Calcified mediastinal lymph nodes in Hodgkin's disease

Four new cases of calcified mediastinal lymph nodes in Hodgkin's Disease in children are reported. Calcifications appeared 13 months to 3 years 11 months following radiotherapy. One of the four cases continued to show a widened mediastinum despite remission. It is still to be determined if the presence of calcified mediastinal nodes in Hodgkin's disease represents a favourable prognostic sign.     

Sonographic diagnosis of a huge necrotizing thymic cyst

We report on a 10-year-old boy with a huge right-sided thoracic mass. The chest radiograph, ultrasonography, CT and laboratory data were suspicious of an abscess-forming pneumonia. Following unsuccessful antibiotic treatment the mass was surgically removed. Histological examination revealed a huge necrotizing thymic cyst.     

Recurrent mediastinal mass in a child with Hodgkin's disease following successful therapy: a diagnostic challenge

The case of an 11-year-old girl with mediastinal stage III B-E Hodgkin's disease is described. She achieved complete remission with combined chemoradiotherapy according to the Swiss Pediatric Oncology Group-HD Protocol 1985. Six months after all therapy was stopped, a slowly growing retrosternal mass was detected. Computed tomography (CT) and gallium-67 single-photon emission CT (SPECT) could not elucidate the true origin of the tumor, nor did ultrasound-guided transthoracic fine-needle puncture. Open biopsy with histologic examination of the lesion has successfully identified the mass as thymic hyperplasia, a rebound immunologic reaction after chemoradiotherapy that mimicked tumor regrowth.     

Concurrent cystic mediastinal lymphangioma and paratesticular rhabdomyosarcoma

The current report describes a 23-month-old boy with paratesticular rhabdomyosarcoma who was incidentally diagnosed as also having an isolated mediastinal cystic lymphangioma. The association of childhood rhabdomyosarcoma with various congenital anomalies and genetic alterations such as p53 mutations have been well known. However, mediastinal cystic lymphangioma has not been reported among the congenital anomalies diagnosed in rhabdomyosarcoma. Both rhabdomyosarcoma and lymphangioma originate from mesenchymal cells. This association may be coincidental or may point to a common genetic and/or developmental disorder of the mesencymal tissue.     

Enlargement of mediastinal masses on simulation films: a radiotherapeutic problem in the management of patients with Hodgkin's disease

The size of the mediastinal mass on standard posterior-anterior chest radiograph in stage I and stage II Hodgkin's disease has both prognostic and therapeutic importance. But the actual treatment is based on the anterior-posterior supine simulation film. Problems arise when the prognosis (whether all the disease can be effectively contained in an irradiation port) and toxicity (more lung and heart irradiated or chemotherapy required) are changed when the mass is markedly enlarged on the radiation simulation films. Differences in the direction of the X-ray beam, distance from the subject, and patient position are shown to increase artificially the size of a mediastinal mass on simulation films. The staging and therapeutic implications are discussed.     

The use of ultrasound in the diagnosis of a large thymic cyst

We present a case of pulmonary sling associated with tracheobronchial stenosis, and with hypoplasia of the right lung and right pulmonary artery. Radiologic studies showed evidence of pulmonary sling and hypoplasia of the right lung; associated hypoplasia of the right pulmonary artery was also present, but not recognized initially. Narrowing of the distal trachea and right main bronchus was present, not due to compression by the anomalous left pulmonary artery, but to congenital stenosis of the trachea and right main bronchus associated with complete cartilaginous tracheobronchial rings.     

Concurrent development of Crohn disease and myelodysplastic syndrome in a child: case report and literature review

A small number of cases of Crohn disease associated with myelodysplastic syndromes or leukemia have been reported in adults in the last 25 years in the English-language medical literature. The authors report a case of a 9-year-old boy who developed Crohn disease and myelodysplastic syndrome concurrently. Analysis of his bone marrow showed a chromosome 20 abnormality. Although chromosome 20 abnormalities have been reported in a minority of these patients, the significance of this association remains unclear at the present time.     

新生儿巨大胸腺囊肿一例

患儿 男,29 d.因“发现颈部肿物并气促22 d”,于2013年4月9日收入我院介入科治疗.曾于11d前行影像引导经皮硬化术,术后患儿颈部肿物缩小,3d前再次增大.入院查体:呼吸较促,左颈部可见一肿物,大小约6 cm×5 cm,质软,边界欠清,无压痛,局部皮温正常,无破溃,肿物表面肤色正常.颈部检查示左侧颈部囊性包块,范围约5.9 cm× 3.6 cm×4.4cm,考虑为淋巴管瘤.     

Thymic cyst appearing after treatment of mediastinal non-Hodgkin lymphoma

We report the first case of a thymic cyst appearing in the course of treatment for non-Hodgkin lymphoma of the anterior mediastinum. The patient was a 9-year-old child in whom an abnormal contour of the left cardiac border persisted after chemotherapy, suggesting residual disease. The mass was found at thoracotomy to be a benign thymic cyst. The lesion was not present 2 years previously, and most likely represented cystic degeneration of the thymus, secondary to lymphomatous involvement. CT scan was not helpful in distinguishing the cystic lesion from residual lymphoma.     

A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst

Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6–10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children.     

Thymic teratoma or thymic remnant attached to mediastinal teratoma? The cellular origin of mediastinal teratomas revisited.

Thymic tissue can be encountered in about 20 % of mediastinal teratomas. It is found located at the periphery of the teratoma mass. Although rare, mediastinal teratoma arising within the thymus can be seen. It has not been defined yet whether the thymus is an organ simply attached to the teratoma or whether the teratoma arises from the thymus. The authors present here two illustrative cases of mediastinal teratoma, one raised within the thymus and the other closely attached to the thymic remnant, to discuss the cellular origin of mediastinal teratomas.