1/77. Flitting radiographic shadows: an unusual presentation of cancer in the lungs.Tumour involvement of pulmonary blood vessels occurs frequently in advanced lung cancer and occasionally may cause pulmonary infarction. A case is reported of diffuse obstruction of pulmonary arteries by cancer in which no primary tumour was found, and which presented as flitting radiographic opacities due to pulmonary infarction.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/77. Recognition and significance of pulmonary bone embolism.Embolism of bone marrow to the lungs is a quite frequent finding after trauma but transport and deposition of solid bone is rarely seen, which may simply be because pulmonary calcifications are not recognized as bone fragments. We report on three patients with embolism of bone spicules to small lung arteries of about 0.5 mm in diameter which were plentiful in two of the patients on postmortem examination. However, the true nature of the emboli was only recognizable after decalcification of lung tissues. It appears that trauma occurring in a septic bone lesion has the greatest chance to provoke bone embolism. The bone spicules do not usually occlude vessel lumina and thus do not severely disturb the blood circulation in the lungs. The bone fragments become covered by endothelium and can remain recognizable for months or even years.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
3/77. Pulmonary hypertension secondary to neurofibromatosis: intimal fibrosis versus thromboembolism.Neurofibromatosis has been known to involve blood vessels throughout the body. Pulmonary involvement with interstitial fibrosing alveolitis has been described but no case of pulmonary vascular involvement has been reported to date. A 51 year old patient with cutaneous neurofibromatosis is described who presented with severe pulmonary hypertension and radiographic, scintigraphic, and angiographic evidence of chronic thromboembolic pulmonary hypertension. Severe intimal fibrosis consistent with vascular involvement with neurofibromatosis was found on endarterectomy with no evidence of pulmonary thromboembolism. Neurofibromatosis of pulmonary arteries should be considered as a possible cause of pulmonary hypertension.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
4/77. Chronic intrauterine meconium aspiration causes fetal lung infarcts, lung rupture, and meconium embolism.Three neonates with chronic intrauterine meconium aspiration are reported. All had distinctive subpleural plate-infarcts of the lungs caused by meconium-induced vasoconstriction of peripheral preacinar arteries. These vessels showed plexogenic arteriopathy with medionecrosis and obliterative hyaline sclerosis. Organized thrombi and systemic-pulmonary arterial anastomoses were numerous. The infarcts contained inspissated meconium with a granulomatous reaction.In one case, lung rupture occurred, causing meconiumthorax and meconium embolism to hilar lymphatics and lymph nodes; this suggests that particulate meconium may enter the circulation. This fetus had rubella and probable acute twin-twin transfusion following the intrauterine death of the co-twin. The cause of the hypoxia that led to intrauterine passage of meconium in the other cases is unknown. meconium-stained amniotic fluid was noted in only one case.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
5/77. Bilateral iliac vein filter deployment in a patient with megacava.An 85-year-old-woman presenting with low back pain developed shortness of breath and right-sided chest pain. She was found to have perfusion defects indicative of pulmonary embolus (PE). heparin was at first employed, but had to be discontinued because of gastrointestinal bleeding. Caval filtration was the obvious course, but it was found on computed tomography (CT) scan that the suprarenal portion of the inferior vena cava was 55 mm in diameter, and the infrarenal portion 44 mm. These measurements were too large for insertion of a Greenfield filter, for which the maximum diameter should be 28 mm. The right common iliac vein was 28 mm in diameter, and the left external iliac vein 25 mm. Two filters were inserted percutaneously in these vessels. The patient was followed for 9 months. No clinical evidence of recurrent PE or venous insufficiency occurred.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
6/77. hepatopulmonary syndrome and venous emboli causing intracerebral hemorrhages after liver transplantation: a case report.Increasing experience has fostered the acceptance of liver transplantation as a treatment for patients with hepatopulmonary syndrome. morbidity and mortality is most commonly attributed to progressive arterial hypoxemia postoperatively. A cerebral hemorrhage has been reported in one patient with hepatopulmonary syndrome after transplantation. However, a postmortem examination of the brain was not performed and the pathogenesis or type of cerebral hemorrhage was undefined. We report on a patient with severe hepatopulmonary syndrome who developed multiple intracranial hemorrhages after transplantation. The intracerebral hemorrhages were most consistent with an embolic etiology on postmortem examination. We postulate that venous embolization, caused by the manipulation of a Swan Ganz catheter in a thrombosed central vein, resulted in pulmonary emboli that passed through dilated intrapulmonary vessels into the cerebral microcirculation. Special attention to central venous catheters and avoidance of manipulation may be warranted in subjects with severe hepatopulmonary syndrome after liver transplantation.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
