1/12. Diffuse alveolar hemorrhage syndrome due to 'silent' mitral valve regurgitation.A variety of clinical diseases are associated with diffuse alveolar hemorrhage. Although mitral valve disease can cause hemoptysis, it rarely is associated with diffuse alveolar hemorrhage at presentation. A 49-year-old woman was admitted to the hospital with the abrupt onset of fever, anemia, dyspnea, azotemia, and diffuse alveolar infiltrates. Two-dimensional echocardiography done several months earlier to evaluate atypical chest pain had been unremarkable. Fiberoptic bronchoscopy 2 days after admission to the hospital revealed fresh blood throughout the tracheobronchial tree. The infiltrates resolved rapidly and completely during systemic steroid therapy only to reappear as the steroids were tapered, suggesting a beneficial therapeutic response. Results of serologic evaluation were negative. Transbronchial biopsies showed inflammation and hemosiderin-laden macrophages; no specific diagnosis was established. The patient was scheduled for open lung biopsy. The surgeon was concerned about the history of chest pain and requested placement of a pulmonary artery catheter, which revealed severe pulmonary hypertension. Transesophageal echocardiography and subsequent cardiac catheterization showed severe mitral regurgitation. mitral valve replacement resulted in complete elimination of symptoms.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/12. Lobectomy for destroyed lung in quadriplegic patients.BACKGROUND: Sixty-seven percent of quadriplegic patients after spinal cord injury (SCI) develop respiratory complications, which leads to death in one third. Preventive measures may fail to avoid parenchymal destruction and possible septic complications. methods: Three quadriplegic patients (C3-C6 level), with destroyed lower lobes and incontrollable septic symptoms, were subjected to lobectomy. RESULTS: Neither operative morbidity nor mortality was observed. All patients were discharged home without ventilatory assistance, and were symptom-free. CONCLUSIONS: When the endobronchial chronic infection calls for repeated fiberoptic bronchoscopies to clear the bronchial tree, the parenchymal destruction is limited to one lobe of the lung, and there is evidence of impending septic complications, lobectomy may be indicated in quadriplegics to eradicate the source of infection.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/12. Primary pulmonary botryomycosis: a late complication of foreign body aspiration.Primary pulmonary botryomycosis is a rare cause of haemoptysis and can enter the differential diagnosis of a mass on the plain chest radiograph. The case history is presented of a 63 year old man with botryomycosis which was initially thought to be a bronchial carcinoma. When the diagnosis was made several years later it was found to be secondary to persisting vegetable material in the bronchial tree following previous aspiration.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/12. The destroyed lung syndrome: report of a case after Harrington rod instrumentation and fusion for idiopathic scoliosis.STUDY DESIGN: A case report is described. OBJECTIVE: To describe the very rare complication of destroyed lung syndrome after scoliosis correction. SUMMARY OF BACKGROUND DATA: The destroyed lung syndrome has, to our knowledge, never been associated with scoliosis in the literature. Bronchial kinking and compression by the vertebral column have been described in severe scoliosis cases. methods: The patient, a 40-year-old woman was operated on in 1976 for a thoracic scoliosis and hypokyphosis using Harrington rod instrumentation and fusion with autologous bone graft. With a follow-up of 26 years, she has developed a very severe functional defect of the right lung, the so-called destroyed lung syndrome. RESULTS: After the index procedure, the patient developed various episodes of pneumonia and abscess formation in the right lung because of kinking and obstruction of the bronchial tree of the right lung. This seemed to be caused by a severe hypokyphosis and by residual scoliosis of the thoracic spine with direct compression of the right bronchus by the vertebral column. Eventually two stents were placed, but this prevented further deterioration only temporarily. CONCLUSIONS: After Harrington instrumentation and fusion for thoracic hypokyphotic idiopathic scoliosis, kinking and obstruction of a main bronchus are possible. In this patient, this complication gave rise to recurrent infections of the right lung, eventually progressing to destroyed lung syndrome.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/12. A rare case of pulmonary bronchogenic cyst associated with bronchial atresia in the same lobe.A rare case of 49-year-old woman having pulmonary bronchogenic cyst associated with bronchial atresia in the same lobe was presented. The diagnosis was confirmed by aortography and operation specimen. Three-dimensional reconstructed images of computed tomography clearly demonstrated the defference between mucoid impaction of bronchial trees in the left S9 not communicating with hilar bronchus and the cyst in the left S10 oppressing surrounding vessels.