Clinical Image
Is it Cyst or Neoplasm? The Role of Thorax Magnetic Resonance Imaging
¿Quiste o neoplasia? El papel de la resonancia magnética de tórax
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Right apical solitary nodule and thickening of the right paratracheal stripe (arrows). (B) Endoscopic view of the larynx reveals RVCP. (C) CT-PET at the larynx. No uptake in the right vocal cord is compensated by hypermetabolism in the left one. (D) Chest CT, sagital view. A lower neck adenopathy (left arrow) lies just above the level of the first rib's (right arrow) trajectory (line). Therefore, it belongs to the 1R nodal station.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> (E) PET scan. Increased uptake of the radiotracer noted at 1R (arrow), 2R, 4R and 10R nodal stations. The lung nodule was also hypermetabolic (not shown). (F) CT-PET reveals hyperactivity in the right juxta thyroid adenopathy (1R).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Navarro Esteva, Javier Travieso Betancor, Jordi Freixinet Gilart" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Navarro Esteva" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Travieso Betancor" ] 2 => array:2 [ "nombre" => "Jordi" "apellidos" => "Freixinet Gilart" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921004006?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000012/v3_202201080532/S1579212921004006/v3_202201080532/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1579212921004055" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.05.019" "estado" => "S300" "fechaPublicacion" => "2021-12-01" "aid" => "2518" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57:768" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Cavitary Lesions in a Hematopoietic Stem Cell Transplant Patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "768" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones cavitadas en un paciente receptor de un trasplante de células madre hematopoyéticas" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 684 "Ancho" => 900 "Tamanyo" => 197558 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Computed tomography of chest reveals new cavitary nodules in the right lower lung. The right lower lung cavitary lesion (yellow arrow) is adjacent to a bronchus (yellow carrot). (B) Convex-probe endobronchial ultrasound image of thickened cavitary wall (yellow asterisk) of right lower lobe opacity. (C) Gomori Methenamine-Silver nitrate statin (A, 600×) highlights the branching gram-positive filamentous organisms. (D) <span class="elsevierStyleItalic">Nocardia</span> is weakly acid-fast, and FITE (B, 600×) stain, which is a modified acid fast stain, is positive with the branching filamentous organism.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Badar Patel, Ajay Sheshadri, Saadia A. Faiz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Badar" "apellidos" => "Patel" ] 1 => array:2 [ "nombre" => "Ajay" "apellidos" => "Sheshadri" ] 2 => array:2 [ "nombre" => "Saadia A." "apellidos" => "Faiz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921004055?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000012/v3_202201080532/S1579212921004055/v3_202201080532/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Is it Cyst or Neoplasm? The Role of Thorax Magnetic Resonance Imaging" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "769" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Adem Karaman, Elif Yilmazel Ucar, Serhat Kaya, Ömer Araz" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Adem" "apellidos" => "Karaman" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Elif Yilmazel" "apellidos" => "Ucar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Serhat" "apellidos" => "Kaya" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:4 [ "nombre" => "Ömer" "apellidos" => "Araz" "email" => array:1 [ 0 => "dromeraraz@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Radiology, Ataturk University School of Medicine, 25240 Erzurum, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240 Erzurum, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Quiste o neoplasia? El papel de la resonancia magnética de tórax" ] ] "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" => 1252 "Ancho" => 1267 "Tamanyo" => 167582 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Chest X ray PA view showing an ill-defined radiopacity in left upper lung field. (b) T2 weighted imagines haste coronal view hyperintense lesion was observed. There was band formation compatible with germinative membrane in the lesion. (c) Positron emission tomography (PET)/computed tomography (CT) showed hypometabolic cavitary lesion was observed in the left lung upper lobe. (d) T2 weighted imagines haste axial view hyperintense lesion was observed. There was band formation compatible with germinative membrane in the lesion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 59-year-old male patient was admitted to the chest diseases clinic with complaints of sweating, fever and cough. The chest X-ray showed a uniform limited radiopaque area in the upper zone of the left lung. Then, the patient underwent positron emission tomography (PET)/computed tomography (CT) (PET-CT) imaging. In PET-CT, 4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mm sized hypometabolic cavitary lesion was observed in the left lung upper lobe. Then the patient was asked for thorax tru-cut biopsy due to suspicion of malignancy. We thought that this lesion may be hydatid cyst. Because our city is one of the endemic regions. The patient was taken a contrast thoracic magnetic resonance imaging (MRI). In thoracic MRI, a 45<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>mm sized T1 weighted imagines hypointense, T2 weighted imagines hyperintense lesion was observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was band formation compatible with germinative membrane in the lesion. Based on these findings, we diagnosed the patient with perforated cyst hydatid. The biopsy was not taken.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">It is difficult to differentiate complicated cysts from tumor, hematoma, congenital cysts, or pneumothorax.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> Thoracic MRI may be more sensitive than CT especially malign-benign differentiation of lesions.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">2,3</span></a> It can be a guide before the interventional procedure.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors received no financial support for the research and/or authorship of this article.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest to the publication of this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "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" => 1252 "Ancho" => 1267 "Tamanyo" => 167582 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Chest X ray PA view showing an ill-defined radiopacity in left upper lung field. (b) T2 weighted imagines haste coronal view hyperintense lesion was observed. There was band formation compatible with germinative membrane in the lesion. (c) Positron emission tomography (PET)/computed tomography (CT) showed hypometabolic cavitary lesion was observed in the left lung upper lobe. (d) T2 weighted imagines haste axial view hyperintense lesion was observed. There was band formation compatible with germinative membrane in the lesion.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three atypical pulmonary hydatidosis lesions mimicking bronchial cancer from Turkey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Kilinç" 1 => "M. Döskaya" 2 => "A. Sakar" 3 => "A. Yorgancioğlu" 4 => "H. Halilçolar" 5 => "A. Caner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "New Microbiol" "fecha" => "2009" "volumen" => "32" "paginaInicial" => "229" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19579706" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnetic resonance imaging as an adjunct to computed tomography in the diagnosis of pulmonary Hydatid cysts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Tandur" 1 => "A. Irodi" 2 => "B.R. Chacko" 3 => "L.R. Vimala" 4 => "D.J. Christopher" 5 => "B.R. Gnanamuthu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/ijri.IJRI_121_18" "Revista" => array:6 [ "tituloSerie" => "Indian J Radiol Imaging" "fecha" => "2018" "volumen" => "28" "paginaInicial" => "342" "paginaFinal" => "349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30319213" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastases of alveolar echinococcosis to the skin, pleura, ribs, and xiphoid process: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Karaman" 1 => "O. Araz" 2 => "A. Koru" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2020" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000012/v3_202201080532/S1579212921004043/v3_202201080532/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000012/v3_202201080532/S1579212921004043/v3_202201080532/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921004043?idApp=UINPBA00003Z" ]
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