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Biomedical subjects

T Kilani

Publications and source records attributed to T Kilani.

At least 19 recordsLinked to original sources
PubMed2006

[Abundant hemothorax revealing extralobular pulmonary sequestration].

Hemothorax is an exceptional, serious and misleading manifestation of extralobular sequestration. We report the case of a 15-year-old patient who consulted for chest pain and sudden onset dyspnea. The chest x-ray revealed fluid pleural effusion. Pleural puncture produced a bloody fluid and the angioscan showed a hyperdense formation without a systemic artery. Thoracotomy was performed. A left intrapleural pyramidal formation vascularized with a pedicle from the thoracic aorta was identified and sequestrectomy performed. At two years, the patient has remained symptom free. Extralobular sequestration is an exceptional cause of hemothorax. The absence of an aberrant systemic vessel on the angioscan should not rule out the diagnosis of sequestration. Precautions must be taken at surgery to avoid vessel damage.

Adolescent↗
PubMed2006

[Management of postoperative chylothorax].

INTRODUCTION: A chylothorax can occur following any intrathoracic procedure. It is generally straightforward to make the diagnosis but optimal management can be problematic. METHODS: Between 1995 and 2002, three women and one man aged from 13 to 58 years were treated for chylothorax after thoracic surgery. Their initial illnesses were a right pulmonary hydatid cyst associated with hepatic disease, a tumour of the posterior mediastinum, an oesophageal carcinoma and metastases in the left lung. RESULTS: These patients had: a pulmonary and hepatic cystectomies, a resection of the mediastinal tumor, an Akyama oesophagectomy and a resection of four left pulmonary metastases. Chylothorax became apparent post operatively between the 1st and the 4th day. All patients were treated with a medium-chain triglyceride diet. Two patients were re-explored with ligation of lymphatic vessels. One woman who did not have further surgery was treated with etilefrine. In the patient who had had an oesophagectomy, chylothorax persisted after re-operation. He was successfully treated by talc pleurodesis via a chest drain, which prevented further recurrence. CONCLUSIONS: In the management of postoperative chylothorax, medical treatment must be started early but surgery should not be delayed as operative risk is increased by the development of malnutrition and immune deficiency.

Adolescent↗
PubMed2005

[Mucoepidermoid carcinoma of the lung. A series of 10 cases].

Mucoepidermoid carcinoma of the lung is rare. The microscopic findings distinguish low grade and high grade tumors. Conservative surgical resection is appropriate if possible for low grade tumors. For the high grade tumors, combined wide surgical resection and radiotherapy is recommended. We report 10 cases of mucoepidermoid carcinoma of the lung (5 low grade, 5 high grade) in 8 male and 2 female patients with a mean age of 43.9 years. Only 5 of 10 were smokers. All 10 patients underwent surgery. Operative procedures included 8 lobectomies and 2 pneumonectomies. Two patients received radiation therapy postoperatively. Three patients (2 high grade and 1 low grade) died. The other 7 patients were alive without evidence of recurrence.

Adult↗
PubMed2005

[Primary pulmonary angiosarcoma].

Pulmonary angiosarcoma is an uncommon vascular and usually secondary tumor. Only a few primary cases of pulmonary angiosarcoma have been described. We report a case of primary pulmonary angiosarcoma in an adult man who presented with hemoptysis. Chest x-ray film and chest CT showed a right para-cardiac opacity associated with diffuse alveolar consolidation of the right basal lobe. Right inferior lobectomy has been performed. Pulmonary angiosarcoma was diagnosed on histological and immuno-histochemical studies of the operative specimen. The primitive character was retained after ruling out all other tumor localizations. The clinical outcome was rapidly fatal. This observation is added to the other rare cases published of primitive pulmonary angiosarcoma. It confirms the poor prognosis and the extremely hemorrhagic nature of this tumor. Isolated necrotic parenchymatous mass was an original radiological pattern observed in this patient.

Fatal Outcome↗
PubMed2005

[Clinical aspects and diagnosis of pleural fibromas].

