Rare Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) Finding in a 9/11 World Trade Center Survivor: A Case Report.

Bronchial carcinoid tumors represent a relatively uncommon category within lung neoplasms, originating from neuroendocrine cells. The exact cause of these pulmonary tumors remains not fully understood. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is characterized by widespread hyperplasia of these neuroendocrine cells, essential for regulating air and blood flow in response to stimuli such as hypoxia, dyspnea, and chronic obstructive pulmonary disease (COPD).

Massive Hemorrhage Following Spontaneous Mediastinal Inflammatory Myofibroblastic Tumor Rupture: A Case Report.

A 45-year-old male in a hypertensive emergency was admitted with complaints of frontal headache, progressive chest discomfort, shortness of breath, dysphagia, and right upper quadrant abdominal pain radiating across the epigastrium and to the back that increases in intensity with deep inspiration. He denied any history of abdominal pain, vomiting, dyspnea, nausea, and weight loss. A computed tomography (CT) scan of the chest showed a posterior mediastinal mass between the esophagus and descending aorta.

A Novel Approach to Repair of Tracheal Occlusion Secondary to Percutaneous Tracheostomy Creation.

The number of endotracheal intubations increased in the United States during the COVID-19 pandemic with an associated rise in laryngotracheal injury. Our patient had a complete laryngeal occlusion just proximal to the first tracheal ring. The Neodymium-doped Yttrium Aluminum Garnet (Nd-YAG) laser is often used to resolve sub-laryngeal occlusions, and without access to the Nd-YAG laser, we had to find an alternative solution.

Calcified Catheter-Related Fibrin Sheath Forms Large Intravenous Cast in Hemodialysis Patient Causing Embolic Sequelae.

Catheter-related sheath (CRS) formation secondary to chronic indwelling central venous catheters (CVC) is a well-documented complication. When these fibrin sheaths calcify, they can form a "cast" surrounding the catheter. Upon removal of the CVC, a rare complication can occur where the calcified sheath remains in situ leaving behind an intraluminal catheter-shaped cast.

Histologic evidence of tracheal stenosis directly resulting from SARS-CoV-2 tissue infiltration, a case series.

Background: There has been an anecdotal increase in the incidence of tracheal stenosis that has coincided with the SARS-CoV-2 pandemic.

Case Presentation: This is a case series in which we report clinical and pathologic findings of two patients who subsequently developed subglottic tracheal stenosis after having been hospitalized with COVID-19 pneumonia. Histopathologic analysis of tissue from these patients shows features consistent with tissue infiltrated with SARS-CoV-2 virus, namely multinucleated syncytial cells with prominent nucleoli.

Esophageal Pulmonary-splenopancreatic Fistula: A Serious Complication of Sleeve Gastrectomy.

Esophagopulmonary fistulas are exceedingly rare and require surgical debridement and repair or diversion to prevent overwhelming sepsis. Fistulas that cross the diaphragm are even rarer. This report describes the case of a patient with an iatrogenic esophageal perforation after sleeve gastrectomy that was never managed definitively and in whom an esophagopulmonary-splenopancreatic fistula developed.

Enhanced Recovery After Thoracic Surgery (ERATS).

Background: Decreasing the length of stay after thoracic surgery provides both clinical and financial benefits to both the patient and the clinical system. Since 2017, our institution has seen advancements in the care of patients undergoing thoracic surgery after utilising our protocol Enhanced Recovery After Thoracic Surgery (ERATS).

Methods: The protocol we implemented is comprehensive, including the patient's pain management, thoracostomy tube drainage, physical therapy and rehabilitation, ventilator support and pulmonary care, as well as other features of preoperative, intraoperative, and postoperative care.

A novel reconstruction technique of a tracheal defect in the emergent setting using a thymus flap in a patient with tracheoinnominate artery fistula.

Background: There is a very high mortality associated with a tracheoinnominate artery fistula; however, when patients survive, they often require reconstruction of the eroded tracheal defect after the bleeding has been controlled.

Case Presentation: This is the case of an 83-year-old male with a tracheoinnominate artery fistula who was stabilized in the operating room and underwent repair of his trachea. A novel technique of using the thymus gland as a pedicled flap to repair a large tracheal defect was executed after achieving hemostasis.

