A Case of Resected Mediastinal Dermoid Cyst |
Pyoung Ki Kim, H. S. Yoo, K. H. Kim |
National Medical Center, Seoul, Korea |
Mediastinal Dermoid Cyst의 일례 |
김병기, 유회성, 김기홍 |
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Abstract |
The case is 47 years old moderately well developed poorly, nourished male farmer. Family history and past history are not contributory. Symptomes started 8 years ago with right shoulder and upper chest pain, and followed by fever and productive cough in few month. Smelled foul smell in expectoration and increased in amount gradually. Hemoptysis started 5 years ago, and repeated it several times every year thereafter. In the past several years he often spat up whitish hair mixed with sticky expectoration. On admission, he appeared poorly nourished, pale and chronically ill-appearing. But was slightly dyspneic only on exertion without high fever. Physical examination revealed no other visible defect or deformity in any part of body, no any palpaale nodules. There was dullness on percussion on right upper chest with markedly diminished breathing sound Whowed marked clubbing fingers. B.P.90/60, Hemoglobin 6.8 gm%, sputum negative for AFB though it was once diagnosed as pulmonary tuberculosis in the past, and others insignificant. During the hospitalization, he used to raise up 300-650 ml of sputum but continued with normal fever, and hemoglobin also improved to 11.3 gm%, Eryhorocyte sedimentation rate improved form 70 mm, to 23,,./hr. Totla serum protein increased slightly with great increase of γ-globulin. ECG was normal. Bronchoscopy showed a big tumor mass in posterior wall of right main bronchus, and the biopsy specimen from that lesion was reported as fibrous polyp. Bacterial culture of sputum showed ordinary throat flora bvut no predominant one. Pneumonectomied right lung contained big fabric polyps protruding into the bronchus which iave impressing of arising from the bronchus. Itwas hard to find where did it come from even in operation or on histopathological examination but he tissue was found to contain tubular structure which is covered by pseudostratified epithelium., cartilage plate, mucosal mixed glands, and also mixed with pancreatic tissues. The polyp was also covered by the suin which is consisting of hair follicles, sebaceous gland and sweat glands. |
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