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Posterior mediastinal nodule diagnosed as a tuberculous granuloma infiltrating into the aorta

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Abstract

Although tuberculous infection rarely results in aortic aneurysm formation or rupture, its precursor lesion has never been identified in cases with tuberculosis. We incidentally encountered a case of a posterior mediastinal nodule with concomitant chest computed tomography (CT) findings of multiple pulmonary micronodular shadows. Since an enlargement of the mediastinal nodule was retrospectively apparent, we considered the lesion as malignant. Enhanced CT showed luminal irregularity in the descending aorta, located adjacent to the nodule, in addition to the disappearance of the fat plane between the lesion and the aorta. We successfully resected the nodule with the aorta under partial cardiopulmonary bypass. Based on the pathological and postoperative bacterial findings, the nodule was diagnosed as a tuberculous granuloma infiltrating into the medial layer of the aorta.

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Acknowledgements

This case was included in a presentation on May 17, 2019, at a selective video session of the 36th Annual Scientific Meeting of the Japanese Association for Chest Surgery, Osaka, Japan. We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Hitachi General Hospital, 2-1-1 Jyounan, Hitachi, Ibaraki, 317-0077, Japan

    Kazuto Sugai, Hideo Ichimura, Yasuharu Sekine & Keisuke Kobayashi

  2. Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Hideo Ichimura & Yukio Sato

  3. Hitachi Medical Education and Research Center, Faculty of Medicine, University of Tsukuba, 2-1-1 Jyounan, Hitachi, Ibaraki, 317-0077, Japan

    Hideo Ichimura & Kanji Matsuzaki

  4. Department of Cardiovascular Surgery, Hitachi General Hospital, Hitachi, Japan

    Kanji Matsuzaki

  5. Department of Respiratory Medicine, Hitachi General Hospital, Hitachi, Japan

    Kei Shimizu

  6. Department of Pathology, Hitachi General Hospital, Hitachi, Japan

    Akiko Sakata

Authors
  1. Kazuto Sugai
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  2. Hideo Ichimura
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  3. Yasuharu Sekine
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  4. Keisuke Kobayashi
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  5. Kanji Matsuzaki
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  6. Kei Shimizu
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  7. Akiko Sakata
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  8. Yukio Sato
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Correspondence to Hideo Ichimura.

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Sugai, K., Ichimura, H., Sekine, Y. et al. Posterior mediastinal nodule diagnosed as a tuberculous granuloma infiltrating into the aorta. Gen Thorac Cardiovasc Surg 69, 572–576 (2021). https://doi.org/10.1007/s11748-020-01499-9

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  • DOI: https://doi.org/10.1007/s11748-020-01499-9

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