Primary renal lymphoma: An incidental finding in an elderly male.

Primary renal lymphoma (PRL) is a rare disease process which represents less than 1% of all renal masses and is an uncommon type of Non-Hodgkin's Lymphoma. PRL is of clinical significance due to the fact that unlike the more commonly seen renal cell carcinoma, PRL is treated with neoadjuvant chemotherapy followed by nephrectomy. This challenges the long held notion that preoperative biopsies are not necessary prior to nephrectomy for renal masses.

Computed Tomography Screening for Lung Cancer: Mediastinal Lymph Node Resection in Stage IA Nonsmall Cell Lung Cancer Manifesting as Subsolid and Solid Nodules.

Objective: To compare long-term survival rates of patients with first, primary, clinical stage IA nonsmall cell lung cancer from a large cohort undergoing computed tomography screening with and without mediastinal lymph node resection (MLNR) under an Institutional Review Board-approved common protocol from 1992 to 2014.

Background: Assessing survival differences of patients with and without MLNR manifesting as solid and subsolid nodules.

Methods: Long-term Kaplan-Meier (K-M) survival rates for those with and without MLNR were compared and Cox regression analyses were used to adjust for demographic, computed tomography, and surgical covariates.

A single institution experience of seven hundred consecutively placed peripherally inserted central venous catheters.

Introduction: Peripherally inserted central venous catheters (PICCs) are being increasingly placed at the bedside by trained vascular access professional such as nurses. This is to increase the availability of the service, for cost containment, and to reduce the workload on the interventional radiologist. We describe a single institution experience with over 700 PICC lines placed by trained nurses at the bedside and determine the success rate, malposition rate of the PICC line , degree of support needed from the Interventional radiologist, and factors affecting a successful placement of a PICC line by the nurses.

Delayed esophageal perforation from stereotactic body radiation therapy for locally recurrent central nonsmall cell lung cancer.

Stereotactic body radiation therapy (SBRT) is a novel form of external beam radiation therapy. It is used to treat early and locally recurrent nonsmall cell lung cancer (NSLC) in medically inoperable patients. It uses high dose, hypofractionated radiotherapy, with targeting of the tumor by precise spatial localization, thus minimizing injury to surrounding tissues.

Balancing curability and unnecessary surgery in the context of computed tomography screening for lung cancer.

Objective: Surgical management is a critical component of computed tomography (CT) screening for lung cancer. We report the results for US sites in a large ongoing screening program, the International Early Lung Cancer Action Program (I-ELCAP).

Methods: We identified all patients who underwent surgical resection.

Sublobar resection is equivalent to lobectomy for clinical stage 1A lung cancer in solid nodules.

Objectives: A single randomized trial established lobectomy as the standard of care for the surgical treatment of early-stage non-small cell lung cancer. Recent advances in imaging/staging modalities and detection of smaller tumors have once again rekindled interest in sublobar resection for early-stage disease. The objective of this study was to compare lung cancer survival in patients with non-small cell lung cancer with a diameter of 30 mm or less with clinical stage 1 disease who underwent lobectomy or sublobar resection.

A systematic review of transesophageal echocardiography-induced esophageal perforation.

A systematic review of transesophageal echocardiography (TEE)-induced esophageal perforation was done using the MEDLINE (PubMed and OVID interfaces), Google Scholar and EMBASE databases. Thirty-five cases of esophageal perforation from 22 studies were analyzed. TEE-induced esophageal perforation occurs in elderly female patients, predominantly in an intra-operative setting.

Primary epithelial myoepithelial carcinoma of lung, reporting of a rare entity, its molecular histogenesis and review of the literature.

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus.

Successful treatment of primary pulmonary melanoma.

Presented is a rare case of a primary melanoma of the lung in an 89 year old male patient. Primary melanoma of the lung has been previously reported in the English literature in about 30 patients. Surgical resection either with lobectomy of pneumonectomy and a lymph node dissection has been shown to be the best chance of long term survival.

Pulmonary carcinoid tumor masquerading as a synovial sarcoma.

A rare case of pulmonary carcinoid tumor exhibiting morphologically as a monophasic synovial sarcoma is reported. The patient is a 37-year-old man who presented with shortness of breath for several weeks. The chest computed tomographic scan showed a 3.