medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-5-104-108medsovet-2351Research ArticleПрактикаPracticeОбразования средостения в клинической практикеMediastinal mass in clinical practiceПотешкинаН. Г.PoteshkinaN. G.

д.м.н., профессор

MD, Prof.

ТрошинаА. А.TroshinaA. A.

к.м.н.

PhD in medicine

МасловаМ. Ю.MaslovaM. Y.ЛысенкоМ. А.LysenkoM. A.

д.м.н., профессор

MD, Prof.,

СамсоноваИ. В.SamsonovaI. V.

к.м.н.

PhD in medicine

ЖелноваЕ. И.ZhelnovaE. I.

к.м.н.

PhD in medicine

Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава России, Москва; Городская клиническая больница №52 Департамента здравоохранения г. МосквыРоссияPirogov Russian National Research Medical University; Moscow City Clinical Hospital №52Russian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава России, Москва; Городская клиническая больница №52 Департамента здравоохранения г. МосквыРоссияPirogov Russian National Research Medical University ; Moscow City Clinical Hospital №52Russian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава России, МоскваРоссияPirogov Russian National Research Medical UniversityRussian FederationГородская клиническая больница №52 Департамента здравоохранения г. МосквыРоссияMoscow City Clinical Hospital №52Russian Federation20181004201805104108Copyright © Потешкина Н.Г., Трошина А.А., Маслова М.Ю., Лысенко М.А., Самсонова И.В., Желнова Е.И., 20182018Потешкина Н.Г., Трошина А.А., Маслова М.Ю., Лысенко М.А., Самсонова И.В., Желнова Е.И.Poteshkina N.G., Troshina A.A., Maslova M.Y., Lysenko M.A., Samsonova I.V., Zhelnova E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2351

Образования средостения включают широкий спектр доброкачественных и злокачественных заболеваний. На сегодняшний день, согласно литературным данным, распространенность образований средостения в структуре всех онкологических заболеваний составляет 3–7%, из них первично-локализованные опухоли (тимома, лимфома, герминогенные опухоли и др.) составляют 3%. Так, наиболее встречающимися образованиями средостения являются лимфома и тимома, гораздо реже встречаются опухоли зародышевой клетки. Примечательно, что нейрогенные опухоли средостения также являются распространенными, составляя от 12 до 21% от всех образований средостения с преобладанием в детской популяции. По морфологической структуре от 25 до 49% всех образований имеют злокачественный характер. Актуальность затронутой тематики обусловлена учащением заболеваемости и маскированным течением. Отмечено, что около 60% случаев образования средостения проявляются классическими респираторными симптомами, в остальных же случаях клиническая картина имеет вариабельный характер, что затрудняет диагностику и, соответственно, тактику лечения. В статье представлено описание клинического случая первично-локализованного образования средостения у пациентки 32 лет с установленным диагнозом «первичная медиастинальная В-крупноклеточная лимфома», дебютировавшим с клинической картины респираторных жалоб. Данный клинический случай описывает алгоритм диагностики заболевания с применением современных лабораторно-инструментальных методов обследования.

Mediastinal masses include a wide range of both benign and malignant diseases. Current evidence shows that they constitute 3–7% of all oncological diseases, with primary tumours (thymoma, lymphoma, germ cell tumours) accounting for 3% of all mediastinal masses. Lymphoma and thymoma, for instance, are the most common, while germ cell tumours are of much less frequent occurrence. Neurogenic tumours, it bears noting, are also widespread making up 12–21% of all mediastinal masses, predominantly so among paediatric population. Morphologically 25–49% of all masses are malignant. The rationale of the subject matter is the fact that statistics for progress of the disease masked as other conditions have been on the rise. It is noted that about 60% of mediastinal masses manifest themselves in classical respiratory symptoms, while the rest of cases are represented by a variable clinical picture, which makes it more difficult to diagnose and decide on the therapeutic approach. The article presents a clinical case of a 32-year-old female patient diagnosed as primary mediastinal large B-cell lymphoma which made its first appearance as a clinical picture of respiratory complaints. This clinical case describes the  diagnosis algorithm using up-to-date laboratory and instrumental methods.

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The authors declare that there are no conflicts of interest present.