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Parvimonas micra chest wall abscess following transthoracic lung needle biopsy.

Gorospe L, Bermudez-Coronel-Prats I, Gomez-Barbosa CF, Olmedo-Garcia ME, Ruedas-Lopez A, Gomez del Olmo V - Korean J. Intern. Med. (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ramon y Cajal University Hospital, Madrid, Spain.

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To the Editor, Percutaneous transthoracic computed tomography (CT)-guided needle biopsy is a well-established, simple, reliable diagnostic interventional procedure for definitive pathologic diagnosis of thoracic neoplasms because of its high diagnostic yield and relatively low morbidity... We present a case of a patient suspected to have lung cancer who underwent two CT-guided transthoracic needle biopsies and developed a chest wall mass 10 days after the second percutaneous biopsy... A 67-year-old male ex-smoker with cough and constitutional syndrome (loss of appetite, fatigue, and progressive weight loss over 6 weeks) and no fever was referred to our institution after chest radiographs revealed a nonresolving opacity in the right lung base... His medical history was otherwise nonsignificant... Physical examination showed decreased breath sounds on auscultation at the right hemithorax... The patient was placed in the supine position on the CT table and an 18 G semi-automated coaxial core biopsy needle (Bard Magnum, Bard, Tempe, AZ, USA) was inserted into the patient's thorax through the right pectoral muscle (Fig. 2)... Pathologic analysis of the obtained specimens also failed to reveal cancerous cells... A new thoracic CT revealed a low density well-defined lesion in the right pectoral muscle (Fig. 3)... The patient was started on clindamycin (600 mg/8 hours intravenous) and the anterior chest wall abscess was drained... After 8 weeks of treatment, the right lung consolidation had decreased in size, the chest wall abscess had resolved, and the patient's symptoms had improved... The patient's mouth was explored and was found to have suboptimal oral hygiene and periodontal disease... Percutaneous transthoracic CT-guided needle biopsy is a well-established, simple, reliable diagnostic interventional procedure for definitive pathologic diagnosis of thoracic neoplasms since it has a high diagnostic yield and a relatively low morbidity... In conclusion, we present the case of an immunocompetent patient who underwent two nondiagnostic transbronchial and CT-guided transthoracic needle biopsies due to suspicion of lung cancer.

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Axial nonenhanced computed tomography image of the thorax (mediastinal window) shows a low-attenuation mass (asterisk) in the right pectoral muscle.
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Figure 3: Axial nonenhanced computed tomography image of the thorax (mediastinal window) shows a low-attenuation mass (asterisk) in the right pectoral muscle.

Mentions: Ten days after the second transthoracic biopsy, the patient developed a painful mass on the right anterior chest wall. Since this mass was on the puncture site of the previous biopsy, needle track dissemination of carcinoma was suspected. A new thoracic CT revealed a low density well-defined lesion in the right pectoral muscle (Fig. 3). This lesion was punctured and pus was aspirated. Microbiological culture of the aspirated pus identified clindamycin-susceptible P. micra.


Parvimonas micra chest wall abscess following transthoracic lung needle biopsy.

Gorospe L, Bermudez-Coronel-Prats I, Gomez-Barbosa CF, Olmedo-Garcia ME, Ruedas-Lopez A, Gomez del Olmo V - Korean J. Intern. Med. (2014)

Axial nonenhanced computed tomography image of the thorax (mediastinal window) shows a low-attenuation mass (asterisk) in the right pectoral muscle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219977&req=5

Figure 3: Axial nonenhanced computed tomography image of the thorax (mediastinal window) shows a low-attenuation mass (asterisk) in the right pectoral muscle.
Mentions: Ten days after the second transthoracic biopsy, the patient developed a painful mass on the right anterior chest wall. Since this mass was on the puncture site of the previous biopsy, needle track dissemination of carcinoma was suspected. A new thoracic CT revealed a low density well-defined lesion in the right pectoral muscle (Fig. 3). This lesion was punctured and pus was aspirated. Microbiological culture of the aspirated pus identified clindamycin-susceptible P. micra.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ramon y Cajal University Hospital, Madrid, Spain.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

To the Editor, Percutaneous transthoracic computed tomography (CT)-guided needle biopsy is a well-established, simple, reliable diagnostic interventional procedure for definitive pathologic diagnosis of thoracic neoplasms because of its high diagnostic yield and relatively low morbidity... We present a case of a patient suspected to have lung cancer who underwent two CT-guided transthoracic needle biopsies and developed a chest wall mass 10 days after the second percutaneous biopsy... A 67-year-old male ex-smoker with cough and constitutional syndrome (loss of appetite, fatigue, and progressive weight loss over 6 weeks) and no fever was referred to our institution after chest radiographs revealed a nonresolving opacity in the right lung base... His medical history was otherwise nonsignificant... Physical examination showed decreased breath sounds on auscultation at the right hemithorax... The patient was placed in the supine position on the CT table and an 18 G semi-automated coaxial core biopsy needle (Bard Magnum, Bard, Tempe, AZ, USA) was inserted into the patient's thorax through the right pectoral muscle (Fig. 2)... Pathologic analysis of the obtained specimens also failed to reveal cancerous cells... A new thoracic CT revealed a low density well-defined lesion in the right pectoral muscle (Fig. 3)... The patient was started on clindamycin (600 mg/8 hours intravenous) and the anterior chest wall abscess was drained... After 8 weeks of treatment, the right lung consolidation had decreased in size, the chest wall abscess had resolved, and the patient's symptoms had improved... The patient's mouth was explored and was found to have suboptimal oral hygiene and periodontal disease... Percutaneous transthoracic CT-guided needle biopsy is a well-established, simple, reliable diagnostic interventional procedure for definitive pathologic diagnosis of thoracic neoplasms since it has a high diagnostic yield and a relatively low morbidity... In conclusion, we present the case of an immunocompetent patient who underwent two nondiagnostic transbronchial and CT-guided transthoracic needle biopsies due to suspicion of lung cancer.

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