No abstract

Inflammatory pseudotumor of the lung is considered to be a rare, benign, neoplastic lesion, consisting mainly of spindle mesenchymal cells, sometimes in such a way that its histological appearance mimics that of a spindle cell sarcoma, fibrous histiocytoma or fibrosarcoma. On the occasion of a case managed in our department, the literature is reviewed, in an attempt to clarify some issues concerning this tumor. Emphasis is given to complete resection of the tumor for both diagnostic and therapeutic purposes. Malignant behavior may occur and recurrence is possible.

Intra-abdominal myositis ossificans, also known as heterotopic mesenteric ossification, defines the formation of bone-like lesions inside the abdominal cavity. It is a rare medical condition, usually following abdominal surgery or trauma. A 55-year-old male presented for closure of a Hartmann's colostomy, created 6 months ago because of sigmoid adenocarcinoma. Intraoperative findings consisted of an elongated bone-like lesion attached on the peritoneum and protruding inside the abdominal cavity, while two more stiff calcified nodules were found in the mesocolon. All lesions were excised. The presence of a hard consistency sigmoid stump led to cancelation of the operation. Heterotopous bone formation constitutes a challenging surgical condition, since its clinical presentation is innocuous and repetitive surgery acts a stimuli for additional bone creation. Computed tomography scan plays a major role in its diagnosis, while nonsteroidal anti-inflammatory drugs and cimetidine are helpful in preventing further recurrence of the disease.

The purpose of this study was to evaluate the role of transbronchial needle aspiration (TBNA) in the diagnosis of peripheral lung lesions. We attempted to perform TBNA in 37 patients referred to our hospital for diagnostic evaluation of radiographically evident peripheral masses (23 cases) or nodules (14 cases). None of them had bronchoscopic evidence of endobronchial lesion. The aspirations were performed under fluoroscopic guidance, through a fibreoptic bronchoscope, employing a 21-gauge, 1.3 cm aspirating needle. They were preceded by bronchial brushing and followed by transbronchial biopsy (TBB) of the peripheral lesion. In two cases, the apical nodules were not accessible by any of these procedures. Bronchial washings were also collected immediately after each procedure (brush, TBNA and TBB). TBNA was diagnostic in 23 of 37 patients (62%) rendering the TBNA yield considerably higher than washing (24%), brushing (27%) or TBB (38%). The addition of TBNA to the combination of TBB, brushing and washing, significantly increased the yield of fibreoptic bronchoscopy in our series from 46% to 70%. No significant complications, such as pneumothorax or major bleeding, occurred either with TBNA or TBB. In conclusion, our findings suggest that transbronchial needle aspiration is a safe procedure, that can improve the diagnostic yield of bronchoscopy in the diagnosis of peripheral lung masses or nodules.

HighlightsGiant inguinoscrotal hernias are a rare entity in modern clinical practice mainly because of the patient’s neglect.Our patient had a type II giant inguinoscrotal hernia extending below the midline between mid-inner thigh and suprapatellar bone lines.We avoided preoperative or intraoperative procedures for the lengthening of the abdominal wall.Despite the longevity and size of the hernia, we avoided a debulking procedure, instead we performed a lower midline incision and connected it with an extended right inguinal incision.Patient’s recovery was uneventful with no complications or signs of recurrence at 6 month follow up.