1/80. 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 = blood vessel, vessel (Clic here for more details about this article) |
2/80. Diffuse alveolar hemorrhage and pulmonary capillaritis due to propylthiouracil.propylthiouracil (PTU) has recently been observed to be associated with antineutrophil cytoplasmic antibody (ANCA)-positive small vessel vasculitis, resulting in crescentic glomerulonephritis and, infrequently, diffuse alveolar hemorrhage (DAH). We describe a case of a 23-year-old pregnant woman who developed a perinuclear ANCA and antimyeloperoxidase-positive small vessel vasculitis manifesting as DAH and crescentic glomerulonephritis after she began taking PTU. An open lung biopsy was consistent with pulmonary capillaritis. She responded to corticosteroid therapy and discontinuation of PTU. DAH can be caused by pulmonary capillaritis, bland hemorrhage, or diffuse alveolar damage. To our knowledge, this represents the first documentation of an underlying pulmonary capillaritis in a case of PTU-induced DAH.- - - - - - - - - - ranking = 0.43871184935687keywords = vessel (Clic here for more details about this article) |
3/80. Pulmonary lymphangiomyomatosis (LAM) developing chylothorax.We describe a case of pulmonary lymphangiomyomatosis (LAM) with chylothorax that developed in a 46-year-old Japanese woman. This patient exhibited clinical symptoms of dyspnea and chest X-ray showed right pleural effusion. Thoracocentesis demonstrated chylous effusion. Chest computed tomography (CT) scan revealed multiple cystic lesions. Subsequent thoracoscopy revealed the chylorrhea from swelled vessels on the diaphragm. The clinical diagnosis, based on histological examinations with biopsy specimens obtained by thoracoscopy, was pulmonary LAM. Although the hormone therapy was not effective, chylous effusion was improved by the pleurodesis. Pulmonary LAM developing chylothorax is rare in japan.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
4/80. Pulmonary hyalinising granuloma: a case report and literature review.This is a case of a rare lung disease known as pulmonary hyalinising granuloma, which is usually discovered incidentally on chest radiographs and poses diagnostic difficulties but has an excellent prognosis. In this case a 75-year-old man had a 6-year history of undiagnosed, enlarging, bilateral dense apical infiltrates. The patient died from his tobacco smoke-related emphysema, which led to diagnosis of the lesion. At autopsy both lungs showed well-defined apical, hard, grey-white masses covered by a rind of thickened adherent pleura. Histologically, the lesion was composed of dense, haphazard lamellar, keloid-like collagen concentrically arranged around blood vessels with extension into the pleura and perivascular collections of lymphocytes and plasma cells.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
5/80. Fatal pulmonary hemorrhage after transbronchial lung biopsy through the fiberoptic bronchoscope.A case is reported in which transbronchial lung biopsy using the fiberoptic bronchoscope was complicated by massive, fatal hemorrhage. This previously unreported complication occurred despite normal prothrombin and partial thromboplastin times and platelets of 93,000. Pathological examination revealed that a very small (0.5-mm) vessel was the source of the bleeding. Although severe complications are undoubtedly rare, this report suggests that the transbronchial lung biopsy is not a totally benign procedure. Suggestions are made to prevent future similar occurrences in very ill patients or in patients with coagulative abnormalities or blood dyscrasias.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
6/80. Pulmonary hemorrhage in association with negative pressure edema in an intubated patient.Negative pressure pulmonary edema due to upper airway obstruction following extubation is a well-recognized problem. However, frank pulmonary hemorrhage as a manifestation of upper airway obstruction is uncommon. We report a case of significant pulmonary hemorrhage and negative pressure pulmonary edema in an intubated patient. bronchoscopy showed a collection of blood in the right lower lobe of the lungs, suggesting a localized source of bleeding. There have been two previously reported cases of pulmonary hemorrhage after upper airway obstruction. One suggested that the bleeding was due to damage to the pulmonary capillaries, the other that it was due to disruption of the bronchial vessels. We feel that in our case there was some indication that the pulmonary bleeding was a result of bronchial vessel damage. A number of factors might have been involved in its development, including negative pulmonary pressure, recent respiratory tract infection, and positive airways pressure (due to coughing).- - - - - - - - - - ranking = 0.43871184935687keywords = vessel (Clic here for more details about this article) |
