarcoidosis and staging of a known lung cancer.Out of 800 EBUS performed between May 2010- Nov 2017, 500 yielded a benign diagnosis (men 55.6%). Rapid on-site evaluation by a cytopathologist was done in 82% of procedures and yielded a diagnosis in 86.8%.In the setting of suspected sarcoidosis (59.3%), the mean diagnostic yield was 61.05%, ATS Station 7 being the most commonly sampled lymph node (66.67%)Granulomatous inflammation wa...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Publication date: Available online 25 August 2018Source: Respiratory Medicine Case ReportsAuthor(s): Sho Shimada, Haruhiko Furusawa, Toshihisa Ishikawa, Eisaku Kamakura, Takafumi Suzuki, Yuta Watanabe, Takasato Fujiwara, Shinichiro Tominaga, Keiko Mitaka Komatsuzaki, Ichiro NatsumeAbstractA 60-year-old man visited our hospital for further examination of an abnormal chest radiograph. Computed tomography (CT) images revealed enlarged mediastinal lymph nodes and multiple pulmonary nodules.Further evaluation by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed and he was diagnosed with ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
CONCLUSION: EBUS-TBNA is associated with a risk of mediastinitis that may manifest as an isolated fever arising within hours of the procedure. The pathogens responsible are usually contaminants from the oropharynx such as Streptococcus sp, probably inoculated directly into the mediastinum during transbronchial needle aspiration. Rapid diagnosis and treatment are necessary in order to reduce morbidity and mortality associated with mediastinitis. PMID: 30098879 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Authors: Tetikkurt C, Yanardag H, Pehlivan M, Bilir M Abstract Sarcoidosis is a systemic disease characterized by noncasefied granulomas in various organs. Incidence of splenic disease is variable and is reported to occur in 6.7 to 77 percent of the patients. Firm data establishing the clinical features and the association of splenic involvement with prognosis in sarcoidosis is scant. The aim of our study was to investigate the clinical features and the consequence of splenic involvement on the prognostic outcome of sarcoidosis patients. We evaluated the clinical and laboratory findings in 82 sarcoidosis patients. ...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Ashu S Bhalla, A Das, P Naranje, A Goyal, R Guleria, Gopi C KhilnaniIndian Journal of Radiology and Imaging 2017 27(4):380-388 The second part of the review discusses the role of different existing imaging modalities in the evaluation of thoracic sarcoidosis, including chest radiograph, computed tomography, magnetic resonance imaging, endobronchial ultrasound, and positron emission tomography. While summarizing the advantages and pitfalls of each imaging modality, the authors propose imaging recommendations and an algorithm to be followed in the evaluation of clinically suspected case of sarcoidosis in tuberculosis-endemic regions.
Source: Indian Journal of Radiology and Imaging - Category: Radiology Authors: Source Type: research
Conclusion: To our knowledge, this is the first case series of pneumomediastinum in patients with pulmonary fibrosis following EBUS-TBNA. We believe the radial traction placed on the airways (splinting) by the fibrotic lung disease and the increased airway pressure may have allowed air in to the mediastinum through the needle puncture sites. Both physicians and patients should be aware of this complication and we suggest a smaller 22 G EBUS-TBNA needle be used in patients with pulmonary fibrosis.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Authors: Matsuura S, Mochizuka Y, Oishi K, Miyashita K, Naoi H, Mochizuki E, Mikura S, Tsukui M, Koshimizu N, Ohata A, Suda T Abstract Sarcoidosis affects multiple organs and rarely has unusual manifestations. A 78-year-old woman was referred to our hospital for coughing symptoms. A chest computed tomography (CT) scan revealed bilateral diffuse miliary patterns and right pleural effusion. Bronchoscopy showed multiple nodules in the carina and the bronchus intermedius. A CT scan of her abdomen revealed hypovascular lesions involving the pancreatic head and body. A transbronchial lung biopsy, bronchial mucosal biopsy...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Granulomatous lung diseases are a heterogeneous group of disorders that have a wide spectrum of pathologies with variable clinical manifestations and outcomes. Precise clinical evaluation, laboratory testing, pulmonary function testing, radiological imaging including high-resolution computed tomography and often histopathological assessment contribute to make a confident diagnosis of granulomatous lung diseases. Differential diagnosis is challenging, and includes both infectious (mycobacteria and fungi) and noninfectious lung diseases (sarcoidosis, necrotising sarcoid granulomatosis, hypersensitivity pneumonitis, hot tub l...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Respiratory clinical practice Pathology for the Clinician Source Type: research
We report the case of a 56-year-old female patient admitted to the emergency department after an unexplained syncope. The patient had suffered from fatigue, exercise induced chest pain, dyspnea and dry cough for 5 weeks before presentation. The remaining clinical history was unremarkable despite a breast cancer which was successfully treated 13 years ago without any signs of recurrence until now. Laboratory testing showed an elevated pro-B-type natriuretic peptide while cardiac ischemic enzymes were within normal range. The ECG documented a third-degree atrioventricular (AV) block which immediately required pacemaker impla...
Source: European Heart Journal - Category: Cardiology Source Type: research
Conclusions: Using the traditional cut-off of ≤10 mm for normal mediastinal LN size during EBUS does not accurately predict cytopathological outcome in a population referred for mediastinal workup for suspected malignancy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 11.1 Lung Cancer Source Type: research
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