Limits...
T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula.

Sharma M, Aronow WS, O'Brien M, Gandhi K, Amin H, Desai H - Med. Sci. Monit. (2011)

Bottom Line: Repeat computer tomography scan of the chest after chemotherapy noted a significant decrease in the cavitary lesion in the right paraesophageal region and right mediastinum.Bronchoscopy revealed a large opening in the posterior wall of the bronchus intermedius leading into the esophagus.A fistulogram was done which clearly demonstrated a fistulous tract between the lower esophagus and the right intermediate bronchus secondary to perforation from the lymphoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Valhalla, NY 10595, USA.

ABSTRACT

Background: The mediastinum is an uncommon location for presentation of peripheral T cell lymphoma. Esophageal involvement by non-Hodgkin's lymphoma is extremely unusual. Although staging can be performed with routine imaging studies, surgical intervention is often required to ensure accurate histologic diagnosis of these lymphomas. Peripheral T cell lymphomas not otherwise specified are among the most aggressive non-Hodgkin lymphomas with often a poor response to conventional chemotherapy.

Case report: We report a case of a 63 year-old-man with an aggressive mediastinal T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula. The patient was treated with a cyclophosphamide, vincristine, and prednisone (COP) regimen. Repeat computer tomography scan of the chest after chemotherapy noted a significant decrease in the cavitary lesion in the right paraesophageal region and right mediastinum. Bronchoscopy revealed a large opening in the posterior wall of the bronchus intermedius leading into the esophagus. A fistulogram was done which clearly demonstrated a fistulous tract between the lower esophagus and the right intermediate bronchus secondary to perforation from the lymphoma. The patient eventually underwent cervical esophagostomy and jejunostomy tube placement to correct the brochoesophageal fistula.

Conclusions: The mediastinum is an uncommon location for presentation of peripheral T cell lymphomas, and surgical intervention is often required to ensure accurate histological diagnosis of these lymphomas. In our patient, aggressive mediastinal T cell lymphoma presented as esophageal obstruction and bronchoesophageal fistula.

Show MeSH

Related in: MedlinePlus

Computer tomography (CT) scan of the chest reveals a 4.6 times 3.1 cm cavity adjacent to the esophagus with a fistulous connection between the necrotic cavity and the right main bronchus.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539550&req=5

f2-medscimonit-17-6-cs66: Computer tomography (CT) scan of the chest reveals a 4.6 times 3.1 cm cavity adjacent to the esophagus with a fistulous connection between the necrotic cavity and the right main bronchus.

Mentions: The chest roentgenogram (Figure 1) revealed a confluent opacity in the right retrohilar and retrocardiac region. The computerized tomography (CT) scan of the chest with contrast (Figures 2, 3) revealed a mid to distal esophageal mass suspicious for esophageal neoplasm. There was a fistulous connection to a right paraesophageal cavity containing oral contrast, debris, and air with suggestion of an additional fistulous connection between the esophagus and the right mainstem bronchus. Right-sided parahilar lymphadenopathy and pleural effusion were also noted.


T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula.

Sharma M, Aronow WS, O'Brien M, Gandhi K, Amin H, Desai H - Med. Sci. Monit. (2011)

Computer tomography (CT) scan of the chest reveals a 4.6 times 3.1 cm cavity adjacent to the esophagus with a fistulous connection between the necrotic cavity and the right main bronchus.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539550&req=5

f2-medscimonit-17-6-cs66: Computer tomography (CT) scan of the chest reveals a 4.6 times 3.1 cm cavity adjacent to the esophagus with a fistulous connection between the necrotic cavity and the right main bronchus.
Mentions: The chest roentgenogram (Figure 1) revealed a confluent opacity in the right retrohilar and retrocardiac region. The computerized tomography (CT) scan of the chest with contrast (Figures 2, 3) revealed a mid to distal esophageal mass suspicious for esophageal neoplasm. There was a fistulous connection to a right paraesophageal cavity containing oral contrast, debris, and air with suggestion of an additional fistulous connection between the esophagus and the right mainstem bronchus. Right-sided parahilar lymphadenopathy and pleural effusion were also noted.

Bottom Line: Repeat computer tomography scan of the chest after chemotherapy noted a significant decrease in the cavitary lesion in the right paraesophageal region and right mediastinum.Bronchoscopy revealed a large opening in the posterior wall of the bronchus intermedius leading into the esophagus.A fistulogram was done which clearly demonstrated a fistulous tract between the lower esophagus and the right intermediate bronchus secondary to perforation from the lymphoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Valhalla, NY 10595, USA.

ABSTRACT

Background: The mediastinum is an uncommon location for presentation of peripheral T cell lymphoma. Esophageal involvement by non-Hodgkin's lymphoma is extremely unusual. Although staging can be performed with routine imaging studies, surgical intervention is often required to ensure accurate histologic diagnosis of these lymphomas. Peripheral T cell lymphomas not otherwise specified are among the most aggressive non-Hodgkin lymphomas with often a poor response to conventional chemotherapy.

Case report: We report a case of a 63 year-old-man with an aggressive mediastinal T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula. The patient was treated with a cyclophosphamide, vincristine, and prednisone (COP) regimen. Repeat computer tomography scan of the chest after chemotherapy noted a significant decrease in the cavitary lesion in the right paraesophageal region and right mediastinum. Bronchoscopy revealed a large opening in the posterior wall of the bronchus intermedius leading into the esophagus. A fistulogram was done which clearly demonstrated a fistulous tract between the lower esophagus and the right intermediate bronchus secondary to perforation from the lymphoma. The patient eventually underwent cervical esophagostomy and jejunostomy tube placement to correct the brochoesophageal fistula.

Conclusions: The mediastinum is an uncommon location for presentation of peripheral T cell lymphomas, and surgical intervention is often required to ensure accurate histological diagnosis of these lymphomas. In our patient, aggressive mediastinal T cell lymphoma presented as esophageal obstruction and bronchoesophageal fistula.

Show MeSH
Related in: MedlinePlus