ABSTRACT
BACKGROUND: Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. METHODS: All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL RESULTS: 1) CTL is most prevalent in young women between the age of 20 30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6% (p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%),other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%),fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). CONCLUISON: CTL is prevalent in women between the age of 20 ~ 40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.
Subject(s)
Female , Humans , Male , Drug Therapy , Fistula , Incidence , Lymph Nodes , Needles , Prognosis , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, Pleural , Tuberculosis, PulmonaryABSTRACT
Several stresses are known to induce synthesis of heat shock protein. The present study was performed to see whether pulmonary ischemia, induced by the bronchial artery occlusion, produced HSP70 in cat lung. To this aim we compared experimental and control groups of cats with respect to the HSP70 production in the lung. Experimental animals were subjected to 10-min bronchial artery occlusion followed by reperfusion. The interval between the end of the occlusion and the end of the reperfusion was 1 hour, 4 hours and 8 hours, whereas control animal was not subjected to any manipulation except anesthesia. According to the interval differences, experimental animals were divided into 1HR, 4HRs and 8HRs groups. To determine the induction of HSP70 in each group, total proteins of lung tissues were extracted and separated by PAGE electrophoresis. Immunoblotting with a mouse monoclonal anti-HSP70 IgG antibody revealed that HSP70 was not detected in the pulmonary tissues resected from control, 1HR or 4HRs groups. In contrast, HSP70 expression in 8HRs group was marked. These results suggest that pulmonary ischemia by the bronchial artery occlusion produces HSP70 in a delayed
Subject(s)
Animals , Cats , Mice , Anesthesia , Bronchial Arteries , Electrophoresis , Heat-Shock Proteins , Immunoblotting , Immunoglobulin G , Ischemia , Lung , ReperfusionABSTRACT
Drug-induced thrombocytopenia and purpura have boon developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects art fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.
Subject(s)
Female , Humans , Young Adult , Ciprofloxacin , Purpura , Pyrazinamide , Rifampin , ThrombocytopeniaABSTRACT
BACKGROUND: To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. MATERIAL AND METHODS: Thirteen women with tuberculous bronchial stenosis(9cases: left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PFT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. RESULT: 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(l/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. But, significant improvement of PFT was noted in only 25% (1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(l/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. . 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. CONCLUSION: We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery, and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.
Subject(s)
Female , Humans , Airway Obstruction , Anesthesia, Local , Bronchi , Constriction, Pathologic , Cough , Cryotherapy , Dilatation , Dyspnea , Fever , Leukocytosis , Mediastinal Emphysema , Mediastinitis , Pneumothorax , Respiratory Sounds , Sputum , Thorax , TuberculosisABSTRACT
BACKGROUND: To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. MATERIAL AND METHODS: Thirteen women with tuberculous bronchial stenosis(9cases: left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PFT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. RESULT: 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(l/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. But, significant improvement of PFT was noted in only 25% (1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(l/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. . 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. CONCLUSION: We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery, and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.
Subject(s)
Female , Humans , Airway Obstruction , Anesthesia, Local , Bronchi , Constriction, Pathologic , Cough , Cryotherapy , Dilatation , Dyspnea , Fever , Leukocytosis , Mediastinal Emphysema , Mediastinitis , Pneumothorax , Respiratory Sounds , Sputum , Thorax , TuberculosisABSTRACT
The pulmonary lymphomas were thought to originate in specialized lymphoid tissue that is associated with bronchial mucosa(bronchus-associated lymphoid tissue(BALT)), and they were categorized as mucosa-associated lymphoid tissue(MALT) lymphoma. MALT lymphoma consists of a monoclonal population of cell, in contrast to reactive lymphoid proliferation, which consists of polyclonal cells. Lymphoma arising from MALT(=MALToma) represents a distinct clinicopathologic features. It is usually localized to their original site for a long time and shows much more favorable prognosis than lymphoma at other site. Some MALT lymphoma could arise simultaneously or successively in different organ or that cells from MALT lymphoma might circulate and give rise to another lymphoma by homing in the MALT of another organ, such as breast, salivary gland, stomach etc, and can be multifocally disseminated or recurred. We report a case of low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue(MALT) of the lung, which was confirmed by open lung biopsy, immunohistochemistry and PCR assay.
Subject(s)
B-Lymphocytes , Biopsy , Breast , Immunohistochemistry , Lung , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Lymphoma, B-Cell, Marginal Zone , Polymerase Chain Reaction , Prognosis , Salivary Glands , StomachABSTRACT
The Swyer-James syndrome is a relatively uncommon disease entity presented with unilateral hyperlucent lung due to hypoplasia of a pulmonary artery and bronchiectasis of the affected lung. The main finding is a hyperlucent lung with small hilar shadows on the chest X-ray. Pulmonary angiography is the standard method for diagnosis. We report a case of the Swyer-James syndrome with a brief review of literature.
Subject(s)
Angiography , Bronchiectasis , Diagnosis , Lung , Lung Diseases , Lung, Hyperlucent , Pulmonary Artery , ThoraxABSTRACT
Granular cell tumor(myoblastoma) of the bronchus is an uncommon benign tumor that causes pulmonary complications due to obstruction of the airways. The tumor as origianally described by Abrikossoff was considered to be muscular origin, but currently neural derivation is favored. We report a case of granular cell tumor of bronchus of 27-year-old female patient with recurrent pneumonia that is confirmed by bronchoscopic biopsy, and review the liturature.