7/77. Combined hepatocellular-cholangiocarcinoma presented with massive pulmonary embolism.A 30-year-old HBsAg-positive woman was admitted to the hospital because of 6 days of progressive shortness of breath. She was in severe respiratory distress with circulatory collapse. She had an enlarged liver but no stigmata of chronic liver disease or signs of cirrhosis. She had rapidly developed respiratory arrest and was transferred to intensive care unit. heart ultrasonography and Doppler scan showed right heart straining and high pulmonary artery pressure. Despite cardiovascular and respiratory support she died a few hours after admission. autopsy revealed combined hepatocellular-cholangiocarcinoma infiltrating the entire liver, metastatic invasion of lung blood vessels and absence of right ventricular hypertrophy. The incidence of hepatocellular-cholangiocarcinoma, a variant of hepatocellular carcinoma, is roughly 2-3% and the presenting symptoms are abdominal pain, weight loss, jaundice, fever or decompensation of liver disease. Associated HBsAg positivity and cirrhosis are reported in 20-30% and 60% of patients, respectively. Metastases to lungs are relatively frequent but this is the first report of hepatocellular-cholangiocarcinoma presented with acute respiratory distress due to massive pulmonary embolism.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
8/77. Bilateral choroidal infarction in a patient with antiphospholipid syndrome: a case report.PURPOSE: To report a case of bilateral choroidal infarction occurring as a complication of primary antiphospholipid syndrome. methods: The case notes of the patient were reviewed. RESULTS: A 25-year-old man with primary antiphospholipid syndrome and a previous history of deep vein thrombosis and pulmonary embolism, developed episcleritis and bilateral choroidal infarction, with deterioration of vision to 6/12 OD and counting fingers at 5 feet OS. Anticoagulation therapy with warfarin was administered and the patient's vision gradually improved to 6/6 OD and 6/9 OS. CONCLUSION: Primary antiphospholipid syndrome is associated with thrombotic phenomena, which may affect the ocular arterial and venous vasculature. Therefore, a detailed ophthalmological examination is warranted in those patients who present with ocular symptoms and deteriorating vision. Retinal fluorescein angiography is valuable in confirming the diagnosis when in doubt, and in determining the extent of vessel occlusion.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
9/77. Case report: pulmonary embolism from thrombosis in a duplicated inferior vena cava developing after an electrophysiologic procedure.Duplicated inferior cava (IVC) is an anomaly we rarely encounter during electrophysiologic procedures. We report a case with duplicated IVC who developed thrombosis of the left IVC following an electrophysiologic procedure, which resulted in an asymptomatic pulmonary embolism. It is speculated that several catheters placed in the torturous route through the left IVC caused either endothelial damage to the vessel wall, or hemostasis in the relatively narrow portion of the vessel, resulting in thrombus formation. Since the prevalence and characteristics of thrombo-embolic complications during electrophysiologic procedures in patients with a duplicated IVC remain unknown, we believe this case should be reported.- - - - - - - - - - ranking = 0.50029883751157keywords = vessel (Clic here for more details about this article) |
10/77. Pulmonary thromboembolism after one and a half ventricle repair. Successful catheter-directed thrombolysis.Acute pulmonary thromboembolism in a patient who had undergone bidirectional Glenn anastomosis was treated by percutaneous selective intravascular thrombolysis. A 20-year-old woman was diagnosed with pulmonary stenosis and right ventricular hypoplasia, complete occlusion of the left pulmonary artery secondary to a Blalock-Taussig shunt, and atrial septal defect. The patient developed thromboembolism of the subsegmental branches of the right pulmonary artery resulting in critical hemodynamic deterioration 2 weeks after undergoing one and a half ventricle repair (bidirectional Glenn shunt). The patient was treated with tissue plasminogen activator administered directly into the right pulmonary artery via an intravascular catheter. Progressive recanalization of the obstruction began immediately. Pulmonary angiography 3 months after thrombolytic therapy demonstrated patent subsegmental vessels. Early detection of the pulmonary thromboembolism and prompt intervention are crutial to relieving this fatal complication after a Fontan operation.- - - - - - - - - - ranking = 0.25014941875578keywords = vessel (Clic here for more details about this article) |
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