7/80. Case report. Metastatic pulmonary calcification in renal failure: a new HRCT pattern.A 56-year-old male with chronic renal failure presented with a 6 month history of progressive dyspnoea. High resolution CT of the chest showed multiple, peripheral, centrilobular nodules in the upper and mid zones, consistent with metastatic pulmonary calcification. Some of these pulmonary nodules showed ring calcification, a pattern that to our knowledge has not been described before. Calcification was also seen in the segmental pulmonary arteries, bronchi, trachea and subcutaneous vessels of the chest wall.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
8/80. Angiocentric immunoproliferative lesions of the lung associated with diffuse renal involvement.A 62-year-old Japanese man presented with high fever, cough, and sputa. Computed tomography (CT) scan of the chest revealed lung infiltrates with air bronchogram of the right middle lobe and mediastinal lymphadenopathy. Bronchoscopic examination was performed, and mycobacterium avium complex was detected from bronchoalveolar lavage fluid. Although the administration of clarithromycin and levofloxacin improved the patient's symptoms, the lung infiltrates on chest CT scan gradually worsened. lung biopsy of segments 4 and 8 by video-assisted thorachoscopy revealed angiocentric and angiodestructive massive lymphoplasmocytic infiltrations with multinucleated giant cells, which were compatible with grade II angiocentric immunoproliferative lesions. The patient was found to have deterioration of renal function, and glomerular filtration rate was 32.6 mL/min. His kidneys were enlarged and showed prominent and diffuse uptake of gallium-67 citrate. Percutaneous renal biopsy revealed massive infiltration of CD4 mononuclear cells, plasma cells, and eosinophils in the interstitium and destruction of normal structure of tubules. blood vessels were destroyed and replaced by inflammatory cells. The combination chemotherapy achieved a remission, and the patient has remained free of disease at 2 years after onset of the illness. We recommend the imaging of kidneys for diagnosis and following renal biopsy to evaluate the renal involvement of angiocentric immunoproliferative lesions.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
9/80. Delayed ANCA positivity in pulmonary-renal syndrome.A 57-year-old man was admitted due to rapidly progressive renal failure and pulmonary edema. Chest X-ray showed a bilateral lung infiltrate, while a normal myocardial contractility was reported by echocardiography. Though initially ANCA were absent, a necrotizing vasculitis with polymorphonuclear leukocyte infiltrate was observed in a kidney biopsy specimen. Renal histology was compatible with microscopic polyangiitis because of necrotizing lesions located at small vessels and at glomeruli that were not crescentic. Corticosteroids and immunosuppressive treatment was played with significant clinical improvement. Six months later, the patient died of a gastrointestinal hemorrhage due to bowel perforation by vasculitic lesion. This time high p-ANCA positivity was detected and at renal histology crescentic glomeruli were observed.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
10/80. Two patients with microscopic polyangiitis and unusual pulmonary manifestation.We encountered two patients with microscopic polyangiitis (MPA) associated with unusual pulmonary manifestations. The first patient was a 45-year-old man who had worked in amine for 3 years when he was young. On admission, chest x-rays showed long-standing silicosis and a new patchy infiltration. The second patient was a 52-year-old female. On admission, chest x-rays showed bilateral patchy infiltrations. Since then, variable patterns of patchy infiltration have waxed and waned repeatedly. The renal biopsy revealed that both patients had glomerulonephritis associated with small vessel vasculitis but with few or no immune deposits. There was neither granulomatous inflammation nor eosinophilic infiltration. Myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA) was positive in both patients. After treatment with glucocorticoids and cyclophosphamide, radiological findings were minimal and stable. These two cases show that patients with MPA have a wide spectrum of radiological findings.- - - - - - - - - - ranking = 0.21935592467843keywords = vessel (Clic here for more details about this article) |
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