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/12. Diffuse pulmonary hamartoma: a case report.Pulmonary hamartoma usually occurs as a benign, well-circumscribed single nodule in the lung parenchyma. We report on a unique case of hamartoma that extended along the bronchial tree, formed endobronchial polypoid lesions, and expanded into the lung parenchyma. The patient, a 48-year-old man, was admitted with dyspnea and chest pain. A transbronchial biopsy was performed on a tumorous lesion that was diagnosed histologically as a hamartoma. As this lesion was found to be growing diffusely along the bronchial tree, a left pneumonectomy was performed. Gross examination showed that yellowish soft tissue had surrounded the bronchial tree and extended into the lung parenchyma. Histologically, the lesion contained mainly mature adipose tissue, cartilage, and muscle tissue with a minor component of short spindle cells in a myxomatous matrix. The patient was diagnosed as having diffuse pulmonary hamartoma.- - - - - - - - - - ranking = 3keywords = tree (Clic here for more details about this article) |
7/12. A case report of congenital isolated absence of the right pulmonary artery: bronchofibrescopic findings and chest radiological tracings over 9 years.A 27-year-old man was admitted to hospital for investigation of haemoptysis. He was a serving member of the japan Self-Defense Forces. A CXR showed absence of the right hilum, and the right hemithorax was smaller than the contralateral hemithorax. Pulmonary arteriography demonstrated complete absence of the right pulmonary artery. Right heart catheterisation did not show any concomitant cardiovascular malformations, and the patient was diagnosed as having isolated absence of the right pulmonary artery. Bronchial arteriograms demonstrated enlargement and proliferation of the small branches of the right bronchial artery. Bronchofibrescopic examination showed obvious enlargement of the bronchial mucosal vessels with submucosal eruptions and swelling in the right bronchial tree, but not on the left side. Re-examination of the patient's CXR from the previous 9 years revealed a chronological decrease of right lung volume and an increase of the cardiothoracic ratio. Isolated absence of the right pulmonary artery is generally considered to have a good prognosis, but close observation is necessary to monitor the pulmonary haemodynamics.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/12. Pulmonary complications from ophthalmic preparations.Topical beta-adrenergic blocking agents are commonly used to treat glaucoma. Exacerbations of asthma and bronchospasm caused by topical beta-adrenergic ophthalmic preparations are well known. We describe a 67-year-old woman who had aspiration pneumonitis characterized by a nodular infiltrate in the right middle lobe of the lung and nocturnal coughing after beginning topical application of an ointment (Lacri-Lube) for treatment of xerophthalmia. Bronchial washing demonstrated lipid-laden pulmonary alveolar macrophages. After the use of Lacri-Lube was discontinued, her cough and the chest roentgenographic abnormality totally disappeared. We postulate that the topical ophthalmic preparation, which contains mineral oil and petrolatum, drained into the nasopharynx, trachea, and bronchial tree through the nasolacrimal duct and caused lipoid pneumonitis from aspiration of the oil contents. To our knowledge, this is the first report of pulmonary complications caused by Lacri-Lube. We briefly review the pulmonary complications, including pulmonary edema, apnea from paralysis of respiratory muscles, bronchospasm from non-beta-adrenergic blocking drugs, and electrolyte abnormalities, attributable to topically and systemically administered ophthalmic medications.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/12. Pleuropulmonary necrobiotic rheumatoid nodules. A review and clinicopathological study of six patients.Pleuropulmonary rheumatoid nodules were diagnosed histologically in six patients of whom five were known to have rheumatoid arthritis; the pulmonary lesion preceded the development of arthritis in the sixth patient. Pulmonary lesions are commonly found in patients with rheumatoid arthritis. These lesions are either non-specific (effusions, pleurisy, fibrosis, arteritis and obliterative bronchiolitis) or the specific necrobiotic nodules that constitute Caplan's syndrome in association with pneumoconiosis. The necrobiotic nodules are usually pleural or subpleural and rarely occur in the bronchial tree. Pulmonary necrobiotic nodules can appear before, coincident with, or after the onset of arthritis. It is essential to distinguish these lesions from infections or neoplasia.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/12. Tracheobronchial mucoid pseudotumors.A collection of mucus, indistinguishable from tumor, can be shown in the tracheobronchial tree, particularly during tomography. These "mucoid pseudotumors" may be distinguished from true tumors by documenting their disappearance after having the patient cough.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
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