[A difficult case of the differential diagnosis of focal infiltrative lung changes in phthisiatric practice].

Errors occur rather commonly in the differential diagnosis of respiratory diseases accompanied by X-ray lung tissue changes as foci and infiltration. Infiltrative and disseminated pulmonary tuberculosis, lung cancer, and pneumonia constitute a high proportion among the detected concurrent lung diseases. The rate of diagnostic discordance for these lung abnormalities accounts for more than 30%; and the diagnosis period for an infiltrative lung process lasts 2­3 weeks in 20% of cases and above 1­3 months in 80%. In particular, clinicians are faced with great difficulties in diagnosing aspiration pneumonia; this is due to that its X-ray manifestations are not purely specific and they are characterized by the parenchymal (alveolar) infiltration of lung tissue with a varying extent of lung inflammation. This paper describes a clinical case of a patient with salivary gland adenocarcinoma and focal infiltrative lung changes. Diagnostic difficulties have emerged in establishing the genesis of the changes in the lung.

[Possibilities for ultrasonic diagnosis of pleura pathology in patients with pleural exudate]. / Vozmozhosti ultrazvukovoi diagnostiki patologii plevry u bol'nykh s plevral'nym vypotom.

The authors have analyzed results of thoracovideoscopy in 45 patients with the syndrome of pleural exudate, 17 of them had undergone the ultrasonic examination of the pleural cavity before thoracoscopy. The examination has revealed high sensibility of the ultrasonic method in the diagnosis of fragmentations of pleural exudate and pathology of the pleural leaves. The endoscopic and echographic classification of the pleural exudate is given depending on the fragmentation degree. The authors consider that echography of the pleural cavity as a noninvasive and highly informative method should be included in the first rank in making an algorithm of clinico-diagnostic measures for patients with exudative pleuritis.