ABSTRACT
The diagnosis of a pulmonary vein varix with a recently introduced new CT technology, multi-slice helical CT, is discussed. The advantage of multi-slice helical CT lies in increased thin-slice coverage during a single breath hold, which is the predominant factor limiting scan time. This CT technique facilitates the diagnosis of vascular pulmonary pathology.
Subject(s)
Pulmonary Veins/diagnostic imaging , Radiographic Image Enhancement , Tomography, X-Ray Computed , Varicose Veins/diagnostic imaging , Aged , Female , Humans , Imaging, Three-DimensionalABSTRACT
A case is presented of interstitial pneumonitis and pulmonary vasculitis ascribed to the ingestion of an L-tryptophan preparation. An unintended rechallenge supported the causal relationship. There was neither myalgia nor peripheral eosinophilia. Bronchoalveolar lavage fluid contained 12% eosinophils but few were present in the surgical lung biopsy specimen. Lung infiltrates receded after withdrawal of the drug and treatment with steroids. Dyspnoea and pulmonary hypertension persisted. Cyclophosphamide had no effect. Sclerodermiform skin lesions appeared as a late sequel. Chromatographic analysis of the L-tryptophan revealed no suspect impurities.
Subject(s)
Lung Diseases/chemically induced , Pulmonary Fibrosis/chemically induced , Tryptophan/adverse effects , Vasculitis/chemically induced , Aged , Biopsy , Drug Contamination , Humans , Lung/pathology , Lung Diseases/complications , Lung Diseases/pathology , Male , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/pathology , Tryptophan/chemistry , Vasculitis/complications , Vasculitis/pathologySubject(s)
Pneumothorax/therapy , Talc/adverse effects , Acute Disease , Combined Modality Therapy , Humans , Recurrence , Time FactorsABSTRACT
A patient with deep vein thrombosis and pulmonary embolism was admitted after profuse hemoptysis. On the third day of heparin treatment intrabronchial bleeding recurred, leading to life-threatening atelectasis of the left lung. The bleeding coincided with a hypertensive attack. Intrabronchial bleeding after pulmonary embolisation is a rare but potentially lethal complication.
Subject(s)
Bronchial Diseases/etiology , Hemorrhage/etiology , Pulmonary Atelectasis/etiology , Pulmonary Embolism/complications , Adult , Female , Heparin/therapeutic use , Humans , Hypertension/etiology , Pulmonary Embolism/drug therapyABSTRACT
Differentiating sarcoidosis from malignant neoplasms is not always easy. Sarcoidosis may present with bronchial stenosis and pseudotumorous formations in the lung and in various other organs. Conversely, metastatic or lymphomatous invasion of thoracic lymph nodes more often closely resembles the bilateral hilar adenopathies of sarcoidosis. Asymmetric lymph node swelling, while suggestive of malignancy, does not rule out sarcoidosis. Regional or generalised granuloma formation may occur in patients with malignant lymphoma or carcinoma of the lung, probably in reaction to neoplastic tissue. Its influence on prognosis remains obscure, but awareness of its possible presence is necessary in the diagnosis and staging of cancer. The present evidence does not indicate that sarcoidosis predisposes to malignant tumours.
Subject(s)
Lung Diseases/diagnosis , Lung Neoplasms/diagnosis , Sarcoidosis/diagnosis , Adenocarcinoma, Bronchiolo-Alveolar/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Lymphoma/diagnosis , Male , Middle Aged , Precancerous ConditionsABSTRACT
Two patients with pulmonary disease due to M. xenopi are presented. Predisposing factors were alcoholism in one patient and previous tuberculosis with emphysema in the other. Whereas the disease was successfully treated in the first, M. xenopi was implicated as a contributory factor to death in the second. Histological examination in the latter case allowed no distinction from ordinary tuberculosis. A review of the literature suggests that infection with M. xenopi should be treated with a combination of rifampicin, isoniazid and one second-line drug, adjustments being made as results of sensitivity testing become available.
Subject(s)
Mycobacterium/isolation & purification , Nontuberculous Mycobacteria/isolation & purification , Tuberculosis, Pulmonary/microbiology , Aged , Alcoholism/complications , Drug Therapy, Combination , Ethambutol/therapeutic use , Humans , Isoniazid/therapeutic use , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/drug therapy , Pulmonary Emphysema/complications , Rifampin/therapeutic use , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/drug therapySubject(s)
Meningocele/diagnosis , Thoracic Diseases/diagnosis , Biopsy, Needle , Female , Humans , Middle Aged , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The compartmental syndrome is not a rare complication of non-traumatic rhabdomyolysis. Early recognition and prompt surgical decompression of the affected area are essential. We feel that a lack of familiarity with the syndrome among nephrologists may contribute to delay in diagnosis and treatment and reduce the chances for functional neuromuscular recovery. Our experience with three cases following overdosage of alcohol (case 1), barbiturates (case 2) and a mixture of alcohol and sedatives (case 3) is reported. The pathogenesis, symptomatology and treatment of the compartmental syndrome in this setting are discussed.
Subject(s)
Alcoholic Intoxication/complications , Barbiturates/poisoning , Compartment Syndromes/etiology , Muscular Diseases/complications , Myoglobinuria/complications , Adult , Compartment Syndromes/diagnosis , Compartment Syndromes/therapy , Diagnosis, Differential , Female , Humans , MaleABSTRACT
The peritoneal elimination of digoxin during C.A.P.D. was studied in five patients. The plasma half life of digoxin varied from 54 hours to 141 hours. Only 7 to 24 micrograms was eliminated via the peritoneal route during 3 to 4 days C.A.P.D. treatment. The total urinary elimination during the same period ranged from 11 to 57 micrograms. It is concluded that adjustment of dose is not necessary when starting C.A.P.D.
