Balloon Rupture and Metallic Ring
Displacement
from a Swan-Ganz
Catheter
To the Editor:
Complications
include
reported
balloon
occurring
during
report
a case
shortly
after
was
because,
tained.
HLA-DR
antigen
cells (arrowheads).
fication
x 312).
the
diagnosis
the foci
from
Langerhans’
stained
samples
from
nant
an
cell
original
also
revealed
used
to wrap
have
lodged
not
cells
and
use
case
also
located
Birbeck
granules
Langerhans’
cells
for S-100
protein
other
patients
with
granulomatosis
pulmonary
that
Hodgkin’s
immunochemically
be more
Andrew
The
similar
disease
than
Flint,
incidental
disease,
neoplasms.
raises
finding
involved
may
of
of
represent
finding
to Langerhans’
M.
Department
of
a
cells
cells
in
that such
School
The University
Smid,
allow
other
symmetrical
by the
was
chest
ob-
1). Two metallic
attached
The
not
material
presumed
x-ray
to
examination
Cha,
fact
should
that
F Roman,
M.D.,
indiscriminate
insertion
Reprint
requests:
and
Center,
Browns
Di: Roman,
Mills,
of
be avoided.
DO.;
Dennis
VladirMaranhao,
Deborah
Heart
Walker,
Cardiology,
Deborah
M.D.;
M.D.,
F.C.C.P.,
and Lung
Center,
Heart
Mills,
NJ
and Lung
NJ 08015-1799
REFERENCES
by malig-
the possibility
and David
the
catheters
disease
coincidental.
M.D.,
catheter.
(Fig
to
sheath
was
biopsy
in all cases.
finding
in view
nodes
pressure
Browns
antigen,
of lung
Hodgkin’s
the
in lymph
such
HLA-DR
A review
of similar
cells
to this preliminary
postulate
to
and
cells.4
balloon
was still
Labora-
introducer
ruptured
vasculature;
be
in
We
this.
Cecelia
the cells
use.
occurring
Edwards
French
unequivocally.
techniques,
of Langerhans’
the
pulmonary
within
would
had
One
to the
reinforces
balloon-tipped
cells
rings
indistinguishable
were
ofimmunoperoxidase
Hodglcin’s
may
confirm
usually
days’
displacement
wedge
inside
dislodged.
in the
several
(American
8.5
pulmonary
situated
the
an
the balloon
had been
ring
catheter
through
insertion,
normally
inflation,
did
magni-
scattered
cytologically
of
identify
including
of pulmonary
association
to
which
response
cytologically
Sternberg
withdrawn
Se Do
varying
numbers
to bring attention
lymphomas,
localized
cases
ten
reportsLS
Langerhans’
were
1). These
positively
characteristic
recent
(Fig
but
demonstration
order
features
demonstrated
We wish
Reed
to
for
septa.
through
question
which
cells
in
However,
disease,
of neoplasm
alveolar
identical
positive
This
Ultrastructural
necessary
S-100 protein.
Note also the
(Hematoxylin
and eosin
stain,
of Hodgkin’s
near
adjacent
and
cytologically
cells
stained
or after
insertion.
On inspection,
rings,
cells
(arrows)
present.
These
1. Scattered
Langerhans’
cells
are
FIGURE
catheter
displacement,”‘
and
rupture
balloon-tipped
upon
of a balloon-tipped
electrode
withdrawal
of balloon
catheter
use
and
catheter
A 7.5 French
tory)
with
rupture’
1 Buchbinder
N, Ganz
W. Hemodynamic
monitoring:
invasive
techniques.
Anesthesiology
1976; 45:146-55
2 Lawson
D, Kushins
LG. A complication
of multipurpose
pacing
pulmonary
artery
catheterization
via the external
jugular
vein
approach.
Anesthesiology
1985; 62:377-78
3 Heiselman
DE,
Maxwell
JS, Petro
V. Electrode
displacement
from a multipurpose
Swan-Canz
catheter.
PACE
1986; 9:134-35
4 Macander
PJ, Kuhnlein
JL, Buiteweg
J, Lee C. Electrode
detachment:
a complication
of the
indwelling
pacing
Swan-Ganz
catheter.
New Engi J Med 1986; 314: 1711
M.D.,
of Pathology,
of Medicine,
of Michigan,
Ann Arbor
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1 Sajjad
SM, Luna MA. Primary
pulmonary
histiocytosis
X in two
patients
with Hodgldn’s
disease.
Thorax
1982; 37:110-13
2 Neumann
MP, Frizzera
C. The coexistence
of Langerhans’
cell
granulomatosis
and
malignant
lymphoma
may
take
different
forms:
report
of seven
cases with a review
of the literature.
Hum
Pathol
1986; 17:1060-65
3 L’Hoste
RJ, Arrowsmith
WR,
Leonard
GL, McGaw
H. Eosinophilic
granuloma
occurring
in a patient
with Hodgkin’s
disease.
Hum Pathol
1982; 13:592-95
4 Flint A, Lloyd By, Colby
TV, Wilson
BS. Pulmonary
histiocytosis
X: immunoperoxidase
staining
for HLA-DR
antigen
and S-100
protein. Arch Pathol Lab Med 1986; 110:930-33
5 Burns
BF, Colby
TV Dorfman
RE Langerhans
cell granulomatosis (histiocytosis
X) associated
with malignant
lymphomas.
Am J
Surg Pathol
1983; 7:529-33
FIGuz
1. Swan-Ganz
ruptured
balloon
(A),
ring (C).
catheter
winding
showing
material
192
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distal
(B) and
catheter
dislodged
Communications
at site of
metallic
to the Editor