1/49. Angiofollicular lymph node hyperplasia of the lung simulating carcinoma: pseudolymphoma with inflammatory changes.Angiofollicular lymph node hyperplasia of the lung developed in a 45-year-old man who was a heavy smoker. Slow growth of the lesion 3 years after biopsy and the finding of atypical cells in the sputum and bronchial washings strongly suggested a malignant lesion. There were no systemic manifestations other than dyspnea, which may have been related to allergy. The lesion was angiofollicular lymph node hyperplasia of the hyaline-vascular type. Invasion by lymphoid cells of both blood vessels and bronchioles suggested that the pathogenesis was probably infectious or inflammatory; also, the nature of the infiltrate indicated an immune mechanism. The course of the disease, as in other cases reported, has been benign, though a patchy density has developed in contralateral lung 4 years after lobectomy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/49. Pulmonary hamartoma. A rare case report.Pulmonary hamartoma is a rare lung neoformation, usually symptomless and by chance discovered, of a probable dysontogenetic origin with prevailing cartilaginous tissue and adult, onset age. The Authors report a rare case of a 25-year-old student, symptomless and fortuitously found by means of a radiograph of the chest. Many interesting features characterize the case report: histological nature of the pulmonary hamartoma, mainly vascular, so much as to feign an angiosarcoma at the macroscopical examination, and with small peripheral calcifications as shown by lung CT scan; the measures (about 7 cm) plentifully above the parameters usually reported in the literature (from 2 cm to 4 cm); the young onset age (about 10 years old). We may consider a case exceptionally reported in the literature. Besides, on the base of a few studies and of our experience, the results of the pulmonary hamartoma growth rate and doubling time are reported.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/49. A case report of video-assisted thoracoscopic pneumonectomy for pulmonary atypical mycobacteriosis.We report a case of a 61-year old woman with pulmonary atypical mycobacteriosis. Although she had been treated with chemotherapy, image findings gradually deteriorated. Chest X-ray and CT scan demonstrated that the advanced destruction with cavity formation and diffused shadow in the right lung. She underwent a right pneumonectomy under the video-assisted thoracic surgery (VATS) approach. The operation time was 4.9 hours, and the amount of intraoperative bleeding was 550 ml. The postoperative course was uneventful and the patient was discharged from hospital on 13th postoperative day. At present, two years after the operation, there is no progress of the pathogen into the other lung, and the patient is doing well with no postoperative complaint. Anatomically, pneumonectomy is a simple procedure, and in consideration of postoperative quality of life with alleviation of pain as well, VATS is worth trying in the cases where the status and nature of the disease are suitable for this technique.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/49. Monthly haemoptysis in a woman with platelet storage pool disease.A 26-year-old female with known platelet storage pool disease presented with a short history of recurrent haemoptysis. Initial investigations were unhelpful until the cyclical nature of the symptoms became apparent prompting the unusual diagnosis of pulmonary endometriosis to be made. This was subsequently confirmed on premenstrual CT scanning. The introduction of a specific hormonal therapy and multidisciplinary input was ultimately successful.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/49. Fatal pulmonary infection due to multidrug-resistant mycobacterium abscessus in a patient with cystic fibrosis.We report a case of fatal pulmonary infection caused by mycobacterium abscessus in a young patient with cystic fibrosis, who underwent bipulmonary transplantation after a 1-year history of severe lung disease. Fifteen days after surgery he developed septic fever with progressive deterioration in lung function. M. abscessus, initially isolated from a pleural fluid specimen, was then recovered from repeated blood samples, suggesting a disseminated nature of the mycobacterial disease. Drug susceptibility testing assay, performed on two sequential isolates of the microorganism, showed a pattern of multidrug resistance. Despite aggressive therapy with several antimycobacterial drugs, including clarithromycin, the infection persisted, and the patient died.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/49. Minute pulmonary meningothelial-like nodules: thin-section CT appearance.Minute pulmonary meningothelial-like nodules are often incidentally discovered during pathologic evaluation of pulmonary parenchymal specimens. These lesions were once thought to represent pulmonary chemodectomas, but pathological studies have shown that they are not of neuroendocrine origin. Minute pulmonary meningothelial-like nodules are benign, perhaps reactive in nature, but are occasionally found in association with lung carcinoma. They may appear as randomly distributed well-defined micronodules on thin-section chest CT, and thus may simulate metastatic disease when associated with lung carcinoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/49. Multiple nodular pulmonary amyloidosis. A case report and comparison with diffuse alveolar-septal pulmonary amyloidosis.A case of multiple nodular pulmonary amyloidosis in a 54-year-old Caucasian man is presented. Discrete symptomless radiodensities had developed in this patient's lungs within a period of three years, leading to a suspicion of a neoplastic process. The amyloid nature of these nodules was demonstrated by biopsy. In this case, as in others previously reported, there was no evidence of systemic disease, and immunoglobulins were normal. Local factors probably play an important part in the pathogenesis of this disease. This entity is to be distinguished from the diffuse type of pulmonary amyloidosis, which has a far graver prognosis. Diffuse alveolar septal amyloidosis is usually associated with primary systemic amyloidosis or multiple myeloma and leads rapidly to respiratory distress.