Subject(s)
Humans , India , Lung Neoplasms/diagnostic imaging , Mass Screening , Tomography, X-Ray ComputedABSTRACT
Background: Examination of specimens obtained through fl exible fi beroptic bronchoscope is an important and often the initial diagnostic technique performed in patients with suspected malignant lung lesion. Aims: To evaluate the correlation of cytological fi ndings of bronchial washings, bronchial brushing and imprint smear of bronchial biopsy in the diagnosis of lung tumors, with histopathology of bronchial biopsy taking the latter as the confi rmatory diagnostic test. Materials and Methods: A total of 200 patients with lung mass were included in the study. Bronchial brushings were obtained from all 200 cases. In the fi rst 100 cases, pre-biopsy bronchial washing (washing collected before the brushing and biopsy procedure) while post-biopsy washing (washing at the end of the procedure) was procured in all 200 cases. Imprint smears of bronchial biopsy were prepared in 150 cases. Results: Sensitivity and specifi city of brushing was 76.58% and 77.78% respectively and that of imprint smear was 81.35% and 78.12% respectively. Pre-biopsy and post-biopsy washing showed high specifi city of 88.89%, but low sensitivity of 30.14 and 36.77% respectively. No signifi cant difference was found in sensitivity between brushing and imprint smear (Chi-square; P = 0.4187); and between pre-biopsy and postbiopsy washing (Chi-square; P = 0.7982). However, there was a signifi cant difference between sensitivity of brushing and washing (Chi-square; P = 0.0001). The sensitivity of combination of three cytological diagnostic techniques was 87.29%. Conclusion: Bronchial brushing and washing cytology in combination with imprint cytology aids in the diagnosis of lung tumors. Therefore, all these techniques may be used concurrently along with bronchial biopsy to diagnose lung tumors.
Subject(s)
Adult , Antiviral Agents/therapeutic use , DNA, Viral/analysis , Diagnosis, Differential , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human/drug therapy , Influenza, Human/diagnostic imaging , Male , Pneumonia, Viral/drug therapy , Pneumonia, Viral/diagnostic imaging , Polymerase Chain Reaction , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
A-23-year-old medical student, resident of an altitude of 700 meters, developed dyspnea and cough during a temple visit at an altitude of 2200 m within 10 hours of arrival and his symptoms improved on descending and with 100% oxygen. Chest skiagram and CT scan chest revealed soft fluffy shadows on the left side with small right lung and absent right pulmonary artery. Absent right pulmonary artery was responsible for development of pulmonary oedema at moderate altitude.
Subject(s)
Adult , Altitude , Humans , Male , Pulmonary Artery/abnormalities , Pulmonary Edema/etiologyABSTRACT
Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. It is seen in 10-40% of patients with active pulmonary tuberculosis. More than 90% of the patients with EBTB have some degree of bronchial stenosis. Ten to 20 percent have normal chest radiograph. Therefore, a clear chest radiograph does not exclude the diagnosis of EBTB. Bronchoscopic sampling has been the key to the diagnosis producing more than 90% yield on smear as well as on culture. Bronchoscopy and computed tomography are the methods of choice for accurate diagnosis of bronchial involvement and assessment for the surgical interventions. Characteristic HRCT findings of FBTB are patchy asymmetric centrilobular nodules and branching lines (tree-in-bud appearance). Early supervised antituberculosis therapy results in minimal structural and functional residua. Corticosteroid therapy may not influence the outcome of endobronchial tuberculosis. Early diagnosis and prompt treatment, before the development of fibrosis is important to prevent complications of endobronchial tuberculosis, such as bronchostenosis.