1/3. Pulmonary sarcoidosis with associated bloody pleurisy.A 64-year-old man was admitted to our hospital complaining of non-productive cough and right chest pain. Chest radiographs showed bilateral hilar lymphadenopathy, diffuse granular nodules and right pleural effusion. serum angiotensin-II-converting enzyme and lysozyme levels were elevated. Since thoracentesis indicated bloody pleurisy, video-assisted thoracoscopy was performed and revealed multiple white nodules on both the visceral and parietal pleura. Resected pleural biopsy specimens showed non-caseous granulomas. Furthermore, some nodules were observed to compress and involve small vessels and capillaries. The bloody pleurisy was assumed to have been derived from the rupture of small vessels that had been compressed and affected by the granuloma with sarcoidosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. Clue to fine-needle aspiration diagnosis of pleural pneumocystoma: neovascularization and Langhans' giant cell reaction.pneumocystis pneumonia is a common component of the acquired immunodeficiency syndrome (AIDS) in the united states. Extrapulmonary pneumocystosis, however, is much less common. Rare cases have been reported in lymph nodes, bone marrow, spleen, pleura, gastrointestinal tract, liver, common bile duct, pancreas, skin, thyroid, and eye. A 39-yr-old man with history of chest wall injuries from gunshot and stabbing presented with multiple pleural masses clinically suspicious of metastatic deposits from an unknown primary. Fine-needle aspiration biopsy of the largest pleural mass revealed extrapulmonary pneumocystis, which led to the diagnosis of AIDS. Similar to the previous reports of pneumocystis mass lesions in extrapulmonary sites, the current case is associated with exuberant vascular proliferation and Langhans' giant cell reaction. Neovascularization and histiocytic influx from the newly formed blood vessels and Langhans' giant cell reaction seem to be a common tissue reaction to the massive deposition of pneumocystis organisms in extrapulmonary sites in patients with AIDS.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/3. Bilateral exudative pleuritis, an unusual pulmonary onset of mixed connective tissue disease.In mixed connective tissue disease (MCTD) pulmonary involvement has been reported. In most patients diffuse interstitial pulmonary abnormalities are present. We describe an unusual pulmonary onset of MCTD in an 18-year-old woman. She presented with a bilateral pleural exudate containing many granulocytes (95%) and only a few monocytes (5%). High titers of antinuclear antibodies were found. One week after hospitalization, an erythema on both hands and forearms developed. skin biopsy demonstrated discrete IgM-C3 depositions along the basal membrane of the epidermis, antinuclear antibodies in the nuclei of the keratocytes in the dermis and granular depositions of IgM in the blood vessel walls of the upper dermis. lung function tests improved without corticosteroid treatment and diffusing capacity remained normal.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |