Emergency imaging studies for intrathoracic processes in children's oncology and hematology

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Abstract

Modern technologies for treating children with oncological and oncohematological diseases have significantly increased survival. However, oncological diseases remain one of the significant causes of childhood mortality. In some cases, fatal outcomes and irreversible disability can be prevented by early diagnosis and, accordingly, timely treatment, which is impossible without non-invasive visualization of critical conditions. Life-threatening oncological conditions of the chest cavity can be primary due to the localization and spread of the tumor itself, or secondary (compression of organs and vessels, infection, complications of chemo- and radiotherapy). Visualization of the chest organs is necessary for the diagnosis of structural oncological conditions (diffuse or focal changes in the lungs, embolism, superior vena cava syndrome, cardiac tamponade). The authors presented the indications and possibilities of ultrasound and radiological diagnostics of primary malignant neoplasms in childhood and their life-threatening complications, emphasizing the need for immediate treatment of the patient.

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About the authors

G. V. Tereshchenko

Dmitry Rogachev National Medical Research Center for Children's Hematology, Oncology and Hematology, Ministry of Health of Russia

Email: delyagin-doktor@yandex.ru
ORCID iD: 0000-0001-7317-7104
SPIN-code: 9413-2500

Candidate of Medical Sciences

Russian Federation, Moscow

W. M. Delyagin

Dmitry Rogachev National Medical Research Center for Children's Hematology, Oncology and Hematology, Ministry of Health of Russia

Author for correspondence.
Email: delyagin-doktor@yandex.ru
ORCID iD: 0000-0001-8149-7669
SPIN-code: 8635-8777

Professor, MD

Russian Federation, Moscow

A. V. Popa

Dmitry Rogachev National Medical Research Center for Children's Hematology, Oncology and Hematology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: delyagin-doktor@yandex.ru
ORCID iD: 0000-0001-5318-8033
SPIN-code: 7609-1467

Professor, MD

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Fig. 1. Echogram of the left ventricle with zones of hypokinesia (white arrows) with relatively preserved contractility in the middle section (gray arrows)

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3. Fig. 2. Thrombus (arrow) in the right atrium Note. RA – right atrium; RV – right ventricle; LV, left ventricle.

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4. Fig. 3. Massive effusion (indicated by crosses) over the entire cardiac surface in an adolescent with lymphoma

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5. Fig. 4. M-mode echocardiography: change in the depth of the heart position relative to the ultrasound transducer during respiration in threatening pericardial effusion

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6. Fig. 5. Volumetric mass in the mediastinum (Hodgkin's lymphoma)

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7. Fig. 6. Computed tomography of the chest organs in Hodgkin's lymphoma. A conglomerate of enlarged, merging lymph nodes is detected in the anterior superior mediastinum. The largest tumor volume is detected on the left side of the mediastinum

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8. Fig. 7. Lymphangioma of submandibular region, face, neck, upper mediastinum, chest wall, upper extremities: volumetric mass represented by small cystic cavities and abnormally formed vessels. The mass displaces from the midline and deforms the lumen of the pharynx and larynx

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9. Fig. 8. Ultrasound image of pleural effusion (crosses)

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10. Fig. 9. Pulmonary aspergillosis with aspergilloma (arrow) in a child with histiocytosis

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11. Fig. 10. Radiograph of the “cytosar lung”. Minimal pneumatization. Due to edema, the lungs are insignificantly different in X-ray density from the image of the heart

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