Can I sound and aspirate a cranial mediastinal mass (6cm) in the chest of a 70lb lean lab. He’s 10 years old and we found it taking senior screening radiographs. It’s 2 cm cranial to the cardiac silhouette and about midway dorsal/ventral.
Can I sound and aspirate a cranial mediastinal mass (6cm) in the chest of a 70lb lean lab. He’s 10 years old and we found it taking senior screening radiographs. It’s 2 cm cranial to the cardiac silhouette and about midway dorsal/ventral.
Comments
Yes you can and we even core
Yes you can and we even core bx these as well depneding on the angle as long as its not cystic. Usually looking for LN masses or thymoma but occasionally medistinal cysts or lung masses in that region. If LN then check the abdomen for pathology because the sternal LN drain the abdomen and may have an easier stick in the abdomen like a multicentric lymphoma or similar. Sedate, collapse the lung manually with the back fof the left hand holding the probe, find the window cranial to the heart and fna like anything else. If fluid filled then drain, cytospin and cytology of the slide prepped.
Here is the procedure described “Lindquist compression technique” in interventional procedures:
http://sonopath.com/resources/interventional-procedures
and here are a couple of exemplary cases with needles.
http://sonopath.com/members/case-studies/cases/mediastinal-lymphoma-diagnosed-fna-mediastinal-lymph-nodes-4-year-old-hyp
http://sonopath.com/members/case-studies/cases/lymphoma-diagnosed-trucut-biopsy-mediastinal-lymph-node-7-year-old-mn-box
… just jumping in with some
… just jumping in with some personal experience (although I’m the cardiologist..):
thymomas are sometimes non-diagnostic on FNA. In that case you can give a single dose of Vincristine. If the mass decreases in size within 1-2 weeks consider lymphoma, if not, consider thymoma.
Best regards!
Peter
Thank You! Thank You!
Thank You! Thank You!
great tip Peter!!!.. and for
great tip Peter!!!.. and for th erecord you are the most broad spectrum cardiologist on the planet in that can scan PSSs, GI obstructions, put needles anywhere and cut a back as well as play aorund with 5 drugs and starlings laws:)
🙂 Thx, Eric 🙂
I’m still
🙂 Thx, Eric 🙂
I’m still learning, though – and I learned a lot from you and sonopath!
Thx peter thats what we are
Thx peter thats what we are here for…but none of use are ever done learning if we are smart and fortunate:)
Update: Â Ultrasound of
Update: Ultrasound of abdomen was clear, US of chest mass moved it from lung to Cranial mediastinum, and FNA was “highly suggestive” of Thymoma. Referred to oncologist, CT done, thorascoscopy scheduled to remove mass.
Thanks everyone!
Nice Thx for the follow-up.
Nice Thx for the follow-up. We like diagnoses:)