Mediastinal malignant lymphoma complicated with esophagobronchial fistula: successfully treated case.
A 64-year-old man presented with mediastinal and bilateral hilar adenopathy, and a biopsy of a scalene node revealed non-Hodgkin's lymphoma. One week after a cycle of combination chemotherapy, he developed an esophagobronchial fistula. Following a resolution of pneumonia by antibiotics, a cervical esophagostomy was made and, after the improvement of his general condition with parenteral hyperalimentation, he was given one course of combination chemotherapy which was continued until the mediastinal lymph node shadow completely disappeared. A subcutaneous bypass operation was performed on the stomach. After receiving one more cycle of intensification chemotherapy, he was discharged. Three months later, a bronchoscopy showed healing of the fistula. Nine months postoperatively, there is no evidence of the lymphoma or the esophagobronchial fistula recurring. Esophageal involvement is rare in malignant lymphoma and this is only the sixth reported case of esophageal fistula of the respiratory tract in association with lymphoma, and just the second to be treated successfully.
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Y
Y
Tachimori
H
H
Kato
H
H
Watanabe
T
T
Iizuka
K
K
Minato
H
H
Yamaguchi
K
K
Mukai
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001983:Bronchial Fistula / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D004937:Esophageal Fistula / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004946:Esophagostomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D013270:Stomach / Q000601:surgery; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone