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Rare Bronchial Tumour and an Emergent Surgery Due to Uncontrollable Haemorrhage
Tumor bronquial infrecuente y cirugía de emergencia por hemorragia incontrolable
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(B) Axial CT scan (parenchymal window) reveals a variant azygos lobe on the left hemithorax and aberrant left subclavian artery. (D and E) Coronal plan MIP CT images show total transposition of visceral organs accompanied with dextrocardia. (C, D and F) Sagittal, coronal and posterolateral projection 3D CT images show aberrant left subclavian artery originated from the distal of the right aortic arc. (E) Coronal MIP CT scan reveals origination and trace of the right and left carotid arteries.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Veysel Ayyildiz, Fahri Aydin, Hayri Ogul" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Veysel" "apellidos" => "Ayyildiz" ] 1 => array:2 [ "nombre" => "Fahri" "apellidos" => "Aydin" ] 2 => array:2 [ "nombre" => "Hayri" "apellidos" => "Ogul" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619303473?idApp=UINPBA00003Z" "url" => "/03002896/0000005600000011/v2_202011100719/S0300289619303473/v2_202011100719/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Rare Bronchial Tumour and an Emergent Surgery Due to Uncontrollable Haemorrhage" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "746" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Marta Nobre Pereira, Maria João Ribeiro, Jorge Dionísio" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Marta Nobre" "apellidos" => "Pereira" "email" => array:1 [ 0 => "martapereira_15@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Maria João" "apellidos" => "Ribeiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Jorge" "apellidos" => "Dionísio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Pulmonology Department, Centro Hospitalar Universitário do Algarve – Hospital de Faro, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Pulmonology Department, Hospital dos Marmeleiros – SESARAM, Funchal, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Pulmonology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor bronquial infrecuente y cirugía de emergencia por hemorragia incontrolable" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1477 "Ancho" => 1374 "Tamanyo" => 355808 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest CT (axial plan (AP)): a 29<span class="elsevierStyleHsp" style=""></span>mm homogeneous nodular lesion in the left lower lobe; (B) Endobronchial view of left lower lobe, with a mass blocking the lateral segmental bronchus (LB9); (C) A closer view of the mass, which was yellow, with a smooth surface and a long implantation base, containing multiple superficial vessels, almost completely blocking the entrance orifice of LB9; (D) The balloon catheter tamponade was inserted at the left common basal trunk; (E) Microscopic examination of the surgical sample revealed tumour free margins and (F) formation of aggregates with plenty of plasma cells and cells having an oval to fusiform appearance.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 41-year-old man, former smoker, presented with a 3-month history of a non-productive cough. Although Lab disclosed mild thrombocytopenia there was no history of hemoptysis. Chest CT revealed a 29<span class="elsevierStyleHsp" style=""></span>mm homogeneous nodule in the left lower lobe (LLL, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Bronchoscopy showed the presence of a yellowish hypervascularized mass at LB9 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C). The first biopsy immediately unleashed a profuse bleeding, which despite maintaining the wedging position and lavage with cold saline and aminocaproic acid instillation could not be controlled. A balloon catheter tamponade was inserted at the common basal trunk (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D). However, severe bleeding persisted whenever the balloon was deflated. Patient was then intubated with reinsertion of the balloon tamponade, enabling clinical stabilization until emergency left lower lobectomy was performed, with uneventful recovery. Pathologic surgical report revealed an inflammatory myofibroblastic tumour (IMT, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E and F). Presently the patient has no clinical complaints.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">IMT is an extremely rare low-grade tumour, with true benign or past inflammatory aetiology, more common in children and young adults. Complete resection is the main treatment choice, providing a good survival.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Lobectomy was carried out because massive bleeding prevented a less aggressive approach. This case highlights the need to anticipate the difficulties and to decide procedure sequence to handle them.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1477 "Ancho" => 1374 "Tamanyo" => 355808 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest CT (axial plan (AP)): a 29<span class="elsevierStyleHsp" style=""></span>mm homogeneous nodular lesion in the left lower lobe; (B) Endobronchial view of left lower lobe, with a mass blocking the lateral segmental bronchus (LB9); (C) A closer view of the mass, which was yellow, with a smooth surface and a long implantation base, containing multiple superficial vessels, almost completely blocking the entrance orifice of LB9; (D) The balloon catheter tamponade was inserted at the left common basal trunk; (E) Microscopic examination of the surgical sample revealed tumour free margins and (F) formation of aggregates with plenty of plasma cells and cells having an oval to fusiform appearance.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammatory myofibroblastic tumour of the lung: a reactive lesion or a true neoplasm?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Panagiotopoulos" 1 => "D. Patrini" 2 => "L. Gvinianidze" 3 => "W.L. Woo" 4 => "E. Borg" 5 => "D. Lawrence" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3978/j.issn.2072-1439.2015.04.60" "Revista" => array:6 [ "tituloSerie" => "J Thorac Dis" "fecha" => "2015" "volumen" => "7" "paginaInicial" => "908" "paginaFinal" => "911" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26101648" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammatory myofibroblastic tumour of the lung" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Sakurai" 1 => "T. Hasegawa" 2 => "S. Watanabe" 3 => "K. Suzuki" 4 => "H. Asamura" 5 => "R. Tsuchiya" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s1010-7940(03)00678-x" "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "2004" "volumen" => "25" "paginaInicial" => "155" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14747105" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005600000011/v2_202011100719/S0300289619303424/v2_202011100719/en/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005600000011/v2_202011100719/S0300289619303424/v2_202011100719/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619303424?idApp=UINPBA00003Z" ]
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