Pleural fibromas are rare malignant or benign tumors requiring pathology study for certain diagnosis. From January 1985 to January 2001, 7 patients underwent surgery in our unit for pleural fibroma: 4 females and 3 males, mean age 60 years. The inaugural symptoms were chest pain (3 patients), dyspnea (2 patients), joint pain in a patient with Pierre-Marie pneumonic hypertrophic osteo-arthropathy, and acute hypoglycemia. Radiological investigations were decisive in orienting the diagnosis (chest X-ray, ultrasound, computed tomography and MRI). Surgical resection and pathological study of the surgical specimen is required to confirm the diagnosis. Patients should be carefully followed due to the risk of malignant recurrence.

Adult↗
PubMed2005

[Huge benign lung tumor in a female smoker].

UNLABELLED: Pulmonary sclerosing hemangioma is a rare, slow-growing, benign tumor. Its potential for progression and its histiogenesis remains controversial. CASE REPORT: A routine chest X-ray revealed a right abdominal mass in 41-year-old woman. Search for a cause was negative. The patient underwent posterolateral thoracotomy for tumorectomy. Intraoperative pathology analysis revealed the benign nature of the tumor. No complication was observed postoperatively. The final pathological conclusion was sclerosing hemangioma of the lung. Pulmonary sclerosing hemangioma is a parenchymal tumor of the lung. The latest immunohistochemical studies of this lesion suggest a pneumocyte origin. Prognosis is good, but extension to lymph nodes may occur. Surgery is always required for cure, and must be associated with lymph node dissection for large tumors.

Adult↗
PubMed2004

[Cervico-thoracic localization of a hydatid cyst].

The authors report a case of cervico-thoracic region hydatid cyst suspected by the presence of a palpable right lower neck mass. This location is very rare. Neck ultrasound and computed tomography showed the cyst. Magnetic resonance imaging can be useful for diagnosis and provided the best anatomo-topographic evaluation before surgery.

Adult↗
PubMed2004

[Lung carcinosarcoma. A case report].

Carcinosarcoma of the lung is a rare highly malignant tumor of unknown histogenesis. There is an epithelial carcinomatous component and a malignant mesenchmatous component with heterologous tissue. Survival at two years after surgical resection is not greater than 10%. We report a case observed in a 71-year-old man who developed chest pain. Outcome was fatal at three months. Pathology examination of a transparietal biopsy provided the diagnosis which was confirmed by immunohistochemistry on the surgical resection specimen.

Aged↗
PubMed2004

[Benign myoepithelioma of the lung].

Benign myoepithelioma of the lung is a benign tumor caused by proliferating myoepithelial cells with no ductal component. These tumors are exceptional: only three cases have been reported in the literature. We report a fourth case in a 37-year-old woman at 8 months gestation. Pathological proof of diagnosis was obtained.

Adult↗
PubMed2003

[Ultrasonographic, CT, and MRI findings of chest wall hydatidosis].

The chest wall is an uncommon localization for hydatid disease even in countries where echinococcosis is endemic. Only isolated sporadic cases have been reported in the literature. We reviewed retrospectively 15 patients who underwent surgery for chest wall hydatid disease. Various imaging techniques were used for diagnosis of our cases. These included chest radiograph, thoracic ultrasonography, computed tomography and magnetic resonance imaging. Hydatid cyst involved soft tissues (n=5), ribs and vertebrae (n=5), ribs (n=4) and sternum (n=1). Imaging techniques were of value for diagnosis (radiographs and sonography) and for evaluation of the extent of involvement (CT and MRI). Chest wall hydatidosis requires surgical treatment but recurrence is frequent.

Adolescent↗
PubMed2002

[Metastatic benign leiomyoma in a 46-year-old woman].

Chest X-ray in a 46-year-old woman with a history of hysterectomy for a uterine mass revealed a nodular opacity measuring 3 cm. Computed tomography identified 3 other nodules. Histology examination of the lung lesions identified the same configuration as that of the hysterectomy specimen performed two years earlier: benign metastatic leiomyoma. Approximately 40 cases have been reported in the literature.

Diagnosis, Differential↗
PubMed2002

[Thymolipoma. A case report].

