https://doi.org/10.4081/monaldi.2022.2306
Unusual lymphadenopathy diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration
Submitted: April 28, 2022
Accepted: May 16, 2022
Published: May 24, 2022
Accepted: May 16, 2022
Abstract Views: 954
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Oxidized cellulose, used as hemostatic in thoracic surgery, may cause in some cases foreign body reactions, and simulate other diseases. We report the case of a 39-year-old man operated on a middle lobe lobectomy for atypical carcinoid. The follow up chest-CT showed enlarged mediastinal lymph nodes, so endobronchial ultrasound-guided transbronchial needle aspiration was performed suspecting recurrence of the tumor. The cytology results showed amorphous fragments such as foreign body reaction secondary to Pahacel®, used as hemostatic during the surgery. A few days later, the patient was re-operated on suspicion of mediastinitis induced by the endoscopic procedure. The aim of this case is to consider the foreign body reaction to Pahacel®, in patients with postoperative thoracic lymphadenopathy. It is also important to remember that in these patients the endoscopic procedures allow the diagnosis but may cause mediastinitis.
Altaylar Medikal [Internet]. Oxidized Regenerated Cellulose. Available from: http://www.altaylarmedikal.com/en/products/oxidised-regenerated-cellulose/6
Badenes D, Pijuan L, Curull V, Sánchez-Font A. A foreign body reaction to Surgicel® in a lymph node diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. Ann Thorac Med 2017;12:55-6.
DOI: https://doi.org/10.4103/1817-1737.197780
Mattsson T, Anneroth G, Köndell PA, Nordenram A. ACP and Surgicel in bone hemostasis. A comparative experimental and histologic study. Swed Dent J 1990;14:57-62.
Pierce A, Wilson D, Wiebkin O. Surgicel: macrophage processing of the fibrous component. Int J Oral Maxillofac Surg 1987;16:338-45.
DOI: https://doi.org/10.1016/S0901-5027(87)80156-X
Tomizawa Y. Clinical benefits and risk analysis of topical hemostats: a review. J Artif Organs 2005;8:137-42
DOI: https://doi.org/10.1007/s10047-005-0296-x
Roshkovan L, Singhal S, Katz SI, Galperin-Aizenberg M. Multimodality imaging of Surgicel®, an important mimic of post-operative complication in the thorax. BJR Open 2021;3:20210031.
DOI: https://doi.org/10.1259/bjro.20210031
Frati A, Thomassin-Naggara I, Bazot M, et al. Accuracy of diagnosis on CT scan of Surgicel® fibrillar: results of a prospective blind reading study. Eur J Obstet Gynecol Reprod Biol 2013;169:397-401.
DOI: https://doi.org/10.1016/j.ejogrb.2013.04.008
Hernández-Bonilla S, Rodríguez-García AM, Jiménez-Heffernan JA, et al. FNA cytology of postoperative pseudotumoral lesions induced by oxidized cellulose hemostatic agents. Cancer Cytopathol 2019;127:765-70.
DOI: https://doi.org/10.1002/cncy.22194
Haidari TA, Petersen RH, Skov BG, Ravn J. Oxidized resorbable cellulose (Gelita-cel) causing foreign body reaction in the mediastinum. Interact Cardiovasc Thorac Surg 2018;27:881-3. Erratum in: Interact Cardiovasc Thorac Surg 2019;29:495.
DOI: https://doi.org/10.1093/icvts/ivz166
Koh JS, Kim YJ, Kang DH, et al. Severe mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration: A case report. World J Clin Cases 2021;9:10723-7.
DOI: https://doi.org/10.12998/wjcc.v9.i34.10723
Varela-Lema L, Fernández-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review. Eur Respir J 2009;33:1156-64.
DOI: https://doi.org/10.1183/09031936.00097908
Asano F, Aoe M, Ohsaki Y, et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res 2013;14:50.
DOI: https://doi.org/10.1186/1465-9921-14-50
Huang CT, Chen CY, Ho CC, Yu CJ. A rare constellation of empyema, lung abscess, and mediastinal abscess as a complication of endobronchial ultrasound-guided transbronchial needle aspiration. Eur J Cardiothorac Surg 2011;40:264-5.
DOI: https://doi.org/10.1016/j.ejcts.2010.11.037
Haas AR. Infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration. Eur Respir J 2009;33:935-8.
DOI: https://doi.org/10.1183/09031936.00025708
Bhavan KP, Warren DK. Acute mediastinitis. In: Kello J, Kollef M, Diaz E, et al., Editors. Infectious diseases in critical care. Springer: Berlin; 2007. p. 542-54.
DOI: https://doi.org/10.1007/978-3-540-34406-3_51
Yokoyama Y, Nakagomi T, Shikata D, et al. Surgical treatment for mediastinal abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review. World J Surg Oncol 2017;15:130.
DOI: https://doi.org/10.1186/s12957-017-1206-4
Parker KL, Bizekis CS, Zervos MD. Severe mediastinal infection with abscess formation after endobronchial ultrasound-guided transbrochial needle aspiration. Ann Thorac Surg. 2010;89:1271-2.
DOI: https://doi.org/10.1016/j.athoracsur.2009.09.002
Voldby N, Folkersen BH, Rasmussen TR. Mediastinitis: A serious complication of endobronchial ultrasound-guided transbronchial needle aspiration. J Bronchology Interv Pulmonol 2017;24:75-9.
DOI: https://doi.org/10.1097/LBR.0000000000000231
Ishimoto H, Yatera K, Uchimura K, et al. A serious mediastinum abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): a case report and review of the literature. Intern Med 2015;54:2647-50.
DOI: https://doi.org/10.2169/internalmedicine.54.4465
Fukunaga K, Kawashima S, Seto R, et al. Mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration. Respirol Case Rep 2015;3:16-8.
DOI: https://doi.org/10.1002/rcr2.90
How to Cite
Stirpe, Emanuele, Floriana Bardaro, and Johanna Köhl. 2022. “Unusual Lymphadenopathy Diagnosed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2306.
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