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/49. rhodococcus equi pulmonary infection in a pancreas-alone transplant recipient: consequence of intense immunosuppression.We report the case of a pancreas-alone transplant recipient who developed rhodococcus equi pneumonia after receiving multiple courses of antilymphocyte therapy for the treatment of recurrent acute pancreas allograft rejection. We also review and discuss the diagnosis, clinical course, and treatment of 18 cases of R. equi infection reported in solid organ transplant recipients. The lung is the most common primary site of infection, but R. equi infection is difficult to diagnose because of the pleomorphic, gram-positive, and partially acid-fast nature of the organism. Treatment usually involves a combination of antibiotics including rifampin, macrolides, vancomycin, and ciprofloxacin. The optimal duration of therapy is unknown, but relapse is common if the duration of treatment is less than 14 days. The duration of therapy should be guided by clinical recovery, culture results, and radiographic findings. Monitoring levels of immunosuppressive agents-such as tacrolimus and cyclosporine-is needed in order to avoid clinically significant drug interactions with rifampin or the macrolides when these agents are used in order to treat R. equi infection in the transplant population.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/49. Significant pulmonary toxicity associated with interferon and ribavirin therapy for hepatitis c.OBJECTIVE: The aim of this study was to analyze the clinical presentation and outcomes of significant pulmonary toxicity associated with interferon and ribavirin. methods: We conducted a retrospective review of patients enrolled in four clinical trials at three sites, two academic medical centers and one community practice, and reviewed the literature. RESULTS: Four patients, while on therapy with interferon a and ribavirin for chronic hepatitis c, developed significant pulmonary signs and symptoms. Further workup, which included lung biopsy in three, revealed bronchiolitis obliterans organizing pneumonia in two, and interstitial pneumonitis in two other cases. There were no other predisposing factors for lung disease identified. Resolution of symptoms occurred in all patients upon discontinuation of interferon and ribavirin, with or without corticosteroid therapy. One of the patients developed pulmonary complications while on a clinical trial of pegylated interferon and represents the first reported case associated with the use of long-acting interferon in chronic hepatitis c infection. CONCLUSIONS: A spectrum of significant pulmonary toxicity, including bronchiolitis obliterans organizing pneumonia and interstitial pneumonitis, can occur with interferon or pegylated interferon in combination with ribavirin. Though pulmonary toxicity of interferon is well known, these cases represent the first cases reported in the literature with combination therapy. It is likely that pulmonary toxicity may not be investigated in patients on combination therapy because of the frequent pulmonary symptoms with ribavirin. Though usually reversible, at least one case has required long-term steroids with inadequate resolution. Though pulmonary toxicity is rare, symptoms which are more than mild or progressive in nature should likely be investigated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/49. Late cardiovascular and pulmonary complications of therapy in Hodgkin's disease: report of three unusual cases, with a review of relevant literature.With the advent of modern therapeutic approaches, even patients with advanced Hodgkin's disease have high cure rates today. Therefore, more attention is gradually being focused upon the late complications of chemotherapy and irradiation, appearing long after the patient is in remission and thought to be cured. In this report, we review the incidence and presentation of some of the cardiovascular and pulmonary complications which may appear later in the course of the disease. Cardiovascular mishaps reviewed include pericardial manifestations, conduction abnormalities, cardiomyopathy, and premature coronary artery disease. Pulmonary complications discussed are lung fibrosis, spontaneous pneumothorax, pulmonary veno-occlusive disease, and hyperlucent lung. Three instructive cases from our recent experience, are also presented. One fatal case was due to cardiac failure because of radiation-induced pericarditis and coronary artery disease. Another patient with an almost fatal complication required lung transplantation because of severe bilateral radiation fibrosis of the lung and pulmonary veno-occlusive disease. The third instance was also life-threatening in nature, with radiation-induced arterial changes in the major arteries of the chest and neck, resulting in recurrent cerebral and ophthalmic thromboembolic disease. It is suggested that potentially severe cardiopulmonary complications be considered during the planning of the initial and subsequent management of patients with Hodgkin's disease, particularly in an era employing autologous and allogeneic bone marrow transplantation as part of therapy in some cases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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