1/509. Early assessment of pulmonary involvement in limited scleroderma. A case report.Limited scleroderma is typified by insidious progression of skin involvement. The onset of internal organ involvement is delayed until the second decade, the lungs being the most important from the prognostic point of view. Early detection of pulmonary lesions is of paramount importance. This paper presents a 16-year-old male patient with a history of Raynaud's phenomenon followed by progressive tightening of skin over the fingers, hands and face. He had early pulmonary involvement detected by high resolution computed tomography (HRCT) and proven by histopathologic examination as usual interstitial pneumonia; even the chest x-ray and pulmonary function tests were normal. A combination of prednisolone and D-penicillamine was planned for treatment because of his having both pulmonary and gastrointestinal system involvement. 99 m technetium diethylenetriamine pentaacetate (99 m Tc-DTPA) test is very sensitive for pulmonary lesions and it has shown a rapid clearance in the early stage. This method is also useful for following up the therapeutic trial.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/509. Catamenial hemoptysis--a case report.Thoracic endometriosis is rare. Its associated clinical syndromes should be considered in menstruating women with pneumothorax or hemoptysis. The availability of chest CT scanning and danazol provide new technique in diagnosis and therapy.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
3/509. The prevention of irreversible lung changes following reversible phrenic nerve paralysis.phrenic nerve paralysis frequently follows operations on the neck such as resection of a cervical or first rib. It all too often passes unrecognised or is incorrectly treated, leading to permanent lung damage which may be severe enough as to result in a functional pneumonectomy. This is particularly unfortunate since the phrenic nerve paralysis is usually temporary. Three case histories are described of reversible paralysis of the phrenic nerve in which, due to prompt diagnosis, the ensuing lung changes were either prevented or immediatley treated. Intermittent assisted respiration with a Monaghan respirator was used to provide nebulised inhalations of mesna several times a day. The method is applicable via a tracheostomy, an endotracheal tube or a simple mouthpiece. The latter is illustrated. The therapy is not hindered by immobilisation of the head and neck and the level of consciousness of the patients is of no importance. Many chest x-rays demonstrate the rapid clearing of the lungs achieved. All three patients were discharged with perfectly normal lungs.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
4/509. sarcoidosis associated with multiple large pulmonary nodules.Parenchymal manifestations of pulmonary sarcoidosis include a diffuse, symmetric, reticulonodular interstitial pattern, a fibrotic pattern, and an acinar pattern. Large pulmonary nodules in sarcoidosis are rare, and their frequency (> 1 cm in diameter) has been estimated at 2-4%. We report a rare case of sarcoidosis associated with large bilateral pulmonary nodules. These nodules reached up to 7 cm in diameter, which is larger than any others reported previously. Furthermore, these nodular lesions developed within only 6 months of normal chest X-ray results and were not found to accompany bilateral hilar lymph adenopathy, which is observed in the usual course of sarcoidosis. As described above, this case of pulmonary sarcoidosis was significant not only in terms of the large size of the nodules but also the unique chest X-ray course.- - - - - - - - - - ranking = 2keywords = chest (Clic here for more details about this article) |
5/509. A fluffy white traveller: imported Coccidiodes immitis infection in an Australian tourist.Pulmonary coccidioidomycosis is a rare cause of pulmonary nodules and respiratory infection in travellers to endemic areas. An Australian tourist suffered an acute respiratory illness while on holiday in mexico. She subsequently developed erythema nodosum and was noted to have a left pulmonary nodule on chest X-ray after return to australia. The diagnosis of coccidioides immitis infection was established by histology and culture of the resected lung lesion. The patient made an uneventful recovery and received one month of therapy with ketoconazole. culture of the fungus took place under controlled Class 3 conditions. An unusual fungal infection in australia, coccidioidomycosis poses special risks to staff of microbiology laboratories.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
6/509. lung mass due to amniotic fluid embolism--an intrathoracic complication of pregnancy.A 29-year-old woman with right chest pain was admitted for radiographic investigation and found to have a round mass in the right lower zone. This was initially suspected to be a hydatid lung cyst but was confirmed as a cystic mass by computed tomography and duly excised. Histologic examination revealed an amniotic fluid embolism. The patient had had a stillbirth three months earlier.- - - - - - - - - - ranking = 1.4039430567939keywords = chest, chest pain (Clic here for more details about this article) |
7/509. Kaposi's sarcoma-associated herpesvirus infection in the lung in multicentric Castleman's disease.A 32-year-old female was admitted for evaluation of multiple infiltrates on a chest radiograph. A diagnosis of multicentric Castleman's disease was made on the basis of typical clinical manifestations. Transbronchial lung biopsy (TBLB) revealed histological findings reported in lymphocytic interstitial pneumonia. Both the polymerase chain reaction and in situ hybridization with a probe specific for Kaposi's sarcoma-associated herpesvirus (KSHV) sequences demonstrated the presence of KSHV in the TBLB sample.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
8/509. Sarcoid-like pulmonary disorder in human immunodeficiency virus-infected patients receiving antiretroviral therapy.We report two cases of hiv-infected patients who presented with diffuse interstitial micronodular lesions on chest X-ray after institution of protease inhibitor-containing highly active antiretroviral therapy (HAART). Granulomatous pulmonary disorder mimicking sarcoidosis was diagnosed on histopathological studies revealing noncaseating granuloma and bronchoalveolar lavage analysis showing an intense CD4( ) lymphocyte alveolitis. Causative agents such as infectious organisms and environmental compounds were excluded. The relationship between sarcoid-like reaction and immune reconstitution under HAART is discussed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
9/509. Spontaneous regression of a bulla with the development of adenocarcinoma of the lung.Spontaneous regression of a bulla in the lung is rare. We describe a case of spontaneous regression associated with the development of adenocarcinoma of the lung in a 59-year-old male smoker. The bulla had begun to regress spontaneously at least six months before lung cancer was detected on a chest radiograph. He underwent left upper lobe lobectomy with mediastinal node dissection. The tumor arose within the bulla, extending along the bulla wall. He has been alive for more than eight years with no evidence of recurrence. This case suggests that spontaneous regression of a bulla should be recognized as one of the early radiographic signs of the development of lung cancer in patients with bullous lung disease.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
10/509. cellulose granulomatosis of the lungs.Chest radiographs and high-resolution chest CT scans were performed in a 30-year-old man with a history of intravenous drug abuse and diffuse micronodular infiltrates. Transbronchial biopsy gave a diagnosis of cellulose granulomatosis of the lung. cellulose granulomatosis should be considered in the differential diagnosis of pulmonary interstitial disease, especially in the setting of intravenous drug abuse.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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