Thymolipoma is an uncommon benign tumor of the thymus. Asymptomatic, it is an incidental discovery. Pathogenesis remains controversial. We report a new case in a 36-year-old woman that was discovered on a chest x-ray ordered for pneumonia. The MRI findings suggested the diagnosis which was confirmed at the pathology examination of the surgical specimen.

Adult↗
PubMed2002

[Endobronchial pulmonary rhabdomyosarcoma. A case report].

We report a case of pleiomorphous pulmonary rhabdomyosarcoma observed in a 64-year-old patient with no history of soft tissue tumor. The tumor was found extending into the right lower and middle lobes. The intra-parenchymatous extension protruded into the middle lobular bronchus and was prolonged by a 4 cm polyp. The polyp extended up to the carina and reached the contralateral common bronchus. Outcome was fatal after surgery performed in an emergency setting due to asphyxia. Explorations could not be continued to determine the primary or secondary nature of the tumor. An intraparenchymatous endobronchial localization is uncommon. Primary rhabdomyosarcoma is generally a purely intra-parenchymatous tumor. The endobronchial localization has been described before but is very exceptional. This localization would also be exceptional for secondary rhabdomyosarcoma mimicking a primary malignant tumor. The histology study revealed an undifferentiated pleiomorphous tumor. Immunohistochemistry provided the final diagnosis.

Bronchial Neoplasms↗
PubMed2001

Hydatid disease of the liver with thoracic involvement.

Hydatidosis, caused by Echinococcus granulosus, is an endemic parasitic disease in Mediterranean countries. The most frequent anatomic locations are liver and lung. Intrathoracic rupture of hydatid cysts situated in the hepatic dome is a serious complication resulting in damage to the pleura, pulmonary parenchyma, and bronchi. From January 1984 to December 1997 we operated on 40 patients with intrathoracic rupture of a hepatic hydatid cyst. Chest roentgenograms showed a shadow of varying size at the base of the hemithorax. Hepatic and thoracic ultrasonography was performed in all cases. The diagnosis of intrathoracic rupture of a liver cyst was confirmed preoperatively in 30 of the 40 cases. Posterolateral thoracotomy was performed in all patients. This transthoracic approach allowed adhesiolysis and treatment of the pleural lesions, pulmonary lesions, and hepatic cyst. Treatment of the diaphragmatic gap is easily done. We performed 15 lobectomies, 10 wedge resections, 16 decortications, and in one patient simple drainage of a voluminous pleuropulmonary and hepatic purulent hydatic collection. The postoperative course was uneventful in 26 cases, but 14 patients had complications, from which 3 patients died. The therapeutic approach depends on ultrasonographic findings. We believe ultrasonography to be the best examination for assessing biliary, hepatic, diaphragmatic, and pleuropulmonary lesions. When an intrathoracic collection is present, thoracotomy must be performed and is sufficient if the biliary tract is safe. An abdominal approach is necessary when biliary duct drainage is required, and it may be sufficient in cases of direct rupture into the bronchi.

Adolescent↗
PubMed2001

[Apropos of a mediastinal teratoma invading the lung].

Mediastinal mature teratomas are rare in children. Diagnosis is often made in the presence of a complication. We report a case of a mature mediastinal teratoma, complicated by its opening in the lung. The patient was a four-year-eight-month-old girl. She was admitted for fever, cough and dyspnea. The chest radiography showed a large mediastinal mass with calcifications. The CT scans and MRI aided in establishing the diagnosis. Biological tests (alpha-foetoproteins and beta-HCG) confirmed the benignity of the tumor. The child was operated on with full success.

Child, Preschool↗
PubMed2001

[Lung metastasis disclosing a calf tumor].

Lung metastasis is a common finding, either before, with or after discovery of the primary tumor. Histological examination of a lung formation of unknown origin can lead to diagnosis of a primary tumor. We report the case of a 28-year old woman who presented an apparently primary tumor in the lower left pulmonary lobe. Pathology reported soft tissue alveolar sarcoma. The first manifestation of this rare soft tissue tumor can be a lung or brain tumor. Imaging evidenced the primary tumor in the left calf. Histology confirmed the diagnosis and the metastatic nature of the lung tumor.

Adult↗