Tzilas Vasilios, Bastas Antonios, Koti Aspasia, Papandrinopoulou Dimitra, Tsoukalas Georgios
4th Respiratory Medicine Department, Athens Chest Disease Hospital Sotiria, Greece.
J Med Case Rep. 2010 Jun 9;4:174. doi: 10.1186/1752-1947-4-174.
Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example.
We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava.
This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.
对于肺癌患者，纵隔评估至关重要。纵隔淋巴结转移在分期过程中起着重要作用。医生应意识到纵隔评估中潜在的陷阱。本病例报告提供了一个例子。
我们报告一例57岁白种男性病例，其有4个月干咳病史。他被诊断为非小细胞肺癌。最初，由于存在主动脉旁淋巴结，认为无法手术。对纵隔进行更仔细检查发现，“淋巴结”实际上是永存左上腔静脉。
本研究强调了纵隔分期的困难，尤其是在未使用静脉造影剂时。识别这种血管畸形显著改变了治疗决策，使我们的患者有机会接受手术切除。据我们所知，英文文献中尚未描述过这种关联。
